310140_INSPECTIONS_20171231

2 N
NUH I H UAHULINA
Department of Environmental Qual

I I ype 01 visit. k�j t-ompliaucc I nspecuon %,j uperation Keview %.j 3tructu re Evaitiation %_j i ecun ical ASSISTanCC
[Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: Owner Email:
Owner Name: U,rj;e7 -" Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Region:
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S"_ '' 3ii-o"aci
Wean to Finish
'I ,
PSU
La er
Layer
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1� � 11111111!1111111111111111111 t
P
w
airy Cow
D airy Calf
f
[TD
Wean to Feeder
"N)n La,
I iNon-Layer I
Feeder to Finish
airy Heifer
i fer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D It
P R611
Layers
a ers
0 e—S i E—n XC" t i ri
rp —ac i
Dry Cow
Non -Dairy
k er
Beef Stocker
Gilts
NPullets
VQTW'
Non -Layers
Turkey Poults
Other
-7
Beef Feeder
I
Beef Brood Cow
Boars
e
Other
ITurkeys
Discharl!es and Stream -Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field F-1 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? (tf yes, notify DWR)
2. ts 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?
D Yes Q-NG�[:] NA D NE
E] Yes [:] No 0 NA [] NE
0 Yes 0 No DNA D NE
Yes 0 No
Yes K2199D
[:)Yes F�/No
NA [:] NE
NA D NE
NA [:] NE
Page I of 3 21412015 Continued

lFacility Number: 3 4 0 =Date—ofinspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? D Yes Oa-K'o D NA DNE
a. If yes, is waste level into the structural firc�board? DYes [DNo DNA DNE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? D Yes Ej>o [—] NA D NE
(i.e.jarge trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a D Yes U,_�Ko E] 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?
D Yes
�o
NA
D NE
8. Do any of the structures lack adequate markers as required by the permit?
0 Yes
[E?&o
NA
D 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
D Yes
C),Xo
NA
D NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
D Yes
0
D NA
NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
Yes
No
[:] NA
NE
F-1 Excessive Ponding 0 Hydraulic Overload [:1 Frozen Ground Heavy Metals (Cu, Zn, etc.)
[:] PAN n PAN > 10% or 10 ibs. Total Phosphorus 0 Fai lure to I ncorporate Manure/S
ludge into Bare Soi I
F] Outside of Acceptable Crop Window D 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
R3<o
0 NA
NE
15. Does the receiving crop and/or land application site need improvement?
D Yes
R;�No
D NA
NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
D Yes
Q_No
NA
D NE
acres determination?
17. Does the facility lack adequate acreage for land application?
D Yes
[�4-No
NA
NE
18. Is there a lack of properly operating waste application equipment?
Yes
�o
NA
NE
Rgguired Records & Documents
19. Did the facility fail to have the 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
D Yes
FErNo
D NA
0 NE
the appropriate box.
EIWUP DChecklists El Design D Maps El Lease Agreements EjOther:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. E] Yes U40 [—] NA [—] NE
El Waste Application F] Weekly Freeboard 0 Waste Analysis D Soil Analysis E] Waste Transfers D Weather Code
M Rainfall D StockingEj Crop Yield D 120 Minute Inspections 0 Monthly and I " Rainfall Inspections E]Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? D Yes [gl E] NA D NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:] Yes � yNo [:] NA [:] NE
Page 2 of 3 21412015 Continued

FF a _Ci li Iff'—N u m be r: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the perrnit? E] Yes �o DNA El NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes [a-Wr D NA NE
the appropriate box(es) below.
M Failure to complete annual sludge survey F� Fai I ure to develop a POA for sludge levels
F] Non-compl iant 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 [D_bLo,— D NA N E
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Yes [:] No [Zj.NA- NE
Other Issues
29. Did the facility fail to properly dispose of dead animals with 24 hours and/6r 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-appli cation)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[:1 Application Field [:] Lagoon/Storage Pond M Other:
[:] Yes E4-W [—] NA [:] N E
[:] Yes g�No [::] NA E] NE
[-] Yes Q-Ne [:] NA D NE
C] Yes Ea No [:] NA [:] NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? E] Yes Eg-N'o NA NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? Yes jg-No NA NE
34. Does the facility require a follow-up visit by the same agency? Yes NA D NE
C-6minentsl(eefe' - ' ""' #).-,Ei01ahf any YES' ibs�Wir's 'a"n"d/or' additipfiai wv&inine"n'daUo'nk.o'r 7
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Rev iewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: C) 10 146 7, � Tq
Ll 11
Date: 1�jle)/,17
015 (

Type of Visit: OrCorn ance Inspection 0 Operation Review 0 Structure Evaluation C) Technical Assistance
Reason for Visit: (2rRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: 5,f �k ot"^r%,
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
4L@1 ire t
lUsigo U n
v' n 11N."Erpil F? MR.1-
Wl(
D co U
a I
tv P
Cb i�b____ac i P.-
W an to Finish
0 a
Layer
Dwj� Cow
an to Feeder
a n
EINon-Layer
Dairy Calf
der to Finish
eede
D� Z_
3 429
Dairy Heifer
Farrow to Wean
arro,
rlBBoars
Dry Cow
Farrow to Feeder
Farro,
-Non-Dairy
Farrow to Finish
Farro'
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
I
o
Pullets
Beef Brood Cow
Turkeys
e
Furkey Poults
her
I IMF-rOther
Discharj!es and Stream Impacts
1. Is any discharge observed from any part of the operation? Ej Yes 2r<o E] NA F] NE
Discharge originated at: E] Structure E] Application Field r_1 Other:
a. Was the conveyance man-made? [-] Yes [:] No E] NA E] NE
b, Did the discharge reach waters of the State? (If yes, notify DWR) F] Yes E] No Ej NA Ej NE
c. What is the estimated volume that reached waters of the State (gallons)?
d, Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
E] Yes
0 No
E] NA
[3 NE
C] Yes
Ear�o
NA
E] NE
[:] Yes
�?No
NA
[:] NE
Page I of 3
:L
21412015 Continued

Facility Number: t q jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes FjNo NA [-] NE
� J­
a. If yes, is waste level into the structural freeboard? D Yes E:]No DNA ONE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway9:
Designed Freeboard (in):
Observed Freeboard (in): 16
5. Are there any immediate threats to the integrity of any of the structures observed? Cj Yes Ul"No D NA 0 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 OYes O'N-o E] 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? E] Yes Np­-O NA D 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
D Yes
CJ'No Cj 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 D Hydraulic Overload 0 Frozen Ground D Heavy Metals
(Cu, Zn, etc.)
PAN M 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?
F ]Yes
Lj N 0 NA
0 NE
15. Does the receiving crop and/or land application site need improvement?
Yes
D NA
D NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
Yes
No D NA
0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
D Yes
0IN13 D NA
D. NE
18. Is there a lack of properly operating waste application equipment?
0 Yes
VNo DNA
D NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes
d No - NA
[:] NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Yes
D NA
D NE
the appropriate box.
OWUP D Checklists 0 Design 0 Maps 0 Lease Agreements 00ther:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. D Yes EdNo D NA D NE
Waste Application D Weekly Freeboard Waste Analysis DSoil Analysis D Waste Transfers D Weather Code
D Rainfall M StockingO Crop Yield E3120 Minute Inspections D Monthly and I " Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? Yes ;�No_ D NA D NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? Yes � rNo [-] NA [:] NE
Page 2 of 3 21412015 Continued

Facility Number: IDate of Inspection: 2 77.-fl (9
2,4. 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 F3"Co C] NA D 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? E] Yes D No C] NA D NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Yes D No � rNA D 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)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
0 Application Field 0 Lagoon/Storage Pond D 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 agency9
k 63 00� -
�' �. P. P�' 0 (-/
RO wc cop -5.
CYes 0--No
D Yes ONo
[] NA [:] NE
[—] NA [—] NE
D Yes U5"No [:] NA [:] NE
Yes C]"No 0 NA [:] NE
No
Yes 6�0
Yes B"No
D Yes ZrNo
DNA NE
[DNA NE
[:] NA NE
7 7s 2-1 & o�-
Reviewer/Inspector Name: Phone: 10 _130�
Reviewer/Inspector Signature: Date:
t:_—z
Page 3 of 3 21412015

Type of Visit: q C ptiance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: CrRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: yr t1k (:L U , ",_,
Certified Operator:
Title:
Phone:
Integrator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
geill
eSign uur t
Iii
111Z V—Ult,
, et
ce 95-5 c i tU
M
i � i 1i
Iiiii I
P. aci
Wean to Finish
Layer
iry Cow
Wean to Feeder
NJ
INon-Layer
I
iry Calf
1�eeder to Finish
_>Ccl 2-
airy Heifer
Farrow to Wean
�Qgsign
Dry Cow
Farrow to Feeder
it.
-a aci-
Non-Daia
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
ElBeef R--d Cow
----------
keys
key Poults
0 er
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
D—N.
Ej NA
0 NE
Discharge originated at: E] Structure E] Application Field Other:
a. Was the conveyance man-made?
E] Yes
E] No
E] NA
0 NE
b. Did the discharge reach waters of the State? (if yes, notify DWR)
E] Yes
Ej No
F] NA
0 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)
E] Yes
E] N o
0 NA
F] NE
2. Is there evidence of a past discharge from any part of the operation?
E] Yes
[nNo
E] NA
Ej NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
E] Yes
CTN o
0 NA
0 NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

IFAcility Number: Date of Inspection: _317/ (I -
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes Ef-No NA [:] NE
a. If yes, is waste level into the structural fi7eeboard? Yes [:] No NA Ej 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? El Iles [� �NoEj 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 0 Yes E3"No [:] NA 0 NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? Yes Z-No NA [:] NE
8. Do any of the structures lack adequate markers as required by the permit? 0 Yes [3"N'o NA 0 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 ErNo NA [::] NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need E] Yes DNo NA NE
maintenance or improvement?
I L Is there evidence of incorrect land application? If yes, check the appropriate box below. Yes [_rNo NA NE
[__1 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground [:] Heavy Metals (Cu, Zn, etc.)
F-1 PAN F-1 PAN > 10% or 10 lbs. Ej Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
F-1 Outside of Acceptable Crop Window [:] Evidence of Wind Drift 0 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?
E:] Yes
[Z] No
0 NA
0 NE
15. Does the receiving crop and/or land application site need improvement?
0 Yes
0 No
0 NA
0 NE
16. Did the facility fail to secure andlor operate per the irrigation design or wettable
Yes
[� �No
0 NA
0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
Yes
Ej No
0 NA
0 NE
18. Is there a lack of properly operating waste application equipment?
0 Yes
E;�Ko'
0 NA
0 NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
0 Yes
En"�M-
0 NA
0 NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
0 Yes
�(No
0 NA
0 NE
the appropriate box.
OWUP El Checklists []Design [:]maps 0 Lease Agreements 0 Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes 0 NA [—] NE
n Waste Application OWeekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
n Rainfall 0 Stocking [] Crop Yield El 120 Minute Inspections 0 Monthly and V Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes �� [] NA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes rNo 0 NA 0 NE
Page 2 of 3 21412015 Continued

lFaci14 Number: JDate of Inspection: -?I( T
24. Did the facility fail to calibrate waste application equipment as required by the permit? D Yes [�J`No [:] NA D NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes [3-<o E] NA D NE
the appropriate box(es) below.
Fj Failure to complete annual sludge survey Failure to develop a POA for sludge levels
0 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? 0 Yes FNo DNA D NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? 0 Yes D No Q-NA [:] NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 0 Yes D-No 0 NA ONE
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?
0 Yes
EJ-K-o—
D NA
D 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
E] Yes
CJ—No
D NA
0 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
Ej^_No
[:] NA
[:] NE
0 Application Field D Lagoort/Storage Pond F1 Other:
32, Were any additional problems noted which cause non-compliance of the permit or CAWMP?
0 Yes
E3"No
D NA
D NE
33. Did the Reviewerlinspector fail to discuss review/inspection with an on -site representative?
E] Yes
D'_N_(o
0 NA
D NE
34. Does the facility require a follow-up visit by the same agency?
D Yes
�YNo[:] NA
[:] NE
MCV1CWCr/1n5peC1UT Narrle-, rnone� �[_' I I t I -ICIT
Reviewer/inspector Signature: Date: 3 � L
Page 3 of 3 21412015

