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HomeMy WebLinkAbout310239_INSPECTIONS_20171231MMMMMMMM� Idm NORTH CAROLINA Department of Environmental Qual W) Reason for Visit: R Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: 11 -1 Arrival Time: Departure Time: County: DU4011tj Region: Ki PD - V 17- Farm Name: M-(NkV'\ logAl-c V;XY- Owner Email: Owner Name: Phone: Mailing Address: Physical Address: Facility Contact: Title: Phone: Onsite Representative: Integrator: Certified Operator: Certification Number: Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: ign ilia apacit - �yAEn0 iltr go _�gesiGurr 4U _P_. -MP Aci-tY I _.0 ; IrCat�HeMc D esign u e t ggp - ggit .YM P Wean to Finish Layer Dairy Cow Wean to Feeder Feeder to Finish I iNon-Layer Dairy Calf Dairy Heifer Dry Cow fer Non -Dairy Beef Stocker Beef Feede*r La ers Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Pullets NJ [Beef Brood Cow I 10ther Turke s Turkey Poul Other I Dischar2es and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: E] Structure Application Field F-1 Other: a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (if yes, notify DWR) c. What is the estimated volume that reached waters of the State (gallons)? d. Does the discharge bypass the waste management system? (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? Ej Yes Ik No [—] NA [-] NE [-]Yes [—]No E] Yes E] No [—]Yes [—]No E] Yes No E] to NA NE NA NE Ej NA F] NE NA [—] NE NA E] NE Page I of 3 21412015 Continued 7-1 Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes No NA E] NE a. If yes, is waste level into the structural freeboard? E] Yes No NA [:] NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: 01/ff Spillway?: Designed Freeboard (in): 3-0 Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? Yes 0 No 0 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 kNo E] NA Ej 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? Ej Yes t4 No NA [—] NE 8. Do any of the structures lack adequate markers as required by the permit? E] Yes No NA E] NF (not applicable to roofed pits, dry stacks, and/or wet stacks) KZ 9. Does any part of the waste management system other than the waste structures require Yes No NA E] NE maintenance or improvement? 6 Waste Armlication 10. Are there any required buffers, setbacks, or compliance alternatives that need Yes E] No NA [�NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. Yes 0 No NA NE Excessive Ponding E] Hydraulic Overload 0 Frozen Ground [—] Heavy Metals (Cu, Zn, etc.) PAN n PAN > 10% or 10 lbs. E] Total Phosphorus E] Failure to Incorporate Manure/Sludge into Bare Soil Outside of Acceptable Crop Window Ej Evidence of Wind Drift E] 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 NqE 15. Does the receiving crop and/or land application site need improvement? E] Yes E] No E] NA �TNE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable E] Yes E] No Ej NA NE acres determination? 17. Does the facility lack adequate acreage for land application? E] Yes 0 No E] NA NE 18. Is there a lack of properly operating waste application equipment? Yes No NA kNE 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 E] Yes 0 No 0 NA 9NE the appropriate box. E]WUP El Checklists E] Design 0 Maps 0 Lease Agreements nOther: 21. Does record keeping need improvement? If yes, check the appropriate box below. E] Yes [—] No Waste Application El Weekly Freeboard E] Waste Analysis El Soil Analysis 0 Waste Transfers Rainfall F-1 Stocking E] Crop Yield E] 120 Minute Inspections E] Monthly and I " Rainfall Inspections 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—] Yes [—] No [—]Yes [:]No NA CK_�E r— E] Weather Code El Sludge Survey NA NE NA IZE Page 2 of 3 21412015 Continued 3� /' fracilify Number: t! - Z3 1 Z-f 4-i 24. Did the facility fail to calibrate waste application equipment as required by the permit? D Yes D No D NA N NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes D No DNA bdNE the appropriate box(es) below. M Failure to complete annual sludge survey D Failure to develop a POA for sludge levels D Non -compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? 0 Yes Ej No D NA NE 9 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? E] Yes No NA NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document Yes No NA E 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. 36. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, fireeboard problems, over -application) 3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. Ej Application Field D Lagoon/Storage Pond F-1 Other: D Yes [—]No DNA KNE [—] Yes [:] No E] NA [>rNE DYes [—]No D NA XNE 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? Ej Yes E] No D NA 00 E 33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? Yes D No JP�A D NE 34. Does the facility require a follow-up visit by the same agency? Y r] NA [—] NE ise arawings oriacnity to Detter explato situations'(nse adaitional pages as necessary).'­M�' I - � 04(1,ed Mdvi'vi P,6-Vic- tb rrq-w+ acce5y --h -fcw-�V, folr InE L* w'ts'v e- i) t0ca-k 4�� we Wnt '1 1 7 �' 4 AA W ai� !�� I z r6L/) - 4ovw' mip "aw-ef' q MaA(�� % '1� 4 Wt VAUU �M&w �\,,V t� A�4 I-egv (rzt�q)% (Culw-�-Cw � Q j Md) Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 Phone: qw —qqy—� m � Date: 12117,111-7 21412015 Reason for Visit: (Z5 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit:F7f.3Qjj Arrival Time: Departure Time: County: Zx)f)tTJzJ Region: Farm Name: Owner Email: Owner Name: Mailing Address: Physical Address: Facility Contact: Title: Phone: Onsite Representative: mc-LCrPJ (36 5�T_Tc Integrator: Certified Operator: Back-up Operator: Location of Farm: Latitude: Phone: Certification Number: 11-71-71 Certification Number: Longitude: Wean to Finish .4 esign ujren gp�ci I�MKTUKRM esign .Rci cle n esign Iljre t �Cffp�cir�ympop. Dairy Cow Wean to Feeder ayer Dairy Calf Feeder to Finish 443?66 41 Dairy Heifer Dry Cow Non -Dairy Beef Stocker Farrow to Wean Farrow to Feeder Farrow to Finish YeT—si g n POM I paci Layers Gilts Non -Layers Beef Feeder B Pullets I jBeefBroodCow I Turke Turke Poults Other _j N Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: D Structure D 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 0 No 0 NA [—] NE Yes No Yes No D NA NE DNA NE Yes E-] N NA D NE Y VN NA NE D YesyNo NA D NE Page I of 3 21412015 Continued I lFacility Number: ".7) 1 - 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 Ej NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: 4 A Caftit)l (AG4J Spillway?: Designed Freeboard (in): r) -7 Observed Freeboard (in): 1�r -) _3 4- 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? E—yes IZN o. 0 NA NE [:]Yes ; /No [—] NA NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmen�tpt threat, notify DWR 7. Do any of the structures need maintenance or improvement? N s Wo NA NE 8. Do any of the structures lack adequate markers as required by the permit? Ye 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 VNo NA NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need Yes M No NA E] NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ZJ/No NA [:] NE F� Excessive Ponding 0 Hydraulic Overload Ej Frozen Ground Ej Heavy Metals (Cu, Zn, etc.) n PAN n PAN> 10% or 10 lbs. 0 Total Phosphorus [:] Failure to Incorporate Manure/Sludge into Bare Soil F-1 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWM_P? 0 Yes IE" ] No 0 NA ONE 15. Does the receiving crop and/or land application site need improvement? Y �i/� o 0 NA NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable Yes ErN o [-] NA N E acres determination? 17. Does the facility lack adequate acreage for land application? Yes d/V(o 0 NA 0 NE 18. Is there a lack of properly operating waste application equipment? E] Yes No F NA 0 NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? Yes [�KN NA 0 NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check 0 Yes VNo 0 NA ONE the appropriate box. OWUP OChecklists ODesign Ej Maps 0 Lease Agreements E:]Other: 2 1. Does record keeping need improvement? If yes, check the appropriate box below. C-] Yes ErNo NA [-] NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers Weather Code F-1 Rainfall ED StrickingO Crop Yield 0 120 Minute Inspections 0 Monthly and 1 " Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes 2rNo 0 NA [-] NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? Yes �(No 0 NA 0 NE Page 2 of 3 21412015 Continued jFacfllty Number: Eate of -inspeclion- I& t 411- 1 24. J)id 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. F-1 Failure to complete annual sludge survey DFailure to develop a PDA for sludge levels F-1 Non -compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: VN [] NE NA No NA [] NE 26. Did the facility fail provide documentation of an actively certified operator in charge? DYes Lj No [:] NA D NE 27. Did the facility fail to secure a phosphor -us loss assessments (PLAT) certification? D Yes F�/No D NA [-] NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, fireeboard problems, over -application) 3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. D Application Field D Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? 34. Does the facility require a follow-up visit by the same agency? 0 Yes E�(No NA D NE Yes Zf No NA D NE Yes E�J'/No NA [:] NE C-] Yes CZNo D NA E] NE Yes Yes Yes D NA D NE KDNA D NE 0 D NA D NE Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments. Use drawings of facilitv to better explain situations (use additional pages as necessary). :_ I I : 1, �' I Reviewer/Inspector Name: Phon,(.Up '�M -73 Reviewer/Inspector Signature: Date: Page 3 of 3 2,141-7015 Type of Visit: IZYCo pliance Inspection (_) Operation Review (.) Structure Evaluation U Technical Assistance Reason for Visit: 7Routine 0 Complaint 0 FoHow-up 0 Referral 0 Emergency 0 Other 0 Denied Access I I DateofVisit: EjjSjjjLJ ArrivalTime: Departure Time: County: Region: T-�r Farm Name: Owner Email: Owner Name: Mailing Address: Physical Address: Facility Contact: Title: Phone: Onsite Representative: N a" &-T-:1--C Integrator: Certified Operator: Back-up Operator: Location of Farm: Phone: Certification Number: 111-71 Certification Number: Latitude: Longitude: Qgn '11;re �t: a I LOPAREM Wean to Finish u I try -AM MM"tpo — I Layer esign 9MM-M - FpKc L gren P -op esip oui6e t D C. �t-ap _ , I . acgyMjr1op Dairy Cow Wean to Feeder I INon-Layer I Dairy Calf Feeder to Finish LfM QQN) Dairy Heifer Farrow to Wean Farrow to Feeder Farrow to Finish Layers I Dry Cow Non -Dairy Beef Stocker Gilts Non -Layers eef Feeder I Ifloars I Pullets IV I I Beef Brood Cow El 10ther . I 1 Turkeys Turkey Poults .1 1 Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: E] Structure E] Application Field E3 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? EDYes C3/No E]NA E]NE Yes No NA NE Yes No NA NE 0 Yes E] No El Yes 0 [-] Yes VN((o NA E] NE NA NE NA NE Page I of 3 21412014 Continued lFacility Number: -91 Date of inspection: Waste Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? 