310173_INSPECTIONS_20171231

NO_ RTH CAROLIN �
Department of Environmental Qual

• Men of Water Resourg6'onservation
FaciliTy Number [] - !7 Division of Soil and
� Other Agency
Type of Visit: C_oommpliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: V Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: rZL Arrival Time: .r7 Departure Time: fiK County: v Region{ Date of Visit: 5^
Farm Name: Vj—� �01-Ig P.. Owner Email:
Owner Name:94
-e�-Y4tt+.c�t / yir•`c(c -LA(° Phone:
Mailing Address:
Physical Address:
Facility Contact: 0 v ' ` t"S Title: Phone: J'n�
Onsite Representative: 1 Integrator: ISWz; Ty l'f T�4 t�,
Certified Operator: `f Certification Number: L 0pna S G 3
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Swine
Wean to Finish
Design
Capacity
Current
Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
O
Non -La er
DairyCalf
Feeder to Finish
(,dp0
Z.aw
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
- oOP
7 PL't?
Dr R ultgy
Layers
Design
Ca achy
Current
P,o P.
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
TurkeyPoults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DW R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DW R)
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 Q-15�o ❑ NA ❑ NE
❑ Yes ❑ No e1VA ❑ NE
❑ Yes ❑ No E3`9A ❑ NE
❑ Yes ❑ No []01GA ❑ NE
❑ Yes [3-No ❑ NA ❑ NE
❑ Yes #ETNo ❑ NA ❑ NE
Page 1 of 3 21412015 Continued

\.
Facili Number: jDate of Inspection:
Waste Collection & Treatment
4' Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �Io ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No LJ#tl ❑ NE
Structure 1 Structure 2 Structure 3 Strr���uctur���e 4
Identifier:_
Structure 5
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ' Q �
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
L2--M
❑ 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
U�<o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
b
❑ 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
L o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
to
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0 o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraalic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �c Pldt +st -5 ro ci I '-j�e--
13. Soil Type(s):
Sj
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
[—]Yes E7-No
❑ Yes [1ONo
❑ Yes [�J_No
❑ Yes C7fNo
❑ Yes DNo
[:]Yes [?NO
❑ Yes 4Fa-No
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E2'No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes f] No
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facift Number: I i - 173 jDate of inspection: .Tv rr
24.;Did the facility fail to calibrate waste application equipment as required by the permit? Yes Q'Plo NA D NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes E No D NA D NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a PDA for sludge levels
Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [—]Yes &No NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Yes Q No DNA NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document Yes g 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:
0 Were any additional problems noted which cause non-compliance of the permit or CA WMP?
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 [Z�No ❑ NA ❑ NE
❑ Yes 2(No NA NE
Yes Callo ❑ NA ❑ NE
Epfe—sdNo
Ej Yes Ej No
❑ Yes I!J No
NA D NE
NA NE
NA NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use: additional pages asnecessary).
e4,a4lo4 - q-� -1 S
Ik -1'r o - 00/&
plou
I.
Id
ate- .3-4-665/
Reviewer/Inspector Name: C6 tiU Iyc�ltC/)
/1 a All �
Reviewer/Inspector Signature:
Page 3 of 3
Phone: l IO-13 J`333 Y
Date:lqmu'k�,n
2/4/2015

Type of Visit: (2F Chop" Rance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit: (p Routine O Complaint O Follow-up 0 Referral O Emergency O Other O Denied Access
Date of Visit: t`1 ! Arrival Time: Departure Time: County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title:
Onsite Representative: l i n 9'� o9!✓°i 1 n S
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number: 9 r,73 it
Certification Number:
Longitude:
Design Current
Design
Current
Design C>urren[
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
W can to Finish
Layer
Dairy Cow
Wean to Feeder
I INon-Layer
I
Dairy Calf
Weeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D , P,ouIt ,
Ca aci r
P.o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No ❑ NA ❑ NE
[—]Yes ❑ No ❑ NA ❑ NE
❑ Yes []No ❑ NA ❑ NE
❑ Yes ❑ Now ❑ NA ❑ NE
❑ Yes E o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[3"No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 5 44e,4,Gvy Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1 D C
5. Are there any immediate threats to the integrity of any of the structures observed?
❑Yes
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes io ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ETNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Q No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes E�o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �rNo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections/ ❑ Sludge Survey
22. Did the facility fail to install and maintain a min gauge? ❑ Yes L'J N ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facie umber: 171 Date of Inspection:
24+Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
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:
9 No ❑ NA ❑ NE
No ❑ NA ❑ NE
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes VNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [:]No ❑ A ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[:]Yes M NNo
❑ Yes J! No
❑ Yes ErNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
011 Io ❑ NA ❑ NE
VL.a N ❑ NA ❑ NE
No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.e:
Use drawings of facility to better explain situations (use additional pages as necessary)-
C C 0�s rD a h C
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: I0 '711 73v
Date: S 2 (G
21412014

(Type of Visit: �Com lance Inspection U Operation Review U Structure Evaluation U Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up O Referral O EmergencV O Other O Denied Access
Date of Visit: I `2S // L / Arrival Time: pn Departure Time: County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: 4-3 LIL, 4.11
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Owner Email:
Phone:
Phone:
Integrator:
Certification Number: I tS 7
Certification Number:
Longitude:
Swine
Wean to Finish
Design
Capacity
Current
Pop.
Wet Poultry
La er
Design
Capacity
I I
Current
Pop.
Design Current
Cattle Capacity Pop.
Dai Cow
can to Feeder
7 WO
7 y 0 1
INon-Layer
11 11Dai
Calf
Feeder to Finish
Farrow to Wean
20�9
2P9
2p 09
]000
Layers
Design
Current
Dairy Heifer
Dry Cow
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
El Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DW R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes 0 o ❑ NA ❑ NE
❑ Yes ❑ No
[—]Yes ❑ No
❑NA ❑NE
❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [ENo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 21412015 Continued

Facility ,Number: j- ( Date of inspection: p f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ea<o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
2�
Identifier. o"Wy Wonjot!5 TCi'%,
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 5_6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes QNo ❑ 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 Et o ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes ENo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Q No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [:rNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes dNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes O No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
QrNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
0/Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
dNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
dNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
dNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[]r No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[3] No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 6 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ] No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: 3 1 - 173-1 1 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Otherlssues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
L UX0 ❑ NA ❑ NE
B"No ❑ NA ❑ NE
❑ Yes
L_d Ko
❑ NA
❑ NE
❑ Yes
❑ No
[DNA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes / No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes E No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ YesrNo�'
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ NA ❑ NE
Reviewer/Inspector Signature:
Date: 4 � i 3-
Page 3 of 3 21412015

Reason for Visit: ourine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: $ Arrival Tim-e1 n Departure Time:® County: Region:
Farm Name: 00 & I `Y D Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: � (> ad�S Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Certification Number:
Certification Number:
Latitude: Longitude:
975'13 8
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Da' Cow
Wean to Feeder
140
Non -La er
Da Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
6
is
I) . P,ouI . +
Layers
Desigct
Ca acit +
Current
P,o ,
Dairy Heifer
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
El Other
Turkeys
TurkeyPoults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes dNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes o
❑ Yes
❑ Yes VNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE.
❑ NA ❑ NE
Page I of 3 21412014 Continued

Facili Namber: - Date of Inspection:
.�9
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ONO
a. If yes, is waste level into the structural freeboard? ❑ Yes [—]No
❑ NA ❑ NE
❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure/4 Structure 5 Structure 6
Identifier: I A(,* ?r,M LAC�3 Ct kc V)A yZ
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): L_ `i
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes WNo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) ,.,/
9. Does any part of the waste management system other than the waste structures require ❑ Yes I ,f No ❑ NA ❑ NE
maintenance or improvement? TTT
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [—]Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes L3 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
NTO
[—]NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑Yes
Q%No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
E�rNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
''No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
JZNo
❑ NA
❑ NE
Required 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
❑ Yes
,�, 'Now
Ltvo
❑ NA
❑ NE
the appropriate box.
7
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EyNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �i Io ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Io ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: Date of Inspection: $
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes CiNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes �dNo
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:
❑ NA ❑ NE
❑ NA ❑ NE
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes Le6 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ✓ No ❑ NA ❑ NE
Otherlssues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes dNo ❑ NA ❑ NE
❑ Yes ]eNo ❑ NA ❑ NE
❑ Yes n No ❑ NA ❑ NE
❑ Yes / No
❑ Yes d
❑ Yes rNo
❑ Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
(Comments (refer to question ft Explain any:YES answers and/or any additional recommendations ocany other;comments. - I
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Date:

Reason for Visit:: (;P'Roufrne 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: II Arrival Time: Departure Time: County: Zop Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: 1))v fs�tiy_yv�
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Owner Email:
Phone:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
'1
Non -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
'-j6tp
D , P,oult .
Layers
Design
Ca aci
Current
P,o ,
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
El Other
Turkeys
TurkeyPoults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
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 V No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[--]Yes n Tji{ ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 21412011 Continued

FacilityNumber: ") 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 -7 Structure 5 Structure 6
Identifier: (Yl�Sec tA_ j G M-1m MPG
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ) 2�0 _ '�>11_ S3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes -ZNo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes 2/No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmen 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 PNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) 777777"''''
9. Does any part of the waste management system other than the waste structures require ❑ Yes O/No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [�Io
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
Ye
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
P"o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑Yes
Io
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
T No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Qo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[-]Yes
I
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Facility Number: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
o
❑ NA
❑ NE
❑ Yes
�'No
❑ NA
❑ NE
❑ Yes [�/No
[-]Yes ]�No
❑ Yes ZNo
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑No
❑NA
❑NE
NA
❑ NE
gV
❑NA
ONE
No
NA
0 NE
Comments (refer to question It): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary). ,
Reviewer/Inspector Name:
Pho4 q10 C —
Reviewer/Inspector Signature:
Page 3 of 3
Date:

