310086_INSPECTIONS_20171231

NUH I H LAHULINA
Department of Environmental Qual

fa ivision of Water Resodices'
Facility Number 3i - ® 0 Division pf Soil and Water Conservation
O`Other Agency
Type of Visit: WCompliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access Date of Visit: Arrival Time: Departure Time:County: rDv- I lve) Region: � RD
Farm Name:sLtw�� ��. s Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Title:
Phone:
Integrator:
Phone:
Certified Operator: Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design .Current ,,.
DesCurrent=
Swine Capacity Pop.
Wet Poultry
Capacity Pop.
Wean to Finish
Layer
Wean to Feeder
I
iNon-Layer
Feeder to Finish
Farrow to Wean
�ignl Cu°crent
Farrow to Feeder
D Poultry
Capacity,' Pop.
Farrow to Finish
Layers
Boars Pullets
Turkeys
[lther Turkey Polllts
Other Other
Discharges and Stream Impacts
1, Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
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?
i . Resign Current
Cattle. Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes MNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[ No
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

Facili Number: - Date of Inspection: 2 ZL
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [:]No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 2
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �JL
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [ 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 Ex No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No
0 NA
[�(NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ NA
V 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 OKNE
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 N NE
acres determination? -
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑ No ❑ NA t NE
❑ Yes ❑ No ❑ NA t4 NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[—]Yes
❑ No
❑ NA
N3 NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[:]No
❑ NA
19 NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
NNE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
6-NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[:]No
❑ NA
NNE
Page 2 of 3 21412015 Continued

Facili Number: ot -
Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA aNE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA A!J, 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 P NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No ❑ NA [X.NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
[:]Yes ❑ No ❑ NA [XNE
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?
XYes
❑ No
❑ NA
tFE
Comments (refer to question # Explain any YES answers,andlor any additionall�recou mendations.or.any Ether ibrnments.
Use drawingsof faeili kbetter. ex lain situations use additional pages as necessa
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Reviewer/inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Z
Phone: q w7q u — (3 C] 7
Date: rz, 1 Z{
21412015

ivision of Water Resources
Facility Number - ® O Division of Soil and Water Conservation
O Other Agency
Type of Visit: Conyfiance Inspection Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint 0 Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: f 4 h( E (rL S re q�' P (C Integrator:
Certified Operator:
Sack -up Operator:
Location of Farm:
Swine
Latitude:
Phone:
Region:
Certification Number: ri 1
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
We to Finish
can to Feeder
Feeder to Finish
r7
oA
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
I \ VII-L,
Pullets
Other
Poults
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dai Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ❑WO ❑ NA ❑ NE
[:]Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑NA ❑NE
❑Yes
❑No
❑NA
❑NE
❑ Yes
E3No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

Facili Number: jDate of Inspection: rL
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structujre/I
Structure 2 Structure 3
Identifier:
p f d
V c
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
u O
Structure 4 Structure 5
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑'No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 6
❑ Yes E3<o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes VNo
❑ NA ❑ NE
8. Do any of the structures 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 No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ ExcessivZPong ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
PANN > 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?
0 Yes
[EJ'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
01No ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
- ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
JNo ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ NA
P
❑ 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 ❑7yes
:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard krWaste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes / ]N ❑ NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes rNo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Mumber: qj - Date of Inspection: I -Z 1 /
Co
24. Did the facility fail to calibrate waste application equipment as required by the permit?
[] Yes
ONo 0 NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
Yes
❑ No ❑ NA
❑ NE
the a rope a 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
❑']qo­^❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[:]Yes
❑ No ❑i'NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [::]Yes 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 EJ'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
El -No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, aver -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
El"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
ErNo ❑ 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
Flo ❑ NA ❑ NE
Comments .(refer to question #) Explain any..YES,aii *ers.,and/or-.any additional recommendations 6r4ny other,comments
Use drawings'of facility to .bLetfer. expI am situations (use. additional;pages`as necessary
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Reviewer/Inspector Name: 04 V t I I/ -ve L
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 7U 73Pt%
Date:
2141201

Obivision of Water Resources
Facility Number - �❑ O Division of Soil and Water Conservation
O Other Agency
Type of Visit: grompliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time:I Departure Time: to County: Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title: Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number: 1103
Back-up Operator:
Location of Farm: Latitude:
Swine
Wean to Finish
)Vean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Pullets
Other
Poults
Design Current
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DW R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
DairV Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [—]No 0-'NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes
[—]No
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
[] Yes ❑ No
❑ NA
❑ NE
E NA
❑ NE
E(NA
❑ NE
Page 1 of 3 21412015 Continued

0
Facifi Number: jDate of Inspection:
L
✓Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ZfNo ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
0 No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: l
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 57 It
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes E 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 ZNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
�
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑Yes Z No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below.
Yes []No
❑ NA
❑ NE
essive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
2/F
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
go
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes 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 I� No
❑ NA
❑ NE
h b
t e appropnatc ox.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Oth
21. Does record keeping need improvement? 1f 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? ❑ Yes dNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes FNo
❑ NA ONE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA C ] NE
Page 2 of 3 21412015 Continued

Facile Number: - Date of Ins ection: 2
•24. Did the facility fail to calibrate waste application equipment as required by the permit? s ❑ 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 FtIlo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [:]No ffNA ❑ NE
Other Issues
28, Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[—]Yes [�No ❑ NA ❑ NE
❑ Yes EfNo ❑ NA 0 NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes WNo ❑ NA ❑ NE
[:]Yes � ❑ NA ❑ NE
❑ Yes k__f o [DNA ❑ NE
[] Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES ;answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
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ReviewerlInspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
I5
o Sotb���,��
I-er- L-A,
"I-J- 11 A,
9 Phone: P 7 4( 7� 9
Date: J Z ( r
21412015

Division of Water Quality
Facility Number - O Division of Soil and Water Conservation
O Other Agency
Type of Visit: O Compliance Inspection 0 Operation Review Q Structure Evaluation p Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit:
Arrival Timer
Departure Time:
County:~ Region:
Farm Name_
Fa,t_5,
Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
W ti��i ►
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
can to Finish
can to Feeder
seder to Finish
grow to Wean
grow to Feeder
grow to Finish
Gilts
Boars
Other
Other
Phone:
Title: Phone:
Latitude:
Integrator:
�q 3 Hof
Certification Number: 6Q
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Dry roultry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 7No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) [—]Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [:]No
[:]Yes Z'No
❑ Yes �No
❑ NA ❑ NE
❑ NA ❑ NE
DNA ❑NE
Page I of 3 21412011 Continued

i
Faciif Number: 10& jDate of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[:]Yes
dNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: Ll
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
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]'Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
r No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
WNo
0 NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
PI 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
0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ONO
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
)Z No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
7fNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Pff No
❑ NA
❑ NE
Repulred Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
7No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
;ZfNo
❑ 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 ONO
❑ 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 4 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ONO
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

.. - - . 0 A
Facility Number: - 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 rNo ❑ NA ❑ NE
the appropriate box(es) below. T
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
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 YTNo
❑ Yes 4 No
❑NA ❑NE
❑ NA ❑ NE
❑ Yes
), 11No
❑ NA
❑ NE
❑ Yes
7rNo
❑ NA
❑ NE
❑ Yes KNo ❑ NA ❑ NE
❑ Yes 71 No ❑ NA ❑ NE
❑ Yes KNo ❑ NA ❑ NE
❑ Yes�No
No ❑ NA ❑ NE
[:]Yes ❑ NA ❑ NE
Comments (refer to question #i): Explain any YES answers and/or any additional recommendations or a4 other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
VW& R �- --%> 9/alhao a
C,al M4tyy &-c �Dlif
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 95�L_%] -ox"If 153
Date: ?Vmli
21412011

. Division of Water .Quality
Facility NumberM — M, Division of Soil and Water Conservation,
Other Agency
Type of Visit b1compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit NRoutine O Complaint O Follow up O Referral O Emergency O Other C1 Denied Access
Date of Visit: [( Arrival Time: 3� Departure Time: ® County:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
OnsiteRepresentative: )_N�SAAZ/7-Zt '50GW/t c�n _ Inte rator
I
Certified Operator: H c r F1 a L� Operato
�
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
Region:
Phone No:
1 r Certification Number: 9 6
Back-up Certification Number:
Latitude: c Longitude:
Design Current Design Current
Capacity Population Wet Poultry . Capacity Population
_ ❑ La y er
❑ Non -Layer
Other
❑ Other ry
Dry Poultry "
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design -Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
4.
❑ Yes x
No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
"FNo
❑ NA
❑ NE
❑ Yes A No ❑ NA ❑ NE
Page 1 of 3 12128104 Continued

Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 a
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3R
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes i 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 Anolication
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 0 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): 5094JJQFY) (A.�OER 1 S la, COi-,V <5 (� ge(L�
13. Soil Type(s):
i _tw l _
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.
❑ WUP M Checklists [] Design r❑ Maps ❑ Lease Agreements
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes 0
No
❑ Yes rZn No
❑ Yes
Yes kNo
No
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
0 Waste Application 0 Weekly Freeboard Waste Analysis Q Soil Analysis ❑ W,`ste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections i❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ Weather Code
[] Sludge Survey
[DNA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection: ako
e
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 tb No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes 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.
1
❑ Yes l/V No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
i�
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes y No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or an other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
t...1 . rr .
5)a)i�
9pj/i
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

Division of Water Quality
Facility=Nx umber ©- L__Slw l O Division of Soil and Water Conservation
O Other Agency
Type of Visit: Compliance Inspection Operation Review p Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint 0 Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: ® Departure Time: [�! County: Region:
Farm Name: A &S- r fnlLLc C-QRA-VS . 11VC. Owner Email: '�-
Owner Name: A P m i L L4 ARMS Ale. Phone: al l a - 996 -1 g S L'
Mailing Address: Cj� S %VC✓ Jam} lJi4G/I�GC-1 A 1 %V C_ o!g LI S3
Physical Address:
Facility Contact:
Title: Phone:
Onsite Representative:Siff FFlFL, 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
Other
Other
Certification Number:
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Non-L
Pullets
Other
Poults
Design Current
Longitude:
Design Current
Cattle Capacity Pop. .
Dairy Cow
Daia Calf
Dairy Heifer
Dry Cow
Non -Daily
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharees and Stream Impacts J
1. Is any discharge observed from any part of the operation? ri
❑ Yes
�No
❑ NA
❑ NE
Discharge originated at: ElStructure ElApplication Field ❑ Other:
a. Was the conveyance man-made? \
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
\❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ 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: I - IDate of Inspection: f j r0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ?O�No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?: p
Designed Freeboard (in):
Observed Freeboard (in): 114 a
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify 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? 0
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 ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): (fO(t-IV W N EAT CSE(_L �(&
13. Soil Type(s): rO (L[ S 7 OJT./ AA T [L ,_A U I Ll- C-
14. Do the receiving crops differ from those designated i to he CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
[]WUP ❑Checklists ❑ Design 0 Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes X
No ❑ NA ❑ NE
Q Waste Application 0 Weekly Freeboard Q Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
Q Rainfall ❑ Stocking ❑�rop Yield Q 120 Minute Inspections Q Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 9 No ❑ NA ❑ NE
Page 2 of 3
21412011 Continued

Facilitv Number: --i I - P 1;;-7 1 Date of Insaection: 1 ire II
24. Did theyfacility 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 0 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? DiYes ❑ No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
0 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)
7�
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Yes
❑ No
❑ NA
❑ NE
91 Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
o
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yeso
tN
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yeso
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. 71
Use drawings of facility to better explain situations (use additional pages as necessarv).
vu.A-
og5 A w A . S6/crr o FF
4- 45 IVO-r ekrAeF_ C3 'L�(ffjCc
r_fs:u� wATECt--LINE (3Q�A�� �H1$'`"C'�Ziu4'—THIS CMA70� 1 Hr #,✓LRGo�+/
�Y I$ S�Q-Va5 A5 mu�,7uOTt fr+cA i ioov 4 A qG-OALk
GJI t�L (;a& rt-i c-e�>
cN r f
�T c.;
�eg16R+Rlcv�
of '[1 o IC.c 6t � *?`7) w/ �-C'ce(to
G 7 c�LS
Reviewer/Inspector Name: AL[ wog 6mmr—c S
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 9/0 _M0_"330'4'
Date: I h lV //
21412011

Division of Water QuaLty
FaCiity Number M
� D L9 Division of Snil,and Water Conseryatrony
Q'Other Agency `
Type of Visit ACompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit V Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: i Arrival Time: I 5 Departure Time: County: L— Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: b, A 10 6, L-LZ Slur FF f G L1a
Certified Operator:
Wqu_« (SQ1 314EFI~
Back-up Operator:
Location of Farm:
Design . Current
Swine Capacity Population
10 Wean to Finish
❑ Wean to Feeder
Feeder to Finish JtR400
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Phone:
Phone No:
Integrator•
lrQ H CO `3
Operator Certification Number:
Back-up Certification Number:
Latitude: E-1 o ET
E__1 " Longitude: [� ° = f 0 u
Design Current',,':Design Current
Wet Poultry Capacity Population' Cattle Capacity :°Population
P[E]
Layer El Dairy Cow
Non -Layer I ❑ Dairy Calf
❑ Dairy Heifer
Dry Poultry ❑ DEX Cow
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes xNo
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes XNo
[INA
ElNE
ElYes
ANo
❑ NA
❑ NE
12128104
Continued

Facility Number: — Date of Inspection
Waste 011ection & 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 St ru t re 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in):
Q�
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes J No
❑ NA
❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
f `
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No
ElNA
❑ NE
through a waste management or closure plan?
I`
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 X No ❑ NA ❑ NE
&. 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 RNo ❑ 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) — B F Cz-� � FOR I�! S G �� �--S t46 4'r
13. Soil type(s) Ft CI= j ON LA, U1 U-22 •
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ 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? ❑ Yes
19. Is there a lack of properly operating waste application equipment? ❑ Yes
�No El NA El NE
No ❑ NA ❑ NE
] No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
Comments(referto;question #j: Explain any YES answers and/or anyrecommendations or. an' other comments.:': ,
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name _ l.: -S ,. y �`:: Phone: S I G �}�1(a -
t439
Reviewer/Inspector Signature: —Z O.Z Y Date: J LP
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection i
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No El NA El NE
the appropriate box. 0 WUP ❑ Checklists Design 0 Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes vl� No ❑ NA ❑ NE
❑ Waste Application 0 Weekly Freeboard 0 Waste Analysis El Soil Analysis ❑ y(aste Transfers ❑ A/hual Certification
El Rainfall ❑ Stocking 0 Crop Yield El 120 Minute Inspections El Monthly and I" Rain Inspections [3 Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�] No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
I
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
[I NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional, Comments and/or Drawings:
�3
k4
J001/0
P1a5]1c) 1.
vc)�j I"r '/O Sc 1 �-S p PLC
'foc-lup-rJoa Vie �
p�5lCarl peuAA
LF} C UCH � � �Lf�l� TC:� ;7u r SUS`' So/�� /1/u7uZr�l7s
Page 3 of 3 12128104

Facility Number �Lp
Division of Water':Quality.
O Division of Soil and Water Conservation
0 Other Agency
Type of Visit A —Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 3&Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: q ��} Arrival Time: Departure Time: County: L A/ Region:
n
Farm Name: �1BS rAm, LM FADS IiUC • Owner Email: �}
Owner Name: ASS If' AM 1 Ls=A SA atit5 . I NC . Phone: 1 f 0r PC? ~�S�
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: b 04/Vx CC r sge FF) C-c%
Certified Operator: i LU E CQA LASH r F F 1 Ir LZ-N
Back-up Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = c = ` E__1 « Longitude: 0 ° 0 , =
Design Current ;Design. Current.. - Design Current.
Swine Capacity Population Wet Poultry Capacity Population a_ -Cattle: - Capacity Pii. , I'' n.ti`s
I❑ Wean to Finish ji
❑ Wean to Feeder
Feeder to Finish Lq
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other A
❑ Layer
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a, Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dai Heifer
E]Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures ��ti•
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑Yes
❑No
El NA
❑NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes]
No
❑ NA
❑ NE
❑ Yes
!� No
❑ NA
❑ NE
12128104
Continued

Facility Number: 3 1— (p Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Strure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: of c]
Spillway?: n
Designed Freeboard (in):
Observed Freeboard (in): 3 S
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ClNE
(ie/ large trees, severe erosion, seepage, etc.) 9
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 P(No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes P�No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ANo ❑ 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
El Evidence of Wind Drift ❑ Application Outside of Area
�� �
12. Crop type(s) E / s6 1 U &1.6pl
4- 1 CS q_-, -S(�; 4V - - -
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes{
No
El NA
El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
El Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
jVNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
,KNo
❑ NA
❑ NE
Comments (refer to question #):' Explain any YES'answers and/or any recomroenda#ions or any other Coin e t •; t 4
Use drawings of facility to better explain situations. (use additional pages as necessary.),,,,
Reviewer/Inspector Name aw&p +t~ S Phone: 916jlo-3�
Reviewer/Inspector Signature: Date: !2LQAfR
12128104 Continued