Type of Visit: NbUiptiance Inspection 0 Operation Review C) Structure Evaluation 0 Technical Assistance
Reason for Visit: )�Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time:EEZ�__]County Region:
Farm Name: Owner Email:
OwnerName:. )eLqA 1. Q"I)v/y Phone:
MailingAddress: Jf>L2 U._� MrSAT-NGL-,� L.W LL�-)A(V�AW:�/VC
Physical Address:
Facility Contact:
Onsite Representative:
Title:
Certified Operator: QkAjN1v
Back-up Operator:
Location of Farm:
Phone:
InI 5ato :
Ll
Certification Number
Certification Number:
Latitude: Longitude:
ine P R
Mici
Wean to Finish I ILayer
Dairy Cow
t
Wean to Feeder
I lNon-lay
Sr
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to inish
si
i
ILayers
Dairy Heifer
Dry Cow _ _
Non -Dairy
Beef Stocker
Beef Feeder
Gilts
Non -Layers
Boars
Pullets
urkeys
key Poults
Other
I I ___]
113cef 13T00d COW
F
761her
Dischames and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: [I Structure E] 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 �4 No [:] NA [] NE
[:]Yes E] No E] NA E3NE
E] Yes []No E3NA [:] NE
[:]Yes [:]No E] NA NE
Yes No NA NE
Yes No NA NE
Page I of 3 21412014 Condnued

lFacility,Number: 73 j - I Date of Inspection: 173 1) tj
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes No 0 NA 0 NE
a. If yes, is waste level into the structural freeboard? Yes No [:] NA 0 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 obsmed? Yes No 0 NA 0 NE
(i.e., large trees, severe erosion, seepage, etc.) P
6. Are there structures on -site which are not properly addressed and/or managed through a 0 Yes No E] NA 0 NE
waste management or closure plan? 'A a
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? [:] Yes No [:] NA [:] NE
8. Do any of the structures lack adequate markers as required by the permit? 0 Yes No E:] NA ONE
(not applicable to roofed pits, dry stacks, and/or wet stacks) A
9. Does any part of the waste management system other than the waste structures require Yes No [:] NA [:] NE
maintenance or improvement? t�
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need Yes No [:] NA [:] NE
maintenance or improvement? P�
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] Yes No [:] NA
Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground [:] Heavy Metals (Cu, Zn, et),)�_
PAN M PAN> 10% or 10 lbs. Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s):
0 NE
-> Z'
LN WAW,
13. Soil Type(s): ("_ nLz S eo�Lo
14. Do the receiving crops differ from those designated in the CAVRVIP? Yes No 0 NA ONE
15. Does the receiving crop and/or land application site need improvement? OYes No 0 NA 0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable Yes No ONA 0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
0 Yes
V No
0 NA
NE
18. Is there a lack of properly operating waste application equipment?
Yes
NA
NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes
No
NA
NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Yes
0 No
0 NA
0 NE
the appropriate box.
EE]WUP OChecklists E] Design E] Maps 0 Lease Agreements
OOther:
21. Does record keeping need improvement? If yes, check the appropriate box below.
[:3 Yes
DQ No
NA
0 NE
El Waste Application [] Weekly Freeboard E] Waste Analysis E] Soil Analysis
0 Waste Transfers
Weather
Code
Fj Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections E] Monthly and I " Rainfall Inspections
Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
0 Yes
9 No
0 NA
ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
0 Yes
XNo
0 NA
0 NE
Page 2 of 3
21412014 Continued

FftiHty Number: 3 ) - J�Llo I Date of Inspection: 11
24, Did the facility fail to calibrate waste application equipment as required by the permit? Yes No [—] NA C:] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check D Yes No DNA D NE
the appropriate box(es) below.
DFailure to complete annual sludge survey Failure to develop a POA for sludge levels
F-1 Non -compliant sludge levels in any lagoon
List structurc(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? Yes No NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Yes No NA NE
Other Issues
28, Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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-appitication)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field EDLagoon/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
D Yes No
D Yes NO
Yes N No
Yes j;P No
Yes Dt No
D NA E] NE
[:] NA [-] NE
DNA [:] NE
D NA [:] NE
NA NE
NA NE
[:INA NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (Use additional pages as necessary).
GO - A -
S)OIJIL4 .':1 __�
),3 �
.54
SO,L_ S,,_,�ILG I '�)IHJ)3
C,L_'Z>6C- SLA�L U C
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date,
Z44M14

II ype oT visit: 'V Uompliance trispectio n . u tiperation Keview u Ntructure j!'valuation f,_j JL ecrimeal Assislance
Reason for Visit: JeRoutine 0 complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: �� County:
Farm Name: -T a Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone:
Onsite Representative:
Certified Operator: _% _e;4\ _Tur n�A - QIILC� - - - - - - -
Integrator:
Certification Number:
Back-up Operator: - Certification Number:
Location of Farm:
Latitude -
Longitude:
Region: 14 &
Wean to Finish
I
slonjej-1
Ul
I JLayer
Designe:611
Kmp'op.
I
Dairy Cow
�n—t
Wean to Feeder
I INon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to inisb
F1_
gp"Tw
Layers
D-es i 2 n
a aci
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layer . s
lBeef Feeder
I
Boars—__
Pullets
'A, -fTI —nd Cniar
er JELLOth
_e s_____
ey Poults
r
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: F] Structure E] 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 Z[ No [:] NA E] NE
[3 Yes E] No NA NE
E] Yes E3No NA NE
[:]Yes [—]No
El Yes 0 No
[:]Yes PTNo
DNA NE
NA NE
NA NE
Page I of 3 21412011 Continued

lFacility-Number: sl - jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
0 Yes
Z No
0 NA
0 NE
a. If yes, is waste level into the structural freeboard?
[:]Yes
[:]No
[:] NA
NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 105 b
5. Are there any immediate threats to the integrity of any of the structures observed?
Yes
0 No
NA
NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
Yes
No
Fr
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?
0 Yes
VrNo
0 NA
NE
8. Do any of the structures lack adequate markers as required by the permit?
0 Yes
PrN.0
NA
NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
0 Yes
;allo
NA
0 NE
maintenance or improvement?
Waste AoPlication
10. Are there any required buffers, ' setbacks, or compliance alternatives that need
E] Yes
0 No
NA
0 NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
OYes
RTNo
[DNA
ONE
0 Excessive Ponding 0 Hydraulic Overload [:] Frozen Ground [:] Heavy Metals (Cu, Zn, etc.)
M PAN F1 PAN > 10% or 10 lbs. Total Phosphorus 0 Failure to Incorporate Manure/Sludge
into
Bare Soil
n Outside of Acceptable Crop Window Evidence of Wind Drift 0 Application
Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14, Do the receiving crops differ from those designated in the CAWMP?
0 Yes
No
0 NA
[:] NE
15. Does the receiving crop and/or land application site need improvement?
[:] Yes
No
[:] NA
0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
0 Yes
No
0 NA
0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
Yes
ONo
NA
NE
18. Is there a lack of properly operating waste application equipment?
Yes
C?fNo
NA
NE
Required Records & Documents
19, Did the facility fail to have the Certificate of Coverage & Pen -nit readily available?
Yes
No
NA
NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Yes
KNo
NA
NE
the appropriate box.
[:] WUP [:]Checklists ODesign Ej Maps 0 Lease Agreements 00ther:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:] Yes No
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis E] Soil Analysis [:]Waste Tr rnsfers
F-1 Rainfall [:] Stocking 0 Crop Yield 0 120 Minute Inspections E] Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? Yes 9�rNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? E]Yes �fNo
[—] NA 0 NE
E] Weather Code
Sludge Survey
NA NE
NA NE
Page 2 of 3 21412011 Continued

1�acili;yll Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes ZNo 0 NA NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes ZO'No [:] NA NE
the appropriate box(es) below.
Failure to complete annual sludge survey Failure to develop a POA for sludge levels
Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
OtherIssues
28. Did the facility fail to property 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)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
E:1 Application Field [] Lagoon/Storage Pond M 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?
0 Yes
P? No
0 NA
0 NE
0 Yes
;e No
Ej NA
0 NE
F-1 Yes
X No
0 NA
ONE
0 Yes WNo E] NA 0 NE
[:] Yes R!rNo [—] NA 0 NE
0 Yes. ;20'No [:] NA [:] NE
Yes No
Yes KNo
0 Yes 4 No
[:] NA NE
0 NA NE
[—] NA E] NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. 7_71
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name: Phone:952-AM-
Reviewer/Inspector Signature: Date: I L )� F 1-1
Page 3 of 3 21412011

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 'ARoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
C: -r L1
Onsite Representative:
Certified Operator: !Se--Tq Tgn"AW':', QWVIV
Back-up Operator:
Location of Farm:
Latitude:
Owner Email:
Phone:
Phone:
Integrator:
cz, tlqm
Cernfica Number:
Certification Number:
Longitude:
S 'jo sign
Wean to Finish
u t
OF u F r e n t
9 0 Pj
EE
!!1111 9 _n 6 Ur. r 4
Met ` ll!
L a r
%t
op
Dairy Cow
Hx
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish 3
Farrow to Wean
Farrow to Feeder
Farrow to Finish
C41,041
Etfe—sign r
D -01 r IN!
zmu
- . P
Layers
r[[Non-Layers.
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Beef Feeder
Boars
Pullets
Beef Brood Cow
0 her,
_�er
'H'Tu—rkg
urkeys
Poults
r
EJO E
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: [] Structure E3Application Field E] 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 IkNo
Yes t No
Yes 10- No
Yes No
Yes No
Yes lko
[:] NA [:] NE
NA E] NE
NA [:] NE
Ej NA NE
NA NE
NA NE
Page I of 3 21412011 Continued

Facility NtOnber: 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 fireeboard? C] Yes No DNA NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: CA6boY
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? Yes No D NA NE
(i.e., large trees, severe erosion, seepage, etc.) 10
6. Are there structures on -site which are not properly addressed and/or managed through a El Yes �0 No E] 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 environmentai 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 [:INA 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 ONo [DNA D NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need Yes No NA [:] NE
maintenance or impmvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. Yes o NA D NE
Excessive Ponding D Hydraulic Overload D Frozen Ground [:] Heavy Metals (Cu, Zn, etc?"�
PAN [-] PAN > 10% or 10 lbs. D Total Phosphorus [:] Failure to Incorporate Manure/Sludge into Bare Soil
Outside of Acceptable Crop Window Evidence of Wind Drift D Application Outside of Approved Area
(�,�77-64 v.-% t4kATI
'5fl
12.CropType(s): C-05CL-kC--(_P')
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? D Yes No D NA D NE
15. Does the receiving crop and/or land application site need improvement? D Yes No [:] NA D NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable D Yes No F] NA [-] NE
acres determination?
17. Does the facility lack adequate acreage for land application?
Yes
o
D NA
E] NE
18. Is there a lack of properly operating waste application equipment?
Yes
No
D NA
D NE
Reguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes
No
C] NA
D NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
ED Yes
No
D NA
NE
the appropriate box.
E] W­UP Checklists E] Design E] Maps D Lease Agreements
Dother:
21. Does record keeping need improvement? If yes, check the appropriate box below.
E] Yes
14 No
[:] NA
NE
El Waste Application El Weekly Freeboard El Waste Analysis E] Soil Analysis
D Nydste Transfers
E] Weather
Code
F, 1 Rainfall 0 Stocking [:] ?op Yield E] 120 Minute Inspections E] Monthly and I " Rainfall Inspections
Ej Sludge Survey
22. Did the facility fail to install and mainta in a rain gauge?
[:] Yes
No
D NA
C] NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Yes
No
D NA
D NE
Page 2 of 3
21412011 Condnued

lFacifity Nuvnber: -3_ li-10 jDate of Inspection: F_19K�
24. l5idthe facility fail to calibrate waste application equipment as required by the permit? Yes No NA F] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes No NA D NE
the appropriate box(es) below.
Failure to complete annual sludge survey Failure to develop a POA for sludge levels
Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? Yes NA NE
27, Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes [—]No NA NE
MLher 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
VNo
NA
NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
Yes
No
�K
DNA
NE
permit? (i.e., discharge, freeboard problems, over -application)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Yes
P�No
[:] NA
NE
D Application Field D Lagoon/Storage Pond DOther:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
D Yes
�(,No
D NA
D NIE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
D Yes
o
[:] NA
D NE
34. Does the facility require a follow-up visit by the same agency?
D Yes
rNo
D NA
D NE
Comments A " " -
,(refer to question #):Explain any YES, answers and/or any additionalxvcommend tions,oranyother',comments
lUsed'rawings of facility to betier,explain situations (use additional pages as necessary).
I LA--). R -
(3,914
i9'4
Reviewer/Inspector Name.
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 9
Date: 21
21412011

Wiffilo�nof W�ia=
ac, En e
Uision o
rype of visit: ?ACompliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine XComplaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
To
a Le SEE r n'
Ggfren
S 'ne @-a ci .5n.
P,
I�Ggnac P op, mc-
1�1111§IMTesig-_n
2 0-ap acitv= p.
C C=�
a .apac
Wean to Finish
D a iry Cow
Wean to Feeder
Feeder to Finish
er
TDa
D ig Calf
a
Dairy Heifer
Farrow to Wean
rr
Qesjgn Current
Dry Cow
Farrow to Feeder
P
Pop Pxu- 1 0
Non -Dairy
Farrow to Finish
Gilts
Boars
Layers
Non -Layers
Beef Stocker
Beef Feeder
Pullets
Beef Brood Cow
Turkeys
Turkey Poults
er
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Yes )� No
[:] NA
E] NE
Discharge originated at: E] Structure E3Application Field Other:
a. Was the conveyance man-made?
Ej Yes
E] No
E] NA
E] NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
E] Yes
E] No
E] 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)
ED Yes
No
F] NA
F] NE
2. Is there evidence of a past discharge from any part of the operation?
Yes
No
0 NA
NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
Yes
Ej No
E] NA
NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