IType of Visit: QrCompfance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emereencv O Other O Denied Access
Date of Visit: Arrival Time: E _95_s_� Departure Time: © County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: >o6- Ay Ka.03
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Integrator:
Certification Number: "1 6 5,7 3y
Certification Number:
Latitude: Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
]Layer
esign
Capacity
Current
Pop.
Design Current
Cattle Capacity P.
DairyCow
can to Feeder
1N0
Non -La er
DairyCalf
Feeder to Finish
o
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
'I M 0
......
Layers
Design
l•8 8C1�Pi0. Ca aci +
Current
P,o P.
Dry Cow
Non -Da'
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
id
Discharges and Stream Impact
Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: _
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes n No ❑ NA ❑ NE
❑ Yes J o ❑ NA ❑ NE
[-]Yes YNo ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: DateotIns ection: -L_
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes G�No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1
Structure 2 Structure 3
Structure 4 Structure 5 Structure 6
Identifier:
(nAGI Q
_AnbPQ I CT MAGI SEG
P1A 7�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 41— V 5 1'iZ 3c�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
eNo ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[—]Yes
[�(No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
dYes
ErNo ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
ONo ❑ 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 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes V No ❑ NA ❑ NE
maintenance or improvement? /
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes C No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Q40
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
E2' Io
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other-
2 1. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 12 iO ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

IFacipty Number: 31
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EfNo
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes j no ❑ NA ❑ NE
❑ Yes T[3�No ❑ NA ❑ NE
❑ Yes E j'No ❑ NA ❑ NE
❑ Yes [fro ❑ NA ❑ NE
❑ Yes ITo
❑ Yes ❑k
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes []rNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes �j(No ❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone_qT) 9�'1 w 8
Date: 1 l L, 1 12,
21412011

Inspection U Operation Review
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: F7,jiokArrival Time: 2'3 Departure Time:© County: 6LO W Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: tN 04-flcyr is Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Certification Number: 99513p
Certification Number:
Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
0
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D . Paoultr.V
Design
Ca aci_
Current
Pao ,
I
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Turke s
Turke Poults
Other
I jBeef Brood Cow
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 E�No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes Do ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 21412011 Continued

Facili Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes dNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: IhA&I SEC MAGI IFef MAGI P2z MA 2
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): l34 lot% 4 k
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
dNo
❑ 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
C�No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or en onental threat, notify DWQ
Yes m❑
7. Do any of the structures need maintenance or improvement?
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
VNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
E�`No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
/
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ NA
❑ NE
maintenance or improvement?
Y
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
WNo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[/� N/q
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Io
❑ NA
❑ NE
Required Records & Documents
No
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E3
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Q No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Q ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Nc ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes Io ❑ NA ❑ NE
Page 2 of 21412011 Continued

Q
Faciflfy Number: Date of Inspection:
• 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes d No
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 EyNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑/No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ONO
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[—]Yes [jNo ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes �o
❑ Yes NNo
[—]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 K
Usedrawings of facility to better explain situations (use additional pages as necessary). -�"'
%) LNUL ad tMflC,l SEC, NOS NOLC, ?Lefts( FX--)L ASAP AND Oo kbf ALL -OW W" 1a
l4.) WHER7 ATY A WD MEW W-619S (o 6E 1 �C.
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 116 7T
Date:
/4/2011

1 dDivision of Water Quality
iervation--
ther Agency
Type of Visit Qf Coptpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit E_�/Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: l Arrival Time: a O Departure Time: County: Region:
Farm Name: MA6' L � Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Uh
Onsite Representative: Z)J Gr f"r y'r�S
Certified Operator:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o = ' = « Longitude: = o = ,
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes U No []NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
E1 No
El NA
[I NE
El Yes
[4 No
❑ NA
❑ NE
Page l of 3
12128104 Condnued

Facility Number: — Date of Inspection B t
-Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 6 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LAG-wA 2"d LA6*, TFr4 LAc6bWP2srr+ "e-m G! M
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1l[) $a t-{ Il
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes J6 No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 12 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 environmentalth at, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑Yes o ❑ NA [I NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 7o ❑ 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 IJ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes dNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
[:]Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
VfYes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
RrNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
EZd No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
ICJ ))to
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑Yes
L�JJNo
❑ NA
❑ NE
Comments (refer' -to question #): Explain any YES answers and/or" any recommendations or any"other comments
Use drawings of facility to better explain situations. (use addttionaLpages as necessary) ;
)4.� CaA�GgAsS uri xzfr, A5 Cj"P, Nt" COPY or, RmFNDMI=JT
Reviewer/Inspector Name 1. Phone,
CLj1Cj i76—
Reviewer/Inspector Signature: 1.F6'�_. Date:
Page 2 of
!'nntinund

FaciliixNumber: — Date of Inspection tt
1teauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections ❑
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge? -
❑ Yes
LI No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Ld No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
E(No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[,-gNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[�No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
O No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
dNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
QYNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
,Jl�,//_
L No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
E314
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
Q&
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
PNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

(Type of Visit ,QS Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit �� Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: u
Farm Name:
Owner Name: _
Mailing Address:
Physical Address:
Facility Contact:
Arrival Time: (7 Departure Time: County:
Title:
Owner Email:
Phone:
OnsiteRepresentative: rb0C- AT Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: =o =. Longitude: =o =, =
Design Current
Design Current
Design Current
Swine Capacity Population
Wet Poultry C•apacfty Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
Wean to Feeder
0
❑Non- La er
❑Dairy Calf
Feeder to Finish
7,6o6
❑ Dairy Heifer
Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
Farrow to Finish
El❑
Laers
El Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
El Pullets
❑ Beef Brood Co
❑ Turkeys
Other
❑ Turkey Poults
❑ Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes L{No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
ElNA
ElNE
❑ Yes
[2) No
ElYes
I!J l o
ElNA
❑ NE
❑ Yes
C1J No
❑ NA
❑ NE
Page I of 3 12128104 Continued

Faiility Number: — 3 Date of Inspection I_[t1tzJp7 1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes jNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: W&(, If MAG 1314 MA& 17-q goo& Z
Spillway?:
Designed Freeboard (in):
d
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
0
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
ZNo
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
❑ 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 t eat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
iNo
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
1
9. Does any part of the waste management system other than the waste structures require
❑ Yes
/U No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
dNo
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes E6 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soiltype(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑JYes [& ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? u Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 9 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes [:� No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 9 No ❑ NA ❑ NE
Comments (refer to question #) 'Explain any YES answer and/or ahy recommgndahons or any other<Comments h
Use drawmg`s'of facthty.td better explain situations (use addthonal pages as necessary) ,A" `* l �°"y, #h'
MLm .w gym}
.
1 rYiT�.
/5, / S c.✓ F �i4 LJS Lo/ tc T6 QC �y �aoec SlJr0�G , tZEq u�7 r� ni► /
-
i6 E✓Y LVAT-E AtJD AECOmmojp f,y. tort[/ 7o opj,2. t,4ssuaJ SO WS
Reviewer/Inspector Name R�f�� '' Phone:` 9!6
Reviewer/Inspector Signature: Date: /! a
12128104 Continued

' Ficility Number: 'j — Date of Inspection I t c
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Ld No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes E No ❑ NA ❑ NE
❑ Yes E�No ❑ NA ❑ NE
❑ Yes
ffNo
❑ NA
❑ NE
❑ Yes
dplo
❑ NA
❑ NE
❑ Yes
o
❑ NA
El NE
❑ Yes
154
❑ NA
❑ NE
❑ Yes
I
[I NA
❑ NE
❑ Yes
❑��Io
[I NA
[I NE
El Yes
[;?'No
[I NA
❑ NE
❑ Yes
/ o
❑ NA
❑ NE
El Yes
/No
❑ NA
❑ NE
❑ Yes
WNo
❑ NA
❑ NE
❑ Yes
�
El NA
❑ NE
❑ Yes
CJ No
❑ NA
❑
NE
12128104

IType of Visit Q(C mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Rea
son for Visit tRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit III IC9 08 Arrival Time: C70 Departure Time: County: 1w&zh2 Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Owner Email:
Phone:
Onsite Representative: DDo fY pfrl zjvj Integrator:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Phone No:
Operator Certification Number:
Back-up Certification Number:
o = , = Longitude: = o = ,
Discharges & Stream Impacts /
1. Is any discharge observed from any part of the operation? El Yes O No ❑ NA ❑ NE
Discharge originated at ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
0
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes dt10 ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Date of Inspection ll I a8
Facility Number: —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
ElYes
{2 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: MPC> 19 MAC, 1S MAG Ir rV1ACrZ
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): IV) Vo III— 3�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
CYNo ❑ 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
thr at, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
I{J 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
Ej No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[IJ Yes
��
I No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
U No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s)
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Y s
No
El NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
Vs
El NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
,❑lNNo
I!I Flo
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
E
[I NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
El Yes
❑ NA
❑ NE
15) FC.Sc.Avc S LL L- n1E69S wo "c oN E�)tA f3 r_ t514 CVCr (U T-fG rt, cou ? ,f
2l.) ALA rr 94'A Y Fi Y KOZ VE.NTUM �AR.M5 I LE _O UPOAtEo tao'1 Stoc1�11JC>,
Fox_ AVfJVA 4t/6266-E 40— "" SztL-
Reviewer/InspectorName I vt1W - I Phone: L`UDJ /"1T l S tip
Reviewer/Inspector Signature: 4 CY Date: 1ef 11 tJ I6
Page 2 of 3 12128104 Continued

Facility Number: 371 — 11 Date of Inspection It o
•Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps s p El Other
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
Yes
❑ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual
Certification
❑ Rainfall stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections
❑
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
�o
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No�
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
,�,/NP
L� No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
12No
❑ NA
❑ NE
Other Issues
�
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
13 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
13No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
P4
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
E3'1�o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
,,��,,G``
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
[I Yes
LNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
,a No
❑ NA
❑ NE
Additional Comments and/or Drawings: -
r
Page 3 of 3 12128104

Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit eCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: �t� I�Ia7 Arrival Time: Departure Time: County:
Farm Name
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: Z6 J it .12"f Rijis Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: = U = ' = Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
i 6 ❑ Non -La et
❑ Wean to Finish
0 Wean to Feeder
® Feeder to Finish'D
2otS6
® Farrow to Wean
G"
6b6
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Region:
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heife
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
❑ Yes No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes ❑Yo
❑ Yes L� N
ElNA
ElNE
ElYes No
❑ NA
❑ NE
12128104 Continued

Faciliryi 1 — )-7�
1 Date of Inspection /1 6
Waste Collection & Treatment
/No❑
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: _I{IA(n 19 AMLr /% yLIAG Z/
Spillway?:
Designed Freeboard (in): '
Observed Freeboard (in): :31
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
EfNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
El Yes
1
L'� 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?
Lj Yes
El NA ❑ NE
Do any of the stuctures lack adequate markers as required by the permit?
El8.
Yes
,❑/No
LI No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
,�,/
2 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ICI No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
Z No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑]Yes
E�`No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
E Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
eNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
El'No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
R No
❑ NA
❑ NE
IComments (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):
9.) PSkE"Lt_ wOKV-- o N ✓ R6 I P ,r- MA 61 5AA4 (- OS 3 r—
t5,) Fps V -r-W
=AA bAo SNnvE
duc To DUC-A-GwUz-C.
ajE Awpuds
D0 No-r ev'VAP
tM/TZI_ UV60, ,ig
�s r�B�-sHE�.
bte &4gr P.SJL6V'&
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone: L
Date: _
12128104

Facility Number: — J -n Date of Inspection 11 a
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropiate box. ❑ WUP ❑Checklists ❑Design ❑Maps ❑Other
21. Does rreecc rd keeping need improvement? If yes, check the appropriate box below. LJ Yes El No El NA ❑ NE
❑.Waste Application ❑ Wee y Freeboard El Waste Analysis ❑ Soil Analysis El Waste Transfers ❑ Annual Certification
El Rainfall cking Crop Yield ❑ 120 Minute Inspections El Monthly and I" Rain Inspections El Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Comments and/or
❑ Yes CJ N/o ❑ NA ❑ NE
El Yes L�J No ❑ NA ❑ NE
❑ Yes ,,❑'No ElNA ❑ NE
ElYes Ldrvo ❑ NA ❑ NE
❑ Yes ONO ❑ NA ❑ NE
❑ Yes r4,o ElNA ElNE
ElYes o ❑ NA ❑ NE
Yes ❑ No ❑ NA ❑ NE
❑ Yes
O o
❑ NA
❑ NE
❑ Yes�'o
❑ NA
❑ NE
❑ Yes
LJ No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
El NA
El NE
❑ Yes
,�Io
L7 tvo
❑ NA
❑ NE
12128104

. Division of.Water Quality
icility Number j O Division of Soil and Water Conservation
— - -- 0 Other Agency _
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit xRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ! Arrival Time: b Departure Time: �unty: 4/c/P4 Zr Region:
Farm Name: ��ify0LZA- /"f-K(/lls L Owner Email:
Owner Name: A) / /''eS Phone:
Mailing Address: _
Physical Address:
Facility Contact: Title:/] Phone No:
Onsite Representative: 1wfCl o-d Pf 1004&�' t %7iiZ/ IS Integrator: ZAMP`/t/- .�Pae4)„�
Certified Opera,-JS Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = c Longitude: n
" Design Current' Design Current Design 'Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
❑ Wean to Finish
Wean to Feeder
14 140
Feeder to Finish
000
Farrow to Wean
0619
Ll Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La er 1 10 Dairy Cow
❑ Non -Layer ❑ Dairy Calf
_ ❑ Dairy Heifer
Dry Poultry
Pullets
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
U Beef Stocker
❑ Beef Feeder
Beef Brood Cowl I
.Number of Structures:. FU7, i
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes 10 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
L(J No
❑ NA
❑ NE
12128104
Continued

�i
Factility Number: —� Date of Inspection ZG
Waste Collection & Treatment ,,,,,,(((
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [IYes ,Y�No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Stru ture 4 Structure 5 Structure 6
r. e IdentifieP
Spillway?: No No
Designed Freeboard (in): ��; 5 4q 5
Observed Freeboard (in): 2 4'7- 6?4
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes XNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes ❑ No ❑ NA ❑ NE
8. Do any of the stucmres lack adequate markers as required by the permit? ❑ Yes g 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 El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes 2 No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Z No ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 Ibs [:]Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
eoNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes )gNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes eg No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes VNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 9No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Sa,irf FRosao d /�o��c<o. /I/o o t-In �9�Ery
N�%ll Ev�1z y �ifzr F sz
Reviewer/InspectorName i' O Phone:
Reviewer/Inspector Signature: Date:
Pape 2 of 2/ n/J _ i 12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes toNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes yet No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 9No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0No ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
21 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
ElNA
[I NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
!1
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
gNE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CA WMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
m No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
;ZNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
P(No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
P No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
VfNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
XS�e_o ZAk2-
1l)O Lf%g5�� Gi r !%�yc s o Ar Q6?19-Cj'A-
M9,0e �D.v ��RO ✓£N6 ��Rm vOq 41UO
FCOS LS,�RyGGFO le�;✓ 66<17c ,6,9
l 5 -r � cC
Page 3 of 3 12128104

Type of Visit 0,,C((ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit JU Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: E/Z / V Arrival Time: Departure Time: County: Region: �-o
Farm Name: TA Alm c!2Z ,,/� /� Owner Email:
Owner Name: /// �i�/17 _® �t� Phone:
Mailing Address:
Physical Address:
Facility Contact Title: Phone No:
OnsiteRepresentative: ��� ��� aG K� Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: o = ' = Longitude: = o = ,
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑Non -La et
❑ Wean to Finish
Wean to Feeder
19 Feeder to Finish
D1
Q
Farrow to Wean
17WI0
LJ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: 5
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 1�1No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes ONO
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes XNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: jaj.jl- &_ ,
Structure 5 Structure 6
Spillway?: /�O No✓
Designed Freeboard (in):
Observed Freeboard (in): 4F (2_ Z/
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 9No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes VNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes ,o No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or t0 Ibs [:]Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
[:]Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
Al'?
12. Crop type(s) / ,/1%,
. (,{/J.' A T��KIJbHr(` �/I 1�L 4Sid
13. Soil type(s) 14
t
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[--] Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
ONo
O No
ZNo
VrNo
El NA El NE
❑ NA ❑ NE
El NA ❑NE
❑NA El NE
❑ Yes PNo ❑ NA ❑ NE
/O���OS Sou T,�� �<Poe��/lflwEO L2�F �ifo�o
.Omg3a, 01,A /A� 0�8 8/:Ding5W 0/17�� 7'4 ,Omg71,a, ,Dm���
IReviewer/Inspector Name g C Phone: 13io 'f - Z6 I
Reviewer/Inspector Signature: T �— Date: OS
12128104 Continued

Facility Number: 3� — Date of Inspection07J
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists gn ❑ Maps
❑ Desi p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ICI No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers/ ❑ Annual Certification
❑ Rainfall Cl Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
VNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
0 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
Y' No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
O No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
gNE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
r�
Ej No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
IQ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
INo
[-INA❑
NE
If yes, contact a regional Air Quality representative immediately
/
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
XNo
ElNA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
ElYes
Pq No
AlDid
i
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
El Yes
No
❑ NA
❑ NE
Additional Comments.aud/or DratVines:
�Z 1 /®�/72r/cP/J� %O GUD2 f- 6/�✓ i ��ig.F�=�srrzv� (�><ts,.S c _ov�.eigc. ,E
(%Q? �f} 5 �Z6 c�/��, �G/�✓NF �✓c (moo T
Z�� �,✓ �oC�55
12128104

(Type of Visit d Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit (�3/Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: q IN w { Time:
10 Not Operational O Below Threshold
Permitted [Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: __. i�A�zt�L7_Y(Lt:._._� Z ____- __.� County:
Owner Name: -�----••---.�._� _ . - _-�---- _- -• Phone No:
mailing Address: --
Facility Contact: �_--_ _. __—� Title:._—` __ Phone No:
Onsite Representative: 1LEUriggE_}•� S 1+a1! Integrator. MUMPN
Certified Operator:- Operator Certification Number:
Location of Farm:
❑ Swine ❑ Pouttry ❑ Cattle ❑ Horse Latitude =• =° =" Longitude =• =' =K
Discharees & Stream hn acts
1. Is any discharge observed from any part of the operation? ❑ Yes o
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: _MAGI - P GnR U I - S _ _ MP�2•^__, !rl q fs y
Freeboard (inches): oiti 19 26
12112103
❑ Yes ❑ No
❑ Yes -❑``No
0 ❑ Yes "No
❑ Yes EkKo
❑ Yes 0 No
Structure 6
Continued

Facility Number: — 7'j Date of Inspection
5: Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑(No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes E TNIo
closure plan?
(H 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 maintenancelmmprovement? tQ I e5 ❑ N
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes �No
9. Do any strictures lack adequate, gauged markers with required maximum and minimum liquid level [I Yes ❑ No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type B -A6 i:kFn oA u Df> r (4 )
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 014_0
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
b) Does the facility need a wettable acre determination?
❑ Yes
^_!Io
j31vo
c) This facility is pended for a wettable acre determination?
❑ Yes
15. Does the receiving crop need improvement?
❑ Yes
_0.90
16. Is there a lack of adequate waste application equipment?
❑ Yes
V❑�1vNo
o
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ®'No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes Q.X6
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 21qo
roads, building structure, and/or public property) ��
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes b No
Air Quality representative immediately.
7,) Corrt�UE t�roR K OW CovEQ- 6f MILC- WrjL
RoW co-op rzEA-0.
kGF,P I" R.PtOeAI 1, W1 l Qt6C-�o6iR �•
ReviewerAU spector Name
Reviewer/Inspector Signature:
Field Copy ❑ Final Notes
Got-y T.LISUE (sM1X1P17►j6 Ljatt.,l[, 6n1
Date: 4 m y o
12112103 Continued