Aw. 4
Facility Number: 31 Date of Inspection ��tL�`L� l•J
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA [:1 NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n 0 Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ]KNo ❑ NA ❑ NE
❑ Waste Application 0 Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis [Xaste Transfers ❑/nual Certification
EIRainfall ElStocking [] Crop Yield 0 120 Minute Inspections 0 Monthly and l" Rain Inspections E] Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes]
No
❑ NA
❑ NE
❑ Yes]
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
A No
❑ NA
❑ NE
❑ Yes
ElNA
❑ NE
ElYeso
ro
❑ NA
❑ NE
❑ Yes
t No
❑ NA
❑ NE
❑Yes
No
El NA
El NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
O No
❑ NA
❑ NE
❑ Yes InNo ❑ NA ❑ NE
12128104

r Division of Water Quality V
Facility Number 3 g(�p 0 Division of Soil and Water Conservation
- 0 Other Agency
Type of Visit
Compliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
)p Routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County:��dL Region:
Farm Name:
��^^ Owner Email:
Owner Name: _ 6 � � FA M 1 � t'AQrvt S , /,Vc . Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: h A N16 Lt. C SN C- FF1 E Lt-'S
Certified Operator: w 1 LLJ E (�Z e_4 ,_k 5F1 r 7F I E L b)
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator:
Operator Certification Number: 19 L99 1
Back-up Certification Number:
Latitude: [= c = =„ Longitude: [� ° =,
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & 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?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
j
❑ Beef Brood Cowl
I i
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)?
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?
Page l of 3
❑ Yes ;dNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑Yes
El No
El NA
El NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
4 No
❑ NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
12128104 Continued

lAacility-Number: — (D I Date of Inspection ! Q
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes \`�No ❑ NA El NE
a. If yes, is waste level into the structural freeboard? ❑ Yes _-❑ No ❑ NA ❑ NE
Structure 1 SDture 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: Designed Freeboard (in): CT. 5 q ?- . S
Observed Freeboard (in): 3 Ly C� k
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes X 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 ` 4 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 ONo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes IFNo ❑ 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? 11
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [to ❑ NA ❑ NE
maintenance/improvement?
It. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window n❑ Evidence of Wind Drift El Application Outside of Area
12. Crop types) S U� {464 1 p F l (i) , S � (6) 1 CG�C /i�
13. Soil types) �G54ZE �7 Oxl � 'A t. (L!A U I C_ LC '
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 J�No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes 2q No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes RNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes KNo
❑ 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):
F14 aPk L O d1C % Ei 00 > `
ca��S i &4T 4 CCD*Z(
Reviewer/Inspector Name F_aii� E S' Phone: �'10 ' 'r`J (O 30'
Reviewer/Inspector Signature: Date: 1Q 0
Page 2 of 3 12128104 Continued

Facility Number: —p Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 4 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes "4No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
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
4 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
J4No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
,� No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
TNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
2�No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
�No
❑ NA
El NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
R No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

$r`
Facility Number 3 ��
B Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 900outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: / a 3V Departure Time: L County: QVPL�j�% Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title:
Onsite Representative: G" y i- DA NTl- tiC Si41 6 GV - Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ c ❑ 6 = Longitude: = ° = r
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish 160 G
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other - - - - - --__ — —
❑❑ Layer - - - -
Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pultets
❑ Turkeys
❑ Turke Poults
❑ Other
Dischames & 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
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: 01
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 [?info ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
El Yes
El NA [I NE
❑ Yes LTNo ❑ NA ❑ NE
12128104 Continued

r
�. Facility Number: 3
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: to (s�t� C h G 00/,/
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2/ P--6
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes O'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 environ ntal threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes *o ❑ 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 0 Yes EJ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) G C C' ) S 6 ti C-L-4s _
13. Soil type(s) --- fo9-c--.kTbP�--
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ 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? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
❑No
❑NA
El NE
GTNo
❑ NA
❑ NE
V(No
❑ NA
❑ NE
L15'N
El NA
El NE
ZL_1 No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
I,} GotJrrNU & WO0-/C— 4 ',/ P rk& "u, .
Reviewer/Inspector Name Phone: ( 1'��J III + *73 ff I
ReviewerlInspector Signature: 't/1 Date: /o Z`l b
Anon 1 -F i
11/11R/011 !'nnHnr.od

�.� Facility Number: 3 — G Date of Inspection
Required Records & Documents WIN'o
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ElYes ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes WNo ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
lJ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
El Yes
❑ NA
El NE
VNo
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
LEI No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[4No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
E_ No
❑ NA
El NE
2&
Did the facility fail to have an actively certified operator in charge?
ElM Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
WNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�o
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
Zo
❑ 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
V No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
�,/
32.
Did Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
El yes
hQ No
❑ NA
❑ NE
/No
33.
Does facility require a follow-up visit by same agency?
❑ Yes
,
❑ NA
❑ NE
Comments and/or
Page 3 of 3 12128104

i
(Division of Water Quality
Facility Number �'3j �Sp 0 Division of Soil and Water Conservation
0 Other Agency \/
Type of Visit ZRoutine
pliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Complaint Q Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
S' Arrival Time: Departure Time: County: �UPL�/ Region:
Date of Visit: IOJTI?7q
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: OA►JLW. t NkLl E A71-kwSbrr Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: [= o [= 1 [=11 Longitude: 0 0
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
❑
Wean to Finish
❑
Wean to Feeder
®
Feeder to Finish.
fob
Ob
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts-.'
❑
Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & 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?
Design Current
Cattle Capacity Population
❑
Daia Cow
❑
Dair Calf
❑
Daia Heifei
❑
D Cow
❑
Non-Dai
❑
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 O No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
ElNA
ElNE
❑ Yes
0 No
ElYes
o
❑ NA
❑ NE
❑ Yes
L;46
❑ NA
❑ NE
12128104 Continued

Facility Number: I -
Date of Inspection �� v
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure i Structure 2 Structure 3 Structure 4
Identifier: t i-Tn( on1e 635G- JiJ 6-
Spillway?:
Designed Freeboard (in): °j / cj , S
Observed Freeboard (in): 30 3-
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 E2 o ❑ NA ❑ NE
El Yes El No El NA ❑NE
Structure 5 Structure 6
❑ Yes [/No ❑ NA ❑ NE
❑ Yes E5No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmentai__thrreat, notify DWQ
7. Do any of the structures need maintenance or improvement? El Yes El' o ❑ NA ❑ NE
8. Do any oft he stuctures 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 o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E,-Ao ❑ NA ❑ NE
maintenance/improvement?
1 I . 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 l 0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12.
Crop type(s) Qe6t- '`004 CG) S G a C 116
13.
Soil type(s) J�atf+ t 5j'rl}.� />VE�_1 V.1"-f
14,
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�,/
l� No ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination', El Yes
1� No ❑ NA
ElNE
17.
Does the facility lack adequate acreage for land application?
EllYes
❑ NA
[INE
18.
Is there a lack of properly operating waste application equipment?
ElYes
v�i
❑ NA
❑ NE
,, 4 k r'�'g z�.�B-�t���^a�".a��a. ..s.� �t<-se,i.�'�
�,,@onuneats (refer�to queshonY#) Ex}ilam any YES3answers and/or -any recommi ndat�onstor any otherVomments
iJseFdrawings of facility to"better, explaun situahons.,(use addEtioaal pagesas necessa, „y'
2q) UPDATE WVP 0MW,5at.. COPS AR-E. (If-EOC, C04TC-D f c,- C4?-V 'Ark.
MA+a-' UPOATFS D006 (_ SLUC'& - a-cm-0j-0, 5++++�^Ga. E/-Trt►. &01JJ zw•Pn.aUhn WATEP-WA'S'�
4L6t0n.a5 XV &� D S
Reviewerlinspector Name I T6 }a-r,) W "Y'j Phone: 41 O f t (I — %.2(O S
Reviewer/Inspector Signature: Date: ) oy
12128104 Continued

Facility Number: 3 ! — Date of Inspection b
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ONo ❑ NA ❑ NE
20. Does the facility fail to ha;ZP
omponents of the CAWMP readily available? If yes, check 'es El No El NA El NE
the appropirate box.
El Checklists ❑ Design El
p
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
El NA
El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
ElIr Yes
,❑-No
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
LI 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
LJ 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
ffNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
ErNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
1212&104

Type of Visit QfCo fiance Inspection O Operation Review O lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: rune: 9 14 0
Facility Number
O Nat rational O Below Threshold
© Permitted ErCerdfied [3 Conditionall Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: __ DAL-6 � It 507 6A9Z I - G County: l70PlTJJ_..... _.... _ .. .. _...�.
Owner Name: . _ _ ......�.....�... . __. .. __. _ Phone No:
Vlat�ing Address:
Facility Contact: ___ . _ .. Title: ... _ _ __. Phone No:
Onsite Representative: Diftsim flmP��L `{ wE 1f'_Antegrator:
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • u Longitude • 9 44
Discharges & Stream IM
1. Is any discharge observed from any part of the operation? ❑ Yes o
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
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes �zo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes C4
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier: — .. 4..' __
Freeboard (inches): V7 �J
12112103 _ Continued