JlFacillity',%Number: Date of Inspection: C?71 III
Waste Coflection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
0 Yes
N No
0 NA
0 NE
a. If yes, is waste level into the structural freeboard?
0 Yes
0 No
0 NA
0 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?
0 Yes
No
0 NA
0 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
0 NA
ONE
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 ED Yes 1XNo 0 NA NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need Yes tA No Ej NA [:] NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. P� Yes E:] No 0 NA 0 NE
14 Excessive Ponding E] Hydraulic Overload E] Frozen Ground [:] Heavy Metals (Cu, Zn, etc.)
PAN M PAN > 10% or 10 tbs. Total Phosphorus E] Failure to Incorporate Manure/Sludge into Bare Soil
Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 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?
Yes
0 No
Yes
[:]No
Yes
[:] No
Yes No
Yes No
EINA NE
[:] NA NE
0 NA 1XNE
NA NE
NA NE
Reguired Records & Documents
19, Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
0 No
[:] NA
NE
20, Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
0 No
0 NA
NE
the appropriate box.
0 W­UP OChecklists 0 Design [:] Maps 0 Lease Agreements
0 Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes
0 No
0 NA
Waste Application Weekly Freeboard Waste Analysis Soil Analysis
F] Waste Transfers
WeaA7de
ORainfall 0 Stocking 0 Crop Yield [:] 120 Minute Inspections 0 Monthly and I" Rainfal I Inspections
Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[:]Yes
[:]No
[:] NA
NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
0 Yes
0 No
E] NA
INE
Page 2 of 3
21412011 Condnued

l; acili .'Number: 3 / - J y U I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA I
NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [:]No ❑ NA NE
27. Did the facility fail to secure a phosphonis loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No ❑ NA �NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
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 0 No ❑ NA ❑ NE
t� Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA �NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes A No
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? [:]Yes [:]No
34. Does the facility require a follow-up visit by the same agency?
Yes [—]No
❑ NA
❑ NE
NA
❑ NE
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other, comments.=•. ': =
Use drawings of facility to better explain situations (use additional pages as necessary).
PmgA1()# ( A-t &S c+ �r_EUlAl iLO"�LAAIo �LG3PON061> Ta cornQC-A/A/
CA CLC.EQ 11V r H A 1 0 GLE C vJAS o fbs�2vED F -r H �q i �L �P 1v c!' CAI
U 1 H E A 0CG47l C1N �! L�/
3. A LTA -r r�A .3 c D l /voT t F PP
F HOLA e � -� �N 5j6Att r_tCAAT JAI N IN -THE NEXT
o-T�T1F1� wPS'/4 IN7a DQAj'A/ 'E AREAS.
P �
l�. SiGN1 FIcANT ?0N01A16 CA% AS a611V 7N 1�ylE AQeFl H
gt-T14f L'J STC wA S ( Nn/livr %oc�allfN � A D
c,c- o►�> pc.Ace- bIfLT A O OS1 HE -T q E ux'AS?c -Ta S (3
i f_(2-ONA_�, N i E(�tN6 017ra 4 2of3Rf•3Zu s 14Aib
15 . fr t E L� 1 g fGx i Q-E M E L �� 1• l T l S a4 (� f} S r �� C �Ir Goc.� � Q J
Cnmp4c i 1 (IN
C F
D I NC • A LA�� f3
01c_ O+D NO1 "(--bLOG To CEF0Q► PON N J4C ticN w
N1 Ak )cN�� AwPCWD1AIG N� 5TASe21I E
i
�EL-T+l 4T I -A � S Ha �N 'T 1ge QtA e-t�
uL
S7flRa t;rf� ,
C51CwA5 F} i LE 7 AN 14a (L AwA� trRoA� TN[ FAa^) SO 17 s ��4s AeROqA1fiE
33.�3�-!. tfi� - -T 14 , n1 16 dN 9 QIl1
Reviewer/inspector Name: 0 Qujyl PWtld Phone: 1/()
Reviewer/Inspector Signature: ' t Date:
Page 3 of 3 V4/20II

rype of Visit: 3�kCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
keason for Visit: 0 Routine 0 Complaint )kFollow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Emafl:
Phone:
Facility Contact: Title: Phone:
Onsite Representative: 'Se—) �+ C>') 'VAI Integrator:
Certified Operator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
-;n ur ent
r
S *ne a
V
itv, UP..
Wean to Finish
Layer
Wean to Feeder
n-Layer
Feeder to Finish
Farrow to Wean
r nt
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish—
ILayers.
I Beef Stocker
Gilts
INon-Layers
Beef Feeder
_Boars
Pullets
Beef Brood Co-,
Turkeys
Turkey Poults
er
Other
Discharges and Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure El 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?
0 Yes N No [—] NA Ej NE
Yes
E] No
[3 NA
E]NE
Yes
E] No
F] NA
0 NE
E] Yes E] No E] NA Ej NE
0 Yes No NA NE
E] Yes No NA NE
Page I of 3 21412011 Condnued

Faicility 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 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 A No E] 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 0 Yes *o E] NA 0 NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? El Yes No [] NA [:] NE
8. Do any of the structures lack adequate markers as required by the permit? E] Yes No 0 NA 0 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 IN No 0 NA [:] NE
maintenance or improvement?
Waste Awlication
10. Are there any required buffers, setbacks, or compliance alternatives that need Yes No 0 NA 0 NE
maintenance or improvement? X
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. Yes 0 No 0 NA [:] NE
Mxcessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
M PAN M PAN > 10% or 10 lbs. E:] Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
F] Outside of Acceptable Crop Window [:j Evidence of Wind Drift Ej 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?
Reouired 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.
OWUP 0 Checklists 0 Design [:] Maps [:] Lease Agreements
Yes 0 No
Yes [:]No
Yes A No
[:] NA [:] NE
[:] NA ONE
E] NA [] NE
0 Yes No 0 NA 0 NE
OYes NNo ONA ONE
[:]Yes 0 No 0 NA
[:]Yes ONo E] NA
0 Other:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. OYes 0 Nc
F� Waste Application [j Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers
F-1 Rainfall 0 StockingO Crop Yield 0 120 Minute Inspections 0 Monthly and 1 " Rainfall Inspections
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?
Page 2 of 3
Yes 0 No
Yes [:]No
NA Q NE
Weather bde
Sludge Survey
0 NA I% NE
NA NE
21412011 Condnued

JF�cility Number: jDate 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 D No NA NE
the appropriate box(es) below.
F-1 Failure to complete annual sludge survey Failure to develop a POA for sludge levels
Non -compliant sludge levels in any lagoon
List structuTe(s) and date of first survey indicating non-compliance:
26. Did the facility fait provide documentation of an actively certified operator in charge?
D Yes D No NA
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
D Yes D No [DNA 4�NE
OtherIssues
28. Did the facility fait to properly dispose of dead animals with 24 hours and/or document
Yes No NA NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
Yes No NA NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
Yes No NA NE
permit? (i.e., discharge, freeboard problems, over -application)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Yes D No NA NE
M Application Field D Lagoon/Storage Pond F] Other:
V�6
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Yes No NA D NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
D Yes
No DNA D NE
34, Does the facility require a follow-up visit by the same agency?
9-Yes No [] NA D NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other c;mments.,.-
Use,drawings of facility to better. explain situations (use additional pages as necessary).
c4 ��EUIA/ 9_GU-SL-I4AJ0 ONSITC- —jo jnC-,C-f C�JC_ jQ(3C�A-T
/V071 C:,V- 1;P0A.1[>JA16
—11447-f L..�PIR bISCOUCCab
SOAL �>Olvc:>IACI C4
-TC) '5c�-C- �VJX4
LAJOL4_6�
-I Fv"P`�
C A Al K G F U 6- L-b C(A:J
( T (_� 1ACi T- C— 5 ( (A E IV
lv6t-- 0 10 L 6 0 r- JV
i- Ac-5c!� )V&6,T'> $&O(LC- -W L-C- b
"Lt._ gC, "INS t4c� du I Al y wo U_�Cso:�.S'
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Aq I �V -Kaw 96 1.1 klel - Phone: q)(y-49('
Date:
21412011

'rype of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
.$LRoutine 0 Complaint
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: C� ��A (?- e-% Owner Email:
—I- 9lb- _jgq�
Owner Name: & L7� r4T. QA IMAI Phone: _oq&
MailingAddress: IS6 LCY MeQC)Ot-,� LAI IVC 02T32
Physical Address:
Facility Contact: Title: Phone:
Region:
Onsite Representative: se7—j I /qp/ Integrator:
oqoi �
Certified Operator: _Se-rw-Tnaww-� 04XINN Certification Number: (CNIC?(9
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
UesJgn M"urrent
es U
t ult
lon
Wo-51VU-5jeri-t.
Wean to F inish
er
Dairy Cow
Wean to F eeder
n-Layer
Dairy Calf
V
Feeder to
Feeder to Finish
Dairy Heifer
F ow to
Farrow to Wean
EF
esign -ur en
D!X Cow
Farrow to Feeder
ow to
11,611
P t aci p
'ou
Non -Dairy
Farrow to Finish
Fa ow to
Layers
Beef Stocker
Gi its
Gilts
lNon-Layers
Beef Feeder
El
I
113oars
pDry
Pullets
Be ef Brood Cow
Turkeys
11 Me EM
Turkey Poults
M
Other T_
M
Other
Discharges and Stream Impacts
t. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El 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 �No E] NA [3 NE
C] Yes E] No
E] Yes [—]No
E] NA NE
E] NA NE
Yes No NA NE
Yes No NA NE
Yes �(No NA NE
Page I of 3 21412011 Continued

[Facility Ni%mber: -3 1 jDate of Inspecdon:
Wasie Collettion & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes 0,No 0 NA NE
a. If yes, is waste level into the structural freeboard? OYcs 0 No 0 NA NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LL6604
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ED Yes No 0 NA 0 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 0 Yes No 0 NA 0 NE
waste management or closure plan? k!
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 pail of the waste management system other than the waste structures require Yes No NA NE
maintenance or improvement?
Waste ADDlication
10. Are there any required buffers, setbacks, or compliance alternatives that need E:] Yes No 0 NA NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. es No [:] NA NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Eu, Zyn, efcp.)�'_'
F-1 PAN F-1 PAN > 10% or 10 lbs. Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift [:] Application Outside of Approved Area�.�. L'*EPT
12. Crop Type(s): (�,SCJ-AC- (0) SC, ?EgZ(- MILU77 tip) Vuf (P) C,-)(W % Z_
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 property 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 No [:] NA 0 NE
Yes No 0 NA 0 NE
Yes No NA NE
Yes No NA NE
Yes No
Yes No
NA
NA
NE
NE
Yes 1A No
0 NA
0 NE
E]WUP [I Checklists E] Design E] Maps E] Lease Agreements OOther-
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes V No
Waste Application E] Weekly Freeboard 0 Waste Analysis CD Soil Analysis 0 Waste Transfers
Rainfall []Stocking 0 /op Yield 0 120 Minute Inspections E] Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? 0 Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes No
NA ONE
Weather Code
Sludge Survey
0 NA 0 NE
0 NA [:] NE
Page 2 of 3 21412011 Continued

[Facility Namber: L/ > jDate of Inspection: 1071
I 4F
24. 61d th6 Acility 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 F] Yes No [DNA NE
the appropriate box(es) below.
F-1 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 16No C-] NA E] NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Yes 1:1 No NA Ej NE
Otherlssues
28. Did the facility fail to property dispose of dead animals with 24 hours and/or document Yes 1� No F] NA E:] NE
and report mortality rates that were higher than normal? t
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)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
E] Application Field [] Lagoon/Storage Pond M Other:
E] Yes M No
Yes No
Yes No
[—] NA E] NE
[-] NA E] NE
F] NA E] NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWNIP? Yes 4 No NA NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? Yes IV No NA NE
34. Does the facility require a follow-up visit by the same agency? Yes allo NA NE
Comments (refer to question #).- Explain any YES answers and/or any additional recommendations or any other commenM�­
Use drawings of facility to better explain situations (use additional pages as necessary).
Lo. P - 1;� 1.1,5 - 4 1
16A8
,
fdJIN.
fj ef'-V� <;-� e.
Reviewer/Inspector Name:
pT
C�CNTQZL
Reviewerfinspector Signature:
Page 3 of 3
L I (.—
011 Li tq/,
Phone: qr,—_j9&r4ig-t
Date:
21412011