Faci\ity Number: — \ Date of Inspection 14
rb
' Reuuired
Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
�/
Ey No
22.
Dees the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
No
23.
Dees record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
—❑
id 'N//o
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
7,,�N"o
L_iv
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
vo
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
0<0
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
eNo
28.
Does facility require a follow-up visit by same agency?
❑ Yes
[3 �
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
[I Yes
No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) LJ Y es ❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑.90
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes —21Go
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes 040
34. Did the facility fail to calibrate waste application equipment? ❑ Yes O�'/10
id 35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes w"0
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
13 No violations or deficiencies were noted daring this visit You wtiH receive no further correspondence about this visit.
_ i � /6iffim 4�Y�Gwrttg$ffi*
12112/03

of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Fallow up D} Emergency Notification O Other ❑ Denied Access
Facility Number i Date of Visit:
Permitted 0 Certified 0 Conditionally Certified 0 Registered
._ .. Farm Name: ....._.. 'ice ....................................
.......... .............
. ..... ..
........
Owner Name: _-__._._...._.D _._. _!!_!_L ___.._..._.
Mailing Address:
Time:
Date Last Opera o Abovve Thresho)ld:..
County: .........
Phone No:
FacilityContact. .._...._......._._....... J_.../__................... Title: ... ......................... ... _................. Phone No,:p_..._._._._.......____....__._........
Onsite Representative:.._._ _Li�p[�........... ... _---_. Integrator: _._._..1 �._.t_�L.:. ...............
Certified Operator: .-........... _.... _._.......... ........ __..
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =• 0` =`° Longitude =• =` =11
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes XNo
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? Oyes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
ct.
ure?1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 _
Identifier: ..... _.__.._._...._....____..__._.._...._....___......._.---......._......_._._ ............
Freeboard (inches):
12112103 Continued

Facility umber: — Date of Inspection
5 ,Are there any immediate threats to the integrity of any of the structures observed?(ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
❑ No
closure plan?
(If any of questions 46 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenancelimprovement?
❑ Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
❑ No
elevation markings?
Waste
Application
10.
Are there any buffers that need maintenanceritmprovement?
❑ Yes
❑ No
11.
Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12.
Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Odor Issues
17.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
18.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
❑ No
19.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ No
roads, building structure, and/or public property)
20.
At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
❑ No
Air Quality representative immediately.
Field Copy ❑ Final Notes
//�oly\ GNdZ,QO/✓mENIAL SPEGzyyzs�/p'1
ly\_ ;q'e ,
'0uR7�an/ ��R/LZ�i4 TZo� EdENT Li9r✓O G1�iJ
Reviewer/Inspector Name }/
Reviewer/Inspector Signature:
Date:
a c.aci v.i a.tinsusuea

FaciBty�Number: Date of Inspection Y
Required
Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
23.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
XNo
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
f ZNo
28.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
❑ No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form []Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
ddiuoaal Comments aiid/or Drarovtngs
40
Z A-5 T� Ap FF_ ,v A/ �i�2^1,E0 ,%%Alp tlmP�D Act
A0
A,QOunJ/J l Of7 D �`p �� too G-iy"_ O/ 1S �A/D
/ /rfflnl I DvD
71> 97 GF s s r T rEaFo uJs���
%/fE �%f1 �E.�j5 EE,.i�Niw vF act l��toG
%� K
�N �2 CLF t✓- �P E�o,eTs,
12112103

Type of Visit F Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for VisitRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: / Time:
10 Not Operational 0 Below Threshold
Permitted 0 Certified 0 ConnQdiitionally Certified 0 Registered Date Last Operate/kr Above Threshold:
Farm Name: 119IS 4/ 9l, County:
Owner Name: to /f t / /A1 i Phone No:
Mailing Address:
Facility Contact: Title: hone No:
Onsite Representative: lzL,2 ©Pe L 7I)M -) Integrator: P
Certified Operator: Operator Certification Number:
Location of Farm:
Vf Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =* =1 =� Longitude =o =` 0-
Design Current
Swine Canarits, Pnniilatinn
Wean to Feeder
Feeder to Finish
O
Farrow to Wean
. DO
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Discharges & Stream Impacts
Design Current
Design
Poultry
Ca acity Po ulation Cattle
Cii. acit
❑ La er
❑ Dairy
I
❑ Non -Layer
I
JLJ Non -Dairy
I
❑ Other
Total Design Capacity'
C
Total SSLW
❑ Sul
FM —No
1. Is any discharge observed from any part of the operation? ❑ Yes I[3 No
Discharge originated at: ElLagoon ElSpray Field El 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 ,,,.....X,,,{{{ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? El Yes I/J No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes XNo
Structure 1 Structure Structure tuS r Strut re 4. Structure 5 Structure 6
n ° rnW= ]dentifier. 1-rttsm
Freeboard (inches): ZQ 'tOO 109 .35
05103101 Continued

FacilityNumber: — Date of Inspection
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
(�No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
No
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
No
Waste Anolication
10.
Are there any buffers that need maintenance/improvement?
❑ Yes�No
o
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN Overload
❑ Yes
12.
••''❑�ydraufic
Crop type Spt��F.^�G I�hIF_RT lsR 1,nQ HA 'sltlRcc. h-ZtJ
\
Qt/F(tSEE.I\
13.
Do the receiving crops differ with t ose designated in le Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14.
a) Does the facility lack adequate acreage for land application?
El1� Yes
,,----//
No
b) Does the facility need a wettable acre determination?
[IYes
'ONO
c) This facility is pended for a wettable acre determination?
❑ Yes
ONO
15.
Does the receiving crop need improvement?
jI❑ Yes
El No
16.
Is there a lack of adequate waste application equipment?
/
Yes
XNo
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
'd
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
[IYes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
�,{
(ie/ discharge, freeboard problems, over application)
El Yes
No
/�tPKNo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
24.
Does facility require a follow-up visit by same agency?
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
'VYes
❑ Yes
XNo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Qommenti (refer to question ."Explam any YES an i'4rs:.aad1oi any recommepdattons or.aoy other,�comments
IUs'e drawings of facility to better eaplmn sr�tuhfions (use.add o` nal pages'as ssary) r Field Copy ❑ Final Notes
I S �ERn,NoA zr c p4v&5 766� 2'4b, 284) 296 30L1 3132 3 f,6D
nINRa1/Eir),SN7-, VERY L2T9«/166,eA 0qf 07-=e1_50 ��✓ FaFco.
�LOS �90 Eni ,OZS,t EO, r/ Lor /01 A-55 f/vD RALF46'
Reviewer/InspectorName�
Reviewer/Inspector Signature: Date:
05103101 ... r Continued

Facility Number: 3 —� Date of Inspection / r
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
3 t. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes P'No
❑ Yes WNo
❑ Yes PNo
❑ Yes [;6o
❑ Yes XNo
❑ Yes ❑ No
Additional Comments'. andlorDrawings: o"• ""
Z¢ Qou�r.JuP FS�� EE�Fo /o �=�%` �c,� �•J
O/1OP.
��7F; �v�,e y.s if��✓� F_LSE � ©Qo�R� �Cf�a�o s
z7"f]oI
05103101

1
1.
_I
a,� - Division of water
Solt aml-Water Consenatton � � 3 . � - ,� ;
O Otlter Agency Y
44
(Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit QrRoutine O Complaint. O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit:
31 f
0 Permitted [3 Certified 0 Conditionally Certified [3 Registered
Farm Name: i t )aon�. i et ryhS bl .
.................................................................................................................
Owner Name:D.....MYr1,-✓hS of Rose �.LL
................................................... ....................
Facility Contact:
Title:
MailingAddress: .....................................................................................................................
Onsite Representative:...../[T._✓r,!,'t 1 ....e..h
...........................................................................
Certified Operatoi
Location of Farm:
�3 D� Time:
O Not Operational O Below Threshold
Date Last Operated or Above Threshold: ...... _.
County�!� ,. � .
Phone No:
Phone No:
Integrator:...../.: 4..0 r................................................ _..
Operator Certification Number: ..... ............... __..__.__....
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =• =, =,, Longitude =• =' =..
Design Current
Csnacitv Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design . Current
Poultry CapacityCipacity Population
❑ Layer
❑ Non -Layer
Cattle Ca an _: Pb olstion=
❑ Dairy
❑ Non -Dairy
❑ Other
Total Design Capacity -
Total SSLW
Number of Lagoons Subsurface Drains Present J10 Lagoon Area . I❑ Spray Field Area
Holding PondsI Solid Traps ❑ No Liquid Waste Management System
Discharees & 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?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Spillway
Structure I
Identifier:.......................
'Structure r2
Structure 3
�...n_....�.........................-2-
Structure 4 Structure 5
............ ..rf.............
Freeboard (inches): Z!
................................................199
45
U D
............................. .
3
5/00
❑ YesXNo
❑ Yes 91,10
❑ Yes P No
It,
[]Yes o
❑ Yes Plf4o
❑ Yes J3!No
❑ Yes )E No
Structure 6
Continued on back