Facility Number: 31g
Date of Inspection 1�
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
r seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenanceJunprovement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Aanliration
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type is t'i' r%&1/DA C& ] S 6-Z)
❑ Yes QrNo
❑ Yes C/No
Q(Yes ❑ No
❑ Yes [:lo
❑ Yes �V0
❑ Yes Wo
❑ Yes L�
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑'
14. a) Does the facility lack adequate acreage for land application? [IYes QZo
b) Does the facility need a wettable acre determination? ❑ Yes
c) This facility is pended for a wettable acre determination? ❑ Yes
15. Does the receiving crop need improvement? ❑ Yes No
16. Is there a lack of adequate waste application equipment? ❑ Yes [?INo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ yes [�lo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes [' NNo
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes No
Air Quality representative immediately.
Commmis (refer to #)' Ezpla:a sqi' YES answers antifui aa3* mr ami'Mer comments. '
lbetttr " �r'TC_ imp ]'?' ❑ Field Copy ❑ Final Notes,m R
�
� - y.�' . �--..f'"'I- ^.x"..�s..1-^PK..Y� � ...n.=...-w�. �'"rf+-��:._.e..r�. -�". ...
.t ...i��,trb
cor a F STa GlLt�� �� w► ��r� GfLp'Po�►
G Er
�� � �^"► C3�`c 0. f b D o CR�R � i.E� � btL S b �► �At� i T� Ar�r►,N�1 � �I�['
7.) CArjTtgVE Wolglc to GR+�S5 �vER *4 Otr_KE WNLL 30AE F9AGk55
ReviewerAnspector NameEft�
Reviewer/Inspector Signature: Date: 4 TS 14
12112f03 1 Continued

Facility Number: -. Date of Inspection
Reo_aired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24_ Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
25. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss reviewlinuspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute inspections ❑ Annual Certification Form
p Yes ❑ No
❑ Yes N
El Yes ❑'I�10
❑ Yes U
❑ Yes No
❑ Yes LYN
❑ Yes No
❑ Yes �70
K
0 Yes
S/Yes ❑ No
❑ Yes
❑ Yes l.�N0
❑ Yes [J/No
❑ Yes dNo
❑ Yes DINO
12112103

Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
(Reason for Visit O Routine O Complaint © Follow up O Emergency Notification O Other
❑ Denied Access
Facility Number 3l 86 Date of Visit: 2/27/2002 Time: t3:40
Not O erational O Below Threshold
® Permitted ® Certified 13 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: - -_ __ __ _. __ ..
Farm Name: 0a1itAtkilsson.fArm.1rh........................................................ County: Au. aiu.................................... }'.YI)30 ......
Owner Name: A�l�Atki�Sitn-------------------------- Phone No:
MailingAddress: J,5B7..,$.NC.5.Q.......................................................................................... magilolia..NC ....................................................... MAU ..............
FacilityContact: ........................................................... Title: ............................................... Phone No: ......................................
Onsite Representative: UapigllftiRAd-��BY-Sh@fGPEd __- ----------._.---- Integrator:l�arr��l'l`o9stslne_______----------___--•
Certified Operator: 'i] [ .. xay.......................... $bCff eW....................... ... Operator Certification Number: 19.69.3 .............................
Location of Farm:
Southeast of Kenansville. On Fast side of Hwy 50, 0.7 miles South of SR 1737.
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 1 34 01 54 11 06 [L Longitude 1 77 0 1 54 1 1 34 u
❑ Wean to Feeder
® Feeder to Finish
4760
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
= Design..... .
Current = ;, Design _Current -
ultry Ca aci _Po u1a#ion Cattle Capactty °Populatian..
r� ..
Nuinlier of Lagoons 1 ® Subsurface Drains Present ❑ Lagoon Area ® Spray Field AreaV.
Holding Ponds 1 Solid, traps , - ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. if discharge is observed, did it reach Water of the State? (If yes, notify 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 ❑ 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: ------------ I ............. ............. 2------------ --------•--•--•-----------.................... ....... ........................... ...........................
Freeboard (inches): 27 25

V�/V�/vt t-unttrtueu
Facility -ember: 31-86 71 Date of Inspection 2/27/2002
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? V `
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ® Excessive Ponding ❑ PAN ® Hydraulic Overload
12. Crop type
❑ Yes []No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
® Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes []No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
p No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
nany other comments
EplapdoaCms z
o
_,
Use dtawmgs of facility to better explain situations use -,additional pages as necessary) Field Copy ❑Final Notes
.W e
This inspection was conducted as a followup to observe the cleanup of the old hay and cow manure from the waterways on the farm. It
appears that the hay and cow manure has been removed from the waterways.
and 11. Swine animal waste is ponded at the outlet of the waterway draining from the field and there are also puddles of the swine
waste in the waterway. It appears that swine waste discharged from the ponded area into a stream. Water quality samples and pictures
were taken.
t
Reviewer/Inspector Name Stoue_wall
Reviewer/Inspector Signature: Date: 3 ZI % O

h
a;� o
Dtvtsion of Water Qaalsty s s.
X
e .
Drv�slon of Soil and WaterConservatioti
n
e
©Othe
Ageney 1 q
a
.„� .
q� 4 -
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: � Time:
FFacility Number 3
Not O erational Q Below Threshold
©Permitted 0 Cerrtiified O Connd7-?<rj4
ditionally Certified 0 Registeered Date Last Operated or Above Threshold:
Farm Name: �J_ 4L4 SLYI% ' O County:
Owner Name: iO,�Gr .it%/4 t�n1 Phone No:
Mailing Address:
Facility Contact: Title: a Phone No:
Onsite Representative: 1?AA1%7J5LL,0 ntegrator:
l
Certified Operator: Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle [I Horse Latitude ' 6 " Longitude ' °
Design Current Design Current Design Current
5w]ne Capacity Population
❑ Wean to Feeder
Feeder to Finish
El Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Poultry Ca seity Population Cattle capacity Population
❑ Layer FE:
Dairy
❑ Non -La er Non -Dairy
❑ Other -
Total Design Capacity
Total SSLW
Number of Lagoons © ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ,�(
❑ Yes ,rJ 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 XNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes yjNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes XNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: f- Z
Freeboard (inches):
05103101 Continued

Facility Dumber: — Go 1 Date of Inspection I� S
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?
(If any of questions 4-6 was answered yes, and the situation poses an
El Yes
[ No
immediate public health or environmental threat, notify DWQ)
T Do anv of the structures need maintenance/improvement?
❑ Yes
X No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
ONO
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum Iiquid level
elevation markings?
❑ Yes
�YNo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
�,(
JLJNo
11. Is there evidence of over applicatio ? ❑ Excessive Ponding ❑ PAN ❑ Hy ulic Overload
❑ Yes
:P'No
12. Crop type F �
B. Do the receiving crops differ with those designated n the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
No
91No
b) Does the facility need a wettable acre determination?
❑ Yes
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
1XNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
No
18- Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes )Z1 No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes 0.No
24. Does facility require a follow-up visit by same agency? El Yes 9No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes �ZNo
0 No violations or deficiencies were noted during this visit .You will receive no further correspondence about this visit.
_6 enti (refer tii-gttest%oii #1) E:phut any 1'ESaanswers anclfor>atty rec©muiendattoas or anv other c4 6e©ts.
_
Use drawings of faciltty Ec► letter ezplatn iitttattons. (ase additi©nal pages as necessary) Field Corsv ❑ Final Notes
_ e — -
`�) - l�o.t► k �,✓ �j�Q,� ��Fi�-s �-�Ro�i+�� L�tc�o.v �•►'�,B.�9n/r�n.�-,,�rs
J
�°QTS fN>�i rvES S�zr� �/4 5 a F-'D L�S�
Reviewer/Inspector Name T y'
Reviewer/Inspector Signature:
- �
Date: W Zi
05103101 1 Continued
r

•
r
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 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 ❑ No
❑ Yes No
❑ Yes No
❑ Yes XNo
❑ Yes 5No
❑ Yes �Z— No
Yes No
Additional Comments and/or, Drawings:::
2 Qom,
/� r 74S CZ 5. F�f �J��QfY1 L!� . �Li���L &7
w
���!-�/�-G Gl/�EDS P/�� SFN� ,Cj,C ��}i4E'�UL �.f�i✓
y 4x F Ge/PL��Z
pu�o Glj, z 4m�S,
2 ���r.,p �flc,4-r���s-�.►�,� ���� �� � its � O/+1�
S/�rr� PL � Uo kz- Z41V o IMP4 -,f Ong S.
t,11IL
r�� No Des A-��o�s7 G-o�.
Npla soma 4f::
qs�5'- 1,�oo
05103101 ���
-s
rK

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit .Routine O Complaint. O Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number8 Date of Visit: r l 9Time: LI
Not Operational 0 Below Threshold
© Permitted © Certified p Conditionally Certified [] Registered Date Last Operated or Above Threshold: ........... ..... _.......
Farm Name: 1 r................................... ........... U
a..1r1Sah..�P..��.'.':............�p.. ty v fn
OwnerName: ....... DAIA.. & irity................................................................. Phone No:.................................................................. _�._. .�.
FacilityContact: .....................:....................................................... Title:................................................................ Phone No:............................... .._� ......
MailingAddress: ..................................................................................r
Orsite Representative: .PA � e 1 � 2_ 517e .P>CLc�. Integrator:...�QrtD�[.�s..........................� .. ........ ........ .........................................
Certified Operator:
Location of Farm:
........................................... ................. Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �� ��� Longitude �• �� OK
Design Current Design Current Desrg Gbreeat
Swine Ca aci ` .Po nlatioa- Poultry . : _Ca act Po tilation „ Cattle :Ca aci Po`uation.,
❑ Wean to Feeder ❑Layer ❑Dairy
Feeder to Finish ❑ Non -Layer ❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
nFA❑ Farrow to Finish TOW 'Des Ca 8Ci
Gilts. P
�.
❑ Boars Total SSLW;
Nnmbet' of Lagoons :; ❑ Subsurface Drains Present ❑ Lagoon Area . ❑Spray Feld Area
gHolduig Ponds /Solid Traps; - ❑ No Liquid Waste Management System V �`
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ONo
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 Stale? (If yes, notify DWQ) 0 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 XNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? 0Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ,!TNo
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:.............1............................... Z............ .................................................................................................................... ... ....... I ....... •.............
Freeboard (inches): 30 9
5100 Continued on back

Facility Number: 3 f — 8 Date of Inspection l ZFS Q
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes XNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ONO
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
fi. Do any of the structures need maintenancelimprovement? ❑ Yes ,,,ETNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes ONO
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ONO
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes R No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ;AO
12. Crop type Be.-m Vd ai Co rn r S--va 11 glot,; rr
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ YesRfNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes',WNo
b) Does the facility need a wettable acre determination? ❑ Yes P41
0
c) This facility is pended for a wettable acre determination? ❑ Yes XNo
15. Does the receiving crop need improvement? ❑ Yes PrNo
16. Is there a lack of adequate waste application equipment? ❑ Yes ONO
Reauired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes 'ONO
18, Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.) ❑ Yes J2(No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) OYes ❑ No
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes O'No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes XNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑.YesJ�7No
24. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 'W'No
10 viola igris :off dgfie�engt" ware ng ;ed• d, Ut.ing this;vi'sit; - You wiii-t& - iye too futthgr - . .
.. correspondence. alioizk this visit..: ;
Comments (referta queslson #) :EXplain any YFS answers and/or any recommendations o€`any othercommeats. �_
iin — =
[lse dra of facih to`better'e mnap srt�ons. (use addrdonal as necessa
t3':. _ .i- gpIi _. _ .( - paw ry) , -
3.-il,ere is S'a"e old 1,10 eOLJ enure r' o v, et Leed;•��`, glen
wh-. A k&x 6grk) OZG ; r, 4AA afa krIP1 :.,,a-fie►-t,�c,� 5. Need
4,o rewtove 4k s y1�-�er q �rn� - l't2 W'�7�r Wq. s a1+'1JG� sfre4,d ev-eld
ovF• -Ac TJ& 44,Y r�a�e►-; al ; �� wa�erwa r ��,
+t,e jt'4L"-e. A'ieeA-j-o tv� etc-#��.4 4Ga�..�ole,�e� �iy � l Z�DZ�
1 o,00- � erGS1c ) V�►p ".s.-Ph.
tf. Wj art � far t�k�rG gredi5 do 1 � n � � ,� .
PT. Cps✓re q 9on� a olr bei'MV41 Oki
Reviewer/Inspector Name , Se r!5
Reviewer/Inspector Signature: Date' % -2-Blotg/gyp

jFaciEit .Number: 31 — Date of Inspection I l Z
Odor Imues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below XYes ❑ No
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',OINo
Cl Yes _,O No
❑ Yes J21No
❑ Yes ONo
❑ Yes JVNo
❑ Yes ❑ No
hO : pmments an or; ravings:. : rt
i. SGi w Q'1P! 1 r ,cet4 d vL Qr W ot-�- e, t3G G 17 G Ir i ►'l�j R 4 k c 41, 0'w &
oc4ebe✓' 1 J z-eo) ; 41%; s evev%4 ix no-' trH&wn ;n -Ae reGo�d�
ve 6eeh �,r~eS¢rl-�e� 4v v le q r G vrr-e+'� V�da�eGt
s4w [!Gy Says -� 7,Qq so ,1 <a f % G-ra ve
s4 n �- o{
{ Aa1 h; s eq� -�'L,e mad say 1 4es1 repYr ;r 4tr4
i n tte ,sec ands av, rleedS 3-o sae, -FAe re s na ,,,J4s-fie
} -�ct kCh sv��f c; end 1 7D Gnv@r Sam
a 4�1- zlet�abav� afe
s ' S s� y►•1 S -F,ee Vt,/a's
1 n n eed �o � s' � ,e -�o se -��.e ore
Q.V ��-�1's j r,. 1��
40 Gn]G111{� 'Z°S. S teGl1�~t^'�eh� 4o 4ke .�tynf IPS Bv�`�J
6!9 d,a,Y-J -b s e A►� a � s, s c�a�ied i� �: ►. bD da tits 016 OtW f,`c a-J1OAS
all �/� - Z,Is . wcaH /�eeQ �d ke�� -4^ ebvpy-4� emceed s
e b Q6 S G11�I'dY41�Yl k ik 4Aee- 7 Iteiise 1cc YI.
J
5/00

of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
(Reason for Visit O• Routine O Complaint O Follow up O Emergency Notification O Other 0 Denied Access
Facility Number 31 $6 Date of Visit: 11-28-2001 Time: 9:40
O Not Operational O Below Threshold
® Permitted ® Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
County: Aluplia__.._._-................
Farm Name: 1DA g A1kitks.Qn.JFAx p.l.-h.......................................................WJ1- -- -- -- .S? __._..
Owner Name: DAag-------------------- Atltinssiu- ----------------------- Phone No: 2J_Q-29f).- 9-----------------------------
MailingAddress:.SQ......................................................................................... MOgjjQjjRL..P.[C....................................................... Z.5.453 ..............
Facility Contact: ........................................................... Title: ........................................ Phone No:
Onsite Representative: D�iolgLl�,Shelfle�d---------------------------------- Integrator: �srr�l'�>�a9sLcln�----------------------•
Certified Operator: W.jUj.c.(r2:ay.......................... .S1cffitLd........................................... Operator Certification Number: XQ6Qj.............................
Location of Farm:
Southeast of Kenansville. On East side of Hwy 50, 0.7 miles South of SR. 1737. +
® Swine El Poultry [I Cattle [I Horse Latitude 34 • ®° 06 �° Longitude 77 • ®� 34
Design Current
Swine Canacitv Pnnulation
❑ Wean to Feeder
® Feeder to Finish
4760
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I JE1 Dairy
❑ Non -Layer JE1 Non -Dairy
❑ Other
Total Design Capacity 4,760
Total SSLW 642,600
Number of Lagoons 1 ® Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes ®No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify 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 ® 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-I---------------2--------------•-----•--•-- ........... ..--._----•--•--•--....._............................. -•--•--•--•--•-...........
Freeboard (inches): 38 29
nr An inr -a

u�iu�iut
Facility Number: 31-86
Date of Inspection 11-28-2001
Lo"Unuea
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Coastal Bermuda (Graze) Small Grain Overseed
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes N No
c) This facility is pended for a wettable acre determination? ❑ Yes N No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Re uired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
N Yes ❑ No
❑ Yes N No
❑ Yes N No
❑ Yes ® No
❑ Yes ® No
❑ Yes N No
❑ Yes N No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to Wquest�on #) Explaxn-any YES answers and/or any-recominendetions or any other _comments__ m -
Use dTawmgs of facility to_better expla�n.s�tuatrons (use addityonal pages as
W — _. m ❑Field Copy Final Notes
3. There is some old hay and cow manure from the feeding area which has been placed in and around waterways. Need to remove this
material from the waterways and spread evenly over the field. Do not put this material in waterways in the future. Need to have activity
completed by January 1, 2001.
7. Monitor bare areas on lagoons for erosion - ptevently erosion.
15. Ensure a good stand of Bermuda on field 6.
19. I saw application os waste occurring at the farm on October 16, 2001. This event is not shown in the records which have been
resented to me as current updated records. Ms. Sheffield says that soil samples have been sent off for this year. The 2000 soil test report
not in the records and it needs to be. There is no waste analysis taken sufficient to cover some of the September applications.
Reviewer/Inspector Name StooewalI Mathis : entered -by Bette Rase
Reviewer/Inspector Signature: Date:

is
•16
05103101 Continued
Facility Number: 31-86 Date of Inspection 11-28-2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ® Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ®No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ®No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ®No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
'A dit�ona' -omments�an or�Draw�ngs m `- �, - -
Jeed to be sure to take waste samples frequently enough to cover application events. Also need to be sure to use the proper waste I
.nalysis to calculate IRR2's I recommend to take samples every 60 days to use analysis dated within 60 days of applications on the
RR2's. Need to keep weekly freeboard records for both lagoons. Currently only keeping it for 4 house lagoon.