1�1y-igio=np ualii
QW,
g-19i 'S5il an
iv MU5 lofi�oil an ate
Type of Visit 9 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Y Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other El Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: STIQ 17-A a M Owner Email:
Owner Name: 16::-- Cit A Phone: C?16-9q(0-1Q(4
nc_�
MailingAddress: ICS(D C&:� Avc :>"3
Physical Address:
Facility Contact: — Title:
Onsite Representative: S eTw OL-4-1 "///
Certified Operator:- SF-74 7-oeaAN`� CkA/)VAI
Back-up Operator:
Location of Farm:
Phone No:
integrator: M A?>
ocvc> ,
Opera-torCertification Number: 0?9(0/
Back-up Certification Number:
Latitude: [=O =I =di Longitude: =0=6 =6L
jlle—si�@-urrent RM esi n U A en t
R-ap
si n Frentm
Foapa ul-'on W11?.o­u1LgA.K@5­Jify 115-1-
y P pat
jeitt=oation
__ple Y LAop
__ple Y LAop
__ple JLA_p2_
__ple Y LAop
ple Y LAop
ple Y LAop
ple Y LAop
-ap—c t- Pop on
FEI —Wean to Finish
JE1 Layer
El Dairy Cow
El Wean to Feeder
Non -Layer
Dairy Calf
RFeedertoFinish 1-No-4Aad n I
El Dairy Heifer
El Farrow to Wean
0 Dry Cow
El Farrow to Feeder
Q Non-Daia
1E] Farrow to Finish El Layers
0 Beef Stocker
IU
JE1 Gilts El Non -Layers
El Beef Feeder
El Boars El Pul lets
[:1 Beef Brood Coy4
El Turkeys
Turkey Poults I
I
10
El Other
Num e
Dischar2es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field El 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 (gailons)?
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 frorn a discharge?
0 Yes
)kNo
El NA
El NE
El Yes
El No
El NA
[:1 NE
0Yes
0No
EINA
EINE
E]Yes
0No
[INA
ONE
Ej Yes No El NA C1 NE
El Yes t o El NA [I NE
12178104 Continued

]Eacil1SyVumber: '75 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Ej Yes ANO [:1 NA D NE
a. If yes, is waste level into the structural freeboard? [I Yes [] No [:1 NA [] NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: C-4245�'
Spillway?:
Designed Freeboard (in): 1q. 5
Observed Freeboard (in): Li 1
5. Are there any immediate threats to the integrity of any of the structures observed? El Yes X No El NA El NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed El Yes 4No 0 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? El Yes No 0 NA 0 NE
8. Do any of the stuctures lack adequate markers as required by the permit? 0 Yes No El NA [_3 NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El Yes XNo [] NA El NE
maintenance or improvement?
Waste A00lication
10. Ar6 there any required buffers, setbacks, or compliance alternatives that need 0 Yes No El NA El NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes ANo El NA El NE
El Excessive Ponding El Hydraulic Overload El Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN El PAN > 10% or 10 lbs El Total Phosphor -us El Failure to Incorporate Manure/Sludge into Bare Soil
El Outside of Acceptable Crop Window [:1 Evidence of Wind Drift El Application Outside of Area
12. Crop type(s)
13,
Soil type(s)
14,
Do the receiving crops differ from those designated in the CAWMP?
0 Yes
X No
D NA
El NE
15.
Does the receiving crop and/or land application site need improvement?
D Yes
%No
ED NA
El NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
El Yes
No
El NA
El NE
17.
Does the facility lack adequate acreage for land application?
Yes
No
El NA
El NE
18.
Is there a lack of properly operating waste application equipment?
Yes
&N o
0 NA
0 NE
Comments (refer to quPstion #)--Explain any YES answers and/or any i&oifim`e'indations� or any othee"commen.M
Use drawings. of facility to better explain situations. (use additional ages as:ne essa-1
v-,
z
7,
AL
Q1,A NX -3 T) U_ 0 1 C //V C- C)CA:r 0 C c j4 A N6 4:,-, r-o ZAA
To "C'& I G 9
Al N C_ (Zy_�Ai &�Ll 14 0&rL
NO hl() I A) K Sj&N C cz M A(MH 00 16
Reviewer/inspector Name 9M.4AInD Phone: (ql 1"')
Reviewer/Inspector Signature: -=Ce=uj'�3 Date:
Page 2 of 3 12128104 Continued

I�Faci!ONumber: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? [I Yes ekNo El NA [I NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check 0 Yes 'V�N. [I NA E] NE
the appropriate box. El WUP El Checklists B Design El Maps 0 Other
2 1. Does record keeping need improvement? If yes, check the appropriate box below, El Yes )� No El NA El NE
El Waste Application El Weekly Freeboard El Waste Analysis El Soil Analysis El /aste TransfeTs El IY4 ual Certification
El Rainfall El Stocking El Crop Yield El 120 Minute Inspections [A Monthly and I " Rain Inspections El Weather Code
22. Did the facility fail to install and maintain a rain gauge? El Yes '*0 No El NA [:1 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes KNo El NA El NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? El Yes bf No C1 NA [I NE
25. Did the facility fail to conduct a sludge survey as required by the permit? El Yes V�No El NA El NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
No
El NA
El NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
P o
El NA
(] NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
0 Yes
No
[:1 NA
[I NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
Yes
No
[:] NA
[:1 NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
1P No
El NA
El NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
El Yes
Nk No
El NA
[:] NE
General Permit? (ic/ discharge, freeboard problems, over appfication)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
E]Yes
PQ No
El NA
El NE
Page 3 of 3 12128104

Type of Visit X�Compliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit XRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 5� Arrival Time: Departure Time: County: T)QWZY Region:
Farm Name: q- eA Owner Email:
Owner Name: C— CDA /,V/v Phone:
MailingAddress: S79131rl MA6 AJO ed 09 We, Q&
Physical Address:
Facility Contact:
Title:
Onsite Representative: 011AW
Certified Operator: 9jLGL_ e, I 'VA1
Back-up Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certifleation Number:
Back-up Certification Number:
Doqn -
Latitude: [=O =g Longitude: =0=6
—i�@"r
ED
nt
i III i
liesign
uNrent
C TP —ac i t:yj
R 7o —Pu I iff t i
Etj iij�0:�N—pacial!. 19tigh'
MoUb—acit—
IYA
RE—n—HINtio
Ntio
10 Wean to Finish
10 Layer
El Dairy Cow
Wean to Feeder
10 Non -Layer
El Dairy Calf
El Dairy Heifer
I
Feeder to Finish
El Farrow to Wean
El Dry Cow
El Farrow to Feeder
El Non -Dairy
Farrow to Finish
Ej Layers
El Beef Stocker
El Gilts
El Non -Layers
El Beef Feeder
El Boars
El Pullets
El Beef Brood Cowl I
er
Other
IN40M e ru u s:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure [I Application Field El 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?
El Yes !�No El NA El NE
[I Yes [:1 No 0 NA [:3 NE
[I Yes [I No El NA El NE
El Yes
El No
El NA
0 NE
El Yes
0 No
El NA
El NE
Yes
rO No
A
El NA
El NE
12128104 Continued

I fiarffity.Tjumber: -3 1 — jqo
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storin 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: Ca GWN
Spillway?:
Designed Freeboard (in).
Observed Freeboard (in): L/ L/
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 XNo
• Yes E]No
Structure 5
El Yes X No
11 Yes XNo
[__1 NA [__1 NE
El NA 0 NE
Structure 6
0 NA El NE
ONA ONE
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? El Yes No NA NE
8, Do any of the stuctures lack adequate markers as required by the permit? El Yes No NA NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El Yes No NA NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need 0 Yes No [3 NA 0 NE
maintenance/improvement?
It. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes o 0 NA 0 NE
El Excessive Ponding El Hydraulic Overload [] Frozen Ground [] Heavy Metals (Cu, Zn, etc.) 11�7
[]PAN [-IPAN>10%orl0lbs [:]Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
El Outside of Acceptable Crop Window 0 Evidence of Wind Drift El Application Outside of Area
12. Crop type(s) F O-SC-L&IF V-(_� V-LA(=_CP) Tka�LL- ALLETr (P)
13.
Soil type(s) Cnouzasca�
14.
Do the receiving crops differ from those designated in the CAWMP?
El Yes No
El NA
0 NE
15.
Does the receiving crop and/or land application site need improvement?
0 Yes No
[] NA
ONE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?E] Yes No
Ej NA
[I NE
17.
Does the facility lack adequate acreage for land application?
0 Yes No
0 NA
0 NE
18.
Is there a lack of properly operating waste application equipment?
0 Yes A No
[:1 NA
[:1 NE
iin�'ibyiV -_9'ahswe-rssTa`fid1 or Any,recom
e .4�i
5PO 16
VW1
Reviewer/Inspector Name a -1 Phone: 9/6 r7
Reviewer/Inspector Signature: AQ�:� Date: 2 3 LQ,3
Page 2 of 3 12128104 Continued

I'Facility- Number: —3 1 Date of Inspection
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? F-1 Yes No El NA [I NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check Yes No [I NA El NE
the appropirate box. El wup El Checklists El Design 0 Maps [:1 Other
2 1. Does record keeping nee ' d improvement? If yes, check the appropriate box below. El Yes [XNo El NA El NE
El Waste Application GWeekly Freeboard El Waste Analysis El Soil Analysis E] yaste Transfers 0 Anual Certification
El Rainfall El Stocking El Crop Yield El 120 Minute Inspections El Monthly and I " Rain Inspections El Weather Code
22. Did the facility fail to install and maintain a rain gauge? El Yes [�No [I NA [:1 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
XNo
El NA
El NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
No
[:1 NA
El NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
0 Yes
No
El NA
El NE
26. Did the facility fail to have an actively certified operator in charge?
El Yes
bo No
El NA
El NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
ro No
[:1 NA
D NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? El Yes KNo [:1 NA [:1 NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
No
El NA
C1 NE
and report the mortality rates that were higher than normal?
'N
30. At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
XNo
El NA
El NE
If yes, contact a regional Air Quality representative immediately
3 1. Did the facility fail to notify the regional office of emergency situations as required by
El Yes
(k No
0 NA
El NE
General Permit? (ic/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes
O(No
El NA
El NE
33. Does facility require a follow-up visit by same agency?
El Yes
XN o
0 NA
El NE
4�s
Page 3 of 3 12128104

WDivision of water Qualuty
Facility Number 0 Division of Soil and Water Conservation
Other Aoenev
Type of Visit O(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 El Denied Access
Date of Visit- Arrival Time: Departure Time: County:)�'-Al Region:
Farm Name:
OwnerName:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: 7::_ruLC)L_
Certified Operator: C— UkA-3 �__ Z-, a V�_ I
Back-up Operator:
Location of Farm:
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number: foot—I)C-)
Back-up Certification Number:
Latitude: [=O [=& Longitude: = 0 =I =
.:Design 'Current Design Current Design. Current —
Swine Capacity. Population Wet Poultry Capacity Population. Cattle Capacity "V
Popul.ation
10 Wean to Finish
El Wean to Feeder
NFeeder to Finish
El Farrow to Wean
El Farrow to Feeder
El Farrow to Finish
El Gilts
El Boars
Other
Other
Laer
1E] Non -Layer
Dry Poultry
[] Layers
El Non -Layers
El Pullets
Turkeys
El Turkey Poults
El Other
Dischar2es & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
El Dairy Cow I
D Dairy Calf I
El Dairy Heifer
[:1 Dry Cow
El Non -Dairy
0 Beef Stocker
El Beef Feeder
El Beef Brood Cowl
....
I
Number of Str uptures:'
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
0 Yes t�`No I--] NA [INE
El YesE]
No
El NA
El NE
Yes
[I No
NA
El NE
El NA
[J NE
El Yes
El No
0 Yes
XNo
El NA
El NE
El Yes
No
'k
El NA
El NE
12128104 Continued

Facility Amber: -�j�q 0 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?
El NA ONE
El NA El NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LAG
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? Yes No 0 NA El NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed Yes o 0 NA El NE
through a waste management or closure plan?
D Yes No
El Yes El No
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? E]Yes gNo [:INA [:1 NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes M-No El 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 El Yes No El NA E-1 NE
maintenance or improvement?
Waste Anolication
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes No [I NA [] NE
maintenance/improvement? V
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes XNo El NA [:1 NE
0 Excessive Ponding El Hydraulic Overload El Frozen Ground El Heavy Metals (Cu, Zn, etc.)
EIPAN EIPAN>10%orl0lbs El Total Phosphorus E]Failure to Incorporate Manure/Sludge into Bare Soil
El Outside of Acceptable Crop Window E]Evidence of Wind Drift El Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
El Yes
0 No
El NA
El NE
15. Does the receiving crop and/or land application site need improvement?
[:1 Yes
RNo
El NA
[:1 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
E] Yes
K, No
El NA
El NE
17. Does the facility lack adequate acreage for land application?
El Yes
4No
0 NA
El NE
18. Is there a lack of properly operating waste application equipment?
El Yes
KNo
El NA
El 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.):::-
aC) JqC:,, TCD OAOLA___� I I
Reviewer/Inspector Name Phone:
I
Date:
Reviewer/In spector Signature: 0 N
Page 2 of 3 12128104 Confinued