0 Yes 0 No 0 NA 0 NE a. If yes, is waste level into the structural freeboard? [-] Yes 0 No 0 NA 0 NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Lfi&4z,- Spillway?: Designed Freeboard (in): Observed Freeboard (in): qq 5. Are there any immediate threats to the integrity of any of the structures observed? 0 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 El 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? E�Yes 0 No NA NE 8. Do any of the structures lack adequate markers as required by the permit? Yes [allo 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 C2-'�o E] NA ONE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need E] Yes [2"No [:] NA 0 NE maintenance or improvement? 11. Is there evidence of incorTect land application? If yes, check the appropriate box below. 0 Yes t�No E] NA [:3 NE r_1 Excessive Pending 0 Hydraulic Overload [:] Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) M PAN F-1 PAN > 10% or 10 lbs. Total Phosphorus Ej Failure to Incorporate Manure/Sludge into Bare Soil M Outside of Acceptable Crop Window 0 Evidence of Wind Drift E] Application Outside of Approved Area 12. Crop Type(s) 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? 0 Ye E3� F-1 NA 0 NE 15. Does the receiving crop and/or land application site need improvement? 0 Yess �?NNO 0 NA [—] NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable Yes VNo 0 NA Cj NE acres determination? 17. Does the facility lack adequate acreage for land application? El Y es Ej NA 0 NE 18. Is there a lack of properly operating waste application equipment? Oyes No NA NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? Yes �' No r NA NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check Yes C��<o 0 NA 0 NE the appropriate box. E]WUP [:]Checklists Ej Design 0 Maps 0 Lease Agreements 00ther: 2 1. Does record keeping need improvement? If yes, check the appropriate box below. [:] Yes E(No 0 NA [:] NE F-1 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers E] Weather Code M Rainfall E] Stocking 0 Crop Yield 0 120 Minute Inspections Monthly and I" Rainfall Inspections Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? E-] Yes E�14 NA 0 NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? E-] Yes rNo NA [:] NE Page 2 of 3 21412014 Continued Facility Number: '2) jDate of Inspection: 24. Did the facility fail to calibrate waste application equipment as required by the permit. Yes F(j 0 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check E] Yes WNO the appropriate box(es) below. D 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 provide documentation of an actively certified operator in charge? [—] Yes 'o D NA 0 NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? D Y �No E] NA NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document Yes E3"No D NA NE and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? Yes 0 No D NA NE If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, fireeboard problems, over -application) 3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ED Application Field D Lagoon/Storage Pond D Other: Yes Q/No NA NE Yes [�/No NA NE 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? D 'Yes 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? D Yes 34. Does the facility require a follow-up visit by the same agency9 C—] Yes NA NE DNA D NE No [:] NA D NE Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments._ Use drawines of facilitv to better exolain situations (use additional Daizes as necessarv). LkATij,96-C_ or-r— BY-)CIC- OF Nauscs OCC—S Ca_AC>j_P6_ e4c- u_ 'Recqu-c- L.T'MOC CV-05-1-twc-- Reviewer/Inspector Name: �,16 j d FA 9JQ C (L� Phof. 99 ci 6 Reviewer/Inspector Signature: qe&A4�w Date: 0) 3- 1 04 Page 3 of 3 t 21412 5 11z' I M S-1 L�__ Type of Visit: ID Co "Hance Inspection Q Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: 7Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: Arrival Time: Departure Time: County: DUPCid Region: Farm Name: Owner Email: Owner Name: Phone: Mailing Address: Physical Address: Facility Contact: Title: Onsite Representative: M(wj�d eos-T-1c, Integrator: Certified Operator: Back-up Operator: Location of Farm: Latitude: Phone: Certification Number: Certification Number: Longitude: 1-71-7.1 esign G S.wine �paci tv Wean to Finish 0 I ILayer esign 11 .4 I gren ign r ent t__,apacLzy= 0 0 ow Wean to Feeder I INon-Layer 11 alf Feeder to Finish ��QO 14M eifer 1 Farrow to Wean Farrow to Feeder 'ow 1L7 ow to FimI Layers iry Beef Stocker I's Gilts Non -Layers Beef Feeder Pullers Beef Brood Cow "Boarsr ..e 'r Turkey Turke oults Other Discharees and Stream Impact 1. Is any discharge observed from any part of the operation? Discharge originated at: 0 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? D Yes [�`No DNA D NE [—]Yes D No [—] Yes Ej No Yes D 0 1 [—]Yes Win 0 Yes gNo DNA D NE D NA [:] NE D NA D NE NA NE NA NE Page I of 3 21412011 Continued F _IiiTNumber: Fac I / D�spectjon: �13 Waste Collection & Treatment 1 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes a. If yes, is waste level into the structural freeboard? 0 Yes 21 No 0 NA 0 NE 0 No 0 NA 0 NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: w3cco I LA &*juJ 2— Spillway?: Designed Freeboard (in): Observed Freeboard (in): 1211-1 7-S, 5. Are there any immediate threats to the integrity of any of the structures observed? OYes d No NA 0 NE (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a Yes �/No NA [—] NE waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? Yes 0 No M NA 0 NE 8. Do any of the structures lack adequate markers as required by the permit? 0 Yes [A No 0 NA 0 NE (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require [—]Yes 6 No [—] NA 0 NE maintenance or improvement? Waste Application �No 10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes 0 NA [:) NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes 0 No ONA ONE Excessive Pending 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) PAN M PAN > 10% or 10 lbs. Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil Outside of Acceptable Crop Window Evidence of Wind Drift OApplication Outside of Approved Area 12. Crop Type(s): 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? 0 Yes 1� No Cj NA 0 NE 15. Does the receiving crop and/or land application site need improvement? 0 Yes �No ONA 0 NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable Yes E"N o 0 NA 0 NE acres determination? 17. Does the facility lack adequate acreage for land application? 0 Yes W�,( NA NE 18. Is there a lack of properly operating waste application equipment? Yes rN o' 0 NA NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? Yes D�No 0 NA NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check Yes E340 [:] NA 0 NE the appropriate box. 0 WUP OChecklists 0 Design 0 Maps 0 Lease Agreements 0 Other: 2 1. Does record keeping need improvement? If yes, check the appropriate box below. 0111yes 0 No ONA ONE M Waste Application 0 Weekly Freeboard [:]Waste Analysis [] Soil Analysis 0 Waste Transfers P Weather Code E]Rainfall 0 Stocking[:) Crop Yield 0 120 Minute Inspections Monthly and I " Rainfall Inspections [��Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? OYes []rNo NA [j NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes EJ'No NA 0 NE Page 2 of 3 21412011 Continued Facility Number: 'sq:] Date of Inspection: !�_/ I I JV I No NA NE 24. Did the facility fail to calibrate waste application equipment as required by the pejit? El Yes M�c 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes E No NA NE the appropriate box(es) below. F-1 Failure to complete annual sludge survey Failure to develop a POA for sludge levels F-1 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? E] Yes [2'No 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [—] Yes [3"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. Yes F-1 No 6_�V NA NE NA NE NA E3NE [-]Yes E]�No [—] NA E] NE 30. Did the facility fail to notify the Regional Office of emergency situations as required by the Yes [;kNo E] NA E] NE permit? (i.e., discharge, freeboard problems, over -application) /No 3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. C-] Yes E ]' NA NE El Application Field El Lagoon/Storage Pond M Other: 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 1:1 Yes El o NA NE 33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? Y No y1i NA NE 34. Does the facility require a follow-up visit by the same agency? Yes E5/No F-1 NA NE Comments (refer to question #): Explain any YES answers andlor any additional recommendations or any other comments. Use drawings of facility to better explain situations (use additional pages as necessary). q.) L6,.j !XoT 40 �SA*-SIDG IF( LA(rcoA/ 2- tJC-00J FC-MT_(�, WIQTa 9A) 5LLJ-0r'1(_ �'Lje-vc"*" -0 0s-j0(-R_ 'Posgzt L,(- roe— SLAJ b -rAj�_c-, L-1' A rr&e-, w-iiF Y 0 L,/(z- , Reviewer/Inspector Name: tTa A [A Reviewer/Inspector Signature: Page 3 of 3 Phone:1 qm Date: 214�2 d] I Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access 1 County: DUPL<11.0 Region: Date of Visit: y, I Arrival Time: Departure Time:F__C?-6o Farm Name: Owner Email: Owner Name: Mailing Address: Physical Address: Facility Contact: Title: Phone: Onsite Representative: m9t.