Facility Number: �/ — / 7,3 _ Date of Inspection 13 ,
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes,,O"No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes
�No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ) J
7. Do any of the structures need maintenance/improvement? ❑ Yes-(] No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes''No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ,(ErNo
Waste Application
10. Are there any buffers that need maintenance/improvement? J ❑ YesZNo
It. Is there evidence of over application? ❑ Excessive Pending ❑ PAN Hydraulic Overload Yes ❑ No
12. Crop type WhecA 6erwv" $c✓' nuAll +'t Gretil
13. Do the receiving crops differ with Anse designated in the Certified Animal ante Management Plan (CAWMP)? ❑ Yes_)ZNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes Z.No
b) Does the facility need a wettable acre determination? ❑ Yes J2fl!No
c) This facility is pended for a wettable acre determination? ❑ Yes _ N0
15. Does the receiving crop need improvement? ❑ Yes
No
16. Is there a lack of adequate waste application equipment? ❑ Yes ONo,
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes &No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
1
WIT,
❑ Yes
(ie/ checklists, design, maps, etc.)
.9fNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes �
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes 9.No
21.
Did the facility fail to have a actively certified operator in charge?
/No
❑ Yes �Io
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes /V(No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes �P&o
24.
Does facility require a follow-up visit by same agency?
❑ Yes 'Poko
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes 11 ( 0
NQ •yi0aWxis'ot• deticWnde' -*qre IW4 00flog Ns:vw1t; • X00 wji1 •#ecgiye 40 WOW • ;
.... . ............................... .
ll• We^s4c loin gDoW-f jhGL /Ltq�. gl�oliCA4;0h,7ilere WeY'e sore sr
p tj (D/ were.
&7_4�,Yi6es Ais :%rvrnwter 4wo or -�ktieL tq�p�l�ca�IphS bddbtt�
-� e n,1n Rwr-- fjetG� ¢a bo°Z�' o, ' ke sq—e
ckreo resJrY;nA I't ✓�torC ��'�'t tJLe�Gtt ✓MA. Pe_✓ da4 .
©vc✓'etll j 41ir -fa l;47 olyi/ rc6oedl gi-e well kT1- l
IReviewer/Inspector Name�ah cti/f ,
Reviewer/Inspector Signature: Date: 61l3 A J S/00

Facility Number: 3i — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below zyes ❑ 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 .)ZrNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes )'No
roads, building structure, and/or public property) /�
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes,&No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes XNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes /; No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
5100

Facility Number j / r/ 3 Date of Visit: tt road C Time: � Printed on: 7/21/2000
0 Not Operational Q Below Threshold
jo Permitted Q Certified 0 Conditionally Certified Q Registered Date Last Operated or Above Threshold: .......................
Farm Name: ....r11.r'.neI �� 'SP. ..._{+!'.s.....I_.�...Z.......................... County: �7...�`..._If h....................................................... ................... ......... ........
Owner Name: ........... a.....r�...r ms........................................................................ Phone No: ......
Facility Contact:
Title:
MailingAddress: .....................................................................................................................
OnsiteRepresentative: Ter�t}.T�.e`.�viL. P>pe, /-j-L'_'+-±al.
Certified Operator:
Location of Farm:
Phone No:
Integrator:..%)(I! 1T..LJ9......_4aG!.')n.r..........................
Operator Certification Number: ....... ,..................................
JWSwine ❑ Poultry ❑ Cattle ❑ Horse Latitude =• 0` =« Longitude =• =' =11
Design Current Design
CaptiCift P01inlition Poultry Ca acif
Wean to Feeder 74D 1 10 Layer
Feeder to Finish jZ000 1 10 Non -Layer
Farrow to Wean I r70 ea I -
Farrow to Finish Total Design Capacity
Gilts
Boars Total SSLW
Nuiuher of Lagoons ® ❑ Subsurface Drains Present ❑ Lagmn Area Spray Freld Area
Holding Ponds i Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structur 2 Structure 3 Structure 4 Structure 5
Identifier: .... !M.5.'.p...�I..-....... ......... ......_Z.......................................
Freeboard (inches):
5100
❑ Yes 1ZNo
❑ Yes .@ No
❑ Yes RrNo
h /q
❑ Yes fdNo
[:]Yes &No
❑ Yes K) No
❑ Yes 0 No
Structure 6
Continued on back

Facility Number:.3(- I % -� Date of Inspection I ( Do
Printed on: 7/21/2000
5. 1 re there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes JO No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? - ❑ Yes jc No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes 0 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
(�No
12.
Crop type So �4 6 e Mtn t, Gvl 1164 6e.r- .-. v-lAtS ,
13.
Do the receiving crops d differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
J<No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement? -
3KYes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
WNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes Z 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 E;allo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) /d Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? . ❑ Yes O No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes �I No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'? ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? if Yes ❑ No
EIOlOtlsOlaCet'-
VVidig WOO h6 ed difg fbisvllt- YOU 'Will 10fufth-,CtH5,Ct,e,
corres otiden&boutthis
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):
IS, =t^ Prarc d/4i norGtc d veye�ti�;ovt04n waJQe-t-`'a�s i-N e�ols ��ci 16
espeo;aU� F)Zld .3e Tic r16-- sy0r-,y o,., sz,-1„ra-eA �4iG✓WAyt. l
Zt�t�ro(ra .(Ov l wet F✓cas ;h F","e1rIS /o -6 S.
�. 6e .sv re Ik-1 e CvCe,.9CS+vim, l�l L�aS�e �Ic n. bye s✓r2
+v -�st'k-� Sc: 6ahP(cf y �y ll.{'i 6I�cS qrt l�I dBS+�nAfB F✓ofvi- (,','Up oK
raw p� e,
25, s<pfle fr jrr.1 were mmde to 4ae^ ud,. ;nL7c�o�er.plar sty 1V7q,A__(ef4,Folfot/Joaal,
I Reviewer/Inspector Name-�Qhet../a I M4 W-r I
Reviewer/Inspector Signature:—,.,ta.[t.,�ri q-l:�2!> Date: N/111,10 5100

Facility Plumber: S/ —1 r/3 Date of Lnspection %) Printed on: 7/21/2000
Odor Issues -
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor below %Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 19�No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes %No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes 10 No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes JJ No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 4 No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
5100

0 Division of Soil and Water Conservation -Operation Review
�r i +4 E3 Division of Soil and. Water Conservation'- Compliance Inspection =
„Division of Water _Quality Co'mphance Inspection_ I F+
- ; =•: 0 Other Agency - Operation Review
J0 Routine O Complaint JV Follow-up of DWQ inspection Q Follow-up of DSWC review O Other
Facility Number 3 / %.3 Date of hrsoecGon 00
Time of Inspection / /$ 24 hr. (hh:mm)
❑ Permitted E3 Certified ❑ Conditionally Certified 13 Registered No[ O cra[ional Date Last Operated:
..........................
FarmName: .... iA...Sn.W. 'Ittrn ...... ..- _2............................ County: �V I.!'...............................................................
OwnerName: ......... FArvvvs........................................................................ Phone No:.......................................................................................
FacilityContact: ..............................................................................Title:................................................................ Phone No:
Mailing Address:
Onsite Representative: ... !.l.U....L.L
.%.... k..Integraor.....................4............................................................... Vpv"/....................
.`? MS
Certified Operator: .................... .......................... ..... ....................................................... Operator Certification Number:..........................................
Location of Farm:
Latitude =a=` =" Longitude =• =' =11
Design Current
Swine Canacitv Pooulaton
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Design Current Design Current
Poultry s Capacity Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non -Layer I I ID Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
INumber_of Lagoons ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
Holding Ponds / Solid Traps -' ❑ No Liquid Waste Management System
Discharges & Stream Impacts '
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ 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 Stale? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
f Yes
❑ No
Structure I Structure R atructurre 3 Structure 4 - Structure d
Structure 6
Q
Identifier: M^5 1 Z P%A.S+A5e 4^1 M45 2._
Freeboard(inches): ......... ..._3.............. ......................_2...1...............................Z......................._.._b....................................................
...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc.)
3/23/99
Continued on back

Facility Number: 31 —� 73 Date of Inspection
;_ r, re there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ) _
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
filfi7 � .
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination? _
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
0' oli:oflicendis -were poed diWittg this:visiC -Yo:µill•rl.yioaiirisr et. u crip fuihr: • ' •'
corres ondence.A6o this
-.
Comments (refer to question #) Explam any , answers and/or -any recommendattoiis'or any other comments
Use drawin s of facilit r ez lam situations a
g y in bette::_..�...,_P (use additional es as necessa
5
.Y�..-
.
_t _ n..-.,.Pg
Sn1PCCJLeh conotucheA -lo -rollot.,ur, uh #1OP%Co.riP 1;4.t; i�n►�sogrd at
•}tie iar✓� 1 i f �• Loon level S s4ou lat be loLoer�cl ;n q
4i will l 7 m Ah/tee.
Reviewer/Inspector Name V.,•-
Reviewer/Inspector Signature:
Date:
323/99

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
.lames B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
September 14, 2000
GERTIFIED,MAIL"70b`0500 0`0i2�3 4�2H�9.8Es9$
RETURN RECEIPT REOUESTED
Mr. A.J. Linton
DM Farms
893 Isharn Fredrick Road
Magnolia, NC 28453
Dear Mr. Linton:
Subject: Inspection Reports
IT
NCDEN
NORTry CAROUNA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Magnolia Sow Farms 1 &2
Facility Number: 31-173
Duplin County
Please find enclosed copies of the inspection reports for the referenced facility for the
inspections which occurred on 7/28/00 and 9/7/00. I noted on July 27, 2000 that freeboard level
records for the second stage lagoon at the Mag I site were not being kept. Please take note of my
continent in the 7/28/00 inspection report which indicates that freeboard level records need to be
kept for the second stage lagoon. Also, be advised that Part III. Monitoring and Reporting
Requirements, Section 2 of the General Permit which the facility operates under requires that
waste lagoon.levels shall be recorded weekly; this applies to all lagoons. Please submit a written
Plan of Action within 10 days of receipt of this letter which addresses the freeboard level record
keeping for all lagoons at the facility. If you have any questions concerning this matter, please do
not hesitate to contact me at 910-395-3900 ext. 203.
Sincerely,
Stonewall Mathis
Environmental Engineer
enclosures
cc: Central Files
Vdlidmin�lp_�b s:\wqs\animals\duplin\2000\31-173letter
127 North Cardinal Dr., Wilmington, North Carolina 28405 Telephone [phone] FAX [phone]
An -Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

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Ilk.

I ❑ Division of Soil and Water Conservation - Operation Review
t-
❑ Divsion or Soil and Water Conservation - Compliance Inspection
jj!rDivision of Water Quality - Compliance Inspection _
❑ Other Agency - Operation Review
JO Routine O Complaint AD Folin;c-un of DWQ inspection O Follow-up of DS%VC review O Other --��
Facility Number 3 1 .-I1 •%3Date of Inspection
Time of Inspection 1425 2.3 hr. (hh:mml
❑ Permitted Q Certified ❑ Conditionally Certified ❑ Registered ❑ \ot Operational Date Last Operated:
Farm Name:.....................M `• °1t' i `v e• i._rf-n-_'^'S -r Z G�7� 1:-,
..... 5'-----' - .- - County:
F1 % C!'Iv;S-------- Phone No:
Owner Name: .................. -'---
Facility Contact: ................. ---'---Title: ---.__—...._ Phone No: _-
Mailing Address: .............. . f ..-...._-.._-.....--
Onsite Representative: , T :e,lI , ,4T 4-i vl �i7h Inre_mtor-
Certified Operator -„—, Operator Certification \umber: —
Location of Farm:
.....................................................-_. ---'--
Latitude i '-' Longitude i !• i f- I �-
Cn.. _tit
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Poultry Caoadty Ponnlation
)Number of Lagoons
Holding Ponds / Solid T. �: ;_i Nr.
Discharges & Stream Impart`
Desi2n Current
Cards Capacity Yonnlati_.a
fug_= I
Total Design Capacity
Xi aze
Is any discharge observes frtr; _r. r_- _•= we eperaio�'
Dischrc�:: on=see` a.. _'rn�oon i IiS=-• ;eL =•?tee:
Total SSLW L
Present 1 —= _sue
h TV
D'--S-c:
2. Is there evidence of pas: 6is:::: _e=-r_...lDv r<_,-t o? the
3. Were there any adverse ; :r moo_ _>. a --verse .^-pa-s : s,e S` D'Mf7
Waste Collection & Treaunc -.. -
4. Is storage capaciq (free�r,a;d _u_: vt:r=:- to._e) les li as a6t=Ult " SP:a�a%
Str__ace i
_:rt:;--are'_
�:r�'wa.,'•
__.:eLa_ __'-'._`_ _
Identifier: rj j�rn�'i
Freeboard (inches): ........�ci.......__..._. _._...
Z 2-
q
r
—
5. Are there any immediate
ar_--Iry of any cf he ;avr:::rrs crse.�e�:' fig` **ec._ r.= e c7
3/23/99
s_
`
:i
- _
. vc,
n
->✓rnta�' n= ice:`+:

Facility Number: 31 — %S Ila4 of Inspection E"r%%l/�
6.,-Are ttv-re structures on -site which arc not properly addressed and/or managed throu.gh a waste management or
closure plan? ❑Yes ❑ No
(If ariy of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑Yes ❑ No
8. Does any pan of the waste management system other than waste structures require maintenance/improvement? ❑ 1'es❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level _
elevation markings? ❑ Yes ❑ No
Waste Application
10.
11.
12.
Are there any buffers that need maintenance/improvement?
Is there evidence of over application? ❑ Excessive Pending ❑ PAN
Crop type
❑ Yes
❑ Yes
❑ No
❑ No
13.
Do the receiving crops differ with those designated in the Certified Animal Waste \lanaeement Plan (CAWNIP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑'Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste %IanaQement Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
21. Did the facility fail to have a actively certified operator in charee9 - ❑ Yes ❑ No
22. Fail to notify regional DWQ of emergency. situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) - ❑ Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified ANVMP? ❑ Yes ❑ No
�'1Vq•violatititis:oi defcie'ncies-Wdreit6fed-d&ing4bis:visit:-Youµ.j1-repeiyenofuiCher
cories onderttie:abbtiEthisvtstt
Comments (refer to question #) �Eaplain any -YES answers and/or any recommendations or any other comments. "
Use drawings of facility to better explain situations. (use:additional pages as necessary):
/i✓o/- t 10 lot,,)er /ef�och shod, pum�
ne:5��n5 bbe W,gPV,'-r-.
Reviewer/Inspector Name �Q y Z ,i7 /lj;�.
Reviewer/Inspector Signature:-"aa,,9 %',/+ „�, Date: '% 7_A//9%i
3/23/99

❑ Division of Soil and Water Conservation -.Operation Review - - -
❑ Division of Soil and Hater Conservation'- Compliance Inspection - - t
=-Division of Water Qualify ;,Compliance Inspection - -_
❑ Other Agency - OperatioifRevtew - _ -
t0—Routine 0 Com laint ,(Follow-u of DWQ ins ection O Follow'-u of DSWC review 0 Other
Facility Number 3 /']3 Date of Inspection p�
Time of Inspection / /5 24 hr- (hh:mm)
❑ Permitted ❑ Certified ❑ Conditionally Certified ❑ Registered ❑ Not O era[ional Date Last Operated:
tin11 ..........................
Farm Name: ..._:.._JOy��101;a _5".' FQ�'�'"v �.�2
............. ........... .......... ..............................
...................... _. _. _........ County:....._VP4 !'1
Owner Name: _,..._9 FAr`%1_5
.................................._..............---._..._.....................__........... Phone No:
Facility Contact:
Mailing Address:
Title:
Phone No:
Onsite Representative: �}T.L i n v
........ ................ .............. .. Integrator: Fq �.hS ................. ..........................................
Certified Operator _V
_
_...._._..._................................_..... Operator Certification Number:
Location of'Farm: �..........................................
.........._...................__...................._...............--- ........... ------------
Latitude ���` 0.: Longitude .---------....._......_..........._.........._......................
Design Current
Swine Capacity Population
rO]ean to Feedereeder to Finisharrow to Weanarrow to Feederarrow to Finish
Design Current
Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Other
,Number of Lagoons ❑ Sul
Holding Ponds / Solid Traps ❑ No
Discharges & Stream Impacts
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Total Design Capacity L
Total SSL«'
Drains Present ❑ Lagoon Area
1. Is any discharge observed from any part of the operation?
Discharge originated ae ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was dre conveyance man-made?
h. 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?
Spray Field Area
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
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?
1i'aste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 5tructum 3 Structure 4 Structure 3
Identifier: M0,9 ZnA a s•d Si.�e ^IA5 2-
Freeboard (inches): .........
5. Are there any immediate threats to the integrity of any of the structures observed? Oe/ trees, severe erosion,
323/99 seepage, etc.)
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
0 Yes ❑ No
Structure 6
❑ Yes ❑ No
Continued on back

La�ilig1Numbcr. 31 —�
.. ti
llalc of Inspection
E4 Arcihc" structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
fi1�i7 �.
(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 pan of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
I L Is there evidence of over application? ❑ Excessive Pending []PAN
12. Crop type
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes '❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes ❑ No
b) Does the facility need a wettable acre determination?
❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
` El Yes ❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes ❑ No
Reguired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes ❑ No
21. Did the facility fail to have a actively certified operator in charge?
[I Yes ❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes ❑ No
.24. Does facility require a follow-up visit by same agency?
❑ Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ❑ No
iVdyigl'afiotis:oi•def........ ere....•dirr'iitgthis:visit: YoirKiil•receiye0tifurther•'
...Corres onden6e'abotitthisbiSIL.,-,.
Comments (refer to question #) `Explain aiiy.YES answers aad/or any recommendations or any other comments -
Use drawings of facility to better explain sttuafions (use addttion5l pages as necessary) _ -
=A.Srcc-lesh eondvc}�d io ellowu� 6h /LOnGwNpl:4.t� F�eebeard ar
41-te AC- i'41- /dos» levels s1101.ld 6e lot.&Jerred
4;"el7 ✓hetnrter.
Reviewer/Inspector Name - r -
Reviewer/Inspector Signature:
A `9 /7 O�
rY-t.�'�% �%/t�.f-�.> Date
3123199

c. C3 Division of Soil and Water Conservation 9peration Review - _ _ �•_x-,;.
E3 Division of Soil and PI ater.Conservatiou'-,Compliance Inspection
Division of Water Quality,-:Comphanee Inspection
E3 Other Agency - Operation Review _ -- _�`s. _. iZ
.. .-. _—
Facility Number 3 ( ,3 Date of Inspection r/12 9100
Time of Inspection 25' 24 hr. (hh:mm)
❑ Permitted 13 Certified ❑ Conditionally Certified ❑ Registered Not O erationrral�� Date Last Operated:
Farm Name:..............✓!Ot Sot„ ForM< � Z County:......1/.SL�
....................m..... ..........................--'---'�-- --
Owner Name: t v' l
Facility Contact: ........................................................................--Tick:
Phone No:
Phone No:
MailingAddress: .......................................................................... .
Onsite Representative:
.-,5%.....!^,,:L...k. �:r..... r7(J D� 6h Inte=rator•-.'.'.(_U. �]: .............................._
..... r........._
Certified Operator ............................................... •, Operator Certification Number: _-_,__-,,,,,,,,,,-,,,-,_._.
Location of Farm:
..............................................................................................................—.—_.......-- -. .................
I—
.......................................... ..................................................... ........... ..— ------......-- -- --.................... !(
'Latitude =•=° =•. Longituee �_i• i' �'
Design Current
Swine - Capacity Population
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts,
❑
Boars
Number of Lagoons
Holding Ponds / Solid Traps
Discharges & Stream Impacts
Design Current
Youltrs Capaitc Population
❑ �v' I
❑ Ncci-' - zr I 4
❑ o- 1 1
Desgn C==
Cattle Caprecitc PO,u nSGIR
❑ Div+ 9 I I
❑ NarrDaii. I I I
Total Design Capacity
Total SSLNV,
Su1�a D. i Present
1. Is any discharge observed from any part of the operation'
Discharge originated ac ❑ Lagoon ❑ S -F•� =wiD'
System 1 ..
❑j als LI YMv
a. If discharge is observed, wz= :n— _nj M .ID2 i-mat?
b. If discharge is observed. didiflir Stx''' (If yes, notify tTJ Q'
c. If discharge is observed..v'h i= :re »=-rraYr� 1`i:ca i;t Jtuin'.'
d. Does discharge bypass a la,R=on =>�tc." tT-+>•s..va!i;a DWQ)
2. Is there evidence of past discharge from any part of the _-tdm'
3. Were there any adverse impacts or potential adverse iM: a:^_-' io .i � `•L�',t�s :[ sie 5cate ether than isacn i dik`args"
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) leess Iiam I'cflll.ia7
Structure I Structure 2
Identifier: i?ivl prlwigry Znof_,Ilaje
Freeboard (inches): ......... �..1.................... ........2.z._.....
—
S',,4 r/ y
19
/' q,j, 2
13, s
J :z•;; iJvG;�
y:j des; I_iIv*'v
D T es �
❑ xi�4 I ItYM�
0-nx; C11-nl'
scrma=&
5. Are there any immediate threats to the integrity of any ti liv inT=itr, otns:-.vcJ°(irJ trees, sevtvt'�;%.m;.
seepage, ctt.lj
3/23/99
❑?'Zs ❑iyfn'
C0r..0r ed,W,&V ;c

Facility �muber. 31 — l /13 Date of Inspection
6. c there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? - ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an -
immediate public health or environmental threat, notify DWQ) .
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Anolication
10.
11.
12.
Are there any buffers that need maintenance/improvement?
Is there evidence of over application? ❑ Excessive Pending ❑ PAN
Crop type
❑ Yes
❑ Yes
❑ No
❑ No
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Reouired 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/ W UP, checklists, design, maps, etc.) -
❑ Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes ❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes ❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes ONo
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
� IO VIOaflQrlS,OI` (tCtICIC,uI'ifS �yCCC IlOtef�• (tl}I'Fllg 3tt.. VISIt... I . . I C'f'.. . . . i10, iuetlll'.r,
:,comes oric�eitce:about:thisvisit -:•:-::::::. .
Comments (refer ia.questton #): E_zpIam any'YES answers and/or:any recomr mendations oanyot e_r comments , , _�.•
Use drawings, of facddy`,to better explain situations (use_addthonal'pages as necessary)-'._=
�. t,✓®-de �o loe,ir� 1�56an )eVels �-o ��m� �urvl� level d.� �
No Z: 13e9,n kc�fl'115 free6aa,4 levels rel. 2n� 54"y 1a500—
A4 M A- 1 s-,'4a .
Reviewer/InspectorName.,�,=''.S�o✓%L'tJcw%�?b'`/./l7t`s
Reviewer/Inspector Signature. � , Date: M 7.128dd
3/23/99

E3 Division
E3 Division
Division
lion Revtew r _ >>2
Hance Insp'ecnon
ff,Routine .M-Complaint 0 Follow-up of DWQ inspection 0 Follow-u of DSWC review 0 Other
Facility Number 3/ 73 ate of Inspection 29 OO
Time of Inspection S
DF24 hr. (hh:mm)
0 Permitted 0 Certified E3 Conditionally Certified Q Registered Q Not O erational Date Last Operated: ..........................
Farm Name: .........M4 n.e.[;,ii._`.roL,) FR,r'^',S t 4Z County: pV.PJ,7n
yy�.............................................................................................................................................
Owner Name:....�........t...... F? � "t $
........................................................................................... Phone No:.......................................................................................
FacilityContact: .............................................................................. Title:................................................................ Phone No:
Mailing Address:
Onsite Representative:
.....
e✓;�,�j,TOa�[ rl J �... ................ Integrator:
II......... ............... ..........................J........................................................
CertifiedOperator: ................................................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
Latitude =• 01 =-1 Longitude =• =' ="
Design Current =-•
.: Swine - Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Design Ci
. Cattle Capacity Poo
❑ Other
s Total Design Capacity
Total SSLW
-Number of Lagoons - F ❑ Subsurface Drains Present 110 Lagoon Area 10Spray Field Area
' q ,Holditig�Ponds / Solid Traps �_` ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
XYes
❑ No
Structure 1- Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: M� {)r? ar7 M12ndi M- 3rd M^j 2
3•..5..........
Freeboard(inches): .......... O.'_5..................2Z........................_2.3.................._1 ...................................
...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc.)
3/23/99
Continued on back

t.cilitv'N,rn ,3I - I / 3 Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application -
10. Are there any buffers that need maintenance/improvement? .
11. Is there evidence of over application? ❑ Excessive Pending ❑ PAN
12. Crop type
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
O'Iti violatititis:or def ciencle$ -were itofed• during this:visit; • Yop will-i ebeiye �iti further -: -
. - . - correspondence: about: this .*vfsit_ .: . :........................... .
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
XYes ❑ No
❑ Yes ❑ No
❑ Yes []No
ff Yes ❑ No
j�Yes ❑No
❑ Yes ❑ No
❑ Yes ❑ No
X Yes ❑ No
❑ Yes IffNo
❑ Yes ❑ No
❑ Yes ❑ No
Use drawings of facility to better ex lain situahons: use additiunal pages -
.. - P . P g _ryi: -
({espon.( ;.-r_q �1-o co,•ti�ia;n-'- L
4. l ^5o0✓I �eVeiS -Ire ✓7011 tP�;Gn7 /n So^\e "a900flS, All Ava,lm&je
pump's ola�f S s►-ioL4d &e vsed 4o res�ror)5;bl lowc, )a9ooh level""s
S-}
4o op ro. % level
l i, pr'efj t4i6 l fer hurri�cgrles�l,va} W2At.�c/e4c,.
15- �/ork I% re-"LOVe (weeds-F''vo•n 6ermuc(c e.(�t.
lBeObfo-�lay z;hdcsTrj�Jjnf L ke(�O bv;4A records.
)4f.Tg12-2's are UrAek4cA 4L rt•t q�e,l2aec, VId-{fe a% jea.S-i tmo-t4l4 Arlo{ ho�P
r
so as-f,e eno( of a CropP,n9 sea on r� a I --I
22. ZX-J Q WraI ✓lo4 ne4 ii"i eAV" -P ins WkC cieh} I/-ee bc,,q Ie�el f. �
Reviewer/Inspector Name
Reviewer/Inspector Signature _� Date: ?% Z i 00
3/23/99

Division of Soil and Water Conservation - OperationReview - -' :_._- _ •:✓
Q Division of Soil and Water Conservation -,Compliance Inspection
M Division of Water Quality -Compliance Inspection =- _
Other Agency -Operation Review' -
{Routine O Complaint O Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number 3\ —�� Date of Inspection 11- 10-=jTj
Time of Inspection E7,0 24 hr. (hh:mm)
OLPermitted [3 �Ceertified1 C] Conditionally Certified s713 Registered Not O erational Date Last Operated:
Farm Name: I f tAam4 p-`Saki RrvKS ` � L..................... County' .........�. ��t ........._.............
.................................................................................. ..............
Owner Name:..........M.................................-�A:Qt�............._............................... PhoneNo:...L Il/� _ � �43A cK-... .q ,3
Facility Contact:.....LK.u.y....................1!1�"5—....................Title:...........D=_.!.rf................................... Phone No:94.�r.
( ........... ........... (1-1w t*
'failing Address; ..................................................................................................................... ...............................................................................................................
Onsite Representative: ...... R. YY l 1a+L....................................................... Integrator:..........Il`F_F...........................................................
.................._
Certified Operator: ........ Jt. YN............................ Tt.{-t, ............................ .............. Operator Certification Number: ... 1 62�.
Location of Farm:
Latitude =• =' 011 Longitude =• =' =-
Swine Canacity _Pannlation
® Wean to Feeder
yµp
® Feeder to Finish
71e00
® Farrow to Wean
-loco .
❑ Farrow to Feeder
PQ Farrow to Finish
❑ Gilts
❑ Boars
Design Current - Design. - Current
Poultry Capacity Po ulation Cattle- Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer JE1 Non -Dairy
❑ Other I -
Total Design Capacity
Total SSLW
Number of Lagoons _ ❑ Subsurface Drains Present 110 Lagoon Area ❑Spray Field Area
Holding Ponds / Solid Traps J❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes ® No
b. If discharge is observed, did it reach Water of the State? (If ycs, notify DWQ) ❑ Yes ® No
c. If discharge is observed, what is the estimated flow in gal/min? N A-
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes M No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [M No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [a No
,Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: mA3*l_6"e In9ocn) t&#10L
Freeboard (inches): .........J._?D. ...........35 a.2- 20
................ ..................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, El Yes UR No
seepage, etc.)
3/23/99 Continued on back

Facility.Numbcr.
Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any pan of the waste management system other than waste structures require maintenance/improvement.'
9. Do any strictures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Pending ❑ PAN
12. Crop type Tg R+'& . M(G) V u e _ S G
❑ Yes
4 No
❑ Yes
'At No
❑ Yes
CK No
❑ Yes
IN No
❑ Yes
No
❑ Yes
® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application'?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement'?
16. Is there a lack of adequate waste application equipmeni?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? -
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps. etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard. waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes NJ No
❑ Yes 54 No
[3 Yes (Z No
Eq Yes ❑ No
❑ Yes IN No
❑ Yes V] No
❑ Yes 91 No
❑ Yes (K No
® Yes ❑ No
❑ Yes [:]No
❑ Yes gNo
❑ Yes (81LNo
❑ Yes ® No
❑ Yes 50 No
❑ Yes 50 No
. ..(0:VI0�. . . .S. . . ..C. . . . .were. . . .. (tIF. . tills.VISIt.:. . . WIt. .. .IV.i. .t�. .t. . ..,
.
. correspondence.about.this visit_ .
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings. of facility to better explain situations. (use additional pages as necessary) -
se ltttp 14)60� At sirs iti rrturd5. TQl-1 -Forms Cl%D-) L 46
be Ieep+ it. cecerAs w'}t4 �RQ 2 �`^-s. a �Q-2 av eL Wbl4 wc-ses need -6 MA4A-
Reviewer/Inspector Name I'. Grlet' CV �f f' S'184CW4/� /rYr'MS e..
Reviewer/Inspector Signature:/Q elvl,14.1 Date: I O l I
315-311D-v)1+22s 3123/99

Facility Number: 3� — 173 Date of Inspection 11-ID-9q
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
[ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours'?
❑ Yes
M No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
[$No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
IM No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
® No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
® No
32.
Do the flush tanks lack a submerged fill pipe or a pennanent/temporary cover'?
❑ Yes
0 No
3/23/99

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality .
IURoutine O Complaint O Follow-uo of DWO insuection O Follow-uo of DSWC review O Other 1
Facility Number I Date of Inspection I1Ls/4g I
Time of Inspection � 24 hr. (hh:mm)
E3 Registered V Certified U Applied for Permit 13 Permitted 113 Not Operational Date Last Operated: ..........................
Farm Name:...../..... °�ht) �........ C ........*.y�!..+�.County:.......lh
...................................................................
A^K. �trf.loj�%.........................................._ .. I
Owner Name: ..... µU!pp�? ........ e mil4.....FsKxn...................................................... Phone No:.� .IRi Z.S.i.." 7 i%...........................................
Facility Contact:.......-.Ui!....... G1ttr..r..IS ............................... Title:..../ AMajt1..................................... Phone No:...................................................
NlailinAddress:... 3....f 1............. U .......................................... ........................
OnsiteRepresentative: ..... .�c0.?i_17rict'...................................................................... Integrator:.....�VIV.r.......................................... ........
Certified Operator............................................................................................................... Operator Certification Number:...�� 3.Y.1................
Location of Farm:
Latitude =e=, 0« Longitude 0' 0' =11
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
ix No
2. Is any discharge observed from any part of the operation?
❑ Yes
i$ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
® No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
'® No
c. If discharge is observed, what is the estimated flow in gaUmin?
NSA
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes]
No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
EA No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
C9 No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
V9 No
7/25/97
Continued on back

Facility Number. —
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes W No
Structures fLaeoons.tioldine Ponds. Flush Pits. ete.l
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
Identifier: ......... .. I .................. ........: .Zc......................:.`E44..... .............................
Freeboard (ft): ........... .( �............................ :....� `S'
................................................................................
10. Is seepage observed from any of the structures?
11. is erosion, or any other threats to the integrity of any of the structures observed'?
12.. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
f
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Anolication
IP Yes ❑ No
Structure 5 Structure 6
....................................................... I.............
......................................................................
❑ Yes � No
❑ Yes NJ No
® Yes ❑ No
❑ Yes �0 No
14. Is there physical evidence of over application? ❑ Yes ;A No
(If in excess of WMP, orrunoffrunoff entering waters of the State, notify DWQ) 1 r
15. Crop type b2fY^U.Q.0............ ..................... St?>ult....4,tYnir.............. '...... .....$.U.YI]MAA.ANnitA.1.........................F�SGUt............................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes ® No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes Ij No
18. Does the receiving crop need improvement? Yes ❑ No
19. ,Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?.
25. - Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
ENO
Yes
X No
❑ Yes
V No
1Q Yes
❑ No
❑ Yes
IJ No
❑ Yes
P No
❑ Yes
JA No
p No.violations or deficiencies were noted during this.visit. You will receive no further
correspondence about this. visit: :
Comments' (refer to question#)i. Explain any YES answers and/or any recommendations or any,'other comments ;
Use drawin s of facility to better explain situations. use additional pages as necessary):' " t
$ - P P g rye'.
Ii kovld he lowet, +o rt u f-;ex6&ld
�. �oo-. t41 Inoc �tSU Ylt.� Fite aa•+- v ti S . �
h\ A
�- +,may ��� ,
12, ?rrku. ;%xVA Qitl to It`Yo1' sl ou�t1 >� reQc.vcd. 1� r»G�Ss o rca>c 11t., 1',ro wJ1 t.ar
aua{t \1 �vn.Q. \ruck eJaci� aci� � � should be over Ca {atsi� 4o Fl evw wask;gc bA 44-t cJreQJ
Ir`1tt t4, 1t. 1��.. 42_ should 1,0exWJ +-44..- evodd &"c, 6c1kN16J w,i1t`vW�s elm w�ti
}t"S�L.t1: Tresx on o�'�e-r d �IG�- t�a•�\ o{ � ar�criF-Z sl�t�e� lOe ttt*WeJ � S'iort� 6�bKr alleYsiv,, o.,,av ow
ish1�ou�ld �Ot. tt�io.�10 �o �Ywct� '�r�ut� erosbrr Mt�ttr t.'xasl�'r`. o,. :rvurJCILc w�c-b of poop� *-Z SuctJl� htz �`1\A tat% r- tt �y resee q�c sGrdlO toe seedcr�, Lid /25/97
..tro�Ahh�K Oh �Ua /M<r n� nnrow 4,7 G �In n_ R1r.:NA. � �
Reviewer/Inspector Name
Reviewer/inspector Signature; Dater .-A/2C)q¢

Facility Number: ... j....... —.__�Date of Inspection: ;{�
Additional Cortwients and/or'Drai3mgs
Wza « 5,, Pei r, Q
IT- wuP &Vw(J bF- IaVeO 0, Nfal reams. t- OOr f L)
be in �10,n. Svb{tu� Om4ier\0A M1i cr A?Pt�cd 40 5rw11 rir 6eletj -6bIb!-/aC C--6r
GWP.
4/30/97

Sol
Ilk Routine 0 Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number \
Farm Status: Registered ❑ Applied for Permit
❑ Certified ❑ Permitted
❑ Not Operational Date Last Operated:
Date of Inspection
Time of Inspection I '. 3 24 hr. (hh:mm)
Total Time (in fraction of hours
(ex:1.25 for I hr 15 min)) Spent on Review
or Inspection (includes travel and nrocessinpl
Farm Name: County:1___....__....__....
Land Owner Name:.. �1. .__. A v1i ....�krayl�....—...._..... Phone No: =� o(,Zl__....�...._....�....
Facility Conctact:....l�iie _�fv� `).__....__..... ....__... Title: _.... Y.... �...._............... Phone No:.._i�d_.%`L
Mailing Address:_..._�a��'1,hh11.:1...:LC.?'�J.�Xr._...__....._......,..._.{.Y.!<.fe,EJ.I�Q�.iR.S-....�.�/.x:..u...__........_.... a.._.t........
OnsiteRepresentative: .....
y� I'6Q]d��JA�+(� ,... 411G��Integrator:_1!1y��
Certified Operator: _.. _...._....... _.... �...._..... . Operator Certification Number:
Location of Farm:
Latitude l Jar 1pEi�]` u Longitude ®• oS , =,,
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is 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
4/30/97 maintenance/improvement?
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
❑ Yes 5a No
❑ Yes
® No
❑ Yes
0 No
❑ Yes
® No
Yes
❑ No
Continued on back

Facility Number:
r 6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes R•No
• 7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes I& No
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ELNo
Structures (Lagoons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes RNO
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
............1.13.........................................................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes 0 No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes gNo
12.
Do any of the structures need maintenance/improvement?
R;Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
R No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
R No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ... wm.l l_S t....................................... v`o+..r xr.....................................................................................
...............................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
N No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
®No
18.
Does the receiving crop need improvement?
14 Yes
[I No
19.
Is there a lack of available waste application equipment?
❑ Yes
py No
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 Out '
22.
Does the facility fail 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?
® Yes
❑ No
5. Rw ttle bt-^t 0.V u s , . Sp {,tt-dS,
IL. R0, 1 ab, Wo-Ll, C�a vrec.t �¢.a. E �,� �I`�oo....
1, Atsct re. ��t E�sti. eb t ��o L con. F'rn w� tr €x i o 0 1-a�
19. w s ey- o,n w-t.2 I i rn sr, c_..t (/ i • I wall.
Z4 . f 4 I• W. 4 4 ✓- J td. 0. c C_e i S 1 Gv r,_ C O Tct 1 4- � V.'v�t Y,-O =
Y-" t o w- s t-v, -s a -c ,mod z t 4w ., L't 1 (..-e t
m -S. � t-t)
Reviewer/Inspector Name _fA'
Reviewer/Inspector Signature: 1nj..,.�� o .. �'I , o-Q.,....�...� o .. Date:
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

Site Requires Immediate Attention:
Facility No. l-ice
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIO S SITE VISITATION RECORD
• DATE: 72= 1995
Time: �a_. 3 3
Farm Name/Owner: Avwv &r (d rlk
Mailing Address: o 90 o i L 2 OYS
County: n
Integrator: w Phone: r�Ll
On Site Representative: // Phone: O 7.27
Physical Address/Location:Z,, 5i9�t // l r/ 2K /< u % yM 7
Type of Operation swine Poultry _ Cattle /
Design Capacity: 7 0Number of Animals on Site: n 0 - q
DEM Certifica 'on Number: ACE DEM Certification Number: ACNE
Latitude:Ll '' Longitude: Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 4 hour storm event
(approximately 1 Foot + 7 inches) 6 or No Actual Freeboard: f Ft. Inches
• Was any seepage observed from thella oon(s)? Yes or(Owas any erosion observed? Gor No
Is adequate land available for spray? Ye or No Is the cover crop adequate? Yes or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from
100 Feet from Wells? es �r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? es oruVoJ
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes olo
Is animal waste discharged into waters o the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or o If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage w�h cover crop)? 14@ or,No /C� 0^1-es
i O
MAN
cc: Facility Assessment Unit Use Attachments if Needed.