Facility Number: Date of Inspection
Reguired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes X No El NA El NE
20. Does the facility fail to have all components of the CAWNT readily available? If yes, check El Yes 'XNo El NA El NE
the appropriate box. El WIN D Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 11 Yes 4 No El NA El NE
El Waste Application El Weekly Freeboard El Waste Analysis El Soil Analysis El Waste Transfers [3 Annual Certification
0 Rainfall 0 Stocking [I Crop Yield [:1120 Minute Inspections El Monthly and I " Rain Inspections El Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
El Yes q No
[:1 NA
[] NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes KNo
El NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes /1� No
El NA
[:1 NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
1:1 Yes _1� No
[:1 NA
E] NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes J� No
El NA
El NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes J�No
D NA
C1 NE
Otherlssues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
11 Yes No
E] NA
[] NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
Dyes No
El NA
El NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
El Yes No
El NA
[:1 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
1:1 Yes 5�No
El NA
EINE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes �'No
El NA
El NE
33.
Does facility require a follow-up visit by same agency?
0 Yes JgNo
El NA
El NE
lAdditional Comments and/or Drawings: i
Page 3 of 3 12128104

�j .
ivision of Water Quality
Facifity Number 0 Division of Soil and Water Conservation
rl Other Aoenev
Type of Visit G(Compliance
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
ReasonforVisit
&Routine OComplaint
OFollowup OReferral OEmergency
00ther El Denied Access
Date of Visit: Arrival Time: Departure Time: County: IN'rel-SI) — Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
FacHity Contact: - — - Title:
Onsite Representative: C— R P_QLA_ (52U,� " &)
Owner Email:
Phone:
Integrator:
Phone No:
Certifled Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Swine
10 Wean to Finish
0 Wean to Feede
R] Feeder to Finish±&djJ3Ld_o
El Farrow to Wean
0 Farrow to Feeder
0 Farrow to Finish
El Gilts
1:1 Boars
Other
10 Other
Latitude: =0 =6 = Longitude: =0=' ="
Design Current Design Current
Capacity Population WetPoultry Capacity Population
El ayer I I I
El Non -Layer
Dry Poultry
E] Layers
0 Non -Layers
0 Pullets
E] Turkeys
1OTurkey Poults
I
F00ther - -.]
Discharges & Stream Impacts
I - Is any discharge observed frorn any part of the operation?
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Npi�latiou
0 Dairy Cow
El Dairy Calf
El Dairy Heifei
0 Dry Cow
0 Non -Dairy
0 Beef Stocket
El Beef Feeder
El Beef Brood CoY4
I
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
0 Yes D<o 0 NA ONE
F-1 Yes
El No
ONA
ONE
0 Yes
0 No
ONA
ONE
[--INA
[:INE
OYes
[:]No
0 Yes
61 0
[JNA
0 NE
0 Yes
�rNo
El NA
0 NE
12128104 Continued

,j I Facility Number: *3 k — jLtio, I
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes O-N. El NA El NE
a. If yes, is waste level into the structural freeboard? El Yes El No El NA 0 NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LkC,=A)
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in)- (I
5. Are there any immediate threats to the integrity of any of the structures observed? El Yes o El NA 0 NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed El Yes 0"No [I NA El 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? 2�yes E]No [INA EINE
8. Do any of the stuctures lack adequate markers as required by the permit? Yes La'No [:1 NA [__1 NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El Yes [;�Ko El NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes D/No El NA Ej NE
maintenance/improvernent?
It. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes ONo El NA El NE
El Excessive Ponding El Hydraulic Overload [I Frozen Ground E] Heavy Metals (Cu, Zn, etc.)
CIPAN EIPAN>10%orl0lbs []Total Phosphorus E]Failure to incorporate Manure/Sludge into Bare Soil
El Outside of Acceptable Crop Window El Evidence of Wind Drifl 0 Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
Y
/Yyee
[6 No
El NA
[:1 NE
15. Does the receiving crop and/or land application site need improvement?
s
[:1 No
El NA
El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre deten-nination?El Yes
ErN.
El NA
0 NE
17. Does the facility lack adequate acreage for land application?
[:1 Yes
EK0
El NA
El NE
18. Is there a lack of properly operating waste application equipment?
El Yes
[2/No
El NA
El NE
Comments (refer to question #): Explain any YES answers and/or any recommend2tiOUS or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
e2,)C,L6AO A"WD Dr,�_C L,,14L".
COuTrkok— K)6coeo Oki ALL
Reviewer/Inspector Name FAIWC-,�—� Phone: (902 71 C —75 X6
Reviewer/Inspector Signature: Date: I C>Z��'O:Z
LVIZOMII "nunuea

Facility Number:' 31 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes [�/No [I NA [j NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check D Yes C3�N. [I NA El NE
the appropirate box. 0 WUP El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. C1 Yes [5/No [I NA (I NE
0 Waste Application El Weekly Freeboard 0 Waste Analysis 0 Soil Analysis [I Waste Transfers 0 Annual Certification
El Rainfall El Stocking [I Crop Yield El 120 Minute Inspections El Monthly and I " Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? Yes [_�No
[] NA El NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes [_�No [_3 NA 0 NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
0 Yes
U o
El NA
[__1 NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
��No
[__1 NA
El NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
O'No
El NA
[:1 NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
[:1 Yes
E,14o
Ej NA
[:1 NE
Otherlssues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
0 Yes
El No
El NA
El NE
29,
Did the facility fail to property dispose of dead animals within 24 hours and/or document
D Yes
ErN.
El NA
El 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?
[I Yes
BIN o
[I NA
El NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fai I to notify the regional office of emergency situations as required by
[:1 Yes
EINo
EINA
EINE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes
EYNo
[I NA
[__1 NE
33.
Does facility require a follow-up visit by same agency?
El Yes
E3No
El NA
[I NE
Comments and/or Drawings:
12128104

14'
Is
Facility N umber D_ - - E am
<�'Division of Water Quality
0 Division of Soil and Water Conservation
09ther Agency
Type of Visit gCoopliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for W_ - �Routjne 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: Arrival Time: Departure Time: County: IMIAL Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: I Title:
Onsite Representative: 6) gwA) Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude: = 0
Phone No:
Operator Certification Number:
Back-up Certification Number:
=" Longitude: = 0 =' =
. . . . . . . . . .
, A�
I) C
0
urren urren 4 ,Wl
esigw esigni
�.Z 7'Capacity. Wet, Poul .'Cattle "ac ty p.
-Population . try caplicity....:,"Population,
�­i _�datioKi
Wean to Finish Layer
0 Wean to Feeder
Non -Layer
Feeder to Finish
0 Farrow to Wean Dry Poultry
L.1 Farrow to Feeder
10 Farrow to Finish
10 Gilts
,,,Other
_100ther
Layers
0 Non -Layers
El Pullets
OTurkeys
10 Turkey Poultsl
1E1_ Other I
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field 0 Other
a. Was the conveyance man-made?
Dairy Cow
Dairy Calf
0 Dairy Heifer
0 Dry Cow
0 Non -Da'
0 Beef Stocker
El Beef Feeder
El Beef Brood Cow
Num6e'r of c.idres:-4f
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
Dyes [�rN. 0 NA 0 NE
OYes
ONo
ONA
ONE
0 Yes
0 No
0 NA
0 NE
El NA
[1 NE
El Yes
0 No
El Yes
(3No
0 NA
El NE
0 Yes
b"No
El NA
0 NE
12128104 Continued

Facility,�umber: Date of Inspection
v
Waste Collection & Treatment
Tfs storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? El Yes dXo El NA El NE
a. If yes, is waste level into the structural freeboard? El Yes El No El NA El NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 44
W­
Spillway?:
Designed Freeboard (in): I So
Observed Freeboard (in): t1l
5. Are there any immediate threats to the integrity of any of the structures observed?
El Yes
�TN/o El NA [__1 NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
El Yes
EI/No El NA I--] 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
environments. eat, notify DWQ
7. Do any of the structures need maintenance or improvement?
El Yes
; No 0 NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit?
El Yes
E14(o El NA D NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
El Yes
2<o E] NA F-1 NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
El Yes
ON 0 NA El NE
maintenance/improvement?
2No
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
E]Yes
El NA [__1 NE
El Excessive Ponding [:1 Hydraulic Overload El Frozen Ground 0 Heavy Metals (Cu,
Zn, etc.)
E] PAN [--IPAN>10%orl0lbs El Total Phosphorus El Failure to Incorporate Manure/Sludge
into Bare Soil
[:1 Outside of Acceptable Crop Window Evidence of Wind Drift D Application Outside
of Area
12. Crop type(s)
13, Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
[__1 Yes
21No El NA [I NE
15. Does the receiving crop and/or land application site need improvement?
[I Yes
E;,<o C1 NA [I NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? E]Yes
17. Does the facility lack adequate acreage for land application? El Yes
18. Is there a lack of properly operating waste application equipment?
0 Yes
P No El NA El NE
LT'N"o El NA El NE
[�No El NA El 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):
21.) .4&MkA 1, (C—R r.
Reviewer/Inspector Name I Phone: klnV -
Reviewertinspector Signature: Date: ORAL
'ru'Kez Uj .3 It 41 Z' U/ Ulf I—Ey"It""Cla

FaciAty Number: To Date of Inspection
Reguired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. F-1 WUP El Checklists El Design El Maps El Other
El Yes 26�o EINA El NE
E] Yes EfNo [3 NA [j NE
2 1.
Does record keeping need improvement? If yes, check the appropriate box below.
U No
U NA
Ll NE
Waste Application E]Weekly Freeboard E]WasteAnalysis OSoilAnalysis
0 Waste Transfers
0"Annual Certification
DRainfall OStocking E]CropYield [:1120 Minute Inspections [I Monthly and V Rain Inspections E]WeatherCode
22.
Did the facility fail to install and maintain a rain gauge?
D Yes
FeKNo
[:1 NA
EINE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes
El"No
[:INA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
1:1 Yes
BIN 0
[] NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
0 Yes
� 'No
[:1 NA
[:] NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
ff N/o
0 NA
0 NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
El No
El NA
QeE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? El Yes D?Ib' [:1 NA [:1 NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
(;Xo
[__1 NA
El NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
E�<o
El NA
El NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
El Yes
Dl�o
NA
[I NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
El Yes
[I No
NA
El NE
33. Does facility require a follow-up visit by same agency?
El Yes
[:�No
El NA
[:1 NE
Comments and/or Drawings:
Page 3 of 3 12128104

TypeofVisit Z Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 9(Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time:3a3zPxounty: Region: &'Va
Farm Name: 04 .5 - fA 9/n----.- Owner Email:
Owner Name: 11�.A 40 CC- z9azin-leg Phone:
MailingAddress:
Physical Address:
Facility Contact: Title:
Onsite Representative: �LF
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
Boars
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: =0 =I Longitude: =O=i
Design Current Design Current
Capacity Population WetPoultry Capacity Population
ElLayer
ID Non -Layer
Other
10 Other J1
Dry Poultry
ElLayers
F-1 Non -Layers
Ej Pultets
El Turkeys
EE11 urkey Poults
10 Other
Discharl!es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge ori-inated at: El Structure F-1 Application Field El Other
0
a. Was the conveyance man-made9
Design Current
Cattle Capacity Populatioin
El Dairy Cow
El Dairy Calf
t ___I
El Dairy Heifei
[TDry Cow
El Non -Dairy
D Beef Stockei
[I Beef Feeder
El Beef Brood Cowl
Number of Structures: ELI:
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?
El Yes fa No [] NA E] NE
El Yes
E]No
El NA
El NE
El Yes(-]
No
[_1 NA
[I NE
El NA
El NE
El Yes
El No
El Yes X, No E] NA [] NE
[I Yes idNo 0 NA 0 NE
b, 12128104 Condnued

Facility Number: 3L fc�Q
Date of Inspection
Waste Collection & Treatment /No
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑Yes ElNA ElNE
a. If yes, is waste level into the structural freeboard? ❑Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: L61/
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
(ie/ large trees, severe erosion, seepage, etc.) /r
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 J[J No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes JNo ❑ 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 J 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 > l0% or l 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
�j/f
12. Crop type(s) f/IZuQL/7,¢� / t zLLFT 11-41e
13. Soil type(s) brA �T
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes FJ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ff No ❑ NA ❑ NE
i
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination.,[ -]Yes X
No ElNA ElNE
17. Does the facilitylack adequate acreage for land application? ❑ Yes No ElNA ElNE
18. Is there a lack of properly operating waste application equipment? ElYes XNo ❑ NA ❑ NE
%¢a,,;¢.: •�,,.,.: "r .. _ _.. _ _ ... —. .._ .. .. .-. , .. .. .i.. ."-'-.. �?".. -i' �°�i�,r''f"'��":.:4< a'�'�azi'3Y�I�L. ..c�.�?�.,f�'�A6,�ii���%�'
W50drawmgs of factlrty to better explaEn situahans {use add�tiodal pages as necessary):
taw',, -��,� . �• _�.a ��.��� �� ��,
L y f "�=/_rG/iD tow /he %�5
L..� '�NSloc. �. �C�!►����f2/] Z/�F /�pO�i,D
C
�FSC�IF�ignvo�J fU�G SpQta���.✓c�js,
Reviewer/lnspector Name11
_ Phone• /d l�
Reviewer/Inspector Signature: Date: !
12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? Dyes No El NA El NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes No El NA El NE
the appropirate box. El WUP El Checklists El Design 0 Maps D Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes VNo El NA El NE
El Waste Application El Weekly Freeboard El Waste Analysis C1 Soil Analysis El Waste Transfers El Annual Certification
El Rainfall El Stocking 0 Crop Yield El 120 Minute Inspections El Monthly and I " Rain Inspections El Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
El Yes
/No
El NA
El NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
ZNo
El NA
0 NE
24.
Did the facility fail to calibrate waste application equipment as required by the pen -nit?
0 Yes
ANo
El NA
0 NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
PrNo
El NA
El NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
/N o
[I NA
El NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
XN o
E:1 NA
El NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El Yes
dNo
0 NA
[:1 NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
;zf No
[I NA
[:1 NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
XNo
0 NA
[:1 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
[:1 NA
NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
C1 Yes
No
/11
F-1 NA
NE
33.
Does facility require a follow-up visit by same agency?
[I Yes
VfNo
[:1 NA
[:1 NE
'W"A "o, dai:coinments DraWings.
(v 7 a,4- r,_ 55 A7,7. C-0
/P 5
- lllb;�_4 -, lAe4M A"f 71
12,28104

s
Type of Visit a Co fiance Inspection O Operation Review O lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Tune: 1070
O Not Operational O Below Threshold
rm Peitted Certified 0 Conditionally Ce ' ed 0 Registered Date Last Operated or Above old:
Farris Name: .._. .. _... __ County:
Owner Name:
Mating Address:
Phone No:
Facility Contact: . _ ..._------- --._ _ Title: _ _ _., ._ . _ .. _. __ Phone No�:r�__...__W_
Onsite Representative: —ie"p u�Integrator:
Certified Operator:
Location of Farm:
Operator Certification Number:
A6
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 1 " Longitude • 4 «
Discharges &Stream Impacts
1 _ Is any discharge observed from any part of the operation?
❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2_ Is there evidence of past discharge from any part of the operation? ❑ Yes
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ;Z0
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes �io
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: — . __ . _ _ . _ _ .. ... _ _ .. --
Freeboard. (inches): yl
12112103 Continued

Facility Number: 3 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structur-es observed? (ic/ 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 mainteriancetimprovement?
8. Does any part of the waste management system other than waste structures require maintenanoerunprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste APRI:tation
10. Are there any buffers that need maintenarice./improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
[] Excessive Ponding 0 PAN 0 Hydraulic Overload 0 Frozen Ground 0 Copper andlor Zinc
12. Crop type 130141"M (14) �(S(W ((1) 50
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWNT)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility nmd a wettable acre determination?
c) 1"his 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?
Odor Lisues
17. Does the discharge pipe from the confinement building to the stomge pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
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
Air Quality repr�sentative immediately.
?.) 66 AXAP7A
Is;) cowrr."L*
• Yes 2/No
• Yes UrNo
Wyes [] No
* Yes E31(o
* Yes Deo
El Yes 014o
0 Yes EWO
0 Yes 0-4o
0 Yes 90�
0 yes 0
El Yes [3�No
0"�es 0 No
El Yes 044/0
DYes O'No
U Yes [5 <N
D Yes �70
0 Yes ffl�o
Field Couy [I Final Notes
DXjq PA L_1__S OF C)V6f L 6" PT)i *1 A#/VK Al-S
L.JLr_-!D CCFAI-rK6L,.�
j2umf'_5o6, C--V6PT-r—eiNAY S14ot)P NbT* 60-c-P-6b 14rPjuLZC,-FXQ.() tpAo.
LA6t36,-) At"AL,-IW &,eFoo 54L_ c-w owr� PMrla� A.Vo AfTG k_ SAwjpt.(, O-A-yE
Reviewer/Inspector Name -",S
ReviewerAwpector Signature:
Date: %
4­­

FadHtY Number. Date of luspection
R�Quired Records & Documents
2 L Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
El Waste Application [3 Freeboard 0 Waste Analysis [I Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewe r/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NIMES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
E] Stocking Form E3 Crop Yield Form [3 Rainfidll [I Inspection After V Rain
El 120 Minute Inspections [3 Annual CzrdficatLon Form
0 Yes 2<0
0 Yes
0 Yes ��O-
0 Yes B<o
0 Yes mi(01'�
11 Yes [I -WO
FE-MMW�-
El Yes [INV
El Yes GN*o"—
Q>er— El No
]--]Yes lizic
El Yes 0-5o'
El Yes QN-011"
0 Yes 0-1<0-�
E3 Yes 01fol",
12112103

11
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notilication 0 Other,..,_ Penied Access
Facility Number Date of Visit; �� Time- E�� --I
21(51V5 rO Not Operational 0 Below Threshold
Permitted M Certified 13 Conditionally Certified [3Registered Date Last Operated or Above Threshold-
FarmName: K�OZ65 F."', County:
OwncrNamc: �9901- S, a kJ I A) A-i PhoneNo: oko-3
MaitingAddress: 19-5� 26 Sicul Z81153
Facility Contact: -Title:
Onsite Representative: RCY
- 00;'0/1
Certified Operator: Y—rr.,l /3� 06�1 N Aj
Location of Farm:
Phone No: -
Integrator: Rrr�j
Operator Certification Number: DaL110
we-t� cl &Ja,A/e, Oo A,�,05t 5,d, ol 59 /70c).; o-plwox. 7�;/.e �Jotl, Y�Zzq �-v
5D Swine [:) Poultry [I Cattle [I Horse Latitude 0 6 " Longitude 0 4
w e .1111MM'Ps-ign
�tn
W ea'
C1 Wean to Feeder
Current
C gIONUTC t-VAP vulation
ILI q 1;EntlI11111111111
-11t.. apa i 'Ovula on Cattle MMPC-"aMa Bropulation
ayer
_��pacity
El Dairy
ee
91 Feedei to Finish
1 3(� 7c;t I
on-Laycri
I
Non -Dairy I
I
r ro,
El Farrow to Wean
r To,
El Farrow to Feeder
M 0,
Farrow to Finish
'
rBoars
0 Al. Desi n a aci &
r
ilts
0 G G, s
0 It
C10 rs
UM U e 01IM60ons P�resent JE] Lagoon Area Spray Field Area
,Un-d-sU/ SiMl IMPS lanagement Syste
MUQ71di!-!-gjP
Discharge§ & Stream ImpaCts
1. Is any discharge observed fi7om any part of the operation? ED Yes No
Discharge originated at: El Lagoon El Spray Field 0 Other
a. If discharge is observed, was the conveyance man-made? El Yes No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) 0 Yes El No
c. lfdischarge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notif� DWQ) [--]Yes El No
2. Is there evidence of past discharge from any part of the operation? L1 Yes A No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? El Yes No
Waste Collection & Treatment F
4. Is storage capacity (freeboard plus storm storage) less than adequate? El Spillway ra F, 1:1 Yes El No
Structure I Structure 2 Structure 3 Structure 4 S re CP
1; ructurc 6
Identifier:
Freeboard (inches):
05103101 Continued

6
Facility Number. Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? (if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancc/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
t 0. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over avulicationw? , E] Excessive Poi
12. Crop type n (Lh hAd I, �
13. Do the receiving crops differ with those desi;�Jed in the C'erti
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?
Reauired 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/ WLT, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, frechoard, 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?
El Yes ;YNo
El Yes No
0 Yes No
El Yes No
0 Yes VNO
El Yes Vf No
El Yes
El Yes
0 Yes
El Yes
0 Yes
ONO
XNo
0 No
yj No
ONO
F-1 Yes gNo
0 Yes �YNO
El Yes 011140� C-2t
Ely_ R_ �V".3
[] Yes 0 No
El Yes RfNo
El Yes &No
El Yes ETNo
El Yes ONO
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
0a, vgi-�Svs­ n't
0 Irecommer r;cdhiminfs
miriiints (fef r to question Aq:,E ?IamianyNTS ans,W6*and/6r-any1 I Idatidn's or' ihk��e
4�
pse,#rawings. of f..RC to fieftirlei'lain si ary):
pages�as necess� :�U
E3Field Copy El Final Notes
Los r-nw
9LIA�,
4W�4�3 IN F—P46/Vi`5
460z-1 7- 2 2Vr e�ZZ� 9A�—�
,,5 -I/-
74
5
ReviewertInspector Name -_ V-426
ReviewerlInspector Signature: Z?d 2! � Date:
05103101 1 1 Condnued

Facility Number: Date of Inspeclion
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
2T Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29, Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e- broken fan bells, missing or
or broken fan bi ade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover-9
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary covee.1
El Yes El No
El Yes ,0.
NO
El Yes
'To
0
El Yes )ZINO
Yes 9I
114
D Yes J3 o
0 Yes [:1 No
.Additional'Comments'andlor Drawings: -
A.
4 4tVO 70
. W-fipk,-.V-
��'q 19E-
1q) Ak-,6-0 70'&6�- MPKe,
Z, 4y 2-4002— Aa;�-5-4�2,4-
L- V look , e-5 4-�� ^,:" 29 44 S- —2-75
(xwe
agp ;9. 4'a
z- 7 �xt" 1��z-
1, W M
- V-5 , —7 4P,,OZ.;ZZ-,v
2,0c?3 15�v
05103101

Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 31 140 Date of Visit: 4/17/2002 Time: 15:10
Q Not Operational Q Below Threshold
® Permitted ® Certified [3 Conditionally Certified © Registered Date Last Operated or Above Threshold_
Farm Name: Moto. Earn) ......................... ........ County: AJull.Iilil.................................... WIRO......
Owner Name: RrrQU $ -- ------------ o------------ - ---------- -- Phone No: 9XQ-245:9JQ3------------ - --- - ---------
MailingAddress: 1,9S.1B.S.1rod....................................................................................... maglIQUA-Kc ....................................................... 18.453 ..............
FacilityContact: ...........................................................Title:............................................... Phone No: ......................................
Onsite Representative: FrxQ1Quinn—
Certified Operator: )errnlB.................................. Quinn
Location of Farm:
--- Integrator: P�CCStAgQ�RCOIS--------------------------•
Operator Certification Number:2241,Q-
West of Beulaville. On West side of SR 1702 approx. 0.7 mile North of Hwy 24. +
® Swine [I Poultry El Cattle ❑ Horse Latitude 34 • 57 ; 51 °� Longitude 77 • 49 S0 u
Design `' ;Current 3 - Design Current Design Current
:Swine Ca`aci Po uEafion Poultry" Capacity Populateon Cattle Capacity-' lPopul»ti.
❑ Wean to Feeder
® Feeder to Finish
3672
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons 1 N Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Ares
Holding Ponds LSolid Traps - ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
?' c. If discharge is observed, what is the estimated flow in gal/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?
❑ Yes N No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes N No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? N Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:.----.......�._----------.--------------------------- .......................... ----------------------.....---------------------------- -•-----------•-------------
Freeboard (inches): 25.5
^--- -- - --,

UNW/V!
]Facility Number: 31-140
Date of Inspection 4/17/2002
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health%r 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?
uUnunuea
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes N No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes N No
12. Crop type Coastal Bermuda (Hay) Small Grain Overseed Fescue (Graze) '
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? N Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
N Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
N No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
N Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
N Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
N No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
N No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
N No
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
N No
24. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #) Explain any YES a s v re s andlor any recomrnendahons or any otlte comments
:..,
Use drawings of facility to better explain s�#nations (use a_dditron0pages as necessary) )❑Field Copy ❑Final Notes
_ rr F
3. There is an area in the sprayfeld of Tract 71812 Field 3 which has been recently graded and leveled. Mr. Quinn indicated that this
ctivity was done to level a rut which had been created whenever the traveling gun cart was being pulled into the sprayfield to make wasp
applications. I asked Mr. Quinn why he was making applications if the field was wet enough that it was creating ruts when he pulled out
e traveling gun cart. Mr. Quinn indicated that his lagoon was getting full and he had to pump to keep his lagoon level down. I told Mr:
Quinn that his waste plan is designed such that he can manage the lagoon level at times of the year when pumping is suitable as opposed
o when it is wet. Mr. Quinn's application records show that there was significant PAN left on his crops last year. Mr. Quinn needs to
evaluate, his available irrigation equipment, irrigation labor capabilities, & current waste management practices and make any necessary
s�
odifications to ensure proper and compliant waste management. Water quality samples and pictures were taken.
Reviewer/Inspector Name Stonewall Mathis
Reviewer/Inspector Signature: Date: e7 -

;. - 051�3101
Continued
Facility Number: 31-140
Date of Inspection F4—/1-7/-200-2-1
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge aVor below El Yes Ej 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 H No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, 0 Yes N No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc,) Yes No
3 1. Do the animals fced storage bins fail to have appropriate cover? El Yes E] No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? El Yes [-] No
9, and 22. The lagoon design drawing shows the lagoon requiring 24 inches of freeboard to be maintained. Mr. Quinn's freeboar(
-ords show the lagoon at 20 inches of freeboard on March 2,2002. Mr. Quinn should have notified the DWQ regional office of
-noncompliant lagoon level. Mr. Quinn also needs to ensure that a gauge is installed showing the start and stop pu plevels,and
m
3 of dam elevation.
14. The facility needs a wettable acres determination with a waste utilization plan written based on the wettable acres determination,
and Mr. Quinn needs to make waste applications in accordance with the wettable acres determination and keep his application
records accordingly. Mr. Quinn is currently using more acreage on the IRR-2's than is given in the waste plan.
15, All bermuda fields have some bermuda in them, however, there is a need for significant improvement of the bermuda stand on
all of the bermuda fields. It has been the case that the bermuda stand needs significant improvement in the three years that I have
be en coming to this farm. Mr. Quinn needs to take immediate action to ensure and also ensure a well established stand of bermuda
on the entirety of his land application fields.
18. The emergency action plan is not available and it needs to be.
19. Mr. Quinn needs to take soil samples for each field for soil testing purposes. Mr. Quinn needs to use a waste analysis dated
within 60 days of application events to calculate on the IRR-2's the nitrogen applied. Mr. Quinn used two IRR-2-'s for the same pull
on field 3 during the 2001 bermuda season; Mr. Quinn needs to use an IRR-2 for each pull during a given cropping season such that
all events for a particular pull are collectively grouped.

_J)rbMsi6n6f Water Quality
­,j
0 Divisio-i -ation
7
n of S�iil and Water Consei�
;0
Wer gencyL
.7s.
Type of Visit j2(Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
IReason for Visit oRoutine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access
---I Printed on: 7/21/2000
Facility Number Date 4Uf ViSit-. ]Tiint-. 1-2-400
I rO-Not Operational 0 Below Thr
.0"Permitted (3 Certified [3 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
Farm Name: ................. 0-110Aes County: ...-
............................................................................................................ .0yr .. bkl ................................... .......................
Owner Name; Phone No.-
............ F ........... ... ... ....................................... ................................ ..................................... .................................................
FacilityContact . .......................................................................... ... Title . ................................................................ Phone No: ............... ......
MaiiingAddress: ......................................................................... ........................................... .....................................................................................
Onsite Representative: ..... 0 -V et rl
.............
Certified Operator:
Location'of Farm:
Integrator: e
....................................................
.- Operator Certification Number:
0 Swine 0 Poultry 0 Cattle 0 Horse Latitude 0 6 &4 Longitude 0 t 44
Desi Current Design
g1k
Current MAgn' rrent
C11
Poultry
------- --- Capadtv Pooulation Capacity
Cattle
Population Capacity-�� 00061ation
Wean to Feeder 1 10 Layer I
I 1[3 Dairy
Feeder to Finish r7 2, 10 Non -Layer I
JE1 Non -Dairy I
Farrow to Wean
Farrow to Feeder 10 Other I
Farrow to Finish
Total Design Capadti'l
Gilts
Boars
N' I0 Subsurface Drains Present jpjUgnon Area I[] Spray Field Areal
U
I0 No Liquid Waste Management System
Discharges & Stream Impac
1. Is any discharge observed from any part of the operation?
Discharge oriamated at: []Lagoon [I Spray Field F1 Other
1�
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
c. li'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 & Trmitment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3
Identifier: .......... 5 ............... ........... ........................ .............................
Freeboard (inches):
5100
El Spillway
Structure 4 Structure 5
0 Yes XNO
Yes 'eNo
Yes No
Yes lallo
Yes ONo
Yes 'P No
[] Yes YrNo
Structure 6
Continued on back

Facility Number: —2 — 14D Date of 111spectior. o 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 �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 ,�f`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 Jf No
8. Does any part of the waste management system other Than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ YesNo
Waste Application
10- Are there any buffers that need maintenance/improvement? ❑ Yes g No
11. Is there evidence of over application? []Excessive Ponding []PAN []Hydraulic Overload ❑ Yes J'No
12. Crop type Qe er-1066% a1 5,;t1,1 Iv1 6r l ih F_eSG u e 'Pas u rE
13. Do the receiving crops differ with those Yesignated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes P'No
14. a) Does the facility tack 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 , J�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 13"No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) J Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 'dNo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ,(No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes J&No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes )YNo
24. Does facility require a follow-up visit by same agency? ❑ Yes I&No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑Tfo
N6 •yibibitions o d0f cie do $ -W4� re noted during this;visit; - Y;oi will •reeeiye iic further - - - ;
correspondence. about: this'
answers and/or any,recomi
Is. NQQd 40 Gv4 a'd bale -Fescue; skoul t be a(o,ie as �rGZ:�j a�t;.�l)S
q,,,e VLO-� 14ee F I P1 i >Ge s, v e e'L40- . doc.✓rll, Info r (4 `t o e*15- -c a't . G� s�ctl
¢ _51ana[ on a f t _0 00(.r; �� vl.eed 4o ,e<lg ,`i av-e, ,-s CTrec;a1175�-;eld4,
Take S1,?1 :5 toy Ies r'ar so 1 -fes� cL^d 1')0tve a ,�7 zeGl �erc ' b, �'ieldt.
7Ake Lvc i4e srjkyl eg evee � 6o ,4 s "Iced Use a W6g51e n"lys"s �eoi
60de,� s o "`"���rd�1��`O� ev e-><s an -lie �R/l Z�S. IU�at I-�o kwje,
Wa s�F QYla117! V of96nr2e0l aM love dn�es x6WP)
Ale-
Reviewer/Inspector Name S¢ o r1 Q Wji C ► S ' L ,1• � ; -
Reviewer/Inspector Signature: _ _ Nq _ _ Date: �' 10o 5100

Facility Number. 1qOJ 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 attor below E] 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? 0 Yes ,�No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt. Ei— Yes A No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? El Yes /P'�10
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',ZNO
31- Do the animals feed storage bins fail to have appropriate cover? 0 Yes'ONO
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? [I Yes [] No
Additional Comments and/or Drawings:-
4) we-*Ot 'q c cavqlv a�1'01 kirelo
re co,--d -< rL cco rd i'lnva
5100

[3 Division of SoUand'-Wiitir-Conservaiion-- Operation R
e
omoli"04
EI'mision of Soil'and-W, nii�r*ation C: nsp��
rp,
Eltiyisjon of Wate W ty --C-OnilDlidficel IDS ti'
13 Other Ag6ncy Opiratib4i.Rivje
Routine 0 Complaint 0 Follow-up of DW2 inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection 00
rime of Inspection 24 hr. (hh:mm)
Date Last Operated:
P(Permitted [3 Certified J3 Conditionally Certified [3 Registered JE3 Not Oper ........
FarmName: ............ ..... L ...... ...... ....... P ..... ............. ............. county: .... ..... D.--4-q ... ............
Owner Name . ........ .................. ......... .... t
6. ke.,X-1 Phone No . .......................................................................................
Facility Contact- ......... 0'. f- v—.. L e Title: ................................................................ Phone No: ...................................................
MailingAddress: ........................ ......... ... . .......................................... --.1-1 ..........
. .................. Integrator: . . ..... r.r411zr--
Onsite Representative: V-
.... ......... .......
Certified Operator: .... t,: ..................... .... ...... �_.. — Operator Certification Number: ..........................................
Location of Farm:
.............................................. ...... -, ............ ....... ............................. I .................... ........................................................ ...............................
......................................... ...... .................................................................................................................................................................................................
Latitude 0 .9 Longitude a 4 14
esign
D' Current- Deg gh Design Cuirent
7 -i Current",
P , " -.:-, � - - - .
'"- . ...... �- -capacity. Populailo C tl" Capacity Populatiou�
at e
Capacity Population -ou try,
0 Wean to Feeder
X1 Feeder to Finish
L
EMuovv to Wean
Farrow to Feeder
Farrow to Finish
Gilts,
Boars
-Nijmber'of Lagoons
'Hoil Poiidsl Solid Traps I I JLJ No Liquid Waste
I- - - - 'd
Discharees & Stream Inivacts
1, Is any discharge observed from any part of the operation?
Discharge oriffinated at: [I Lagoon [] Spray Field
0
El Other
Subsurface Drains Present 1JU Lagoon Area
System
a. If discharge is observed, was the conveyance man-made?
V I
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 systein? (If yes, notify DWQ)
Spray Field Area
Yes WNO
Yes E] No
%J
E] Yes [] No
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 stonn storage) less than adequate? El Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard(inches): ........ .... ........ I . ........................... I ....... .................................... ................................... ....................
E] Yes El No
C1 Yes KNO
El Yes' 11�0
0 Yes K�
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
[:]Yes Lwqo
Continued on back

lFacility Number: -Z I— jjjhj Date Of 11IS13CCtiOn. FO��) Printed on: 7/21/2000
-C ) . - - %
5. Are there any immediate threats to the integrity of any of the structures observed. (icl 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 XRplication
10. Are there any buffers that need maintenancelimprovement?
11. Is there evidence of over application?
12. Crop type
11 Do the receiving crops d
[:] Excessive Pondiny [] PAN [] Hydraulic Overload
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?
Z�
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
/19�.bes record keeping need improvement? (ic/ irrigation, freeboard, waste analy�is & sgll --gaigg re[Z.QW
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22- Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24, Does facility require a follow-up visit by same agency?
25� Were any additional problems noted which cause noncompliance of the Certified AWMP?
.......... ............. * . ...............
13. �q�'*Watidfis'ojr. &ejcWndi�s'-w'e'r'eh6't*e d* dtWifid 4bis'visit' . - -"ti Will -t&d*c� �fid ffifth&
coix-iso6iride�ce'. aboiuk this' isk ........................................
V I .................... I .........
0 Yes P�No
0 Yes * _0
[]Yes cg���
El Yes It-Nb
El YcsC9P4
[]Yes 4440
El Yes P'No
0 Yes dN(No
El Yes &(No
0 Yes
El Yes 0
[:1 Yes jn:&
El Yes eo
x7MMIrs-Mil
Wes 0 No
El Yes IZNo
E] Yes P(No
El Yes fi0o
El Yes 4NO
El Yes 10 No
El Yes V-No
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):
o,
sao,,f il-ss avf
tool
le-s-) ICA-Lp
37a ko Wdxs L -
C,
a4l-� %-V;v �-
L:h V\Ar-Zk_A�0� CZA_ VA-3 o L W I S P 1114 a_ot aL LLf
Reviewer/Inspector Name
Reviewer/Inspector Signature:
0 V -7,,Otq j-
Date: 10 /;�� / d 5/00

F!Cifity tumber: Dateof,111spection
Odor Iss"es;
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
Yes
0
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
El Yes
28,
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
El Yes
RfNo
roads, building structure, and/or public property)
29.
Is the land application spray system intakc Dot located near the liquid surface of the lagoon?
C3 Yes
0
R�
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,)
E] Yes
No
31.
Do the animals feed storage bins fail to have appropriate cover?
El Yes
IR
0
32.
Do the Rush tanks lack a submerged fill pipe or a permanent/temporary cover?
El Yes
EM"To
d oinments an
--On
3/23/99

[3 Division of Soil aind,'Water.-C�us��ation -gOperation.-Rivww
�C[Division of Soil afid-412iterConservadi ce�!r sp
ty - Coiripliance- nspection
, , = 7'"
Division of W�ter
C[Other Agienc� - qjperati'0'4'1�0�ew-, J,
r9 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Folkow-op of DSWC review 0 Other
acility Number Date of Inspection 0 26 q
Time or inspection 24 hr. (hh:mm)
[3 Permitted [3 Certified [3 Conditionally Certified E3 Registered 1[3 Not Operational I Date Last Operated: ... .......................
Farm Name: ............................. Fokr,--, County: ..... DI"PI),rl
................. .. 111-1 .......... - ....... 1-11.1.1-1- ....... I .. ......................
Owner Name: C-r ro /rn
...... ...... ......... I .......... -61.0 ........... I ........... I .................. I ......................... Phone No: .......................................................................................
Facility Contact: ... .......................................................................... Title: .......
MailingAddress: ................................................................. ..................................
Onsite Representative . ...... ;,IV)
....... .. . . ................................................
Certified Operator: .....................................
Location of Farm:
I-- .... I ....... Phone No:
..................................................................................... .......................
Integrator: ..... em-s 4 ..................................................
Operator Certification Number: ..........................................
A
.................................................................. I ....... ........ .................................................................... I .......................... I ......................... ...................................
.................................................................................................................................................................................................................................................................
Latitude Longitude
Design Current Design, 'Current.1- Design Current,
�wine'.. Capacity Population .. -Foiiltr;y Capacity Popul;ition Cattle capacity . Population.
E] Wean to Feeder
Feeder to Finis�---
Farrow to Wean
Farrow to Feeder
Farrow to Finish
E] Gilts,
El Boars
"Niumbei: of L 1[:] Lagoon Area JEI Spray Field Area
agoons 10 Subsurface Drains Present
n'
Waste Management System
Poiids
_JE] No Liquid
-Holding Solid Traps
Discharges & Stream Impac
1. Is any discharge observed from any part of the operation?
Discharge originated at: [3 Lagoon [] Spray Field [] Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is obsei-ved, 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? El Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: I
Freeboard(inches): ........... Vq ................ ............................. .................................... ................................... ..-I.....-I .....................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
E] Yes JR No
D Yes
TO No
El Yes
91 No
h i Ldi
Yes
Zj No
E] Yes
E No
C1 Yes
4 No
[I Yes 19 No
Structure 6
El Yes 18 No
Continued on back
3123/99

Facility Number-. Datt� of' I tispection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? L1 Yes ;K 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? X Yes D No
8. Does any part of the waste management system other than waste structures require maintena6ce/improvement? H Yes El No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? El Yes 19 No
Waste Aryulication
10. Are there any buffers that need maintenance/improvement? 0 Yes C8 No
11, Is there evidence of over application? 0 Excessive Ponding PAN Yes Fj No
12, Crop type JL?� r M v CIO, Na I
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? El Yes ONO
14. a) Does the facility lack adequate acreage for land application? El Yes No
b) Does the facility need a wettable acre determination? El Yes No
c) 'Mis facility is pended for a wettable acre determination? C3 Yes 0 No
15.
Does the receiving crop need improvement?
K Yes
No
16.
Is there a lack of adequate waste application equipment?
El 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.)
[I Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
9 Yes
El No
20.
Is faci lity not in compliance with any applicable setback criteria in effect at the time of design?
[:1 Yes
% No
21.
Did the facility fail to have a actively certified operator in charge?
El Yes
Og No
22.
Fail to notify regional DWQ of emergenCy situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
El Yes
E9 No
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
El Yes
59 No
24.
Does facility require a follow-up visit by same agency?
El Yes
"I No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
El Yes
No
0.. . ... . t- . . . . . . . , , , , , * * . . . . . * , , , , , * ...........
NO -*i6lh5d0S,'ojr-d&f;cJe.ndes -were "ik will 4,eboi*4� 1j6fufth&-'-'-
............. ..........
.................................
...............................
co, iriso6ridenke'. aboiui thfS'ViSA.'*" . _. * 4 ..............................
�Cornmen _(referto..question4): Extilaiii an--y YES' �=�s--wei-§-an�/o"ny'�recom-m'effidatii)n-s:or�any.,o ercomments.—
fit
-,Use'drawin of fa y t!!�befter-expi'ain"situ-ations.'(uge additional-, -necessar�y
—.0 ._page�'as
'T. Mow lagoey) d;,ke tjodIs
FA-,rVVNetr S-'k-OtAjet be- VjLj4re_ oF t_#r"0w_f -(or cee
f:6n-vc 9&,,0'Pe Ar cvceik 6).1 w;lldotv wA
af;_o.ric-f W, 'Ce,
resrj(7
yel in Fcbr~11"rch
1q. —Fek�,e, V)CW
Reviewer/Inspector Name vti" vV '11-J-
(CTI
Reviewer/Inspector Signature Date: 1101-2f1+1
3/23/99

11,
P�a—c i —1i i y 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
[I 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?
El Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
C] Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
El Yes No
31. Do the animals feed storage bins fail to have appropriate cover?
El Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
M Yes F1 No
--�l 7:
Mona- -6m, ments and/or Dra
P
3/23/99

Division of Soil and Water Conservation Other Agency
a y. El Division of Water Quality
J;Q Routine�O Complaint O Follow-up of D'V4Q inspection O Follow-up of DSWC review O Other J
Date of Inspection
Facility number i Time of Inspection 24 hr. (hh:mm)
© Registered © Certified © Applied for Permit 0 Permitted [3 Not O erati[tnal Date Last Operated:
Farm Name: ..... i .62 rM................... County:.....1h.................................................................
Owner Name:........... C ............. ..... - Phone Nw -Co 14.kft:".'..............................................
Facility Contact:..................................................... .. Title:.................... ......... Phone No:
Mailing Address:, ........................................ �.... ......i��al.7 j.... Td'?.6... .......................... .... gfi'4z i,�1L.. I..4 .USf0 .........
-- /> ( �•- Any
Onsite Representative :•...�.:!(................. ....... Integrator: ........lv`iJ �y
Certified Operator,................... .. Operator Certification Number,..... `.. Q..
Location of Farm:
` . s....at ...1 . SF. .. ... lZ.. o. ...i:.......:r!:t tz..tna�.......... ....l�r,.z.:................... .................................. ....................... I ....... ..........
......:. .*
.........................................................................................................................................................................................................................................................
Latitude 00. ' " . Longitude ' "
General
1. Are there any buffers that need maintenancelimprovement? ❑ Yes Q5 No
2. Is any discharge observed from any part of the operation? ❑ Yes 10 No
Discharge originated at: El Lagoon' ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what"is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? {If yes, notify DWQ)
3. is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes M No
❑ Yes No
tj
❑ Yes IF No
❑ Yes M No
❑ Yes [5 No
❑ Yes If- No
❑ Yes No
Cl Yes (p No
Continued on back

k
Of I
P illFaqlitylNumber: -31 — ho
8. Are there la(,00ns or storage ponds on site which need to be properly closed? El Yes [;5 No
Structures (Lagoons,11olding Ponds. Flush Pits,stcL.1
9. Is storage capacity (freeboard plus storm storage) less than adequate? El Yes 10 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier ........ ................... ............... ............ ......... ........ 11 ........ ........
Freeboard (ft): Z_
....................... ....................... ............ ................................... .................................... ....................................
........ ...........................
10. Is �eepage observed from any of the structures?
0 Yes
No
11. Is erosion, or any other threats to the integrity of any of the structures observed'?
[I Yes
No
11. Do any of the structures need rnaintenance/improvement?
Yes
C1 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?
D Yes
No
Waste Application
14. Is there physical evidence of over application'?
D Yes
No
(If in excess of WMP, or runoff entering waters of the State. notify DWQ)
15. Crop type .......... � cs.c U.f k .......... 6_Y-OtJp�: ............. <,rkat)_..jCyr.,* ...... ........ ................................................................
16. Do the receiving crops differ with those desiffnated in the Animal Waste Management Plan (AWMP)?
M C4
Yes
00 No
17. Does the facility have a lack of adequate acreage for land application'
D Yes
CX No
1
18. Does the receiving crop need improvement?
D Yes
No
19. Is there a lack of available waste application equipment?
D Yes
No
20. Does facility require a follow-up visit by same agency?
D Yes
No
21. Did Revievver/Inspector fail to discuss review/inspection with on -site representative?
D Yes
No
22. Does record keeping need improvement?
Yes
No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
Yes
No
24. Were any additional problems noted which cause noncompliance of the Certified AWN10
El Yes
No
25. Were any additional problems noted which cause noncompliance of the Permit"
El Yes
99 No
No.vio'lations" or deficiencie's. w'ere'- no'te'd- d u r'ing' this -visit. yo'u will receive no ftirther
�otribspi)hden�e �ihoiit this'. visit'.,'.,
�Comments (refer toquestion;#): Explain any YES answers and/or"any iecommendations orariyo�here,o,,M,M"en�tS."�,���,, ,
A -
,us facility to better eiplaidsituationsjyse additional pages as neemary):
"Fawings 01
V­ gai-c- oAtLs ak.- (olpaA J(U wpAi 6e- rbecW, lnw-- J14 wO 4woP '6.e- W,&JeJ -
Of, 5601h� 10t44joK 0� Vit-5M-5 + rttl Ir, Stf Ll� -,�WVO 60- �_K' p6v,
Im I IYI-Tii �,56 TI
7/25/97
Reviewer/Inspector Name
L
Reviewer/Inspector Signature:. Date:

❑ DS WC Animal Feedlot Operation Review
�j DWQ Animal Feedlot Operation Site Inspection
Routine 0 Com taint 0 Follow-up of DW } inspection 0 Follow-u of DSWC review 0 Other
Date i►#' Iuw f�ectton
::Fa�ci�lity-,u�mber 3
Time of Inspection 124 hr. (hh:mm)
Farm Status: [3 Registered ❑ Applied for Permit
aCertified [3Permitted
Total Time (in fraction of hours
(ex.t.25 for I hr IS mite)) Spent on Review
or Inspection (ittcludes travel and processing)
10 Not O erational Date Last Operated:..... .................... ..... �i
FarmName: ............FW.es...... c!�...................... .. County.........} !K\................. ...................
Owner Name: ..........
.4�1"s........ ...i>Y�4 .......... I. ... ..... Phone No: L�iIO�Z 4 �..........................................
Facility Contact: ...... .................�.... Title: ....... Q.j4A-#.r..........p............................ Phone No: .C`�1�� .b..` b. SC.........
Mailing .-address:...4.�.l.... A.0r.`.�k.:...... Sl �2�RA.... ,61,?1N ........ N.:.............. ......!.]�f.fl.�,C�0.11c. r. ............................... ... ,�wi. a ....
Onsite Representative:...[ e� S......i�, ..AM....... ... ..... Integrator: ....... M(hrA4 ..........
Certified Operator:,..
Location of Farm:
Operator Certification Number: ........... .,.L.,7„. (
........:�.11,t....... .L.....t�1 5......... trt �.,....l.tNt�......Y`i. pn.......��QX.........,r..r�....iS.....L1............4Cy........
...Alt.S ....�i��.....�t.e�....,.............................................................................................................................................................................................................
Latitude 0 4 « Longitude a 6 zc
Type of Operation Design.,- .Current° Design Current �'DesignCurrent.
Swore. Capacity Population Poultry Capacity, Population Cattle ="Capacity Population
❑ Wean to feeder
Feeder to Finish
El Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
-❑ Other
Number Of Lagoons 1 Holding fonds ❑ Suhsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
General
1. Are there any buffers that need main tenance/improvement? ❑ Yes 9 No
2. Is any discharge observed from any part of the operation? El Yes ® No
Discharge originated at: El Lagoon ❑ Spray Field El Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes [0 No
b. If discharge is obsen ed, did it reach Surface Water'? (If yes, notify DWQ) ❑ Yes D 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) El Yes M No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes IR No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes 0 No
5. Does any part of the waste management system (other than lagoons/holding ponds) require M Yes ❑ No
maintenance/improvement?
4/30/97 Continued on back

FacilityNumber: 31 —1140
6, Is facility not in compliance with any applicable setback criteria in effect at the time of design? Yes No
7, Did the facility fail to have a certified operator in responsible charge? 0 Yes M No
8. Are there lagoons or storage ponds on site which need to be properly closed? Yes CN No
Structures (Lazoons and/or Holding Ponds)
'9. Is storage capacity (freeboard plus storm storage) less than adequate? Yes IN No
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
....................................... ...................................... ........ I ............................. ........................... I ......... I . ...... ...... ­1­1 .... ................. I ........
10. Is seepage observed from any of the structures? 0 Yes 'IN No
11. Is erosion, or any o.ther threats to the integrity of any of the structures observed? R1 Yes KNo
12. Do any of the structures need maintenance/improvement? Yes 0 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? El Yes RJ No
Waste Application
14. Is there physical evidence of over application? 0 Yes [Z No
(if in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ............ 1��91 ........................... .............................................. cnaskl ............ ...................... ........................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? [A Yes 0 No
C
17. Does the facility have a lack of adequate acreage for land application?
Yes
W No
18.
Does the receiving crop need improvement?
Yes
91 No
19.
Is there a lack of available waste apphcation equipment?
C1 Yes
E�jNo
20.
Does facility require a follow-up visit by same agency?
Yes
No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
Yes
No
For Certified Facilities OnI
22.
Does the facility fhil to have a copy of the Animal Waste Management Plan readily available?
Yes
No
23.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
Yes
No
24.
Does record keeping need improvement?
KYes
No
c"I .� (,,,, in 3.
6e- 46deiM, alli
6f �&500V, wed�
jXV-1 &�e_ :r e-C12
I LIYUN- p��e7s ___s6ald be- txW J Gr4tAr �n� N-Acoh.
C A�ld i.-c lis.W to 4i-t C-AEJMP.
MIS
, k, 6
L4. S " rtcol nu"ea skou Maa 4k CAWAO qvvn6ers. Opjakd w0de- -t
'5600 6e., kV.V%_ f
cc: "wision of water Lluality, water LivatttyNection, tacility ASSessment Unit 4/JU/�F

Site Requires Immediate Attention: 93
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANDAAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: _7— XC 1995
Time: 1+ 1
Farm Narnelpwner:- LY� V D
Mailing Address: ��Ci i. c-". -6 S
County: D Up
Integrator- Q f )p Phone:
(910) rL,10_
_
On Site Representative: Phone:
Phvsical Address/Location- t'3 c ci_ G
Type of Operation. Swine Poultry Cattle
Design Capacity: -3 L7 X Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACTNEW
Latitude: 7 Longitude: 41 ' 5(o Elevation:- Feet
Circle Yes or No
Does the Animal Waste Lagoonhave sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) 6�� No Actual Freeboard- -�__Ft. Inches
Was any seepage observed from the lagoon(s)? Yes
I= Z� or�Do Was any erosion observed? Yes or Cc
Is adequate land available for spray? (Ce
s�or No Is the cover crop'adequate?(De or No
Crop(s) being utilized: 5 C_- \'k
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? (Mor No
100 Feet from Wells? cy-Dor No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or
Co
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes orePm_ If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreagewith cover crop)? Yes o o"
V �A. - % 6)
Additional Comments:
WQ'5V
Inspector Name
_'�s \,j �j
Signature
cc: Facility Assessment Unit �
Use Attachments if Needed.