-Vy Zt; gT-cc- Integrator: Certified Operator: Back-up Operator: Location of Farm: Latitude: Phone: Certification Number: I -�j -11 Certification Number: Longitude: DFsi gn r ent apaci P NP. E�@ Layer Q`cit- LCL QyAL u e _!TeE PF p�' esign urre paci rop 'op Dairy Cow I jNon-Layer I Dairy Calf /4 6 Dairy Heifer r Farrow to Finish It Layers —imn XT�p­ac I - _n P. Dry Cow Non -Dairy Beef Stocker Non -Layers Beef Feeder Pullets 113eef Brood Cow T eys Turke- Poults Discharges and Stream Impact 1. Is any discharge observed from any part of the operation? Discharge originated at: 0 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? E] Yes ZNo [-] NA [-] NE Yes No NA NE Yes No NA NE Yes E],yo E] NA Ej NE Yes o E] NA E] NE No E] NA E] NE Y �111 Page I of 3 21412011 Continued Facility Number: Z4 7 Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes ZI/No D NA D NE a. If yes, is waste level into the structural freeboard? D Yes No D NA D NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: LACrad4J L'4&v-&� Spillway?: Designed Freeboard (in): Observed Freeboard (in): '2� 5. Are there any immediate threats to the integrity of any of the structures observed? Yes EfNo [—] 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 D Yes E�/No DNA D 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 ,�tpl threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 0) V D NA D NE 8. Do any of the structures lack adequate markers as required by the permit? D Ye No D NA D NE (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require Yes [J/No C—] NA [:] NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need D Yes JZ /No NA NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. Yes 0 No NA NE Excessive Pending D Hydraulic Overload [:] Frozen Ground DHeavy Metals (Cu, Zn, etc.) PAN M PAN > 10% or 10 lbs. F_jTotal Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil Outside of Acceptable Crop Window DEvidence of Wind Drift D 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? Ye ff]N NA NE 15. Does the receiving crop and/or land application site need improvement? Yess VIN o NA NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable Yes fNo NA NE acres determination? 17. Does the facility lack adequate acreage for land application? C:] Yes o 0 NA NE 18. Is there a lack of properly operating waste application equipment? Yes No D NA Cj NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? Yes E o 0 NA NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check Yes D No D NA NE the appropriate box. [:] WUP E:]Checklists [j Design D Maps 0 Lease Agreements [:]Other: 21. Does record keeping need improvement? If yes, check the appropriate box below. E(Yes 0 No Waste Application El Weekly Freeboard 0 Waste Analysis E�f Soil Analysis D Waste Transfers Rainfall D StockingD Crop Yield D 120 Minute Inspections D Monthly and I" Rainfall Inspections 22. Did the facility fail to install and maintain a rain gauge? [:]Yes Y�6 23. If selected, did the facility fail to install and maintain rambreakers on irrigation equipment? D Yes Lj o NA D NE Weather Code Sludge Survey D NA [—] NE D NA Ej NE Page 2 of 3 21412011 Continued k_1 lFacility Number: gi -sill 113 24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes o NA Ej NE �5. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes No NA E] NE the appropriate box(es) below. F� 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? El Yes "'o NA NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? C] Yes gNo 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) 3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. [] Application Field E] Lagoon/Storage Pond M Other: 32. Were any additional problems noted which cause non-compliance of the permit or CAWW? Yes ZTN ' o NA [:] NE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? Yes "o NA E] NE 34. Does the facility require a follow-up visit by the same agency? Yes gNo F] NA NE Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments., Use dravvines of facilitv to better exnlain situations (use additional va2es as necessarv). [-]Yes EdNo F] NA [] NE Yes dNo NA NE Yes dNo NA NE ) W re- r, It_ -5o= L_ -re5T AP,0 Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 [—]Yes [j No F] NA F] NE CAQXCLA-T,t6j,J, et."T NkSE' Phone: tTID/ '1116 - Date: 2Y4,12011 for Visit: U Routine Q Complaint C) Follow-up Q Referral Q Emergency Q Other Q Denied Access Date of Visit: Ito j Arrival Time:En=Departure Time: County: 00j?l Region: Farm Name: Owner Name: Mailing Address: Physical Address: Facility Contact: Title: Owner Email: Phone: Onsite Representative: E_ L Q T.J 1�>oS-rQ_ Integrator: Certified Operator: Back-up Operator: Location of Farm: Latitude: Phone: Certification Number: 1-71-71 Certification Number: Longitude: Ig W i��apac an to Finish ry _U Layer i n �flci apaci C- ent Pop. Desip -CF44EQ0 !N1111111 �f.,apaci rop 0 Cow an to Feeder ]Non -Layer Calf der to Finish Heifer I ow to Wean arrow to Feeder jEarrow to Finish D­rr-.yjP6�-iuflI Layers ign paci Men ow - airy Beef Stocker Gilts Non -Layers BeefFeeder I lBoars Pallets Beef Brood Cow 10ther Turkeys Turkey Poults Other Discharges and Stream Impact 1. Is any discharge observed from any part of the operation? Discharge originated at: [] Structure E] Application Field Other: a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does the discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Yes 2f No [:] NA E] NE [-]Yes [-]No [:] Yes Ej No E] NA E] NE 0 NA [:] NE E]Yes El NL, EINA NE 01 NI E] NA NE E] Yes No 0 NA 0 NE Page I of 3 21412011 Continued i Facility Number: I Ing 1 111, Wa;te Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes OeNo a. If yes, is waste level into the structural freeboard? E] Yes [—]No Structure I Structure 2 Structure 3 Identifier: WC2�) LA Spillway?: Designed Frecboard (in): Observed Freeboard (in): _34 [:] NA NE r-1 NA NE Structure 4 Structure 5 Structure 6 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? E] Yes EfNo F] NA E] NE [:] Yes � No E] NA [:] NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? [:]Yes ZNo 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 C:] Yes E] No 0 NA NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes ZNo NA NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes 2<0 NA 0 NE E] Excessive Ponding E] Hydraulic Overload 0 Frozen Ground [:] Heavy Metals (Cu, Zn, etc.) PAN M PAN > 10% or 10 lbs. 0 Total Phosphorus [:] Failure to Incorporate Manure/Sludge into Bare Soil Outside of Acceptable Crop Window [:] Evidence of Wind Drift [] Application Outside of Approved Area 12. Crop Type(s) 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? F] Yes C3rNo E] NA E] NE 15. Does the receiving crop and/or land application site need improvement? E] Yes �j<o [:] NA NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable Yes UTNo E] NA NE acres determination? 17. Does the facility lack adequate acreage for land application? Yes NA NE 18. Is there a lack of properly operating waste application equipment? Yes VNo NA NE Reguired Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? El 'Yes g io NA NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check F] Yes E:] NA 0 NE the appropriate box. OWUP ElChecklists ODesign []Maps E] Lease Agreements E]Other: Z 2 1. Does record keeping need improvement? If yes, check the appropriate box below. E] Yes eNo E] NA E] NE Waste Application E] Weekly Freeboard 0 Waste Analysis E] Soil Analysis E] Waste Transfers E] Weather Code Rainfall [] Stocking [:] Crop Yield Ej 120 Minute Inspections [jMonthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? F] Yes [3'<o NA E] NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:] Yes E114o NA [:] NE Page 2 of 3 21412011 Continued iFacility,Nimber: 2 �*101 FDate of l"s ection. 24. 6id the facility fail to calibrate waste application equipment as required by the permit? Yes D NA D NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check D Yes 6/No [:] NA [:] NE the appropriate box(es) below. Failure to complete annual sludge survey D 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? DYes [!f�No D NA D NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [—]Yes ErNo D NA D NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over -application) 3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. D Application Field E] 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? D Yes 040 DNA NE [—]Yes ZNo D NA NE E) Yes [2rNo [—] NA E:] NE D Yes [2/No [:] NA D NE D Yes Z�W [—]Yes 71�i6 Y �rN o D NA NE NA NE NA NE Comments (refer to question ft Explain any YES answers and/or any additional recommendations or. any other comments. Use drawings of facility to better explain situations (use additional pages as necessary). Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 Phone: 7102'17(q -I X I Date: �Vl � 21411011 Type of Visit crCorabliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit (;?Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: A ,I,,[ Time:F--39-57 Departure Time: County: DUPL��j Region: Farm Name: Owner Email: Owner Name: Mailing Address: Physical Address: Facility Contact: Title: Onsite Representative: rn (--Ldro 8,D5fr_C,_ Phone: - Integrator: Phone No: Certified Operator: Operator Certification Number: Back-up Operator: Location of Farm: Back-up Certification Number: Latitude: =0 =, Longitude: [� 0 ign -Desi -orrent Current;;.--!�' d C Design'- ur e esig, e'-_', W1 C�ptacity,Po in 'Wet P ultry .,-,C p�c _,P -Cattle-.,-,Capaci -�Popuhf on ulation a - 'I-- ­` FEI Wean to Finish7 ,,I[] Laver I El Dairy Cow El Wean to Feeder '10 Non -Lay er I El Dairy Calf I 0 Feeder to Finish 17�! �=I, Dairy Heifer Farrow to Wean Dry Cow 0 Farrow to Feeder Farrow to Finish La ers Non -Dairy Beef Stocker El Gilts Non -La ers El Beef Feeder I i� El Boars Pullets Turke s Turkey Poults Ll Beef Brood Cow] Other Other '7` _27 it in a., S Flat as: �7777­777-777��—,, 71 _1W111. Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: El Structure El Application Field 0 Other a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? El Yes D/No EINA El NE • Yes E]No 0 NA EINE • Yes [I No 0 NA El NE 0 N EINA D NE El Y es E El NA El NE Yes No [I NA [:1 NE Page I of 3 12128104 Continued Facility Num Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [I Yes 2/No El NA [] NE a. If yes, is waste level into the structural freeboard? [I Yes [:1 No EINA [:1 NE Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: LACv61A LA(ImIV 2� Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? El Yes E�No El NA 0 NE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed El Yes O/No [3 NA [I NE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 0 Yes E34o El NA El NE 8. Do any of the stuctures lack adequate markers as required by the permit? El Yes [;3'No El NA El NE (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require [3 Yes U/No D NA [I NE maintenance or improvement? Waste Auplication 10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes E�No El NA 0 NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes 1;2<0 [I NA [I NE El Excessive Pending El Hydraulic Overload El Frozen Ground El Heavy Metals (Cu, Zn, etc.) [] PAN EIPAN > 10% or 10 lbs [I Total Phosphorus El Failure to Incorporate Manure/Sludge into Bare Soil E30utside of Acceptable Crop Window El Evidence of Wind Drift D Application Outside of Area 12. Crop type(s) 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? 0 Yes D"No 0 NA El NE 15. Does the receiving crop and/or land application site need improvement? 0 Y DIN D NA 0 NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? El Y:: 7No [I NA [I NE 17. Does the facility lack adequate acreage for land application? El Yes E� �No 0 NA [:1 NE 18. Is there a lack of properly operating waste application equipment? 0 Y � [I NA D NE to�m'i���t's(rifert��'quei"on'#): tiplafitativ YES answersin'd/6'r- any�_rec`uuim6fidati6`n-s o�ran"y,'citti-e"r�'eoiimments: �Usc drawings of facilitv to better explain situations. (use additional vitees as necessary)* % �LAMT"Tlrjc- Reviewer/Inspector Name Phone: Reviewer/Inspector Signature: 'A�/ Date: -1/h/l/ Facility Number: Date of Inspection Required Records & Documents 19. Did the facility fail to have Certificate of Coverage . & Permit readily available? 0 Yes [2(No [:1 NA El NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check 0 Yes [�No 0 NA El NE the appropriate box. 0 WUP 0 Checklists El Design F-1 Maps El Other 21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes 12'No El NA ONE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis El Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking El Crop Yield El 120 Minute Inspections 0 Monthly and V Rain Inspections OWeatherCode 22. Did the facility fail to install and maintain a rain gauge? Yes [3No 0 NA ONE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes [k) o 0 NA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 NA F-1 NE 25. Did the facility fail to conduct a sludge survey as required by the permit? El Yes WNo [:1 NA El NE 26. Did the facility fail to have an acti�ely certified operator in charge? 0 Yes Ld 0 ONA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? I �FNo 0 NA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAW1vIP? 0 Yes dNo 0 NA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document 0 Yes U(No 0 NA El NE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? 0 Yes WNo 0 NA El NE If yes, contact a regional Air Quality representative immediately 3 1. Did the facility fail to notify the regional office of emergency situations as required by El Yes dNo El NA [] NE General Permit? (ic/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? El Ye s WNo 0 NA 0 NE 33. Does facility require a follow-up visit by same agency? 0 Yes �No 0 NA ONE �idilititifialComrnic�nti'iindior. rawings::-,�:�.,. Page 3 of 3 12128104 Page 3 of 3 12128104 U Type of Visit 95 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit O/Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other [I Denied Access Date of Visit: Arrival Time: Departure Time: County: Region: Farm Name: Owner Name: Mailing Address: Physical Address: Facility Contact: Onsite Representative: Certified Operator: _ Back-up Operator: — Location of Farm: Title: Owner Email: Phone: Phone No: Integrator: Operator Certification Number: Back-up Certification Number: Latitude: =0 =' =" Longitude: =0=, =" Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure [I Application Field El Other a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? El Yes dNo El NA El NE 0 Yes D No EINA EINE E]Yes E]No E] NA El NE El NA ONE E]Yes Cj No El Yes o El NA EINE Yes N( [I NA 0 NE Page I of 3 12128104 Continued Facility Number: — 3 9 Date of Inspection 3 3 I D Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [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: (,Aec6N t.)Z- Spillway?: Designed Freeboard (in): Observed Freeboard (in): 9\ 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 2No ❑ NA ❑ NE (ie/ large trees, severe erosion, seepage, etc.) / 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ZNo ❑ 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 thFeat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑Yes Z J❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ NA ❑ NE (Not applicable to roofed pits, dry stacks and/or wet stacks) �// 9. Does any part of the waste management system other than the waste structures require ❑ Yes E/ No ❑ NA ❑ N maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ N maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes dNo ❑ NA ❑ N ❑ Excessive Pending ❑ 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 E E E 12. Crop type(s) 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or landapplicationsite need improvement? ❑ Yes ❑ Yes 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 17. Does the facility lack adequate acreage for land application? ❑ Yes 18. Is there a lack of properly operating waste application equipment? ❑ Yes Q No ❑ NA ❑ NE ZNo ❑ NA ❑ NE WNo ❑ NA ElNE Wo ElNA ElNE o ❑ NA ❑ NE Comments (referto 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): , n R' C,dcm( N6u G f0 a4"n- k-cc r tj779 ; PecoROS, IReviewer/Inspector Name �%D A� '.� Phone: Reviewer/Inspector Signature: Date: Page 2 of 3 12128104 Continued Facility Number: 3 j —a,� Date of Inspection 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 CAW MP readily available? If yes, check ❑ Yes E?(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 2No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code //o 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes L'N ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E(No ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �(No ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ENo ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes E(No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes o ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CA WMP? ❑ Yes CJ No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes LI 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 dNo ❑ 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 �// E 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 o ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes E]'No ❑ NA ❑ NE jAdditional Comments and/or Drawings: Page 3 of 3 12128104 (Type of Visit E5 Colnpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access Date of Visit: (! t Arrival Time: ® Departure Time: County: 1:k) Region: Farm Name: Owner Name: Mailing Address: Physical Address: Owner Email: Phone: Facility Contact: Title: Onsite Representative: M L (3 OS TL L Integrator: Certified Operator: Back-up Operator: Location of Farm: Phone No: Operator Certification Number: Back-up Certification Number: Latitude: [ o =' O Longitude: [� t Design Current Design Current Design Current Swine Capacity Population We[Poultry. Capacity Population Cattle CapacityPopulation ❑ Wean to Finish ❑ Layer ❑Dai Cow ❑ Wean to Feeder 10 Non -Layer I❑ Da Calf ❑ Feeder to Finish ❑Dai Heifer ❑ Farrow to Wean Dry Poultry ❑ D Cow ❑ Farrow to Feeder ❑Non-Dai ❑ Farrow to Finish ❑ Layers ❑Beef Stocker ❑ Gilts ❑ Non -Layers [Ell Beef Feeder ❑ Boars El Pullets ❑ Beef Brood Co ❑ Turkeys Other ❑ Turkey Poults ❑ Other Number of Structures: ❑ Other Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWQ) 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 M No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE 0 ❑ NA ❑ NE ❑ Yes ❑ No ❑ Yes 0 ❑ NA [I NE ❑ Yes LQ No ❑ NA ❑ NE 12128104 Continued Facility Number:31 -rt Date of Inspection ! S Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 Identifier: LAGaGN % L-A6aa/✓ ae, Spillway?: Designed Freeboard (in): Observed Freeboard (in):_ 7 b 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? ❑ YesLI No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE Structure 5 Structure 6 ❑ Yes , ,(/No ❑ NA ❑ NE ❑ Yes LI No ❑ NA ❑ NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmentalthat, notify DWQ P [I Outside of Acceptable Crop Window [I Evidence of Wind Drift [I Application Outside of Area 7. Do any of the structures need maintenance or improvement? El Yes No ❑ NA [I NE 8. Do any of the stuc[ures lack adequate markers as required by the permit? ❑Yes No El NA ❑ NE (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require El Yes No El NA El NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑Yes L�J N ❑ NA [INE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑Yes No El NA 1-1NE ❑ Excessive Ponding El Hydraulic Overload El Frozen Ground ❑ Heary Metals (Cu, Zn, etc.) ❑ PAN ❑PAN > 10% or 10 lbs El Total Phos horus El Failure to Incorporate Manure/Sludge into Bare Soil 12. Crop type(s) 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ NA [I NE 15. Does the receiving crop and/or land application site need improvement? ElYes Zo El NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Y Yes ,,,���,,, ///7No ❑ NA [3 NE 17. Does the facility lack adequate acreage for land application? ❑ Yes LEI N [I NA NE 18. Is there a lack of properly operating waste application equipment? El Yes No ❑ NA ❑ NE Comments (refer to qugstion #):, Explam any`YES answers and/or, ny recdmm dations o anyrothee omments. :Use drawm ,to beerezplin situations. (ussoffactht�ttaddttionaLpages as'necessary) Reviewer/inspector Name p Phone: (Fin) 77G-23A Reviewer/Inspector Signature: Date: G Pape 2 of 3 12128104 Continued Facility Number: 3 1 —91c) I Date of Inspection G O Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ViNo ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [jNo ❑ NA ❑ NE the appropimte box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes dNo ❑ 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 2 No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain minbreakers on irrigation equipment? ElYes EJ No ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes dNo ElNA ElNE 25. Did the facility fail to conduct a sludge survey as required by the permit? ElYes 6 No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes PI No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes VNo ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ���/// Uo ❑ NA El NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑yes No ❑ NA El NE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? ElYes // 2 No ❑ NA ❑ NE If yes, contact a regional Air Quality representative immediately 3 L Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes No ❑ NA ❑ NE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes VN ❑ NA ❑ NE Additional Comments and/or Drawings: Page 3 of 3 12128104 Division of Water Quality Facility Number O Division of Soil and Water Conservation 0 Other Agency Type of Visit Cofnpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral + 0 Emergency 0 Other ❑ Denied Access Date of Visit: 3 7 df Arrival Time: II Ob Departure Time: County: OUPL W Region: Farm Name: Owner Name: _ Mailing Address: Physical Address: Facility Contact: Title: Owner Email: Phone: Onsite Representative: m6c (3017rc— Integrator: Certified Operator: Back-up Operator: Location of Farm: Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feedej Farrow to Finish Gilts Boars Other ❑ Other Phone No: Operator Certification Number: Back-up Certification Number: Latitude: =o =' [= Longitude: E710 M Design Current Design Current Capacity PPop—ulatioonn Wet Poultry Capacity Population I I ❑ Layer 1 10 Non -Layer Dry Poultry ❑ La ers ❑ Non -Layers ❑ Pullets ❑ Turkeys ❑ Turkey Poults ❑ Other Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made? Design Current Cattle Capacity Population ❑ Dairy Cow ❑ Dairy Calf ❑ Dairy Heifei - ❑ 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: d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes �No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE 0 ❑ ❑ NA ❑ NE ❑ Yes ❑ Yes C ❑ NA ❑ NE El Yes No El NA ❑ NE 12128104 Continued Facility Number: 3 — �3 i Date of Inspection �— W Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? /� Structure 1 Structure 2 Structure 3 Identifier: (,AGy a 0 1 L Ac wTW Z Spillway?: Designed Freeboard (in): Observed Freeboard (in): I— 3 L ❑ Yes LI No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE Structure 4 Structure 5 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? ❑ Yes 0 No ❑ Yes ONo Structure 6 ❑ NA ❑ NE ❑ NA ❑ NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental [(treat, notify DWQ El Outside of Acceptable Crop Window El Evidence of Wind Drifi ❑ Application Outside of Area 12. Crop type(s) 7. Do any of the structures need maintenance or improvement? ❑Yes o ❑ NA El N E 8. Do any of the stuctures lack adequate markers as required by the permit? ❑Peso ❑ NA El NE (Not applicable to roofed pits, dry stacks and/or wet stacks) / 9. Does any par[ of the waste management system other than the waste structures require El Yes Ed No NE El NA [Imaintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ,�,/ El Yes LJ o NE ❑ NA Elmaintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑Yes No El NA ❑ N E El Excessive Ponding ❑Hydraulic Overload [I Frozen Ground ❑Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑PAN > l0% or 10 Ibs ❑Total Phosphorus El Failure to Incorporate Manure/Sludge into Bare Soil 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CA WMP? ❑ Yes o ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes 90 ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ yes No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? ElYes 12I ❑ NA El NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes '17-V_x/.�o ❑ NA ❑ NE Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. Use drawings of facility to better explain situations. (use additional pages as necessary): Reviewer/Inspector Name V 6AI") LC-- Phone b - 731 Reviewer/Inspector Signature: Date: 3 IL 12128104 Continued Facility Number: — a3� Date of Inspection Required Records & Documents / 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ElYesYNo —/o El NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ NA ❑ NE the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes U No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections[/ ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes `[_i �!o ❑ NA El NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes [f/ o ❑ 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 [a No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ,[��J/.yo ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes L1 No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes E ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes hjo ❑ NA ❑ NE and report the mortality rates that were higher than normal? 7wo J/ 30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes❑ 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 ❑ 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 ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes ❑ NA ❑ NE Comments and/or 12128104 Facility Number: _,2A3ffl Date of Inspection Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 7No o ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ NA ❑ NE the appropirate box. ❑ ArLM ❑ Checklists ❑ Design ❑ Maps ❑ Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [O/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 ElWeather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes f 0 El NA El NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes [f/ o ❑ 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 ,,,[���a,,,///No El NA El NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes �1'o ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes No ❑ NA ❑ NE Other Issues / 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes d ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ YesZ ❑ 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❑ 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 ❑ 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 ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes No ❑ NA ❑ NE Comments and/or Drawings: 12128104 Q Q Division of Water Quality Facility Number >l a3 g 0 Division of Soil and Water Conservation 0 Other Agency Type of Visit 6 Ptiance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ,coo t0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access Date of Visit: Arrival Time: 3 J Departure Time: County: ObO Region: Farm Name: Owner Name: Mailing Address: Physical Address: Facility Contact: Title: Owner Email: Phone: Onsite Representative: / 11 ec , ' lj 94' SIX 5— Integrator: Phone No: Certified Operator: Operator Certification Number: Back-up Operator: Back-up Certification Number: Location of Farm: Latitude: L__1 U [--] 1 1--] 11 Longitude: = o = , = « Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feedej Farrow to Finish Boars Other ❑ Other .Design Current Design Current Capacity Population Wet Poultry Capacity Population ❑ La er ❑ Non -La et Dry Poultry ❑ Layers ❑ Non -Lavers ❑ Pullets ❑ Turkeys ElTurkey 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 Heifei ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stocker ❑ Beef Feeder ❑ Beef Brood Co I Number of Structures:. �i -I b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes �'No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE 0 ❑ NA ❑ NE ❑ Yes ❑ No ❑ Yes VJ El NA El NE ❑ Yes I�1 No ❑ NA ❑ NE 12128104 Continued Facility Number: I — �3'1Date of Inspection t o Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: LA'%ot1JI LA6o,)fV Z- Spillway?: G Designed Freeboard (in): 1 . S 27 Observed Freeboard (in): a i. 3S 5. Are there any immediate threats to the integrity, of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? ❑ Yes Er/No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE Structure 5 Structure 6 ❑ Yes Lam] No ❑ NA ❑ NE ❑ Yes D iVo ❑ NA ❑ NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes 41 No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes O 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 [he waste structures require ❑yes ❑ No El NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E3 No ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ,�/ CJ No ❑ NA ❑ NE ❑ Excessive Pending ❑ 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 WNNo ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes El NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes ,[3rNNo � No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. Use drawings of facility to better explain situations. (use additional pages as necessary): Reviewer/Inspector Name Ju_Pw 21 tL \, Phone: Reviewer/Inspector Signature: Date: W, L/ o 12128104 Continued Facility Number: .l S Date of Inspection Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E/ ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 93 1 No ❑ NA ❑ NE the appropirate box. ❑ W-UP ❑ Checklists ❑ Desig n El Maps El Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E?I o ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rain Inspections Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ElNA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Q o ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EJ NNoo ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes 1'�J, NNo El NA El NE 26. Did the facility fail to have an actively certified operator in charge? El Yes 9No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes NNo El NA El NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document El Yes 2, fJ 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 ETNo ❑ NA ❑ NE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes No ❑ NA ❑ NE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes N-o El NA El NE 33. Does facility require a follow-up visit by same agency? El Yes ,0, 1GNo ❑ NA ❑ NE Comments and/or 12128104 QDivision of Water Quality / %� Facility Number 3 I 1.3 e 0 Division of Soil and Water Conservation `v/ _ 0 Other Agency rype of Visit CCoompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit V Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access Date of Visit: Arrival Time: t7t7 Departure Time: county: PL7/J Region: Farm Name: Owner Email: Owner Name: Phone: Mailing Address: Physical Address: Facility Contact: Title: Onsite Representative: (V e'V�rw It70 Sri. C. Integrator: Phone No: Certified Operator: Operator Certification Number: Back-up Operator: Back-up Certification Number: Location of Farm: Latitude: = o = . =„ Longitude: = o = Swine Other Design Current Design Current Capacity Population Wet Poultry Capacity Population sh ❑ La er 3er I ❑ Non -Layer fish I k4gbo I q?00 can 1 i -I Dry Poultry ❑ Layers ❑ Non -Layers ❑ Pullets ❑ Turkeys ❑ Turkey Poults ❑ Other Design Currei Cattle CapacityPopulati ❑ Dairy Cow ❑ Dairy Calf ❑ Dairy Heifer ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stocker ❑ Beef Feeder ❑ Beef Brood Cow Number of Structures: . Discharges & Stream Impacts I. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made? 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 E�No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE 0 ❑ NA ❑ NE ❑ Yes ❑ No ❑ Yes 2 El NA El NE ❑ Yes ba "o ❑ NA ❑ NE 12128104 Continued Facility Number. ( —a Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 Identifier: lA6 W nl 1 LAC>06J Z Spillway?: Designed Freeboard (in): I ct Observed Freeboard (in): aQ 3 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? ❑ Yes No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE Structure 5 ❑ Yes dNo ❑ Yes ICJ No Structure 6 ❑ NA ❑ NE El NA ❑NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes O No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes dNo ❑ 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 O No ❑ NA ❑ NE maintenancehmprovement? ,�,(/ 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ICI No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or l0 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) VioP_ CwS 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ffNo ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes L3/No ❑ NA [I NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? [Ild Yes No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes O No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes ONo ❑ NA ❑ NE Comments (refer to question ft 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): 1S) 00 StvOGE Sij"-y j&✓, MAACP (, ZooG Auto lcEcP coPY Al.a►t(„ wstN Reviewer/InspectorName I �.T6NYJ �Ae.AYotA� I Phone:�y[IJ'ISC - Y1GS Reviewer/Inspector Signature: 6 ^{0X'o-_ Date: Poop 2 of ? Facility Number: 3 —a3 Date of Inspection Required Records & Documents .// 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes L] No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes -E�No ❑ NA ❑ NE the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other ,...,// 21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes L:J No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code '0 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes El NA [I NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑/j%es �No ETNNo ElNA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? Yes Ego ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ❑ NA El NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes aWiNo IJ No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes IVT El NA El NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes IJ 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 N ElNA [INE 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 ElYes?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 O/No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes P'No ❑ NA ❑ NE Page 3 of 3 1212"4 Type of Visit Ol Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit JO Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access Date of Visit: cl // O$ Arrival Time: t7.' eparture Time: Zr unty: Farm Name: /{La2 1 AeS A` Owner Email: Owner Name: v 42S7,2 L Phone: _ Mailing Address: Physical Address: Facility_ Contact: Title: Onsite Representative: C_ Certified Operator: Back-up Operator: UPLZr1 Region: Phone No: le Operator Certification Number: Back-up Certification Number: Location of Farm: Latitude: Q0 = [�„ Longitude: =o=, = Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes to 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? ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE 12128104 Continued Facility Number: —23 Date of Inspection 15/ Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? �S[truct re Sttrructur 2 Structure 3 Structure 4 Identifier: If',� I AcOfr / Spillway?: P 14)p Designed Freeboard (in): I f'. -.5 Z ?- Observed Freeboard (in): Z 3 3/ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? ❑ Yes Of No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE Structure 5 Structure 6 ❑ Yes mNo ❑ NA [INE ❑ Yes A No ❑ NA ❑ NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes i No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ElNA ❑ NE (Not applicable to roofed pits, dry stacks and/or wet stacks) 1p 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 tA No El NA ❑ NE maintenance/improvement? ��,,,{{I 11. Is there evidence of incorrect application? If yes, check the appropriate box below. El 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? ❑ Yes No 15. Does the receiving crop and/or land application site need improvement? ❑ Yes `� No 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑ Yes ,,�No 17. Does the facility lack adequate acreage for land application? ❑ Yes IJ] No 18. Is there a lack of properly operating waste application equipment? ❑ Yes ONo Nn�uB r�aw�,E,t� ❑ NA ❑ NE El NA ❑NE ❑NA ❑NE ❑ NA ❑ NE ❑NA ONE Reviewer/Inspector Name Phone:VAJ Reviewer/Inspector Signature: — Date: f O Jr 12128104 Condnued Facility Number:-5 Date of Inspection S [/ 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 ❑ Design ❑Maps El Other rrr���ttt 21. Does record keeping need improvement? If yes, check the appropriate box below. ElYes y1 No El NA El NE [I Waste Application [I Weekly Freeboard El Waste Analysis El Soil Analysis El Waste Transfers/ ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? '0 ❑ Yes VrNo ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes VNo ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes )�fNo ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes XNo ❑ NA EI NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? El Yes ❑ No ElNA XJ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes No ❑ NA ❑ NE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes /No ❑ NA ❑ NE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by ,_,/ ❑ Yes 117No ❑ 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 /0No /lv ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes No ❑ NA ❑ NE Ad'dihonal,Commerits=and/or-Dr$wings• " x:;� 4+ .g r v „x,;�„ht�'+ ,.�jE Z7 Awl-& lee--Ne t4e tt%145 7'� ft/r) P�f_s my 7i(//�59F �%��LysZS �o C.b✓f-2 /V�UE�/.�f'.� �x✓O J��'/'mb�',e 2D0 �/ �tlirt / 2GN0. F/dE'nJZS , L �,4TTZfZcl97zo�Y /l ECO�1J5 ��ll �i✓D ���� F 12128104 of Visit .40 Compliance Inspection O Operation Review O lagoon Evaluation Reason for Visit .QMoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access Facility Number Z Date of Visit: 3 oq Time: I Z 6'0 0 Not Operational Q Below Threshold �J Permitted)2:(Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above eshold: Farm Name: ..... ----...1hLi�._....�Citr.�S..__ M...._........_........ County:.._.....__)/.UQ.._................................_ Owner Name: Madmirg Address: Phone No: Facility Contact: ................................................. ------------ Title: .................................. Phone No: ........ -..... Onsite Representative: ..... M:[ 14.S.fJ-......_....._pa-mce................_.. Integrator: ....... .5..................._...._......... Certified Operator:-----_._...._._._.........._._...._.... Location of Farm: Operator Certification Number: .......................................... ❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =• =1 =11 Longitude =• =1 =11 t Destgn : Current Design Current Design Current Swine _ 'Ca an ._'Po nlahon= Poultryay `. Ca`aci "kPo 'elation;' ,Cable _ '_ `-,Ca acit' . Po"Mahon :. ❑ Layer - Dairy a Wean to Feeder eeder to Finish Ww 3YOb T ❑Non -Layer ❑ Non -Dairy Farrow to Wean IQOther A Total DestgnCapacity - _- �u Total SSLZV- t' Farrow to Feeder Farrow to Finish Gilts Boars Nom_ber of Lagoons 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 1 Structure 2 Structure 3 Structure 4 Structure 5 Identifier: .......... .f...... ............ _........__.`...._...... ........ _.._...................... .............................. _._ Freeboard (inches): �Ir 39, ❑ Yes ONo ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑A/VO [� ❑ Yes 'No ❑ Yes No Structure 6 12112103 Continued Facility Number: — Date of Inspection 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 7No seepage, etc.) ❑ 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or Yes 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 maintenance/improvement? ❑ Yes 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 7'" 0 elevation markings? Waste Application 10. Are there any buffers that need nuuntenancerimprovement? ❑ Yes No 11. Is there evidence of over application? If yes, check the appropriate box below. ❑Yes o ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc 12. Crop type c'5 0 / 13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 11160 14. a) Does the facility lack adequate acreage for land application? ❑ Yes 'J(% b) Does the facility need a wettable acre determination? ❑ Yes �" QNg� c) This facility is pended for a wettable acre determination? ❑ Yes 15. Does the receiving crop need improvement? ❑ Yes No 16. Is there a lack of adequate waste application equipment? ❑ Yes No Odor Issues 17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes 2 liquid level of lagoon or storage pond with no agitation? 18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 8<0 19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 9440 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 o Air Quality representative immediately. Comments (refer to quLon)Fsplaany YFS ersa�/orauy recominendahousor mny ot6ec rnmmen_ is Use drawmgs.of fact7tty:totbetterxezplatn srttrabo�•(use;addt4o�nal pages as necessary) Freld Co l ��� �.�. �� �,.�;_� �4 � �❑ PY ❑Final Notes � ,, suumG,E Svav( y To & 000C (S'.e CAc��Tt6o3 r� Vc oaNE Y PC-, zs} SOP Y-:'7( LO Foy T�6 6E UeC)A7(, 1J. �q 6LM �tj C-ro 0 `() Corj r6j �J �v✓ LE V C. Ufa V G Z ►.� LA G100 "d Z Reviewer/inspector Name tr:( O ' l..t..� T Reviewer/Inspector Signature: Date: 3 nnWmi .--•.----' Facility Number: -I Date of Inspection Required Records & Documents 21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes M 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 N 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 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 01 27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ❑ IQo/ 28. Does facility require a follow-up visit by same agency? ❑ Yes 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) /esFNo 31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑Yes32. Did the facility fail to install and maintain a rain gauge? ❑Yes 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 113 No violations or deficiencies were noted during this visit You wHl receive no further correspondence about this visit Add itronal Coiumeots and/or Drawtpgs - 12112103 Type of Visit -0 Compliance Inspection O Operation Review O Lagoon Evaluation Reason for Visit O Routine O Complaint O Follow up O Emergency Notification 21j01her ❑ Denied Access Facility Number 3 Date of Visit: Q Permitted 0 Certified 0 ConditionallyCertified0 Registered Farm Name: %fie) V 'tom X3t4' ! Fes,. r_% Owner Name: 1-nC IV; .gi S4t G Mailing Address: Facility" Contact: Title: Time: Date Last Operated or Above Threshold: _ County: Di/O Ilr1 Phone No: Phone No: Onsite Representative: Integrator: -�OLJn /s of Certified Operator: Operator Certification Number: Location of Farm: ❑ Swine ❑ Poultry ❑ Cattle ❑Horse Latitude Longitude =• =' =11 Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No c. if discharge is observed, what is the estimated Flow in gal/min? d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No 2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No Waste Collection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Freeboard (inches): 0510310] Continued f Facility Number::3 —23 Date of Inspection 02 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? (It 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 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 Ponding ❑ PAN ❑ Hydraulic Overload 12. Crop type 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 or other Permit readily available? 18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ie/ WUP, checklists, design, maps, etc.) 19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 21. Did the facility fail to have a actively certified operator in charge? 22. Fail to notify regional DWQ of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? 24. Does facility require a follow-up visit by same agency? 25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ONO ❑ Yes ❑ No ❑ Yes ❑ No 10 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit. Comments (refer to question #): Explmn any�YES.answers =and/or an krecomnie d [tons or au` othe�'commepg. ts: ' U'se draw ngs°oflfactlityto better explam situations (usexadditional pages.as necessary) r fl ❑ Field Copy (I Final Notes p0:4I; le ;s be;�9 a�P1i'e0 to a irir,1A ih -Ile su;.tee wGf-Ie t+�eltlayv h� f), r).Z'4 ^ Coif —1-t t� I).e rc (n"^�(J be "e 1vq-4e i<e de�'i _1A.at �O'!-1':'1 if !h G �j�OY�a>1(ie jn/. -�L� -� r. i'i' �'l ✓1 i-j ^Orit e w Irl.��lL� 4o Mom- $DJaiL neeOi5 -Svbrt-4 a i -Per Sq^��le q%,,X Q{e4e41n �atnnoli v/ NNrsge,� �6r c1Grt c�O�)��d ih iiPc�- q✓dAadv } 411,'Sc" cu re a. \ -i 1-re A 11 el.,We� q• tya nfi in C: el ul Z On L,t? l7�GOrn i nGJ GD/Y7 GrOP . Reviewer/Inspector Name , 1 :— ,0 j1BW-iLI rt•(q "is Reviewer/InspectorSignature: Date: 05103101 Continued Facility Number 31 2 3 Date of Visit: 2 2 % 02 Time:rO Not Operational 0 Below Threshold 0 Permitted D Certified 0 CConditionally Certified 0 Registered Date Last Operated or Above Threshold: Farm Name: Aiely;r) n FLt^� �County: D up u,� i Owner Name: W . Me V ('1 %S o4; [ Phone No: Mailing Address: Facility Contact: Title: Phone No: Onsite Representative: _ il/12 �V i n 8oS-1-i e Integrator: ��ol..�n `J Gq �011"IC' Certified Operator: Operator Certification Number: Location of Farm: ❑ Swine ❑ Poultry []Cattle ❑ Horse Latitude F­—j• 0` =« Longitude =• 0` 0- Design Current Design.. . @y��t Designi Current Swine -'Ca -aci Po motion Ppultry Ca arity,P,o ulation Cattle "pact P,o mlation . _, ❑Wean to Feeder ❑ La er ❑ Da' ❑ Feeder to Finish ❑Non -Laver ❑Non-Dai ❑ Farrow to Wean ❑ Other _ ❑ Farrow to Feeder ❑ Farrow to Finish _0tta'I Design Capacity ' --� ❑ Gilts ❑ Boars Total SSLW Number of Lagoons ❑ Subsurface Drains Present ❑ La oon Area ❑ Spray Field Area Holding Ponds /Solid Traps ❑ No Liquid Waste _ Management System Discharges & Stream Im acts 1. Is any discharge observed from any part of the operation? 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 Structure 2 Structure 3 Structure 4 Structure 5 Identifier: 1 2- Freeboard (inches): 9.3 3S. ❑ Yes yJ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes gNo ❑ Yes EfNo ❑ Yes ZNo Structure 6 05103101 Continued Facility Number: 3l — 2 3 Date of Inspection 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? & 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 Aoolication 10. Are there any buffers that need maintenance/improvement? 11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload 12. Crop type SOy4ec,hS 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? Reauired Records & Documents 17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? 18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ie/ WUP, checklists, design, maps, etc.) 19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 21. Did the facility fail to have a actively certified operator in charge? 22. Fail to notify regional DWQ of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? 24. Does facility require a follow-up visit by same agency? 25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ONO ❑ Yes J_erNo ❑ Yes A!:fNo ❑ Yes .H No ❑ Yes ;EIINo ❑ Yes ETNo [:]Yes ONO ❑ Yes EfNo ❑ Yes ZNo ❑ Yes JZNo ❑ Yes j2'No ❑ Yes ,fNo ❑ Yes ,ETNO [:]Yes '�2No ❑ Yes ONO ❑ Yes ONo ❑ Yes JZ'No ❑ Yes ,�fNo JET -yes ❑ No ❑ Yes L211No ❑ Yes ZNo ❑ Yes ONO 10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. Comments (refer to question #) Exp am ainy Y<ES aoswervand/or any �ecommen tions'loi''Fauyr they comments „Use drawings oflf icility [o better explainsituations (use addrtional�pages as necessary)' , : y .. Copy ❑Final Notes' .,_❑Field 22_ Lotgooi Z , -(l e net -a lagoon j re9 v; ees elf legs- ze. Z ;^rke5 er in -rr-eeboA,-A 6e ✓nu;nigi�[el flee {jcttJoov�.ThF level/ CvaS StiGL fllai )ki5 -(Derr Was jesS FrGebo�i�d �t,�,11 ;n A��11 n,14 Flay 7001, m� s, 54;c -ire, ;el he Wtis hei a✓� tv41e 41iod44e veeboa,a( fvo,s a-i )a4S4 20, 2-,'� C l-,es Ar fit; f letye-t. /(10-{r : 0 eee( *o gpfly 1;Mile Ge Lord;-xq -40 SOl' 4e-54 -e CoAA ^'tehLlgi e011S, I � Reviewer/Inspector Name Reviewer/Inspector Signature: Date. Z 2 D2 05103101 Continued Facility Number: 3 —23 Date of Inspection p D 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 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 ONO 28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes .1no 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 P'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 ONO 31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ,dNo 32. Do the flush tanks lack a submerged till pipe or a permanent/temporary cover? ❑ Yes ❑ No Additional Comments and/orDrawings:-. . Ti,e-F'ac,'1i+4,cro�f, Ah�i records c9/'C Lvel! mai��'gi/IgG�- 5100 - Division of Water Quality Q Division of Soil and Water Conservation Q Other Agency (Type of Visit _2(Compliance Inspection O Operation Review O Lagoon Evaluation I Reason for Visit ABoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access Dale or Visit: Facility Number tEEP Permitted [3 Ce tit/fired onnditionalllly'Cer 'fi O Registered Farm Name:.......A�Al.�:�..L......Vf.`'.........� Y Owner Name: Facility Contact: Mailing Address: ..... {^ Onsite Representative: Certified Operator:..,_. Location of Farm: �._�...................... Title: OY\ Printed on: 7/21/2000 ional O Below Threshold Re Last OperAbove Threshold: ........................ County: ... .......�ji .A...1..�..C.....1 ..... Phone No: No: Integrator: Operator Certification Number: .......................................... Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =• r7' =•. Longitude =• =' =" Design Current Design Current Design Current Swine Capacity Population Poultry Capacity Population Cattle Capacity Population ❑ Wean to Feeder ❑ Laycr I I Dairy eeder to Finish ❑ Non -Layer I JE1 Non -Dairy ❑ Farrow to Wean ❑ Farrow to Feeder ❑ Other ❑ Farrow to Finish Total Design Capacity ❑ Gilts ❑ Boars Total SSLW Number of Lagoons JE1 Subsurface Drains Present ❑ Lag•,on Area ❑Spray Field Area Holding Ponds / Solid Traps H==❑ 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 now 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 Suuclule I tt Structuurrcl2 y Structure 3 Structure 4 Structure 5 Identifier: ...... L{j.'................:..).t{(........................................................ ............ ........................ ........... Freeboard (inches): FytS � v5l5 5/00 ❑ Yes XNo ❑ Yes []No ❑ Yes.. //❑ No ❑ Yes []No ❑ Yes kfNo ❑ Yes KNo ❑ Yes �LNo Structure 6 Continued on back Facility Number: — Date of Inspection Printed on: 7/21/2000 5. Are there any immediate thre is to the integrity of any of the structures obse ed?0(telees, severe erosion, ❑ Yes H1do seepage, etc.) TT'' 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 4 No 8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes I No 9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level elevation markings? ❑ Yes N0 Waste Application 10. Are there any buffers that need maintenance/improvement? ❑ Yes 11. PAN Hydraulic Overload Is there evidence of pr app ic�lon? ❑ Excessive Ponding [I[It ❑ Yes �E!�No !FNo 12. Croptype /l`/ �I l 13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes QN4e 14. a) Does the facility lack adequate acreage for land application? ❑ Yes 0N10 b) Does the facility need a wettable acre determination? ❑ Yes 0116 c) This facility is pended for a wettable acre determination? ❑ Yes 9�No 15. Does the receiving crop need improvement? ❑ Yes ` &o 16. Is there a lack of adequate waste application equipment? ❑ Yes *0 Required Records & Documents / 17. Fail to have Certificate of Coverage & General Permit readily available? - ❑ �7„ Yes 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 Vigo 19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes 0Io 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes V�qo 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 4�0 23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ����t-No 24. Does facility require a follow-up visit by same agency? ❑ Yes o 25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes No tVq yi.... t..o. il........ were .... dit .. this:visit; Yoir will i ebeiye titi Further :: cories oridence: about his visit: Comments.(refer to question #): Explain any YES answers and/or any recommendations or any other comments Use drawings of facility to better e "I'lain situations. (useadditional pages asnec cssarY) 1 x 6 a P vG tnkW r�, �v�cc {� vYJ z Reviewer/Inspector Name 0 l� Reviewer/Inspector Signature: Date: Facility Number: y�%u� Date of Iuspection 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 at/or below ❑ Yes V0 liquid level of lagoon or storage pond with no agitation? 27. Are there any dead animals not disposed of properly within 24 hours? 28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, roads, building structure, and/or public property) 29. Is the land application spray system intake not located near the liquid surface of the lagoon? 30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or or broken fan blade(s), inoperable shutters, etc.) 31. Do the animals feed storage bins fail to have appropriate cover? 32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? aCC, uA A,oa�U � ❑ Yes tCNo ❑ Yes C�No []Yes VI No ❑ Yes No ❑ Yes No []Yes XNo 5100 - _ - 0_Divission of Soil and Water Conservation - Operation Review-,-,--'-. 0 Division of Soil and Water Conservation - Comphance.Inspecdon -- - - - - _- - ®.Division of -Water Quality - Compliance Inspection _ - ;` 13 Other -Agency - Operation Review - - - Routine Q Complaint Q Follow -tip of DWQ inspection Q Follow -tip of DSWC review Q Other Facility Number 3l L3 Date of Inspection sli y Time of Inspection 24 hr. (hh:mm) IA Permitted 91 Certified 13 Conditionally Certified 17 Registered Q No[ O erttional Date Last Operated: FarmName: .........n! a..._I�t,.O,.S+1.......!rfM'M..................._......................................... County:.... IJIa;tAf»......................................... ....................... Owner Name: Phone No:..�.k.� pll�.L`I:iv....: Facility Contact: Title: Phone No: Mailing Address: .... AqSZ h....NL....i]� 4. r1°i'r"'� ........... p...............................................M �,.....Nc......................................... Onsite Representative:......... ....HA.S................................................................ Integrator: ... 13/A.ons................................................................ Certified Operator............a�L�.fA!!1.......M.:..........�ASia.i....................................... Operator Certificafion Number..._�.�,11I ........................... Location of Farm: Latitude 0•=' =1 Longitude =• =' 0.1 Swine Capacity Population ❑ Wean to Feeder Feeder to Finish t41(p O Dd ❑ Farrow to Wean ❑ Farrow to Feeder ❑ Farrow to Finish ❑ Gilts ❑ Boars _ __- Number of Lagoons Holding Ponds / Solid Traps Poultry Capacity Population Cattle Capacity Population ❑ Layer ❑ Dairy ❑ Non -Layer ❑ Non -Dairy ❑ Other Total Design Capacity gpp Total SSLW I Drains Present ❑ Lagoon Area Spray Field Area Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation (If yes, notify DWQ)? Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. If discharge is observed, was the conveyance man-made''- b. ll' discharge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State c. It discharge is observed. what is the estimated flow in gal/min? d. Does discharge bypass a lagoon system? 2. Is there evidence of past discharge from any part of the operation? 3. Were there any 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'? Structure I Structure 2 Structure 3 Structure 4 Structure 5 Identifier: ',I L Freeboard(inches):...........'✓'A.................. ................ A( ................................................................................................................... 1 /6/99 ❑ Yes ® No ❑ Yes t" No ❑ Yes 5g No ❑ Yes (d No ❑ Yes No ❑ Yes No ❑ Yes 511 No Structure 6 Continued on back 1 Facility laaumber. 3t — L3 Date of Inspection qi 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? - ❑ Yes No (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? Yes ❑ No 8. Does any part of the waste management system other than waste structures require maintenance/improvement? Q Yes ®No 9 Do any stuctures lack adequate, gauged markers with required top of dike, 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 applicatio1n?� ❑ Ponding ❑ Nitrogen ❑ Yes ® No 12. Crop type.O.Y..r.............W.lhlk..........�5.�.?.(A`5............................ ...................................................................................................................... 13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No 14. Does the facility lack wettable acreage for land application? (footprint) tA 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 ,.p ,gt No 18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ie/ WUP, checklists, design, maps, etc.) ❑ Yes No 19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ® No 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ® No 21. Did the facility fail to have a certified operator in responsible charge? ❑ Yes ®No 22. Fail to notify regional DWQ of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) ❑ Yes ® No 23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes CO No 24. Does facility require a follow-up visit by same agency? ❑ Yes ®No 0" deficiencies.werepokedduringts'v......................'.' ....l...... ctirrespot....e....t.this:visit.. ....... ; :: ; :: ; ; ;•::•:•:•:•:•:•;•:•;•; ;•:•;•; Comments (refer to question #): Explain any YES answers and/or any. recommendations or any other comments UsCdra wAngs -of facility to better explain situations. (use additional pages as necessary): T Lr%,5;v� o-,<,� o- dv, f- J,11. OtAl 4 6-10on it z sl. aJ Lam_ klial-a-4 k-S,tcd ul. ilar, ake- S60A 6, rtayti� en Iwjt� 1z d; U oI It • 9 • La,0-f.' i6.4 ( ING•vli - i Y.- l a yx, Z a (r) b e to� C � t"-,A.( 5�iic.'�a��SF Slw-ld � 'ke W��lrit-J�'or DW�-•cr� �>icv. e.�� �7P,ptaeu d �4t !'!O a. , ty^ uA It c t �{ t v ; rri�i wtr0 in{tWtwH�ioY� aV` ewtS�� 1Vt}t� tw be st t (Jtlr.j DWI Reviewer/Inspector Name Reviewer/Inspector Signature: /J- Date: S�qQ I I/6/99 Division of Soil and Water Conservation 13 Other Agency Division of Water Quality Date f Inspection oI q�2 Facility Number 3l 23 Time of Inspection � ?A he (hh:mm) 13Registered gVCertified 0 Applied for Permit JUPermitted 113NotOperational Date Last Operated:...,,,,..,_... Farm Name: ............... Nk1.V.i ...... td:s k.....rax,.I................................................ County: ....... D41n ..................................... ....................... Owner Name: ...................!L M.ALita.....ctS.%.t.,............................................... Phone No: ...... �q.14.%. ��-L1.7..�t........................................ FacilityContact: ..................................................................... ........ Title:................................................................ Phone No:................................................... Mailing Address:.....! Z.�.......S.G.s�%......... N.G.....t.......$0............................. ............. k�.GeSho�:.a..l..N...G<...................................... �FF(T�..... Onsite Representative:..............%fit I........Caa..L....................................................... Integrator:............ ....................................................... Certified Operator:............................................................................................................... Operator Certification Number .......................................... Location of Farm: Latitude 0• =, =" Longitude =• =` =" Design. ,= Current; Design, Current Design Current ' Swine, `' _ ''Capacity"_Pop`ulation' `Poultry Capacity Population 'Cattle_F '`'xCapacity=Population_ >. ❑ Wean to Feeder „_;, ❑ Layer JE1 Dairy Feeder to Finish 4800 10 Non -Layer I JE1 Non -Dairy ❑ Farrow to Wean ❑Other ❑ Farrow to Feeder ❑ Farrow to Finish TOtal Design Capacity ❑ Gilts ❑ Boars -TOtal S4,W". Number of Lagoo Ho1dEonds ubsurface Dtains Present Lagoon Area 151 Spray Field Area M§❑ ^... za ❑ No Liquid Waste Management System e'. General 1. Are there any buffers that need maintenance/improvement? ❑ Yes No 2. Is any discharge observed from any part of the operation? ❑ Yes ® No Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. If discharge is observed, was the conveyance man-made? ❑ Yes 119 No b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes M No c. If discharge is observed, what is the estimated Flow in gal/min? IT d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes M No 3. Is there evidence of past discharge from any part of the operation? ❑ Yes [P No 4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes M No 5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ® No maintenance/improvement? 6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ISO No 7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes W No 7/25/97 FacilitfNumber: 31 —L3q 8. Are there lagoons or storage ponds on site which need to be properly closed? Structures (Lagoons.Holdine Ponds, Flush Pits. etc.l 9. Is storage capacity (freeboard plus storm storage) less than adequate? Structure I Structure 2 Structure 3 Identifies...............1.................. Z ................................................................ Freeboard(ft):.............. 3................................._3............................................. 10. Is seepage observed from any of the structures? ❑ Yes 14 No ❑ Yes 10 No Structure 4 Structure 5 Structure 6 11. Is erosion, or any other threats to the integrity of any of the structures observed? 12. Do any of the structures need maintenancelimprovement? (If any of questions 9-12 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 13. Do any of the structures lack adequate minimum or maximum liquid level markers? Waste Application 14. Is there physical evidence of over application? (If in excess of WMP, or runoff entering waters of the State, notify DWQ) 15. Crop type .......................... S..Qrl.............. .tilLL k..............S54....c....................................................................... 16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? 17. Does the facility have a lack of adequate acreage for land application? 18. Does the receiving crop need improvement? 19. Is there a lack of available waste application equipment? . 20. Does facility require a follow-up visit by same agency? 21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? 22. Does record keeping need improvement? For Certified or Permitted Facilities Only 23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? 24. Were any additional problems noted which cause noncompliance of the Certified AWMP? 25. Were any additional problems noted which cause noncompliance of the Permit? 0` No.vitilatioiwordeficiencies were noted during this.visit. Yoii4iH receive nafiirther. correspotideuce about this:visit:." ❑ Yes ® No ❑ Yes 12 No [Yes ❑ No ❑ Yes [BNo ❑ Yes A No ❑ Yes NNo ❑ Yes W No ❑ Yes ® No ❑ Yes ® No ❑ Yes W No ❑ Yes ® No 0 Yes ❑ No ❑ Yes M No ❑ Yes No ❑ Yes ® No iJS4' I �^•.�''l[�.� QQ lj r\Vut t II 1 tY1if�Q�/ g0.K"WS`S S�oU16 bE zYtVf1Lt e `c90Ch ttZ z. Lo Spe, I arA;9r. 4- irr4T\. oh to jV .,k '_' e4E Ecc< tons a kOLj)j � z Ra ah hur..her i-kou)J g 6� gabe4r) On I(Z(L-1 {'-ormS- [apyt. Slwugt) bt aa�eJ io "u Cc'o� 7/25/97 Reviewer/Inspector Name Reviewer/Inspector Signature: _ ,(jam % f) Date: �i ,s r 'M1 i MAY.0^ 040 IqNHN 3. I ,® a TL AA MAY�� 02 040 NNHIA 4.