ar l
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 31 86 Date of Visit: 11-28-2001 Time: 9:40
Q Not O erational Q Below Threshold
® Permitted ® Certified [3 Conditionally Certified (3 Registered Date Last Operated or Above Threshold:
Farm Name: 1DA19.A1kin5QA.k'.Um.l.-6........................................................ County: J)ugiilx.................................... WJRQ.------
Owner Name: Q-----=-------------- AtltiuSslA-------------------------- Phone No: 11.44frJ�9-------------------------- --
MailingAddress: 15 .S.B.C. S.Q......................................................................................... MovaoliaL.AC ....................................................... M.453 ..............
Facility Contact: ..............----...................------....---.........Title: .............................. Phone No: ................
Onsite Representative:]Biell1�J�------------_--------------------- Integrator:
Certified Operator:Williit:.Gray......................... Sheffield Operator Certification Number: 19.693 .............................
Location of Farm:
Southeast of Kenansville. On East side of Hwy 50, 0.7 miles South of SR 1737. +
® Swine ❑ Poultry ❑ Cattle [I Horse Latitude 34 • ®� 06 Longitude 77 • 54 f 34 u
Design Current
Swine. Canacitv Ponulation
❑ Wean to Feeder
® Feeder to Finish
4760
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non -Layer I JE1 Non -Dairy
❑ Other
Total Design Capacity 4,760
Total SSLW 642,600
Number of Lagoons 1 ® Subsurface Drains Present ❑Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify 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 N No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway N Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ------------- I ------------- ...2............--------------------------------......_......................................... ---------------------------
Freeboard (inches): 38 29

u3iujiut
Facility Number: 31-86
Date of inspection 11-285001
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level .
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Coastal Bermuda (Graze) Small Grain Overseed
a,unttnueu
❑ Yes N No
❑ Yes ® No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes N No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes N No
b) Does the facility need a wettable acre determination? ❑ Yes N No
c) This facility is pended for a wettable acre determination? ❑ Yes N No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes ® No
® Yes ❑ No
❑ Yes , N No
t
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
13 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to ques6 i6 _ Explain any YES answers and/or any recoiniinerid atidns or any other cominents
Use drawings of facility to better explain situations (use`addrtional pages as necessary) Field Copy ❑ Final Notes x -
3. There is some old hay and cow manure from the feeding area which has been placed in and around waterways. Need to remove this
material from the waterways and spread evenly over the field. Do not put this material in waterways in the future. Need to have activity
completed by January 1, 2001.
7. Monitor bare areas on lagoons for erosion - prevently erosion.
15. Ensure a good stand of Bermuda on field 6.
19. 1 saw application os waste occurring at the farm on October 16, 2001. This event is not shown in the records which have been
resented to me as current updated records. Ms. Sheffield says that soil samples have been sent off for this year. The 2000 soil test report
s not in the records and it needs to be. There is no waste analysis taken sufficient to cover some of the September applications.
Reviewer/Inspector Name Stonewall Mathis: _ ente'red':by Bette Rose -
Reviewer/Inspector Signature: Date:

a
05103101 Continued
Facility Number: 31-86 Date of Inspection 11-28-2U01
Odor Issues
26. Does the discharge pipe from the conf"mement building to the storage pond or lagoon fail to discharge atlor below ® Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ® No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
A" itiona oinments an or rawmgs ri: y -
Need to be sure to take waste samples frequently enough to cover application events. Also need to be sure to use the proper waste
analysis to calculate IRR2's I recommend to take samples every 60 days to use analysis dated within 60 days of applications on the
HZR2's. Need to keep weekly freeboard records for both lagoons. Currently only keeping it for 4 house lagoon.
1W

Type of Visit O Compliance Inspection O Operation Review Q Lagoon Evaluation I
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access 1
Facility Number 31 86 IDateofvisit: 11-28-2001 Time: 9:41i
r Not Operational Q Below Threshold
® Permitted ® Certified 13 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: _ __
Farm Name: 1D.419.A.tkittm1YA'j:m.17f........................................................ County: I? PU-----.-_.-----•--------•--•-
Owner Name: �?al�.--------------- - - Atliiusszv-------------------------- Phone No: 4�QZ4�g---------------------------- -
MailingAddress: 1517.5.N.C.50........................................................................................ ].1' agulia..Xc....................................................... 18.453 ..............
FacilityContact:......-••..................................................Title:............................................... Phone No:
Onsite Representative: ��pj!<llP.$�l@f_________-------------------_-__-- Integrator: C0rr9A'.jE4DdsJilt--------------------•
Certified Operator. l?Yi1jEe..G.ray.......................... SUf idd........................................... Operator Certification Number:19.6,9,3 ............................
Location of Farm:
southeast of Kenansville. On East side of Hwy 50, 0.7 miles South of SR 1737.
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 ' S4& 1 06 66 Longitude 77 • ®6 34
Design Current
Swine Capacity Pouulation
❑ Wean to Feeder
® Feeder to Finish
4760
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 4,760
Total SSLW 642,600
Number of Lagoons C� ® Subsurface Drains Present 11D Lagoon Area 10 Spray Field Area
Holding Ponds I Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ 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: ............. ------------- ------------- ............ --•---------..._..--•-----........................... ............. --.----------- ---------------
Freeboard (inches): 38 29

r
Facility Number: 31-86 Date of Inspection 11-28-2001
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?
El Yes
No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
®No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
®No
9. Do any stuctures lack adequate, gauged markers with required maximum and • minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
®No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12. Crop type Coastal Bermuda (Graze) Small Grain Overseed
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
®No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
®No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15. Does the receiving crop need improvement?
❑ Yes
®No
16. Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
®No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
®No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
® Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
®No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24. Does facility require a follow-up visit by same agency?
❑ Yes
®No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments {refer 6 question #i) Explain any YES answers and/ar any_recommendations or any other comments W
Use drawings of facility to°better explain situations {useadd�fional pages as necessary) Field Copy [I Final Notes
- r
There is some old hay and cow manure from the feeding area which has been placed in and around waterways. Need to remove this
material from the waterways and spread evenly over the field. Do not put this material in waterways in the future. Need to have activity
completed by January 1, 2001.
7. Monitor bare areas on lagoons for erosion - prevently erosion.
15. Ensure a good stand of Bermuda on field 6.
19. I saw application os waste occurring at the farm on October 16, 2001. This event is not shown in the records which have been
resented to me as current updated records. Ms. Sheffield says that soil samples have been sent off for this year. The 2000 soil test report
s not in the records and it needs to be. There is no waste analysis taken sufficient to cover some of the September applications.
id,
Reviewer/Inspector Name Stonewall,,Mathis - entered.by=Bette Rose -f,
Reviewer/Inspector Signature: Date:

05103101
Facility Number: 31--86
Date of Inspection 11-28-2001
Continued
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ® Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ® No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ®No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ®No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
- omments an or ratg-
— _ , �wn—=
❑ Yes ❑ No
Need to be sure to take waste samples frequently enough to cover application events. Also need to be sure to use the proper waste I
analysis to calculate IRR2's I recommend to take samples every 60 days to use analysis dated within 60 days of applications on the
IRR2's. Need to keep weekly freeboard records for both lagoons. Currently only keeping it for 4 house lagoon.

i
3
0 Division of Water Quality
0 Division of Soil and Water Conservation -
0 Other Agency .- -
Type of Visit '0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit $f Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number j Date of Visit: I OT257/00 Time: �D Printed on: 7/21/2000
0 Not —operational 0 Below Threshold
.Permitted [3 Certifiedn © Conditionally Certified E3 Registered Date Last Operated or Above Threshold: .........................
Farm Name:
rl k;�50 ....... County: v l;'
Owner Name: 'D tl4k'✓\.ren Phone No:
.......................... .....................................................................
FacilityContact: ................................................................ ....... Title:................................................................ Phone No:...................................................
MailingAddress:......................................}.................................................---...........................................---................................................................... ..........................
S Lie
"Oe
PrDjj
Onsite Representative: ? ,....r .d....Integrator:...GI
.....................................---...........................°..........................................................................
Certified Operator: ...................................................
Location of Farm:
Operator Certification Number:
Swine []Poultry []Cattle []Horse Latitude �4 Longitude ' 4 «
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder r ❑ Layer ❑ Dairy
Feeder to Finish 1,0 ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons 2 Subsurface Drains Present ❑ Lag—n Area WSP
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream lrnpactS
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance; 3nan-made?
b. If discharge is observed, slid it reach Water of the State? (if yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min'!
d. Dees discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ................ �...............................Z....................... I ........ .
Freeboard (inches): 30 Z (0
5100
Field Area
❑ Yes ONo
❑ Yes 13 No
❑ Yes ff No
h 1n
❑ Yes ® No
❑ Yes ® No
❑ Yes No
❑ Yes R No
Structure 5
Continued on back

Facility Number: 3 1 — B�j Date of Inspection printed on: 7/21/2000
�5. Are here any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, El 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 [5No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes � No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidenceofover application? ❑ Excessive Ponding ❑ PAN El Hydraulic Overload El Yes ONo
12. Crop type t— C! 5 CUe M OLa ) 6C r" Ud rj N ��-j �i (� G'"Q � �► _. .
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ZNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ONo
.b) Does the facility need a wettable acre determination? ❑ Yes (3 No
c) This facility is pended for a wettable acre determination? ❑ Yes allo
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
:. N,6-violati66s:oi- Micienc�es •were potted• during #his visit: • Y;ou will receive iio further : :
icorres�ondence. about: this visit. • . • . - . - . • .. . ... . . . . . . ... . . . ...... . . ' .. .. '
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Yes ❑ No
❑ Yes VNo
❑ Yes RNo
❑ Yes allo
❑ Yes ONo
❑ Yes No
❑ Yes No
❑ Yes WNo
❑ Yes KNo
❑ Yes No
❑ Yes No
jS. mock •�o �ieTre'' es�U�I�S�► ber�?ud� i�t areas d>C .f�rayti',`c-�o(. .gC .ru/'e �d �
rerioye ev4 6 M4;,r,el rwtatnher se cis to gvo+d da�,as�:�j U Ider-jy,•v�
G fD+� w Zt ; G�, Gi tp' Qa rs �� �av�e oGG vr+^e� Tl�ar+� /ras rG Geyt G vW;' , 1
��. g��:•, keQp;�� 1 eck1 �rcc�ic�i�a� secerd5 or t,14A JA)aehs, ✓J
IUa�F'• irt,Jtis-]•e pPq►'�-J?•t �jtoKld be r�b,lr+•1�G�t bc,sGd py-� We-���le gcrCs�e-�er�^1:r,o�,'
Nf-7'C- Fig 640 9reti4e�- 41,,►., 1 t�r. old ►-seed �o be !�e►'tvYevl-r<rnml{�gr�L
a��v�;l7zed. �peo.F;�ti[I rlofe4 q,-e -f• o5e, GIB back offesruc
NOTC= [%SQ G�v��a� t,/l1Pit slo✓a�yrlcj over-
Reviewer/Inspector Name J '7D ,nett/ ^ 0 maA i r
Reviewer/Inspector Signature: f Date: ?� ®Q/pp

Facility Number: 3t — A� Date of luspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge aYor Wow ❑ Yes ANo
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes JRNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes --Fg] No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes 10 No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes j No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ffi Yes ❑ No
Additional Comments and/orDrawings:
4. filar k o owfr l AGooV).T -44 ��J'dl pv^��0 level 1 ►� G1
('ES1p6►7S± 61e, 1,xrtl J►'11q✓1v1e,r
5100

© Division of Soil grid WE
- s � Dr�ision of Soil and WE
rvision of Water CQual
.-. .
DOther. Agency, Operat
100koutine O Complaint 0 Follow-up of DWQ i
Facility Number]
ter Conservation-;Uperatioi►=Review
ter:Coaservation, Compliance Inspection
ty Compliance Inspection
on Review °- '
nspection Q Follow-up of DSWC review
Date of Inspection
4
4-
O Other
Time of Inspection I ° D 24 hr. (hh:mm)
Permitted,Certified © Conditionally Certified © Registered JE3 Not Operational] Date Last Operated:
Farm Name: ..... ... -.......!d.��.; r+l-S...:`.......................................................... Connty:..........-... cJ PC r i IV
Owner Name:.. ....................... Phone No:...-.............
Facility Contact:........................................................................ . Title:.............. Phone No:
MailingAddress: .............................................................. ............................................................................................................ ............................... ..........................
Onsite Representative:....
a.�/ ��..... ....... s................. lntegrator:.... A Iat-`............................................
Certified Operator................................................................................................................. Operator Certification Number:..........................................
Location of Farm:
r
.........................................................................................................................................................................................................................................................................
Latitude �� �C •4 Longitude • ° 49
Number of Lagoons E �2— J ❑ Subsurface Drains Present ❑Lagoon Area ❑ Spray Field Area
u.,.
Aoldrrig Ponds / Solid Traps r ❑ No Liquid Waste Management System
Discharses & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes J-D"No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes FzrNo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) []Yes PNo
c. If discharge is observed. what is the estimated flow in gal/min'?
d. Docs discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ZNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes P'No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes j6No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 0No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): ........ '. ............... .... ..-Z.2..............................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes �'No
seepage, etc.) ///
3/23/99 Continued on back

Facility Number: 31 — `� Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate. public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenatice/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type C_
i Z?
❑ Yes ;dNo
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss reviewfinspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0: �'VQ yiol'aiiQtis'or de#ieiencies were itotedd4rring �his,'visit: - Y:oir wii1-f&6iv16 trio further; • : •
. . corresporideitce. A4o� this visit.: . • ... . • . • . • . • . • ... • . • . • .
`Yes #�' 0
'1
ElYes No
❑ Yes 2fNo
❑ Yes P'No
❑ Yes ;1No
❑ Yes ;?(No
❑ Yes ;rm
❑ Yes QfNo
Oyes ❑ No
zYes ❑ No
❑ Yes ZNo
❑ Yes XNo
❑ Yes ;2'No
❑'Yes ❑ No
❑ Yes ONO
❑ Yes J02"No
❑ Yes ,EfNo
❑ Yes 0'No
❑ Yes ❑ No
❑ Yes ❑ No
Coiinments (refer to question #} ExplaEtt ;any YES answers andlor aay recommendations or any otter comments .V
Use�drawings of facility tobetter explainsituations {use additional'pages as:necessary) S-
�) P FAG tri Ti E5 A( 4��u743 �� �•.f �'qFN e.- „r�.�lct: -SoA2p LAG
} O1/tE�0t'V. OtteVjt�� at�F frJt�O� trr�[.LS A.hD OurS�9E vJfRLC.S'T� ��
G 4 C& em s Arta
s�E s Jai ��� A•�D nl£�oS co.fs: �gLF C,a gnto
[Mpi F >; r 'aAs-- A�8U'" VMS ,P_
t P ao t AC. Fv.?L. 4C A-r—S P To waTkX W A Ll S
r
ILk C) -14&pScr4_T'a Sc'p LTTE a-o,.CR���:eZ^n E Tw�- 9ta)3SS-39b��
Reviewer/Inspector Name ( ;t
Reviewer/Inspector Signature
Date: ?I Z1
3/23/99

Facility Number. 3� — 8 6 Date of Inspection z
Odor .Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes (2'-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 C3"No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑,No
roads, building structure, and/or public property) !!
29, is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes E;kNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes PIN
31, Do the animals feed storage bins fail to have appropriate cover? ❑ Yes . dNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? [�es ❑ No
Additional. Comments, and/or rawint
3Z I.D • LkP9 of oQ- w�a• i a
3/23199

.!T
........ ......... . ........ ......... ................................ ..
❑ DSWC Animal Feedlot Operation Review
Jg DWQ Animal Feedlot Operation Site Inspection
11M Routine O Complaint O Follow-utf of D1V0 inst)ection O Follow-uu of DS%VC review• O Other
Facility Number
Date of inspection 14 2 0
�f
Time of lnspezlion �24 hr. (hh:mm)
�1 pp 0 Not O erational Date Last Operated:..,._.,•„._.......
� Registered Certified Applied for Permit [� Permitted •.•,•.
Farm Name ..... ......f+'��a«15. .......�.''i, rarh. County:........ !? i!!........................................................
r'................................ ........................
Owner Name: .......Yr.�,(............ Ar.�.±4+tz`o&............................... Phone No:
Facility Contact: .....'ir. .............:................. kVL ... .. Title:.......hKic c................................ Phone No:. ...................
�1
MaitingAddress:... ...i. ...............S.dv.-...N!r...bkvy...p .................................... .....'w0.1�rAj ,L .... ............................................
Onslte Representative: ... 51VA.Cl..............................................---...........Integrator: ..... C_GkJA?.1f.5..................................................
�rp!t. .........
Certified Operator.... ?......I.thr-Ld...................... .. Operator Certification Number:...... I..11 k.-41 ---s ......
Location of Farm:
fa,14.........R!1OM.... ca.t f......!dim....T.-�f1a..1.�Etu� fi�.....l�timc�...��...i:.... kta...... t*...�L�r�..s..Tvnn:....1.t.;......o a.....!+.atl�....tt.......r►cr 41a1....I.,.... �
vrn .7t3 yK.otN.... U-ILA'�.Lt.r4.f.A.... L.Q.C:T'.... Qh....' SD O Z...M.f.�.... f!�...t`a�' 15.> .... Atle. .
Design . Current Design Current Desrgn Current,
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
El Wean to Feeder ❑ Layer ❑Dairy
Feeder to Finish 1 0 JE1 Non -Layer I I JE1 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder JE1 Other
❑ Farrow to Finish Total Design Capacity ;
❑ Gifts
❑ Boars Total SSLW
Number of Lagoons / Holding Ponds Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is obsen ed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes No
❑ Yes No
❑ Yes
® No
❑ Yes
No
N
❑ Yes
No
❑ Yes
14 No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes �D No
IN Yes ❑ No
❑ Yes ;M No
❑ Yes V No
Continued on back
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97

Facility Number: 3 —
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons,11olding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
........................... ............................... ...... ........"..................... ............. ................ ........................ I.-............. .
.1.
Freeboard (ft): .........`...
................... ...........................................................................................................................
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)
15" Crop type ....."-"TSLV:! ................."..... ............... .".............. ....... .........".
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?
❑ Yes X No
❑ Yes 91 No
Structure 6
❑ Yes ® No
(� Yes ❑ No
j Yes ❑ No
❑ Yes ® No
❑ Yes Dd No
....................................................
❑ Yes P No
❑ Yes UNo
0 No violations or deficiencies were noted during' this.visit..You,will receive no' further
correspondence about this`visit:•
Yes ❑ No
❑ Yes No
1A Yes ❑ No
❑ Yes JUNo
CW Yes ❑ No
❑ Yes 5fl No
❑ Yes ® No
❑ Yes [A No
Cottunents;(refer to question #f): Explain any YES answers and/or any recommendations or any other continents
Usedravnngs of ftictlity.tt betier explain srtuat�ons (use additional;.pxges asynecessary) o ;
. S h ON et We of a;ws ` a-, Y&' v
1!./1z• F-YrOokami orn ?t.nw- "Ok. 6e- AM W41 fivi o*j rueedpJ. Bart
CU-eG' S�aul� lae_ re.�4J. talcs ors nAr wall s�wA 6t F+ 16) W4L c(y_1 0.4 rtiv-dad.
u" N:�#+�a ew So�Lc„ Ct iN S �r rtco�S s�+�acl� b� u�d��d mon' � • f..ao�cr, ciesi 4
la ODD` .5600 be- t,_ fan.
N 7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:

❑ Division of Soil and Water Conservation ❑ Other Agency
C1 Division of Water Quality
KD Routine O Complaint ' O Follow-uti of DWO inspection O Follow-up cif DSWC review O Other
Date of Inspection
Facility Number `
Time of Inspection 24 hr. (hh:mm)
D Registered ® Certified 0 Applied for Permit It Permitted O Not Operational Date Last Operated: ..........................
Farm Namea`e.t`y. ,n trrnV. County in...............................................................
........................................ n�sca.......Nr ................ 4..............."..................... ........... 1
Owner Name: .....Q,(ai.i+3!a .... Phone No: �`� 107Tr�La.'io,T ................. ................. t ................... .................... .... ..... ...........................................
Facility Contact : ............... :..... :.. !�! .. &o................ Title:... 2i� .............................. Phone Nod° 1 12`1.Lc..`.f. g.............
Mailing Address:......��g �..... S � f' l{y� ...�............................�I'�GgtaA.1.ib...#..�.C,�...................................------ �.'.F�.......
Onsite Representative: ........ &I ...... 5 yGi�l- Integrator: .......aY.!12�.0.......................................................
Certified Operator:- 4 }. I.1. [..c. ...........� ........................... Operator Certification Number,.........................................
Location`of Farm:
lan....ea5......�x�.�...af.:....-"�`I-..t... Sr...phi.hts.....ix ....a .... ,.t' -.................. I.......
Latitude Longitude �• �' �"
General
L Are there any buffers that need maintenancelimprovement? ❑ Yes No
2. Is any discharge observed from any part of the operation? ❑ Yes] No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (if yes. notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes
[] No
❑ Yes
(� No
❑ Yes
No
❑ Yes
No
❑ Yes
No
Yes
❑ No
❑ Yes �3 No
Cl Yes 1P No
Continued on back

Facility Number: 3t —
8. Are there lagoons or storage ponds on site which need to be property closed'? ❑ Yes 10 No
Structures (Lagoons,11olding Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? RYes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: k-aZ
............................ I.... ................................... .................................... ........... ..............................................................................................
Freeboard (ft): .............:. -...... I.........
10. Is seepage observed from any of the structures'.'
L�J Yeti
0 No
It. 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'?
_(� Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
i
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
[3No
Waste Application -
14. is there physical evidence of over application?
❑ Yes
No
(If in excess of WMP, or runoff entering waters of the State. notify DWQ) _
15. Croptype .... SCui...................... yp �Qr> ..............Snn►5�...... !!lkl...........----•-
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
® No
17. Does the facility have a lack of adequate acreage for land application?
r
❑ Yes
No
18. Does the receiving crop need improvement?
f�5 Yes
❑ No
19. Is there a lack of available waste application equipment?
❑ Yes
[9No
20. Does facility require a follow-up visit by same agency?
Yes
❑ No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
22. Does record keeping need improvement?
Yes
❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
19 No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
O No
25. Were any additional problems noted which cause noncompliance of the Permit'?
❑ Yes
P No
0 No.violations or d'iciencie-s.were noted -during this'visit..Yo'U.W'ill receiveno further
correspondence about this: visit::::
Coniinent§,('refer to question #): ;Explain any YES answers and/or'.an`� recommendattons:oraoy, other comments: _
Use drawings of facility to better explain situations (use additional gages as necessary}
5 C—,V\S,.eJ V)W14, swi 1� t` f-j-
�jl1���'t++�01(oA
,1 {
1- �gop, rob S i,5v- t,it i✓Y w�1DWrF � . Lagann �A � 3�nD�W L-1 WeVJ l& 1011
Z�
17-. Exo!� ov~ce�S a� ,A� wt;Ak 4kwtJ be k1W W� C- re Cor��i� �
&ems. oUkt,, &VL I'm VV'id.
c4w,6 �- �v wv- berwwjo , `k i Tt k z�a i) �, �iE .P,IIl t w13 a—
Z. Cc � -4, � CpJera 2ska,\) �. 0" s,
31,-
7125/97
.r
Reviewer/Inspector Name
Reviewer/Inspector Signature: ' Date:

Site Requires Immediate Attention:
Facility No. 1-ts'r,
. DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: d , 1995
Time: w
Farm Name/Owner.— 1 L6 — --
Mailing Address: - S-� i� r --„"�. �`Y✓-I t'✓,d�� A- . N� -- a-g �i s �i --
County:
Integrator: rr��`ls - - — Phone. / 5 3 Ycl
On Site Representative: 7)u- �K�l�i _ Phone: _ % 6 /'S Sy
Physical Address/Location: C
Type of Operation: Swine Poultry Cattle
Design Capacity: tf 7y �^ s } Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: q° G ` _" Longitude: ��° S-�(' C� " Elevation:, Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches ' Y or No Actual Freeboard: �Ft. C> Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? e or No
Is adequate land available for spray? Y@^es or No Is the cover crop adequate? Yes o 0
Crbp(s) being utilized: 'WP.,P�S &, ;i -P ,4t G0,7-rna ( 4" - C
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? e ' or No
100 Feet from Wells? es 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 or T� 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: 0PA,.bCe_ Lr" )>a-.- s%dE -1 1>tX0 t"It �F
rxf
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed_