310132_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quaa
II

IType of visit: UFUompliance inspection V uperation meview V structure Evaluation V Technical Assistance
Reason for Visit: t4outinc 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: � Arrival Time: / Ov Departure Time: County:
Farm Name: iz --yt c •c �^ [c2uvN �''I J�f caner E ail C�
RECEIVED/NCDENR/DWR
Owner Name: ��--DU.`�i1'`�C�� �c �' �"'`'L Phone:
Mailing Address:
Physical Address:
Region: t
quo y ntegionai .
+ r Operations Section
Facility Contact: �� sti/j Lt �•'l `'�"� Title: Pngton Regional C1ff;rp
Onsite Representative: t t Integrator: 6�5
Certified Operator: 6vt-- Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish (> Z 115f—
Design Current
Wet Poultry Capacity Pop,
La er
Design Current
Cattle Capacity Pop.
DairyCow
Non -La er
DairyCalf
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D . P�oul [sa aci P,o ,
Layers
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Turkeys
Turkey Poults
Beef Brood Cow
Qther
Other
Lj2ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [].-NCF- ❑ NA ❑ NE
[:]Yes [-]No [3-NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
❑ Yes
[:]No
' NA
❑ NE
[-]Yes
O No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
Page I of 3 21412015 Continued

Facili Number: - '2 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 E2- A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[3N-o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[3 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
E3"'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
0No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑nApplication Outside of Approved Area
12. Crop Type(s): 113e /lf",c o S6 O Ctt>6
13. Soil Type(s):
W p
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?
l8. 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 ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes O No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EJNo
❑ Yes
21'No
❑ NA
❑ NE
❑ Yes
E3'No
❑ NA
❑ NE
❑ Yes
[J'No
❑ NA
❑ NE
❑ Yes [TNo ❑ NA ❑ NE
❑ Yes F;rNo ❑ NA ❑ NE
❑ Yes [rNo ❑ NA ❑ NE
❑ Yes [�J1 o ❑ NA ❑ NE
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - 1371 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [;LNe­ ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [;jXo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [; o ❑ NA ONE
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
ONo
❑ 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
E2*No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
Ej4o
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EJ'No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
dNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
FA"No
❑ NA
❑ NE
ns;ooraany-
Cl>- LC X L P- C, I.1� Y
T 0-3 os- 6 �5V
Reviewer/Inspector Name: �3 f) [tfJo Phone9N-U3-3331-
` Reviewer/Inspector Signature: �� Date: 4 7
Page 3 of 3 21412015

Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visir:CVRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: /%61 Arrival Time: Departure Time: County: �4 /ice Region: LJ/
Farm Name: /Ct LC �,czi Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone::
Integrator: / r'; /5
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish ILayer
Design Current
Wet Poultry Capacity Pop.
Cattle
Dairy Cow
Design
Capacity
Current
Pop.
Wean to Feeder
I
lNon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D . P,oult . Ca aci $o ,
Layers
DEX Cow
Non -Dairy
f Stocker
r
Gilts
Non -La ers
f Feeder
Boars
Pullets
Beef Brood Cow
Wither
Other
ZOther
urkeys
Turkey Poults
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes, ;;�No ❑ NA ❑ NE
❑ Yes ;aNo ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
,23'No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
ONo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
ETNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[2-Ko
❑ NA
0 NE
of the State other than from a discharge?
Page 1 of 3
2/4/2015 Continurl^`

Facili Number: -7 jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [3 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes P'No ❑ NA .❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: 02
Spillway. :
Designed Freeboard (in):
Observed Freeboard (in): 6 T
5. Are there any immediate threats to the integrity of any of the structures observed?
❑Yes J7*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?
0 Yes [:I No
0 NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes L2No
❑ 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 Q-No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes J20No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes .VrNo
❑ 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 12,,No
❑ NA
❑ NE.
15. Does the receiving crop and/or land application site need improvement?
❑ Yes EET 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 L2'1No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes J;kNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes Jallo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes ,E]'No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes L2'No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes sE�:rNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes eNo
[DNA
❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes jalgo ❑ NA ❑ NE
25. u the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ETNo ❑ 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 _E;?No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �'No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes P�No ❑ NA ❑ NE
❑ Yes ff No ❑ NA ❑ NE
❑ Yes J2'f'o ❑ NA ❑ NE
❑ Yes )21" No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 1?!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 FjWo ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional"recbn mendations or any other c6minen6.-
Use drawings of facility to better explain situations (use additional pages as necessary)..
0-Too
/- 00
74
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
/1;;, 0, 1e L e" r�S
/04/C' J a Cat.
Phone:
Date:
Aa
21412015

Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: rrivai Time: eparture Time: County: Region: jjj'&:>
Farm Name: _ _ Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: _ I ,f. Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Da' Cow
Wean to Feeder
Non -La er
Ell
DairyCalf
Da' Heifer
Feeder to Finish
Farrow to Wean
Farrow to Feeder
to Finish
D . P,oul
RFarrow
Layers
Non -Layers
Design
Ca aci
Current
IN
P,o
Cow
Non -Dairy
Beef Stocker
Beef Feeder
Gilts
Boars
Pullets
Beef Brood Cow
Other
L_JDther I
L10ther
Turkeys
Turkey Poults
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
0 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
]:a No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
'�TNo
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
[3"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 21412014 Continued

Facili Number: - Date of Inspection: p
Waste Collection & Treatment
4. Is storage tapacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes o No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes J�fNo ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes M-No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [2-No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes O'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 .El —No 0 NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 5�,No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes ❑ NA ❑ NE
❑ Excessive Ponding ❑ . Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc
❑9-1110
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): I
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes eETNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ,E�No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes O No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes P} No
TT
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes o
T
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes -EfNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAW -MP readily available? If yes, check
❑ Yes E' No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ;Z�No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I ° Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes`g 1 o
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [ No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes T�Io ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No
[—]Yes EfNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes PrNo ❑ NA ❑ NE
❑ Yes
ep No
❑ NA
❑ NE
❑ Yes
�o
❑ NA
❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes X No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes VNo ❑ NA ❑ NE
Reviewer/Inspector Name: Phone:�L�%2�
Reviewer/Inspector Signature: , � — _ Date:�ZZI,61,1
Page 3 of 3 2142014

Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 310132 Facility Status: Active
Permit: AWS310132
Denied Access
Inpsection Type: Compliance Inspection
Inactive Or Closed Date:
Reason for Visit: Routine County:
Duplin Region:
Wilmington
Data of visit: 04/15/2015 Entry Time: 04:00 pm Exit Time: 5.00
pm Incident #
Farm Name: Jarman Farms
Owner Email:
Owner. Ronnie Jarman
Phone:
910-29"144
Mailing Address: PO Box 96 305 Brown Rd N
Seulaville NC 28518
Physical Address: 305 Brown Rd N
Beulaville NC 28518
Facility Status: ❑ Compliant ❑ Not Compliant Integrator.
Murphy -Brawn LLC
Location of Farm: Latitude:
34' `- 3' 17" Longitude:
77" 48' 16"
South of Beulaville. On East side of SR 1965 approx. 0.2 mile South of SR 1800.
Question Areas:
Dischrge & Stream Impacts Waste Col, Star, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator: Ronnie W Jarman
Operator Certification Number:
17230
Secondary OIC(s):
On-Slte Representadve(s): Name Title Phone
On -site representative Johnny Lanier
Phone:
Primary Inspector. Kevin Rowland Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

'Permit: AWS310132 Owner - Facility : Ronnie Jarman Facility Number: 310132
Inspection Date: 04/15/15 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
#1 (HP)
19.50
25.00
Lagoon
2
25.00
page: 2

i Permit: AWS310132 Owner - Facility : Ronnie Jarman Facility Number: 310132
Inspection Date: 04/15/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
01scharaes & Stream Impacts;
Yos No Na He
1. Is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
M ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
M ❑
❑
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)
❑
0 ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
01111
State other than from a discharge?
Waste Collection, Storage S Treatment
Y No o No No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
E ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na He
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. 1s there evidence of incorrect application?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS310132 Owner - Facility: Ronnie Jarman Facility Number. 310132
Inspection Date: 04/15/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes
No Na No
Crop Type 1
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
M ❑
❑
Management Plan(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 acre
❑
❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
■ ❑
❑
18. Is there a lack of property operating waste application equipment?
❑
■ ❑
❑
Records and Documents
Yes
No No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ 01111
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

. Permit.
AWS310132
Owner - Facility :
Ronnie Jarman
Facility Number.
310132
Inspection Date:
04/15/15
Inpsection Type:
Compliance Inspection
Reason for Visit:
Routine
Records and Documents
_
Yes NoNo-No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
M ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 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?
❑
M ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na He
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
■ ❑
❑
and report mortality rates that exceed normal rates?
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 regional DWQ of emergency situations as required by Permit?
❑
00
❑
(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
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewerlinspector fail to discuss reviewfnspection with on -site representative?
00011
34. Does the facility require a follow-up visit by same agency?
❑
■ ❑
❑
page: 5

Type of Visit: GrCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: V Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: _ ��-�4 Arrival Time: Departure Time: =gyp PN1 County: Region:
Farm Name: 71OL—q M y\ _66nns Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: &&6 f 2ft
Back-up Operator:
Location of Farm:
Phone:
Title:
Phone:
Integrator:
Certification Number:
5� Marti
Certification Number:
Latitude: Longitude:
Design
Swine C►apacity
Wean to Finish
Current
Pop.
Design Current
Wet Poultry Capacity Pop.
Cattle
DairyCow
Design Current
Capacity Pop.
Wean to Feeder
'ENon-L]ayer
Dairy Calf
Feeder to Finish 'j b
Dairy Heifer
Farrow to Wean
Design Current
D , P.oul Ca acity Po ,
Dry Cow
Farrow to Feeder
Non -Dairy
Beef Stocker
Farrow to Finish
Layers
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
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 k!rNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
[—]Yes [—]No
❑ Yes No
❑ Yes No
❑NA ❑NE
❑ NA ❑ NE
❑NA ONE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: - Date of Inspection: -
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
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: LI
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in): aL
r
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 ;' No ❑ NA ❑ NE
❑ Yes P
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 ETNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes to 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 VI No ❑ NA ❑ NE
maintenance or improvement?
Waste Aoolication
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 Y No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
0
9-1
❑ NA
❑ NE
❑ Yes
No
0 NA
❑ NE
❑ Yes
4No
❑ NA
❑ NE
❑ Yes WrNo ❑ NA ❑ NE
[:]Yes kfNo ❑ NA ❑ NE
❑ Yes L'No ❑ NA 0 NE
❑ Yes K No ❑ NA ❑ NE
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 9 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I ° Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes J�:rNo
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 21412014 Continued

b
Facility Nd mber: - Date of Inspection: —J -
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes XNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes VrNo
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 KNO
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes F No
Other Issues
2& Did the facility fail to.properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ogfNo ❑ NA ❑ NE
❑ Yes /o No ❑ NA ❑ NE
❑ Yes /fNo ❑ NA ❑ NE
❑ Yes 96No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Phone:
Date: T�C1; 14
�]214,12014

Type of Visit: Z5 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: qlRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access j
Date of Visit: Arrival Time: p /tIL Departure Time: b County: Region:
Farm Name: �a,,rY�M1{� �7ArwN Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative:
Certified Operator: �ji/ �l►/ �N+iwctn
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Desigu C►urrent
Wet Poultry Capacity Pop.
La er
Desigu C►urrent
Cattle Capacity Pop.
DairyCow
Wean to Feeder
Nan -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D�, P,oul_ , Ca aci P,o
Layers
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Turkeys
TurkeyPoults
10ther
Other
Discharp-es and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes Z,No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ 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 PTNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes WNo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

laacili umber: - Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes pr'No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ! -- a
Spillway?: c
Designed Freeboard (in):
Observed Freeboard (in):�j d-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes r`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 D 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 VfNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes ETNo
❑ 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 allo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes f!TNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes eNo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Wo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? -
❑ Yes
KTo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
)�J`No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
P�-No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 4?IrNo
❑ 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,,allo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �o
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili dumber: -13 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ZI No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes ET'N-o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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
JZ No
❑ NA
❑ NE
[::]Yes
ZrNo
❑ NA
❑ NE
❑ Yes
J2� No
❑ NA
❑ NE
[:]Yes Rn No ❑ NA ❑ NE
❑ Yes VfNo ❑ NA ❑ NE
0 Yes in No ❑ NA ❑ NE
[:]Yes 0 No
❑ Yes P!rNo
❑ Yes L;�-No
❑ NA FINE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #l: Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:00
Date:
21412011

Type of Visit: Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: s (} Arrival Time: Departure Time: L¢.� County: C' f I� Region:
Farm Name: q-#t Owner Email:
Owner Name: 9:�PAIIJIF_ S(��1.M-AN Phone:
Mailing Address: T( 'G - e0X �1�ew—AUl L-LE- , / VG 9K! �
Physical Address:
Facility Contact:
Title:
Onsite Representative: � �/F f?-- Integrator:
Certified Operator:
Phone:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish I
Design Current
Wet Poultry Capacity Pop.
ILayer
Design Current
Cattle Capacity Pap.
Dairy Cow
Wean to Feeder I
jNon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
D , P,oul_ Ca aci P,o
Dry Cow
Farrow to Feeder
Non -Dal
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other I IOther
Turke s
Turkey Poults
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
❑ Yes Mo ❑ NA ❑ NE
Yeso ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
❑ NA
❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
.pn(
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):^
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
lT�
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes'ANo
❑ 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 N
No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes] No ❑ NA ❑ NE
maintenance or improvement? ,
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ .
Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, 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): �p �t� S'C (esca&) ' e{eq:M) CcSex %. t- _.4T
13. Soil Type(s): �/�..�6 C-0 J� `' A Iq� _
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
KNo
❑ NA
❑ NE
Required Records & Documents
l9. 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.
Q WUP QChecklists Q Design Q Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [] Yes No
Q Waste Application ❑Weekly Freeboard ❑� Waste Analysis ❑Soil Analysis ❑'Yaste Tr sfers
❑ Rainfall ❑ Stocking Crop Yield ' 0120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 9No
❑ NA ❑ NE
Q Weather Code
0 Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: -R 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 M 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 fast survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? Yes [:]No ❑ NA ❑ NE
27. Did the facility fait 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? L
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes 1L I 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 V9,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 R No ❑ NA ❑ NE
❑ 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
❑ Yes No
[—]Yes No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any, additional recommendations.or any.. other; -,comments. ,
Use drawingsof facilityto better explain situations use additional pages as. iiecessa
S{�,�06'C- SUR vEIS G�►� r�C)i H L/ COON S
CO(IMAT)O)V Dui ao �3
W.A.
-3) 0 a
Q t C. c� j �c�os � �� ��—C.l� � 1►M-� T C3
CCP
u k IC_ A-c 1► V&_
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date. " S11Q��0
21412011

Type of visit: (AC:ompliance Inspection U Operation Review U Structure Evaluation U Technical Assistance -
Reason for Visit: Loutine O Complaint O Follow-up 0 Referral Q Emergency O Other O Denied Access
Date of Visit: J Arrival Time: Departure Time: County: Region:
Region:
Farm Name: ►2rn i�/� Faam s Owner Email:
Owner Name: V=g�NAl I r � A M 4J`/ Phone: I 1 V J « I w_ 3NL%
Mailing Address: P . . G x q�o SQ5 Caa,14M 1L a IV R C-(,C(_,iQk31'-LE ,)V C
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: �f1I11 7 N Integrator:
Certification Number: Certified Operator: ��VlJV w. �An.m�� � $'4sc�5
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
t
urrenSER
DesigMy
Swine Pop.
Wean to Finish
Desigu Current
Wet Poultry Capacity Pop.
La er
Design Current
C*attle C►apacity Pop.
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Dairy Heifer
Cow
Non-Dairy
Beef Stocker
Feeder to Finish
esign Current
Dft
D , P,oultr, C•.a aci P,o
Layers
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
PP'ullets
Non -Layers
Beef Feeder
Boars
Turkeys
TurkeyPoults
Other
Beef Brood Cow
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes [:]No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ro ❑NA ❑NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yeso ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

[FacilityNumber: I - 1 Date of Inspection: UP /
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: _ S/_
Spillway?:
Designed Freeboard (in): 1q. S 14.5
Observed Freeboard (in): OQ Ll tl
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes I IV No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) Tr
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? T
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 0 No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window / ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type{s}: &�VF--t.N� S'G � W 064T -sR 1 �,5c C —
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
QWUP QChecklists ❑Design F1 Maps ❑ Lease Agreements
❑ Yes No ❑ NA ❑ NE
❑ Yes rNo
o ❑ NA ❑ NE
Yes ❑ NA ❑ NE
❑ Yes
o
❑ NA
❑ NE
Yes
kNo
❑ NA
❑ NE
❑ Yes
o
❑ NA
❑ NE
❑ Yes
tNo
❑ NA
❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
ElWaste Application ❑ Weekly Freeboard ❑ Waste Analysis [] Soil Analysis ❑ Waste Transfers
0 Rainfall ❑ Stocking Crop Yield Q 120 Minute Inspections Q Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes OiNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes j"d No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili 'Nud►ber: - J Date of Inspection: CaklY
24. Did the facility fail to calibrate waste application equipment as required by the permit? [—]Yes ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes9No
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 tNo
o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]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 EANo ❑ 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 CAWW? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments. (refer to question#): Explain any YES answers and/or any additional recommendations or -any other cnminents.
'to better explain situations (use additional pages. as necessary). Use drawings of facility
P
�(A
i�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: l9
21412011

Type of Visit
Compliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
xFoutine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: ® Departure Time: County: �i rl Region:
Farm Name: S�mN mS Owner Email: /
Owner Name: jw1,Nlyll C- �pRmRAI Phone: �0—
Mailing Address: R_ d � za( ` Q 305 WL..W (�_ ) &L,_ -A UI C(_E ,,X/C O E SIR _
.1
Physical Address:
Facility Contact: Title: r Phone No:
1i�1 �� `-'�'. Integrator: Onsite Representative:
Certified Operator: NI {%J A211't Oper`ator1Ce hfcation Number: ��v��
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: E__1 n I--] ' E__1 Longitude: [� ° [� l
Design Current
Design Current
Design Current
Swine C*apacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
ID Layer
I
I
❑ Dai Cow
❑ Wean to Feeder
IQ Non -Layer
I
I
❑ Dai Calf
Feeder to Finish
Dry Poultry
❑ Dairy Heifer
❑ Dry Cow
❑ Farrow to Wean
ElNon-Dairy
❑ Farrow to Feeder
❑ Layers
❑ Farrow to Finish
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Beef Feeder
❑ Beef Brood Co
El
Other
❑ Other
❑ Turkey Poults
❑ Other I
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?
❑ Yes YNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes )KNo [INA ElNE
El;YesNo ❑ NA ❑ NE
12128104 Continued

I
�!acility Number:-3 ! — f3
Date of Inspection JC9 /d
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 STre 2 Structure 3 Structure 4
Identifier: I
Spillway?:
Designed Freeboard (in): v! .6 1 q • 15
Observed Freeboard (in): 110
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 10 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 14No ❑ NA ❑ NE
❑ Yes ANo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes b6o ❑ 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 Cl Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes )1-No ❑ NA ❑ NE
11.
Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes N,'No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
Crop type(s) � s6 C_Lkd� Ca"
13.
Soil type(s) �tJS WA t/` bA
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes V 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 ?
`�VNo
ElYes (. R No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes XNo ❑ NA
ElNE
18.
is there a lack of properly operating waste application equipment?
❑ Yes dNo ❑ NA
❑ NE
Comments (refer to question #): Explain any YES,answers and/or any.r„ecommendations.oraany other comments
'Use drawings of facWty'to better explain situations. (use additional pages as necessary)
`.
Reviewerllnspector Name
/h �iN�>a-f}llSl F S _
Phone:
Reviewer/Inspector Signature:
Date: (51/6 fin
Page 2 of 3 12128104 Continued

Facility Number: 1 — VI Date of Inspection
Required
Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes )(No
El NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes �No
❑ NA
[I NE
the appropriate box. ElWUP El Checklists 0 Design 0 Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes XNo
[3NA
ElNE
0 Waste Application ElWeekly Freeboard ❑ Waste Analysis ElSoil Analysis ❑/aste Transfers❑,�Knual Certification
0 Rainfall ❑ Stocking 0 Crop Yield 0 120 Minute Inspections ❑ Monthly and V
Rain Inspections B Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes KNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes XNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes o
❑ 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 `iNo
❑ 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
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes ;No
❑ NA
❑ NE
Additional Comments and/or Drawings:
cAU I0A) ou DO
aa3t��-
� j
LfJa
3.0
-�" SCE �f=�1GfcD
FWYE�L V)Lk I A/ /A/ C_A-rvc�,v a
2j}e )j6
1_o H&CP W 1 K-ECRINK Up L'_3� dss IQLE
«1251��
t. S
P lP� C L_ 0(s G ►/'/
Page 3 of 3 12128104

NCDENR
North Carolina Department ofEnvironment and Natural Resources
Division of dater Quality
Beverly raves Perdue Coleen H. Sulttns Dee i reeman
Governor Director Secretary
Ronnie Jarman and Kevin Jarman
Jarman Farms
PO Box 96
Beulaville, NC 28518
February 19, 2010
Subject: Sludge Survey Testing Dates
Certificate of Coverage No. AWS310132
Jarman Farms
Animal Waste Management System
Duplin County
Dear Ronnie Jarman and Kevin Jarman:
The Division of Water Quality (Division) received your sludge survey information on February
8, 2010 for the lagoons at the above referenced facility. With the survey results, you requested
an extension of the sludge survey requirement for the lagoon at the R&K Jarman Farm 4-7. The
Division agrees that a sludge survey is not needed until 2012 for lagoon #1. However, due to the
amount of treatment volume available, and the rate of sludge accumulation for lagoon #2, DWQ
feels that an extension is not appropriate at this time.
The next sludge survey for the lagoons R&K Jarman Farm 4-7 should be performed before as
follows.
Lagoon #1 Sludge Survey due before December'31, 2012.
Lagoon #2 Sludge.Survey due before December 31, 2010,
Thank you for your attention to this matter. Please call me at [phone] if you have any
questions.
Sincerely,
F�a z 2 zolo
Christine D. Blanton
Animal Feeding Operations Unit .
cc: Wilmington Regional Office, Aquifer Protection Section
Permit File AWS310318
163 Mail Service Carver. Ralegn, Nortn Carohna 27699-153e v13'
Location: 2728 Capital Blvd- nalkft. Nort:r Ca. --Tina 2760' N owl CwOlir a
°hone:9:9-73a-3221tFAX: 9?9-735-05881Guavorner5ervice:1.877—K-7-o74E
Inteme;: www.ncwatemuajay.orc K 4
An Eauai OpDonljairy : tarmativeAcion

Type of Visit 'compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1 O f��1 Arrival Time: Departure Time: County:
Farm Name: Q a-m �1� A R �U1 S Owner Email:
Owner Name: �l�l1�1F� hCU1N ��czm/�i� Phone: _
Mailing Address:
Physical Address:
Facility Contact: I Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Integrator:
N Region:
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0[� i [=« Longitude: [� o= f
Ke—s ig-5-11MURrrent Design Current
Design
Current
Swine Capacity Population Wet Poultry Capacity Population
Cat#le Capacity
Population
❑ Wean to Finish ❑ Layer
❑ Dairy,Cow
❑ Wean to Feeder I ❑ Non -La er I I
❑ Dair Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
El Gilts
❑ Boars
Dry Poultry
El Layers
❑Non -La ers
El
❑ Pullets
❑ Dry Cow
❑ Non -Dairy
El Stocker
❑ Beef Feeder
El Beef Brood Co
El Turkeys
Number of Structures:
Other
❑ Other
❑TurkeyPoults
tfo_ther
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes $ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
�fNo
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
12128104 Continued

Facility Number: ] — 1 Date of Inspection 1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? WYes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? A Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: P2t,V& SEt=
Spillway?:
Designed Freeboard (in): nn
Observed Freeboard (in): /O O� ]
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 El Yes LXNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes hANo ❑ NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes ❑ No
l I. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soi
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13, Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
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
❑ NA NE
❑ NA �NE
❑ No ❑ NA kTNE
❑ No ❑ NA NE
❑ No ElNA NE
❑ No ❑ NA NE
❑ No ❑ NA NE
Comments (refer -.to question #I) Explain any YESy
Use drawings of .to q to better ex la ini'an ahonsanswers and/or anv recamm ndations or any other comments.
g facility p {use additional pages as necessary}: .-
Li. 1 HGG 1S '� p l BGt� � wE�N THE T� L-l4[UpN S - LAB O0IV bP_S)G N S
7�1C.�� i o ��� �oc� l� i To C ��- FEE fACz� ��l Q�� m Ate.
-TN c C,cx:VV Mfg �(z 1S oLi'�, q-W-)T CCJVIDG)YT r14A► IT rS
Reviewer/Inspector Name Phone: /V CJ(D
Reviewer/Inspector Signature: Date: I Mdloq
12128104 Continued

Facility Number: — J Date of Inspection tt
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA NE
ElWaste Application ElWeekly Freeboard ElWaste Analysis ❑ Soil Analysis ElWaste Transfers ❑ Annual Certiftc tion
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
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 IqNE
❑ Yes ❑ No ❑ NA E�NE
❑ Yes [--]No ❑ NA �NE
❑ Yes ❑ No ❑ NA RNE
El Yes ❑ No ❑ NA �E�NE
❑ Yes KNo ❑ NA ❑ NE
bd Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA NE
X Yes ❑ No ❑ NA ❑ NE
�►►dditional Comments andlor Drawiugs:
(�ACc�01� CGU ('C -S R GL-E QECc�Q-�E� +� S%Cyv D�2� L (cZCv�1.
l lQE IW0S CLOGC C0w UN)G-9-\h% 14GC ';�4 l
�H � (-PC�x DCS !C �-E Da �o� 4 �L+�C i
To g�oNc a
-rH- LA-Gcx S '3(:!D G)VT CA -Al fir=
SNCILr�
12128104

Type of Visit kcompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit:� Arrival Time: Departure Time: County: l._i %V Region:
Farm Name: _ \mwpw Sr-p-mg_ Owner Email:
OwnPrNnmP- <z0NN1C-_-+ KEVIN �4(LMAN PhnnP-
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = 1 = Longitude: = ° = 6 a
Design C«urgent
Design Current
Design
Ogrent
Swine
Capacity Population
Vet poultry C►apacity population
Cattle
Capacity
Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow.
❑ Wean to Feeder
1 10 Non -Layer
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry poultry
❑ Dry Cow
❑ Farrow to Feeder
ElNon-Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑Non -La Non -Layers
El Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cow
❑ Turke s
Other
❑ Other
❑ Turkev Poults
A ❑ Other T
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?
❑ Yes XNo ❑ NA ❑ NE
❑Yes
El No
El NA
El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
�No
"-�N
El NA
❑ NE
El Yes
�`
o
❑ NA
❑ NE
12128104 Continued

Facility,Number: 1 —)391 Date of Inspection tit
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier, WA fYl AEG
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): p[
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes )No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
❑ NA
ANE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NANE
�(
(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 Ie NE
maintenance/improvement?
It. is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA KNE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or i 0 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)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ 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
4NE
❑ No
❑ NA
RNE
❑ No
❑ NA
jt� NE
❑ No
❑ NA
14rNE
❑ No
❑ NA
VNE
_
Comments (refer to. question #): Explain any YES answeis and/or any recommendations or any other comments ,]
w b
Use di avvings:of facility`to;berier explain situations; (use additional pages as necessary) t _
�.... ,a:
0AI SZ WNuGS ON maR C01J 1 41E
C..AC,crw5 AQ-E A 1 �,WLIDZILA-M _ g<:s _T4E VA PE 1 SAS Qt✓GN [.lnt�LoGG'ED . S'71 LL
NICEb is PXr Al lm�+c_E[Z I At �ZIMp2t� S[ NCE �oC WC 15 AN I S�CnE , I -S0
AS Qw L-r5 0 IF- -Ii�y+l l' 10C)o CW S
Reviewer/Inspector Name N :. ! < 5 = .`; Phone: JC}9(g- 3
Reviewer/Inspector Signature: Date: l l
12128104 Continued

r
Facility Number: -3 l — Date of Inspection 11
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 ;E�NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA XNE
❑ 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 Cade
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
[INAZNE
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
XNE
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 N 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 Cl NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ No ❑ NA NE
12128104

Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: oK+ OC] Arrival Time: �D Departure Time: County: L1 N Region:
Farm Name: _� A2�Gw A 2 m Owner Email:
1L
Owner Name: k..3'1!/V/I= ', AiZfYli�n/ Phone:
Mailing Address: '2,Ca• 5 RGZr3t-'AN O a Y E C.t CA U I t*L E/ A C-
Physical Address:
Facility Contact: ` Title:
Onsite Representative: )0& �� 1] 0X'y �2
Certified Operator:C'aoY/Vl
Back-up Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number: 1 —49 SC)
Back-up Certification Number:
Latitude: = o = 6 Longitude: = o = 1
Design Current Design
Current Design Current
pacity Population Wet Poultry C►apacity
Pcity Populatito
Finish ❑ La er
❑ Dai Cow
to Feeder ❑ Non -La er
7Farrow
❑ Dai Calf
❑Dai Heifer
IN to Finish
to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
El Farrow to Finish
❑ Layers
❑ Beef Stocker
❑Beef Feeder
❑ Non -Layers
❑ Gilts
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ Turke s
Other
❑ Other
❑Turke Poults
❑ Other
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?
❑ Yes 0No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
�(No
❑ NA
❑ NE
❑ Yes ANo ❑ NA ❑ NE
Page I of 3 12128104 Continued

Facili Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ANo. ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: _ACOC.YJ
Spillway?:
Designed Freeboard (in): 1�•
Observed Freeboard (in): 451
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
4No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
�No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
f<No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
4No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
91No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
❑ PAN ❑ PAN > 10% or t0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
SZ04� X-SEZLIJ )
12. Croptype(s) 15E LQKf� tA�,dSQT
W",s
bf—scutE U
— -
13. Soil type(s) _t,t CA fnn A
f`�
&NA W�o�—
_
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
I,�J No
'
❑ NA
El NE
15. Does the receiving crop and/or land application site need improvement?
El Yes
`No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
jo
XNo
❑ NA
❑ NE
CAC_xli C>0 -TJod CuGTWS 1,.�G{.�tZ •
p 09 D4
Reviewer/Inspector Name rrlfaNDA CAA/IK�S Phone: 916 TWO 3cs -7
Reviewer/Inspector Signature: Date: ,j /pfC7Jt�`�
Page 2 of 3 12128104 Continued

' Facility Number: Date of Inspection
Required Records & Documents )(No
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑
Yes ❑ NA ❑ NE
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes e� No ❑ NA ❑ NE
the appropirate box. 0 WUP Q Checklists [] Design 0 Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes )� No
❑ NA
❑ NE
0 Waste Application ❑ Weekly Freeboard ❑ Waste Analysis 0 Soil Analysis ❑ NVaste Transfers El A/nual Certification
0 Rainfall El Stocking 0 Crop Yield 0 120 Minute Inspections El Monthly and V
Rain Inspections []
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes )<No
❑ NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes No
El NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes No
El NA
El NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes A No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑Yes
No
ElNA
❑ 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
VfNo
IN
ElNA
❑ 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
b6o
❑ 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
0, No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[(No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Division of Water Quality
Facility Number Q Division of Soil and Water Conservation
- - - - 0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit (� Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: ISUPLIA1 Region:
Farm Name: (� ,� Owner Email:
Owner Name: 1-VNAm S AZMPN Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: CNNIV LA/V f it R Integrator: n
Certified Operator: �N�r Jr A R RMAN Operator Certification Number:
Back-up Operator:
Location of Farm:
Design Cup
f Swine Capacity �Popul
a ` ❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish up
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑Other
Back-up Certification Number:
Latitude: [= o = & Longitude: ❑ ° = ' =
of =Design Currenf ' Desrgn",
[on"" 4:. wet,Poultry, :Capacity Population Cattle Capacity~' F
]r ❑ La er
❑ Non-Layer-1-I -
--I Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
Turke Poults
[ED 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?
❑ Daia Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
NumberofStructures
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes 0No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
WNo
❑ NA
❑ NE
❑ Yes
&No
❑ NA
❑ NE
12128104 Continued

t Facility N&nber: 3 1 — f 3 a
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: LAaocw
Spillway?:
Designed Freeboard (in): • S
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 0 No
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes P No ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes r o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 5(No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) ` 11
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes] No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
WNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
1�1 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
E No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Wo
❑ 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-7,40A r S rlv e.XCF L(_5A/ T coral )l 710/V -
Reviewerlinspector Name - 1. 4 C- — Phone:
Reviewer/Inspector Signature:rm��Date: Q LUC—)
Page 2 of 3 12128104 Continued

Facility Number: —13rD Date of Inspection �a
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design 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 0 Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
RNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
CR�No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
KNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
KNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
gNo
❑ 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
El Yes
.�No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
q No
❑ NA
❑ NE
Page 3 of 3 12128104

FaciItty Number 32
Division of Water Quality
0 Division of Soil and Water Conservation
O Other Agency V I
Type of Visit Qf Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Q(1 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: �County: 7'�Zg�v Region: LIA K O
Farm Name: Owner Email:
Owner Name: 'M 4.d Phone:
Mailing Address:
Physical Address:
Facility Contact: 1 Title: Phone No•
Onsite Representative: D N A,)
Certified Operator: - f"2)- J7;�D_'!o
Integrator• _sPr� �/�-4�/1)
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Latitude: E::] o [�] ' [=] Longitude: [=] ° = ' =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
_ ❑ Layer
❑ Non -La er
Dry Poultry
❑ La ers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population -
El Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: ©!
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
El NA
El NE
El Yes El No
❑ Yes No
❑ NA
❑ NE
r
El Ye No
❑ NA
❑ NE
12128104 Continued

r
Facility Number: 'Jj Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes /ffNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA
❑ NE
Str c e l Structure Structure 3 Structure 4
Identifier:
Structure 5
Structure 6
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
Oe/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No
❑ NA
ElNE
through a waste management or closure plan?
'X
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes ('No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes /No
❑ NA
❑ NE
maintenance or improvement.
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes XNo ❑ 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 D.ri�fl ❑ AZoa&s'�'O�
lication Outsif Areea���12. Crop hPe(s) A69MunA ('4 44 d i�i47�i'�. Vw� ��"'``G�j�zo�� 0—"'&
13. Soil type(s) - Ay4e
I4. Do the receiving crops differ from those designated i the CAWMP?
El Yes
No
16
ElNA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
�No
El NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
ZNo
El NA
El NE
18. Is there a lack of properly operating waste application equipment?
El Yes
/No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name / Phone: O
Reviewer/Inspector Signature: Date:
12128104 ' ' Continued

Facility Number: Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design/
El El
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
ONo
❑ 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
y1fNo
ElNA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
ElYes
No
ElNA
ElNE
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
/////16
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
J(J No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
jNo
❑ NA
❑ NE
AdditionalCommentsa/ndlor Drawings:
I!� /of�/� /vfaLrJ C fI G 4VO �''.291z_ ECOQ�S�
LS
a
12178104

0 Division of Water Quality
Facility mmber 0 Division of Soil and Water Conservation
- —.... 0 Other Agency
Type of Visit O Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: ©: eparture Time: r unty:
Farm Name: /Y15 Owner Email:
Owner Name: T ljIl� Aoe_M Phone: _
Mailing Address:
Physical Address:
Facility Contact: Title: M Phone No:
Onsite Representative: �1 a5 ri L � �2 Integrator: A?. S a
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Region: a 14 V
Latitude: = o = Longitude: = 0 0 I =
Design ;. Current;;' DesIgn< Current, ,Desrg Current
Swine
Capacity. Population Wet Poultr} C-apacity Population Cattle k Capacity Population.
Wean to Finish ❑ Layer
Wean to Feeder . ❑Non -Layer
Feeder to Finish1AC-4070C701
Farrow to Wean I Dry Poultry
Farrow to Feeder
Farrow to Finish
El Layers
Boars
Other;
❑ Other
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Puults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes YINo ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes I,, No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

�.
Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
iftV)
1 Structure 2
Identifier:
Spillway?: Al
Designed Freeboard (in):
Observed Freeboard (in); ,50
Structure 3 Structure 4
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 gNo
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
❑NA El NE
Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
10No
�No
[I NA
El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
ElYes
/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
0"'No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑Evidence of Wind Drift ElApplication Outside of Arew ��� %
12. Crop type(s) (� C/1)A [ 1�A4�� (r�FFT}_ 5•6 (&46e544�) �1� Ct�f}?-� C�� % W- `�'�-�•
13. Soil type(s) /Ae'6 , A-0
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
[I NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
El /�No
❑ NA
[INE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes 9 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
ElYes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes] No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations oranyyother comments.
Use drawings of facility to better explain situations. (use additional pagesas necessary):
Z=' e-C /ve'c'qg5o Foe G FZe ems:AL
0.
- �.� � S�
G_�•� Gorr �c,� ���� ,
Reviewer/Inspector Name �% ^� Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection ZS O
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �Q No ❑ NA El NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes eNo ❑ 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. yJ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste/Transfers ❑ Annual Certification
❑ Rainfall eStocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes Z No
Xyes
Yes'10No
ElNo
❑ Yes No
ElYes X �No
❑ YeslFfNo
❑ NA ❑ NE
El NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[I NA El NE
❑ Yes
jQ No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
IgNo
❑ NA
❑ NE
❑ Yes
'P'No
❑ NA
❑ NE
❑ Yes �7No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes If I
No ❑ NA ❑ NE
Additional Comments and/or Drawings:
/V
7,o
�� �
1N
ls'0014-49
4) 35-0-2_e9&_)
Page 3 of 3 12128104

_;t.
IType of Visit OrCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Wi G Arrival Time: Departure Time: r Z� County:
Farm Name: C/—\,kf \ A I _ �11ARci\S Owner Email:
Owner Name: \� DtJt�zL�C�JZ�d��lY��'� Phone: _
Mailing Address:
Physical Address:
Facility Contact: Title:
�
Onsite Representative: _ y� �EyZrj Z"QA'n_ftn)_
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
Integrator:
Phone No: _
71- �_ �
Operator Certification Number:
Back-up Certification Number:
Region: 14e
Latitude: [ c 0 [= Longitude: = o = S
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
- - ��-,— ❑ Nan -La ex -
Other
❑ Other - - - --
Dry Poultry
❑
Layers
❑
Non -Layers
❑
Pullets
❑
Turkeys
❑
Turkey Pou Its
❑
Other
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
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?
E
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 9 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
O No
❑ NA
❑ NE
❑ Yes ZNo - ❑ NA ❑ NE
12128104 Continued

.41,
. \1
Facility Number: Date of Inspection
117/
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?
StruNA
� Structure 2� Structure 3 Structure 4
Identifier: 10�/'L
Spillway?: f .�1�4
Designed Freeboard (in): ?, 5
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes ONo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
El Yes ANo ❑NA [I NE
El Yes ;MNo El NA El NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 71 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes VNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes )dNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes XNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below, ❑ Yes XNo ❑ 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 Wi Jow ❑//1widence of Wind
%D�rifl/ ElApplicat' n Outside of Area
12. Crop type(s) �i�iQjJ'Idfj/g l y� � / � �[!� /t�S ` � �!/ i f •
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 7No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination: ❑ Yes �INo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes LdNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes XNo ❑ NA ❑ NE
Irmetsjrefer�to question # Explamtatiy YES answers'and/oranyrecomm ndationor anmenings1bFfacility to better egplam situations ;(use addlhanal pages as3neccessary
ff%f-f© yi✓r- v.✓ n r ,r1%� �� �ucL ��G
,e4✓.o
Reviewer/Inspector Name a Phone: l6"`
Reviewer/Inspector Signature: Date:
12128104 Continued

}
l~aeilityTiumber: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ,M No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes /" No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
XNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ONo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
VNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ZNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
VNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
/No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
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
VNo
❑ NA
ElNE
General Permit? (ie/ discharge, freeboard problems, over application)
/
32. Did Reviewer/Inspector fail to discuss reviewhrispection with an on -site representative?
❑ Yes
JXNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additionsl=Comments and/or°lJrawings:
. Nr,_C/ZA� ,
12129104

1
(Type of Visit O'Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit outine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number l Date of Visit: S d Tune:
Q Not Operational G Below Threshold
�ermitted,0"Cerfified 13 Conditionally Certified © Registered Date Last Operated or Above Threshold: ....... ........
FarmName: T {(. .cYN. s......................................................... County: 7C Y1 ..» .».. _.... .._.._ ..... .
Owner Name: -----• ........................_....._........ Phone No:
Matting Address:..- ... — - — _ .�.
FacilityContact: ..................................... ... ........... ................ Title: ... ............................................. ......... Phone No:...._.._..........�..�.....�.._..........
Uj%
Onsite Representative: ..klej ta..• Integrator:
Certified Operator:._......._ .................. .._ .. ._ .� _.................. Operator Certification Number: ..+... .....................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 " Longitude �' �4 "
Discharges & Stream Impacts
I- 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)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ...... . ............................. .... ....... •-................. ......... ................. ..........
Freeboard (inches): 3
r
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes J314o
❑ Yes „EOo
❑ Yes 0'Tq-o
Structure 6
12112103 Continued

Facility Number: — Date of Inspection
5 Are Are any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yeso
seepage, etc.)
6_ Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
MKo
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 maintenancelimprovement?
Yes
190
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes
eNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
2INo
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
. <a
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
❑'Ro
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload Frozen Ground ❑ Copper and/or Zinc
/❑%
12. Crop type , /� rJSi 4-6 f LO-9_
/� l
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
.ENO
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
Rr<o
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?
-jales
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes L2�Ko
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes .E tVo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ,0 No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes El No
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 J2Mo
Air Quality representative immediately.
Jse nr wmzs!ottacmty to !better expi" srmaaons tuse acmtconsu pages as necessary') 'vi ❑ Feld Copy ElFinal Notes
-7) reu _ �te� eCo dell afee.S ",n sp60,tPa
� e
!� 'TJ QQ5G Core �'1�� � �-�s ��i ml n��e- � je-
J
j Y: -Be6 My C10\ 5Q fad -71-e
- �ecor�s Ck fe a- acdef1\
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
12112103 Continued

Facility Number: �� Date of Inspection
Reouired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
BNo
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
H'io
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
PKo
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
,8 No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
[moo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
Yes
(ie/ discharge, freeboard problems, over application)
❑
plmo
27. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
12'fTo
28. Does facility require a follow-up visit by same agency?
❑ Yes
O'go
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ATNo
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) IEKyes ❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Rio
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0<0
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes O No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ONO
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ;2 1Ro
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0 No violations or deficiencies were noted during this visit, You will receive no further correspondence about this visit.
3S) fl-eot o 't ram--e,r
- Tran.s-Cer
_FdrV'V_
-MaG'-)-0LWn reccJ6ds
Crop yield
�'e co (' ca 5 C
n se c koY�
)eased lqv,J)
12112103

F
Type of Visit 0 Compliance Inspection 0 Operation Review goon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Date of Visit: ENt
ime:=Facility Number �erational 0 Below Threshold
0 Permitted C] Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: a /"r;n _ County: 01443 11��-
,
Owner Name: O M l h - e o Ja r/K4 r, Phone No: v
Mailing Address:
Facility Contact:
Onsite Representative:
Title:
Integrator:
Phone No:
Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ram` 6 " Longitude 0 6 ff
Design Current .. Design Current Design Current
Swine Ca aci P,o �Wation Poultr,:y. Ca aci P,o elation Cattle Ga aci Po elation
❑ W to Feeder ❑ Layer ❑ Dairy I
eeder to Finish Non -La er t ❑Non-Dai
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ La oon Area ❑ S ra Field Area
Holding Ponds 1 Solid Traps ❑ No Li uid Waste Management 5vstem
Discharges & Stream Impacts
I- 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 S Cturel Structure 3 Structure 4 Structure 5 Structure 6
rl C
Identifier: J
Freeboard (inches):
05103101 Continued

Y
• Facility Dumber_ Z Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
yes
❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
El Yes
El No
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
S. Does any pan 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 Almlication
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
I2. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Re-quired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
El Yes
❑ No
=: l & Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ I UP, 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 noti& regional DWQ of emergency situations as required by General Permit?
(iel discharge. freeboard problems. over application)
❑ Yes
❑ No
23. Did Reviewer/Inspector fail to discuss reviewiinspection 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
0 No voolations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
w . ..... �,... ems,...,=..�
iromments'{fefer to gaestaoa �.=Eip7aut.any YFS answers gnd/or.-atty'treroa3me�da�oas or��v other comaxenis: --F�.
w
Use.drawin of facih to better explain sat-iikW.(use addstiozW pages as n r Copy ❑ Final Notes
ty irurl
Field
W,
- 1749 4-41
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: qltza
05/03/01 ' Continued

Type of Visit /0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for VisitRoutine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number ! Date of Visit: Time:
Not erational 0 Below Threshold
0 Permitted ©Certified 0 Conditionally Certified ©Registered Date Last OperatOMP41ZI/V
r Above Threshold:
Farm Name: _ . R R to A 0 QrAft [i1's County:
Owner Name: O -'T- D( KEUr_'7,J ;:!��PINAd Phone No:
Mailing Address:
Facility Contact: Title: - phone No:
�J � 002E
Onsite Representative- �m[R� E � Integrator: jr 6E
Certified Operator: Operator Certification Number:
Location of Farm:
Nuanaber of Lagoons �f �iJ Subsurface Drains Present _� ❑ Lagoon Area ❑ Spray Field Area
Holdyrtg f'oAds% Sohd Traps a -� ` ❑ No Liquid Waste Management System
Discharbes &- 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 ko
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes PNo
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ,ZfNo
Structure I StrilctuTe 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
05103101 Continued

Facility Number:3 1 —
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
.8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Analication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN E2 Hydrauliq Overload
12. Crop type
13. Do the receiving crops differ with those designated in the C rti
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 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 fo No
❑ Yes 56 No
❑ Yes VIN0
❑ Yes 9 No
❑ Yes IVNo
❑ Yes No
❑ YSs No
U Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes ONO
❑ Yes No
❑ Yes No
❑ Yes VNo
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes 9 N1
❑ Yes ONO
❑ Yes �No
❑ Yes VNO
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
Comments (refer to"question #) =Explain anyVES.attswers`and/Or any recommentiatlaa5`nr any uthercommerits.`
Use dra""ings of fai:i"litr to better explain:setuationi: (nse additional'pages as aecessarv) - £ - T '0. _
-. -.�� � Field Copv �❑Final Notes
lS �p�nE �A4L��� �i�'E� v�JPRat- �✓f�'O�'p �^r��m</Ds} `�✓
Sr�i4 yFzF�O r
Reviewerllnspector Name -., el -le F -
Reviewer/Inspector Signature: Date:
05103101 V Continued

Facility Number: — 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 ❑ 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, ElYes 9No
roads. building structure, and/or public property)
29. Is the land application spray system intake not 16cated 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 A No
31. Do the animals feed storage bins fail to have appropriate cover.) ❑ Yes X No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ElYes ❑ No
Additional' Coinihents'and/orDr.2wings:
F-46PAAW ACA DZ - J OW �5//2/0 2, U45 472-467
U45 �Z " ���� /No Al �� z G4-720A)
AP,-OEg2 13e- /49repqizsr
F-%,Drn PS F- r Q [)g F.�1 S ��v�crAr\A�v CJs
&-r GU6"r* rRO�E60Ar O
1b LAG-:�N ��52G-�✓ ��G,�ECKFip,
r
No
M.,
05103101

Type of Visit Compliance inspection Q Operation Review O Lagoon Evaluation
V
Reason for Visit , Routine O Complaint. O Fonow up O Emergency Notification Q Other ❑ Denied Access
Facility Number 3 Date of Visit:
0 Permitted 0 Certified 13 Conditionally Certified 13 Registered
Farm Name: "e '�'"� �'�]]/�S
Owner Name: (�,a°.'�'",l� � l�LV rl � /'✓+'�q "'
............ ..................... ..... r.........................................................
Facility Contact: .............................................................................. Title:
Time:
Not Operational O Below Threshold
Date Last Operated or Above Threshold: ..............
County: ... U_ .'...
PhoneNo: ........................ . .............................. . . . .._-
Phone No: . ................ . . . ........ . . . . .
MailingAddress: ............................................................................................................................. ...... _
G� V , f � Integrator: r :! rh s�Gf h 4 ✓
Onsite Representative: ....................---�.�-----•--------......................................................... g �.k..........L!......................�
Certified Operator: ........... _................................................................................................... Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
Design Current -
Wean to Feeder
Weeder to Finish
`' Z
❑ Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
Gilts
Boars
s ` Subsurface Drains Present ❑ Lagoon Area . ©S Spray Field Area
Number of Lagoons ❑ P Y -,
$olduig Ponds /Solid Traps, -. ❑ No Liquid Waste Management System
- - .
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes WNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ANo
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ONo
c. If discharge is observed, what is the estimated flow in gaUmin? / r^
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 j2wo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes .0%
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier. ....R �7- ...................................................................................................................................................................................................................
Freeboard (inches): 37
5100 Continued on hack

Facility Number: 3 Date of Inspection
5. Are -there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes o
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes Po
(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 E�No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes 'JZ(No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes Xj No
_Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes _E No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload r� ❑ Yes _Jallo
12. Crop type J6&rVnVAe, rta'1) S 01 4,-0."V1, J!?er✓hvdpi p.s4„rL9 , �SGve ��5�[!>"e
13.
Do the receiving crops differ with 'those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes ,EfNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes'Q'No
b) Does the facility need a wettable acre determination?
❑ Ye 0
c) This facility is pended for a wettable acre determination?
❑ Yes'ONo
15.
Does the receiving crop need improvement?
❑ Yes C''1T0
16.
Is there a lack of adequate waste application equipment?
❑ Yes _p No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes'0No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
)3'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 J314o
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes"00
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes No
(ie/ discharge, freeboard problems, over application)
jo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes ff No
24.
Does facility require a follow-up visit by'same agency?
❑ Yes 'gNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ONo
yiQi�t itiris:o d�f clepc{e wire nQ#ed. ii0t" g thjs'vlsjt; • Y'o0 will-tee¢iye iio fufth�r.
correspondence. abotif this visit.
C.nmments (re%r to=questiott #}:; Explaw any YES answers andlot any recamre�endations ar any other camuftnts. >,
_ e
Use dra � _
e �gs_a[-[acilty to:better. ea�pla� s�tt�atio�s , (nse additional;pages as necessairy)
;.� o) wa5,4e 16rik cil 4M Flush Jo Middle hPuse• .
naed1 be P; x e f p
f �. 1l�BGQf p °�GJ-� �'^'1��c}tvtCy LtC 1+a°i �1��>OGio>✓' (0►j4ril �I<1�57 / l►� SeC�
C0,14roj G eC�l�s� MOrig1'1��1 1'LLti+tl} 2M2Qt?f SI�Qc Ih �P p�llf.
/1 tJeeA 4e hqvc w4s4e le- �4kch oil q rouj,'I) bAs;d s-04
he ve 04 W"4e Qh c, J, J p�6ded fd-A y M dayya �1!�
Reviewer/Inspector Name d
Reviewer/Inspector Signature: , Date: of s/pp

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 JzrYes ❑ 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,.IdNo
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes-4!fNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ YesO'Na
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 _Z'No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes fno
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Yes ❑ No
Addition2l Comments an or ravings:
1q. (r'-fPtO /)e'--4 40 GLtwvT 44e QGre L -o✓ r0j �G-�✓�ow, s_ 7 gGres
Z. To 92 ;-1 Gdr-L)Q V4t,,- ,
TG,e f a c� ooh ®F
eG(es�r9c�,f 6L, Ir ep( F� ec6aa►�[ s
��O ted -r( 4ta, �X�h�;4 joo►, aPid oriq�.�g1 jq�tDo�
resPec4i✓e17'-\/00 /teed �0 Con.5014 W,44 your J�,n►cal f✓ �,�l�s�
46 Ve/IC'yA TP -4 4FV i.l Very -Fred �Aei, ofrq-le -s ysc�
(T�4er~lN4Se° moLke vteGessgr� C�Iat'LgeS�q wtcnd'�IG✓l�S to de,s;9hs a.hd
-Ae 6e.,-. V'd A rGsc„e4 bQA-J, OeV Well key. I Ae Rre& q.1o44nd
the h owrS ajiol A-e lcjoo►? S are t cell kell.
5100

-_W.
1 Tl
,:
ins io n of Water Q ty
w �
,
x
D ion of Stsii and stet Conservation
ins.
t�Other'Agency f
�
Type of Visit %k Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit ?& Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number = Date of Visit: V'a —GCJ Time: GQ Printed on: 7/21/2000
Q Not Operational Q Below 'Threshold
�ermritted © Certified (3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: �C^`r' ... County: .....
.�l.•...
Owner Name:
Phone No:
Facility Contact:.............................................................................. Title:.............. Phone No:
MailingAddress: .... ............................................................... ........................... .................... ..................................................................................... ..........................
Onsite Representative: Integrator: ...... t.G oi'"&
......................................................................................
Certified Operator:......, ... Operator Certification Number:
Location of Farm:
IT
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• ��
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder JE1 Layer ❑ Dairy
Feeder to Finish r)a ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder JE1 Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Im acts
1. is any discharge observed from any part of the operation? ❑ Yes NNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. II' discharge is observed, was the conveyance mall -made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State" (if yes, notify DWQ) ❑Yes ❑ No
c. Ii' discharge is observed. what is the estimated flow in gal/tnin?
d. Does discharge bypass a lagoon system? (If yes, notify DW'Q) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes D(No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes DZINo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes P(No
Str turc I Structure 2 Structure ? Structure 4 Structure 5 Structure 6
Identifier: ............. �'.�.............. ......... .;w ............. ................................... .................................... .................. ._1............. ....................... .............
Freeboard (inches): a I
5100
Continued on back

FacilityNPmber:'3i —T13L Date of Inspection Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, El 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 b(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
A"'No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes
_kNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
J'No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
_tJ No
11. Is there evidence of over ap lication? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
�(No
]
12. Crop type C SG ! �� SCA
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
9No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
M No
b) Does the facility need a wettable acre determination?
❑ Yes
qNo
c) This facility is pended for a wettable acre determination?
❑ Yes
C&No
15. Does the receiving crop need improvement?
❑ Yes
Nf No .
16. Is there a lack of adequate waste application equipment?
❑ Yes
Z No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
tKNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes
9No
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
ji�No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
C 'No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
gNo
22. Fait to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems, over application) ❑ Yes (;A
No
23. Did ReviewerAnspector fail to discuss review/inspection with on -site representative'? ❑ Yes M No
24. Does facility require a follow-up visit by same agency'? El Yes ��No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 1 No
�: Rio violaf}otis:or deficiert:*9 mere h6 ea during this:visiC. • you will •ireee ,06 rio futther •
�carreso oTidence: 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):
tX44e
U-e � A - •� al lG � G d` A
Reviewerfinspector Name �� �� � GftQ -- 5 —yjCIQ aac
Reviewer/Inspector Signature: Date: b —' H--EIJ 5100

lfa�ilityNumber: 31 — Date of Inspection � Printed
on: 7/21/2000
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor below
Kyes
❑ 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
28.
Is there any evidence of wind drift during land application? (i_e, residue on neighboring vegetation, asphalt,
❑ Yes
o
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
o
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 peimanent/temporary cover?
❑ Yes
!� No
Additional:Comments: and/orDrawings:
J
5/00

Division of Soi14 d Water Conservation -Operation=Review ,
`.[3.Divisaon of Soil and WaterConservation - Compliance Inspection
Dwtsion of -Water Quality`=Compliance Inspection _
- Other�_Agency-.Qperation.Review k
jQh Routine 0 Complaint 0 Follww-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number 43
Date of Inspection
lime of Inspection 1 124 hr. (hh:mm)
Permitted 10 Certified © Conditionally Certified [3 Registered JE3 Not O erational Date Last Operated:
Farm Name: ................ 00. hfl4kl...... �!�5.................................................. County: lien.............................. .
`...... p ,J
Owner Name:...«tiV�1111S-.Y...Ii.W�i�4�........�l�seli!I!QVa.L...................................... Phone No: �11 .� �-�.0.. 3.� .Y .....................
............................
Facility Contact . ............................................... ........... I ........... I....... Title:...................... J I Phone No:
MailingAddress: ...... Po .... &Q,....a. �............... .............................. .. ....... ....&y14.V.}.�.!�(..t.rj.G............................................. .2�Nr.......
......
Onsite Representative: ...... ...Lw n.......�IGY.ItC�tk........................................................ Integrator:..... 4�W A................................. .................
Certified Operator:..... tQ,......W,............."......................................... Operator Certification Number....................
Location of Farm: _
Q4� ......sib..-.4. �?.5.. :. ...r�s. sos�.........-.9.....-59�...�� �................................................................. �1 .................. t...
.................................................................................................................................................
Latitude •& :4 Longitude �`
Design Current
Swine Capacity Population
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer 10 Non -Dairy
❑ Other
Total Design Capacity
Total SSL W
Number of Lagoons JE1 Subsurface Drains PresenElEl 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 (If yes, notify DWQ)? ❑ Yes bg No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes km No
I), if discharge is observed, did it reach: ❑ Surface Waters ❑ Waters of the State ❑ Yes No
c. If dischar-e is observed. what is the estimated ]low in Val/tnin?
d. Does discharge bypass a lagoon system? ❑ Yes J No
2. Is there evidence of past discharge from any part of the operation'? ❑ Yes [P No
3. Were there any 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? ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 II
Identifier: m l '� Z
Freeboard (inches) : .............ZU
............................................ ................................... .................................... .................................... ....................................
1/6/99 Continued on back

gf"cili>,yr Number: 3 ( f32 Fate of Inspection
-5. -Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes &No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes D9 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 maintenancelimprovement? ❑ Yes 0 No
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings? ❑ Yes j�?No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes JM No
H. Is there evidence of -over application? ❑ Polnding ❑ Nitrogen j I ❑ Yes IN No
12. Crop type.YYri.V.t1(t............. ...51.....t►............... Y.�....GuV.Ilf...........5(iljlLLur-..........................................................
B. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. Does the facility lack wettable acreage for land application? (footprint) Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes No
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21,
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
22.
Fail to notify regional'DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
[� No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
14 No
24.
Does facility require a follow-up visit by same agency'?
❑ Yes
0 No
13.
Nn.violation3:Or. deCcienrie-s .were noted d'urin'g.ttiis.visit:. V6u'-AI.rereive na ftirtiier....
correspofideftee; a;botit; this viset.; ; ; :: ; ; ; ; ...; ; ...; ; ; ; :: ; ;
Comments (refer to.question #): Explain any YES answers and/or any recommendations or any.other comments
Use drawirigs`of facility to better explain situations. (use additional pages as necessary):
-7. Urc- att,(,i on (tv Qilli, wktt o� 1n�oor, RS1 S6,0 6 lreset^Wi EYos;or` c.
vh bilL Wall of �41 Ll ,uycei(X. skoolo 6e PO + Hucaea.
it. L.eoe� "ee e_ SV\Wq IAe J�,3 �o0t� Of - WO? 4-o 6e OtCCa*id 1 ie, &(Tct
"L • -
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 11/6/99

1
i
F
a?'` .. -�' .. dHm:�ti?o"' Fes:-'s'::s,M. ,:.-;.r:;s` :,: :,;:ws:re>:r� '�`" 1.:; �✓-' 'a
Division o€Soil and Water Conservation 0 Other Agency s'
.�� �k� Division o€ Water Quality � _
Routine O Complaint O Follow-u of DWQ ins c•ction O Follow-up of DSWC review O Other
Date of Inspection MJ
Facility Number _
Time of Inspection 3Q0 24 hr. (hh:mm)
© Registered [3 Certified Pf Applied for Permit 0 Permitted U Not 22erationai Date Last Operated:....
......................
FarnaName:..q`�ti--- ................................................. ...... County:..................''...................................................
Phone No: { d. / n
Owner Name:........G.!.:�!!��....................................................... - • ... �. `.......�....�b.,.1.U.................
FacilityContact:..I.�.......................................................................... Title:..........................
Mailing Address:.........................�---.a.....�J
Onsite Representative:..1 .............c sll ��........---........----
Certified Operator. .................................
Phone No:
.................................................................................. ... I......................
Integrator: ..... Vbc, ....................... I ... .......
Operator Certification Number: .........................................
Location of arm• p
. ...... ....o.a........ ... - .t.. -............................................................................................................................................................................
Latitude =0=' 0" Longitude =' 06 0"
AS'kXiestgn CurrentW , Design ,Current Design ;Current
Svvtne ':k Capacity PopuLataon , Poultry Capacity Population 'Cattle * Capacity Popetlation'
❑ Wean to Feeder
❑ Layer
❑Dairy
Feeder to Finish
Z�
❑ Non -Layer I
JE1 Nan -Dairy
❑ Farrow to Wean
❑Farrow to Feeder
❑ Other
` QQ
❑ Farrow to Finish
a
Total Design Capacity
❑ Gilts
Total 5SL W
❑ Boars
r W
Number of Lagoons /Hotdrag bonds`
❑ Subsurface Drains Present
110 Lagoon Area
ID Spray Field Area
n r= -
s: ❑ No Liquid Waste Management System
k
F
(General
1. Are there any buffers that need maintenancelimprovement?
❑ Yes
M No
2. Is any discharge observed from any part of the operation?
❑ Yes
lK No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
A No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yeesi
I[ No
c. If discharge is observed, what is the estimated flow in gaUmin?
1�
d. Does discharge bypass a lagoon system? Of yes, notify DWQ)
❑ Yes
XNo
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
M(No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
M No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
�]No
7/25/97

J" Facility Number.-3 —
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes CKNo
Structures (Laeoons.Holdine Ponds. Flush Pits. etc.
9. is storage capacity (freeboard plus storm storage) less than adequate? Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Id-
............. ....................................................................... ................................... ...................................
Freeboard (ft): .......... �.x.3........................... �1...!................
10. Is seepage observed from any of the structures? ❑ Yes 0 No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes 19 No
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 eptering waters of the State, notify DWQ)
15. Crop type ...... j ��.f....�..\.� QJ......1.1n1rn................................................I—...........................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
❑: No.viWaitions_o' deficiencies: we re noted;duiitig this:visit: You;will i•ecei've.no_ftirtlier, :;
:.�correspQudegceaboufthis:visit:•:•:•:::-:••: : ::-. :-: .•�•.••:•:-:-::.�•:•:•:•:. :-. :•:
MYes ❑ No
❑ Yes a No
❑ Yes ❑,'No
❑ Yes KNo
❑ Yes "No
❑ Yes RNo
❑ Yes CKNo
❑ Yes $4 No
❑ Yes HNo
❑ Yes 9No
❑ Yes KNo
❑ Yes gNo
❑ Yes JM No
�1
ly Lt
y•s
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:

........... ............ ........... .... ....._.... ........_ ... ....... .............
❑ DSWC Animal Feedlot Operation Review
® DWQ Animal Feedlot Operation Site Inspection
® Routine 0 Complaint 0 Follow-up of DWO inspection 0 Follow-up of DSWC review 0 Other
[��Facility Number
Date of Inspection
Z
Time of Inspection 0 24 hr. (hh:mm)
© Registered C1 Certified [3 Applied for Permit ❑ Permitted 0 Not Operational Date Last Operated:..........................
{
Farm Name: �4r1k.4......t)f��aax�.......................... .......... Cotinty:........�? ir...............................................................
..........
Owner Name: •............t+eV11LIc!.0 ....... Atf;Raru^------- I ..................... Phone No:
Jec�Eley rsat. m� Z4g- 241
Facility Contact: �nhir........ 1,�Ot,r- ---... ... Title: 6Wru✓ ...... Phone No: nLP).A :-vq.4.. .
MailingAddress :.......... ?.o.....n.&A...... �k......................................................................... ..�Ku[I�.Y.��.�......�...I1�.{.,r....................,................... ...7$�i.g........
(?nsite Representative. -.-....VIM, f C ....�14�![7htre� ..................... .............................. lntegratilr:--......bakIOA�...... ....................................................
Certified Operator; ............................... ............ Operator Certification Number,....... //:, •,- ..
Location of Farm:
+.a.► � .....«Hr� .......i ......W. br....... yin tx3n...... ...c�i_.- .... L ........Dh.........K...1200- t.... j&.N...... e. cn.............1...I
s..... ...mi Cs....e ....-tom ...... ;.�.�-...�..le.h).......--..-- ..----..................................................................................................
Latitude ' 1 " Longitude • .4
Design Current
Swine Capacity Population Poultry
❑ Wean to Feeder
IN Feeder to Finish
3
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer
❑ Non -Layer
Design . Current Design, -Current.
Capacity Population Cattle Capacity, Population
❑ Dairy
❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons / Holding Ponds JE1 Subsurface Drains Present ❑ Lagoon Area I0 Spray Field Area
❑ No Liquid waste Management System
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
CA No
2. Is any discharge observed from any part of the operation?
❑ Yes
Ji No
Di:chari?e originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
�9 No
b. If discharge is observed, did it reach Surface Water" Of yes, notify DWQ)
❑ Yes
90 No
c. If discharge is observed, what is the estimated flow' in gal/min?
d. Dees discharge bypass a lagoon system'? (If yes, notify DWQ)
❑Yes
No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
No
5. Does any part of the waste management system (other than lanoons/holding ponds) require
4
❑ Yes
No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
]R No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
W No
7125197 Continued on back

Facility Number: 3 —t
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes 54 No
Structures (Lagoons,11olding Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes El No
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Structure ti
Identifier: Z
.�.... ��.................................................................................. I ........ I............. ..............-..................-.
Freeboard(ft): ................1......................................... ....
................................
10.
Is seepage observed from any of the structures?
❑ Yes
J9 No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
VI No
12.
Do any of the structures need maintenance/improvement?
54 Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
® No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
,(9No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ..... -
..... hirtv.b........................................5�-1---- .. ii.n.......---.................-----............ Sr.---....-....................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
ONo
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
�No
18.
Does the receiving crop need improvement?
❑ Yes
No
19.
Is there a lack of available waste application equipment?
❑ Yes
IXNo
20.
Does facility require a follow-up visit by same agency?
❑ Yes
P9 No
21.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
D[ No
22.
Does record keeping need improvement'?
X 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
[RNo
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Permit"
❑ Yes
[1,S No
No.violkions or. deficiencies. were: noted during this'visit.- .YO.u.wi11 receive no further
correspondence shout this:visit:•:
Cominents [refer to::question #) Explain any YES ans�°ers and/or any recommendations or and other comments.
Use drawings of facility to better explain .situations (use additional pages as necessary) _
1L. 00-,it, " 0" Wall of oyo, # i sF wid be.. �� oA , jAy Vut ec e �
� a_vw, e� mm-k- t1 0� 664-1 (o�aYtt S.ho d be pmeY)a�.
zz. 19-k!-1 Worn. svw@ be ust o 4r �a� i jyV4 r CAS .! .ale l 5•
# CtA,tl f Un "UAW. 5? COvvbcf 5WYY t ti A 6e +,_AJ ��oA. Cr-1-c�y pi~P'�n �ioa � 1fri�
4 �
7/25197
Reviewer/Inspector Name
Reviewer/Inspector Signature: V-t4 _/, A Date: