310257_INSPECTIONS_20171231

r
NUH I H CAROLIN
Department of Environmental Qual

Type of Visit: (O CoptpHance Inspection U Operation Review U Structure Evaluation () Technical Assistance
Reason for Visit: 'UL Routine 0 Complaint 0 Follow-up Q Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: / Arrival Time: Departure Time: 2 O/) County: Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
OnsiteRepresentative: '/ (A �`�lq �T. —7
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Phone:
Integrator
Certification Number:
Certification Number:
Latitude: Longitude:
Design Carrept
Design
Current
Design Currept
Swine
Capacity op.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
W an to FeederI
lNon-Layer
I
Dairy Calf
eerier to Finish
by 14,cw
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D . + P,oultr. +
Ga aci
P,o P.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Qther
TurkeyPouets
El Other
I I
Other
Discharges and 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 DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes /�No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [—]No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Page I of 3 21412015 Continued

z
Facili .Number: -ago jDate of Inspection:
Waste Collection & Treatment
"No
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Ed❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): IJ O
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
CjNo ❑ 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 environments real, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [ ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[j No
❑ NA
❑ NE
Required Records & Documents
111
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
I , 13db
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
El Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes YNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes yo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili ,Number: - zs' Date of Inspection
2, Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes ❑'56' ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA
B❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑'NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [-,I'Iqo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time ofthe inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No ❑ NA ❑ NE
❑ Yes E�,Ntii ❑ NA ❑ NE
❑ Yes U "o ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
E21Z
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as neeessary).f„iy[
I�r Clp r/ l✓1 't �✓ 'lei SoL �jTa i.S . S �un{ —SAP/ - �/1 �%4/'•
Veal L,4-1 fk 1qjr-0���,sti /� oC-A 3-/00� (a 651— Got r
Reviewer/Inspector Name:
Reviewer/Inspector Signami
Page 3 of
Phone: 9 fp 776 7A9y
Date: )I b j' 11 r
21412015

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: tO tcoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: /(/ Arrival Tiroe:© Departure Time: County: ( , � Region: t
Farm Name: I< / k/ Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
OnsiteRepresentative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
` La►t'iFude:
Phone:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design CurrentMIM
Swine Capacity Pop.
Wean to Finish
Layer
esign
apacity
Current
Pop.
Cattle
Da' Cow
Design Curreat
Capacity Pop.
Wean to Feeder
Non -La er
Da Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
I)r. P,oult ,
Layers
Design
Ca aci
Current
P,oP.
DairyHeifer
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
El Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 F;KNo ❑ NA ❑ NE
❑ Yes ❑'No
❑ Yes V No
❑ Yes E] No
❑ Yes E� No
❑ Yes VNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page I of 3 21412015 Continued

Facility Number: Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
!
❑ Yes
0 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
�allo
❑ NA
❑ NE
Structure t Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: /
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
[—]Yes
VNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[-No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
E7'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[� No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
E34No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP El Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes [EfNo
❑ Yes E% No
❑ Yes 3 No
❑ Yes 0 No
❑ Yes [?rNo
❑ Yes No
❑ Yes No
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes U No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes CZ No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ['No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection, !
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes o
25. Is. the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes j1d,I0
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of fast survey indicating non-compliance:
❑ NA ❑ NE
❑NA ONE
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
P'No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Otherlssues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
nj' No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard. problems, over -application)
T
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes Jc;�No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers.and/orany additional recommendations or any, tither comments.:
Use drawings of facility to better explain situations (use additional pages as necessary).
71ar l6 Fir,,,, -- Yecor�3- 1czk 5o�,
/. 0 3,d
�• / 3 vAhc
Reviewer/Inspector Name: Phone:
ReviewerAnspector Signature: �`- �iC___b� Date: t/ e b
Page 3 of 3 2/4,2015

Type of Visit: JQ<mnpliance Inspection 0 Operation Review p Structure Evaluation Q Technical Assistance
Reason for Visit: ORoutine O Complaint 0 Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Ivl I It_ IIQ� Arrival Time: QZ=Departure Timer County: �4 tom_ Region:A�trio
Farm Name: �- �l „� Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: - Title: Phone:
OnsiteRepresentative: �4�1 Integrator:i•)
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine CapacityPop.
Wean to Finish
Wet Poultry
La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
00
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D , P.oult ..
Layers
Design
C:a acity
Current
Pop.
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Beef Brood Cow
Boars
Pullets
Other
Other
Turkeys
TurkeyPouets
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWI)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No NA ❑ NE
❑ Yes In No D NA ❑ NE
Yes Z] No ❑ NA D NE
Yes
4 No
❑ NA
❑ NE
Yes
�No
❑ NA
❑ NE•
Yes
�No
NA
NE
Page I of 3 21412015 Continued

Facility Number: Date of Ins ection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes �An No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
jff No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ZI No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[!I No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[3"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
❑iNo
'77`
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ET14o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[2rNo
❑ 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 Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
4�j No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
,❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
�ffNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
ETNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
dNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
f 2 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
ff No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �no
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑.Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes o
❑ Yes gNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 21412014 Continued

Facility Number: z I -I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes W No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes EfNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ff No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [;"No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes [;TNo ❑ NA ❑ NE
and report mortality rates that were higher than normal? TT
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes VfNo ❑ NA ❑ NE
❑ Yes PNo ❑ NA ❑ NE
❑ Yes ff No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWW? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [3/No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawines of facility to better exDlaiD situations (use additional uaees as necessarv).
f—�6rrkN 4- reccaf s laolc (sCfo
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: To
Date: Q 1 (7
2/4/2014

Type of Visit: JQ�C-ompfiance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: JO'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: /a Arrival Time: Departure Time: County:,Region:
Farm Name: 8 Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:jj//////
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Title:
Phone:
Integrator: 4M /'Z
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current
Swine Capacity P.
Wean to Finish
Wet Poultry
]Layer
Design
Capacity
Current
Pop.
Desi11 gn Current
Cattle Capacity Pop.
Da' Cow
Wean to Feeder
]Non -Layer
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Du+P,oaI .
Layers
Design
Ca aci
P,o ,
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
01 Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 jEr No ❑ NA ❑ NE
❑ Yes JE No ❑ NA ❑ NE
❑ YesCa-go ❑ NA ❑ NE
❑ Yes O'No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes ENo [:]NA ❑ NE
Page I of 3 21412014 Continued

Facility Number: I --2 Date of inspection
WastC Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes UNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes EfNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
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
❑ Yes
�TNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
L�3 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[3-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
gNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[�!rNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
ONo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes jTNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[EfNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Ef No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑SJo
T[;�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑' No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑'No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes allo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes .f No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [3'fJo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes .�No
the appropriate box(es) below. ,
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes allo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes jfjNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ;D-No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
3 L Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes _"No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [2-No ❑ NA ❑ NE
[—]Yes
0-Ro
❑ NA
❑ NE
❑ Yes
ED—No
❑ NA
❑ NE
❑ Yes
dNo
❑ NA
❑ NE
Comments (refer to question fl): 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).
fa%'Jades.
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ? 791<732_3
Date: /
4/20

Reason for Visit:
Date of Visit: LL.�
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
e Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Arrival Time: Departure Time: County: nIZO& Region: ( �
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Owner Email:
Phone:
Phone:
C�/tip Integrator:
Certification Num er.
Latitude:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
We[ Poultry
La er
Design
Capacity
Current
Pop.ill
Desigrt Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D , P,oult .+
Layers
Design
Ca aci
Current
P,o ,
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
NJ Other
Turkeys
TurkeyPoults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes�No ❑ NA ❑ NE
❑ Yes ,
❑ Yes No
❑ Yes 'ETNO
❑ Yes E!fjNo
❑ Yes 6No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 21412011 Continued

Facility Number:
Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes .15No ❑ 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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes grNo ❑ 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 do ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes [;}'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes I_'Ro
'/
❑ 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 P'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
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 ONo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes,,Ej`No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes 1/� No
l❑
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes o
❑ NA
❑ NE
acres determination?
r'
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑Yes/Ell
es No
T
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes Oo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes J�fNo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes O No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes E2/No
❑ NA
❑ NE
Page 2 of
21412011 Continued

Facili Number: 2 Date 4z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes_'La'No ❑ NA ❑ NE
r�
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ,�No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Ye,;,,1ffNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes PETNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes J�o ❑ 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 �o ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes J�'No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes JDI To ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes Z"No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yeso ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
w^j(3occ)Lk-
/Zsj� 3 Y
Z Fz�r,Y�-- d- ieCat- cX J
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: Q 6 7
Date:
1G011

IType of Visit jDxbrnpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit f0houtine O Complaint 0 Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: d Arrival Time:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Time: County:
Owner Email:
Phone:
Phone No:
Integrator: �I J
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: [ o = ' = Longitude: = o =
`Design "Current Design --,-Current
Destgfi— —.Current
Swine ^^ ,Ca
act FP Mahon, =.. WetRdultry ..Ca`"aci -Po Mahon TM"tCattle"°""'"', Ca act Po ulahon�
❑ Wean to Finish
❑ Layer
f ❑ Dairy Cow IM
❑ Wean to Feeder
❑ Non -La er
❑ Dairy Calf I
I-
n ❑ Feeder to Finish
-µ *_ ;KK - y` *. ❑ Dairy Heifer
❑Farrow to Wean
"""`�° '""`
P'o'ultry
- ,; ❑ D Cow
El Farrow to Feeder
'�.. ❑Non-Dai
r=- ❑ Farrow to Finish
❑ Layers
❑Beef Stocker
❑ Gilts
- ❑ Non -Layers
` ❑Beef Feeder
❑ Boars.
❑ Pullets
❑ Beef Brood Co
Other
❑ Turkeys
❑Turkey Poults�
,
�.
❑ Other
❑Other
Number of.Structures
77
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes,�TNo ❑ NA ❑ NE
❑ Yes JUNo
❑ NA ❑ NE
❑ Yes ONo
❑ NA ❑ NE
0
❑ NA ❑ NE
❑ Yes )2Tlo
❑ Yes Aj`NNo
❑ NA ❑ NE
❑ Yes No
❑ NA ❑ NE
Page 1 of 3
12128104 Continued

Facili Number: Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the penni ? ❑ Yes [2"No ❑ NA ❑ NE
25', Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ZNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes LJNo ❑ NA ❑ NE
❑ Yes ZNo ❑ NA ❑ NE
[—]Yes V"No
❑ NA
❑ NE
❑ Yes ONo
❑ NA
❑ NE
❑ Yes 6No
❑ NA
❑ NE
❑ Yes �No
❑ NA
❑ NE
❑ Yes
I /I No
❑ NA
❑ NE
❑ Yes
�^�'
No
❑ NA
❑ NE
❑ Yes
E] No
❑ NA
❑ NE
Comments (refer to question 0): Explain any Y US 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:
Phone:
Date:
Page 3 of 3

FacilityNumber: - -2. $� Date of Inspection.
o
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ YesNo
❑ 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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to`ththeintegrity of any of the structures observed?
❑ Yes Z_No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes I /I No ❑ NA ❑ NE
waste management or closure plan? ii
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 �Z N' ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 1/ I 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
❑ NA
❑ NE
maintenance or improvement?
/0—No
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes �o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[—]Yes o
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground El Heavy Metals (Cu, Zn, etc..)`'
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes ONo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes EjNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ YesEfNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes x]-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes o
/�y� tv
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes r%No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes �No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other: -�
21. Does record keeping need improvement? If yes, check the appropriate box below. Z Yeso
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste ransfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes lf:�iNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes .E No
DNA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Type of Visit: 'Compliance Inspection 0 Operation Review C) Structure Evaluation C) Technical Assistance
Reason for Visit: O'koutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: / Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Integrator: /'7y
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current Design Current
Swine C*apacity Pop: Wet Poultry Capacity` Pop.
Design Current
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I INon-Layer I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D ,+ P,oult . Ca aci P,o
Layers
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I
lBeefBroodCow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes E�'No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes AD No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes Z ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ZNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

[Facility Number; Date of Inspection :
'Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes e!No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes VI"No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes rjt'No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) T
6. Are there structures on -site which are not property addressed and/or managed through a [—]Yes iii o ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes KNo ❑ 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) iiiiii"''''
9. Does any part of the waste management system other than the waste structures require ❑ Yes FNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 1 3 No ❑ NA ❑ NE
maintenance or improvement? T
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes dNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, et//cc.)��)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes y I No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
fNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
eEl o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�/
g No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
;2-No
T
❑ NA
❑ NE
Required Records & Documents
19. Did facility fail have
�No
the to the Certificate of Coverage & Permit readily available?
❑ Yes
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
0 No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements []Other:
Q21. es record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspection udge Survey
22. Did the facility fail to install and maintain a min gauge? ❑ Yes o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain minbreakers on irrigation equipment? ❑Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 31 Date of -Inspection. !
24. DiS the facility fail to calibrate waste application equipment as required by the pernnt? ❑ Yes gyNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes PrNo ❑ NA ❑ NE
the appropriate box(es) below. �"
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes EfNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes/fNo ❑ 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 ,,E�No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes 0No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application) ❑ //////"'''""''//'
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. Yes � 3 No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: T��"'''""'''
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 40 ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments..
Use drawings of facility to better explain situations (use additi nal pages as necessary).
/v /x /i
� 7 atr
In 5_"j
kept e'f
/ Gl o20/6 Abrb e J rQl
ReviewerAnspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
�d lec ores
Phone:
Date:
21412 l

[vision„of Water Quality
FaC1ltiy;NUmti¢c j „„O Drvtston of Soil and -Water Conservation
O'OtherAgency
Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O T
Reason for Visit �outine O Complaint O Follow up O Referral O Emergency 0 Other
Date of Visit: C Arrival TTime: �/� Departure Time: County:
T/ im
Farm Name: l h 0n — Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
:al Assistance
❑ Denied Access
Facility Contact: %j Title: Phone No:
Onsite Representative: �� /� Cf�G Integrator: 113
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: =o =' =" Longitude:
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)
I2. 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?
pQBe pof 3
_i
Region: ``7` -E
a
❑ Yes J No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ZNo ❑ NA ❑ NE
❑ Yes )!fNo ❑ NA ❑ NE
❑ Yes PrNo ❑ NA ❑ NE
12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 2 Structure 3 Structure 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes KNo
❑ NA ❑ NE
❑ Yes 17No
❑ NA ❑ NE
Structure 5
Structure 6
❑ Yes J2'No
❑ NA ❑ NE
❑ Yes V'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 ,Z'No
❑ NA ❑ NE
8.
Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes �No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9.
Does any part of the waste management system other than the waste structures require ❑ Yes ONo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10.
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes JNo
. ❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes dNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
Crop type(s)
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAW -MP? ❑ Yes E!rNo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ,.�,(' No El NA [I NE
17. Does the facility lack adequate acreage for land application? ❑ Yes ,F!� No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes pi'No ❑ NA ❑ NE
IReviewer/Inspector Name l , " yu' Phone: 7/i//—
Reviewer/Inspector Signature: /� i �� �� Date:
Page 2 of 3

Facility Number: �.3(Date of Inspection
Required Records & Documents �(
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes JV No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [:]Yes ;ZNo ❑ 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 ZNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard El Waste Analysis LJ foil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall El 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 j2rNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ZrNo ❑ NA ❑ NE
24. id the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
id the facility fail to conduct a sludge survey as required by the permit? ❑ Ye o ❑ NA ❑ NE
L26. Did the facility fail to have an actively certified operator in charge? ❑ Yeo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes PNo ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes RrNo ❑ NA ❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes
�Z`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
EfNo
❑ 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
PNo
❑ 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
VrNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
7No
❑ NA
❑ NE
Additional Comments and/or Drawings:
a f4i s,5 (ova r (1, 006..E
J u-cue'Q�)
4?cC
Page 3 of 3 12128104

Facility Number: — ®r v Date of Inspection ' '7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes EfNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes EfNo ❑ NA ❑ NE
Struc e l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier. _
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): y
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes A No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes PNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7.
Do any of the structures need maintenance or improvement?
❑ Yes Ptvo
❑ NA ❑ NE
8.
Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes eNo
❑ 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 PNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10.
Are there any required buffers, setbacks, or compliance alternatives that need
,�{c,
[I Yes /b No
El NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below.
,e,
El Yes No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12.
Crop type(s)
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes ,rNO
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes P-No
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑
Yes ;2'No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes ;2No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes Z 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 situatio s. (use additional pages as necessary):
d� racy q� )C7
Reviewer/Inspector Name h Phone:
Reviewer/Inspector Signature: Date: Ivy O
12128104 Continued

,- Facility Number: Date of Inspection I p/P 47
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 /ZNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. dyes ❑ No ❑ NA ❑ NE
__ [] Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
infall ❑ 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 _BNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
[:]Yes ffNo
❑ NA
❑ NE
[--]Yes
yJ No
❑ NA
❑ NE
❑ Yes
ONo
❑ NA
❑ NE
❑ Yes
PNo
❑ NA
❑ NE
❑ Yes
Z No
❑ NA
❑ NE
❑ Yes �o ❑ NA ❑ NE
❑ Yes i'`'"'o ❑ NA ❑ NE
❑ Yes Z No ❑ NA ❑ NE
❑ Yes L_I No ❑ NA ❑ NE
❑ Yes P14o ❑ NA ❑ NE
12128104

Type of Visit Otompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: © Arrival Time: G�.� Departure Time: County:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: / Title:
Onsite Representative: Lod �l
Certified Operator: T—
Back-up Operator:
Location of Farm:
Swine
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Num er:
Back-up Certification Number:
Latitude: F--I o M , F7 « Longitude: o
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Region:
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes Jallo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
[]-No
❑ Yes
E5 No
❑ NA
❑ NE
❑ Yes
El -No
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection
ti
v9ste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes D-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:
Spillway?:
Designed Freeboard (in): ,_'2 V�•-7V
Observed Freeboard (in): 02 /
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes tom' No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ETNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [�Po ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes PNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes Q-No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑"No ❑ NA ❑ NE
maintenance/improvement? r
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [)xo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) (-?77—N
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes 4�No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes 2-No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination, El Yes EI-No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes 1[j`No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes--EINo
❑ NA
❑ NE
Reviewer/inspector Name ; - i "- e Phone:
Reviewer/inspector Signature: Date: / .,D
12/2 4 ! Continued

Facility Number: — Date of Inspection �6 d
RWuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑-90 ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ YesNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ,.QYes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ZWaste 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
J2'No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
)D-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
ONo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
,O'NO
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
u No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑'No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
P'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
ED 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
,fNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
VNo
❑ NA
❑ NE
Addiiional.Comments and/or Drawings:.,
r
Gp
cs-
Jut)
�n�l�
s (s ac-e
vod
d— 6o
AO-Y&S
b4�0Cc ,
TYah C6#- Fret�oW`df
�J rm S
�� Iryt t 5 t' 5 oacB 5 t �cc;✓rcQs
jteo -� a_ 6rckc CY.
12128104

Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 3 Date of Visit: rJ Tune: V f// //1 I
O Not Operational O Below Thresho
Permitted a ed O�Conditionally Certified [3 Registered Date Last OWPM Qr Above old: _
Farm Name: ---�—L• r s1 u Couty/✓)�
Owner Name:
Mailing Address:
Phone No:
Facility Contact: Title: Phone N� —
Onsite Representative- __— Integrator. -/------_
Certified Operator. _ Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =• =_ =" Longitude =• 0= =11
Desrgn Curren e= Desngn Current Deszgu rCarr®t
Swine Po hone .P4dtry :. a ePo on,.,'sCettie`, .s ;C8 aei "Po tilation
Ca
Wean to Feeder
Layer
Dairy
-
eeder to Futish
Non -Layer
Non -Dairy
Farrow to Wean
Farrow to Feeder
Farrow to Finish
cstgn
- 7 - 777. -
3 -- Total SSLW
Gilts
Boats
Number of Lagoons
A -r
Dischames & Stream Im acts
1. Is any discharge observed from any pan 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 pan of the operation? ❑ Yes f�No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? [I Yes �No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Struc e l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
12112103 Continued

Facility Ntmtber: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures served? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelrmprovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ wj@f 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?
Odor issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
is-
Reviewer/Inspector Name
Reviewer/Inspector Signature:
❑ Yes';290
❑ Yes--J23v'o
❑ Yes_J214o
❑ Yes )2,go
❑ Yes-.0lffo
❑ Yes,01Qo
❑ Yes P"K
❑ Yes,,ONo
❑ YesZ j No
❑ Yes�Ergo
❑ Yes �o
❑ Yes -$iTo
❑ Yes Aff o
❑ Yes .2-M
❑ Yes ,giio
❑ Yes,-2No
Field Couv n Final Notes
�2Oa3 bud �s
;'--Z. mac' Y
Date:

Facility Number- 3
Date of Inspection C G
Reeuirecl Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP.
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes Z<o
❑ Yes
❑ Yes _9390
❑ Yes Aff<o
❑ Yes .B-<o
❑ Yes La<
❑Yes
❑ Yes 2'1<o
❑ Yes 12,140
.t- r es ❑ No
❑ Yes ,lido
❑ Yes .$No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes J!I'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
❑ No violations or deficiencies were noted daring this visit You will receive no further correspondence about this visit
Corn`mertis aad/onDrmvings t
�, .. - ..
�.YY-x'Y+-^r:3:= `ice-�-�`-. 4.iGs`-.e� s-ca�_vzs -u5
A% w CllGoec'�.-�
l2/i2t03

Facility Number 3/ 2 Date of visit: Z3 OZ Time: 3 M
Not Operational 0 Below Threshold
Permitted ® Certified 0 Conditionallly Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: >FGrms 9-9 County: 01,01ih
Owner Name: CrQ M1i h 5 Phone No:
Mailing Address:
Facility Contact:
Onsite Representative: J(J4�'Wy bi A
Certified Operator:
Title:
Phone No:
Integrator: _A";P A/
Operator Certification Number:
Location of Farm: -
r
[]Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude =' =` =
-' Design F
Current-
-'.
-<.Ca
`Design ;=,Current _. .Design. ..Current
aeRV
Po-dlatiou
., . Poultry _
nd" P.o p uhttion -=Cattle - -
_ .•Cap acity_ Po ulation r
❑ Wean to Feeder
="
❑ Laver
t,�'.
❑ Dairy
®Feeder to Finish
0
❑ Non -Layer
I I IIIk; ❑ Non -Dairy _•
,,
t _..
❑ Farrow to Wean
„-�._ -. .-� ": ..:..-., -`_ �. _71.-s - - -
❑ Others '�•
=-9,. s,.. _ F _ _
❑Farrow to Feeder
^
❑Farrow to Finish
-❑Gilts
Total Desigtt Capacity
t s< _v"-e`71
AWer-:_ •'i
TOtaI SSLW' _�ll
❑ Boars
" Numb rsof ooK ns''".t
Ft' t' ❑Subsurface Drains Present ❑ Lagoon Area IEI S ray Field Area
LHoldtngiPonds /4SdhdrTta�pr
r ❑ No
Liquid Waste Management System y }
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)
a if discharge is observed, what is the estimated flow in eal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: I
Freeboard(inches): 37
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ESNo
❑ Yes �5No
❑ Yes ® No
Structure 6
05103101
Continued

Facility Number: 31 -- C.7 ! Date of Inspection
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion.
❑ Yes
IN 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
[Z No
([f any of questions 4-6was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
® Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
El No
9.
Do any smctures lack adequate, gauged markets with required maximum and minimum liquid level
elevation markings?
❑ Yes
®No
Waste Amlication
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
&No
11.
Is there evidence of over application? ❑ Excessive Pending ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12.
Crop type ODrn 104e +
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
Da Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15.
Does the receiving crop need improvement?
❑ Yes
N No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
JX1 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
C5�No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
®No
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
1�a No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25. Were any additional problems noted which cause noncompliance of the Certified A WMP? []Yes ®No
Q No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit
Field Conn L l Final Notes
7 }11t C041 54n4 —'Oorw+ei-is /et 41'-frW4 e-- be Ajeen -ka Ao7 Ho ✓ses. Aow- AA[ G011yir1Q
t+s wblt}.•5 4.-4eir well dr.%l[✓ fi Ti'r4 prob/era,
_41% /d ci �i+y Hee04 I-W-gnGk acre- 4r L't'Bj-43 I"tli2et
Z�Z9 Need -rP Ao+ a 14110af ah rNe, iH-kke-.
Reviewer/Inspector Name
Date:
05103101 Continued

Facility Number- � — 2j % Date of Inspection Z L
Odor Issues
26. Does the discharge pipe from the confinement -building to the storage pond or lagoon fail to discharge atior below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
O5103101
❑ Yes 0 No
El Yes ®No
❑ Yes ® No
® Yes ❑ No
❑ Yes N[No
❑ Yes ($No
❑ Yes ® No

Division of Water Quality
Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit 'N Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: O Time: Printed on: 7/21/2000
Facility Number a
Q Not Operational Q Below Threshold
Wermitted 0 Certified ❑ Conditionally Certified 17 Registered Date Last Operated or Above Threshold: .........................
I�� 1.
FarmName: ............. 1:F.....1.!... �................................................................ County:.... ...... .11..........................................................
Owner Name:
Facility Contact:
Mailing Address:
Title:
Phone No:
Phone No:
Onsite Representative: .... k.?.1f.... 1.:....................................................... Integrator:...._L���... �k
Certified Operator: ................................................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude =•
Design Current Design Current Design Current
5 ' ' Capacity Population Poultry Capacity Population Cattle
Ca 'acit 'population
Wean to Feeder ❑ Layer ❑Dairy
Feeder to Finish aIFFO ❑ Non -Layer 10 Non -Dairy
Xr' Farrow to Wean
Farrow to Feeder ❑ Other
Farrow to Finish Total Design Capacity
at Gilts
Boars Total SSIW
umb F­­
Ner ofLagooac ❑Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area I
HobfmgPonds / Solid Traps ❑ No Liquid Waste Management Systemm
thscaarges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes 4 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 PIo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes kyNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4
❑ Yes R(No
Structure 5 Structure 6
Identifier: ....................
Freeboard (inches): w�
5/00
Continued on back

Facility Number: 3 k —D37 I _ Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
Vp No
seepage, etc.)
-
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
KNo
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?
❑ Yes
9No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
WNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
WNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
P No
12. Crop type t`I/t�J j 1 Sa �o
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
allo
b) Does the facility need a wettabie acre determination?
MYes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
BrYes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
gNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
SNo
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
VNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
ONO
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
P No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
J4 No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24, Does facility require a follow-up visit by same agency?
❑ Yes
�No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
Cy/No
f.•e•c$-i0f hjs:visit;-Yopw t:h•:$•t:
•::•
-•tVor-yioslariidnence:aboufthciisys iwsit:•:-:-::-:�-:•:•:•••••••••---i-h•-•::•
::coieuo::'::::::::::::::y•:e•::-:fu•:r•:
t3o t`l-e s c. mot. p lae t� acr ��t t-c�, ct Ej s
5-65 �ee� ptc• o� �<ts�
I S) Wt,� e�l . 4, e\\�` �(�d'�a�'�rc� I F i s
t� ���+ t� GAY t QY d't2� (S ��t", �1d t 2 � 4 L
Reviewer/Inspector Name ' } Nz _ - F, �, _ ,y r =suss
-r � (
Reviewer/Inspector Signature: Date: o�•�— �) 5/00

Facility Number: `31 — Date of Inspection Printed on: 7/21/2000
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
PYes
❑ 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
�J No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
XYes
❑ No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
'U'Q4' No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
MNo
Additional Comments and/or Drawings: _: .' •.':`�
fee J \�' Ao�� I.1 ti -.
Xzt d t t_ t-` 5
5100

}Division of Water QoaGty -- - _
Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit )16 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit oRoutine O Complaint O Follow up O Emergency Notification O Other �J [I Denied Access
Facility Number
Date of Visit: 1Z 1� DO 'time: E-219 Printed on: 10/26/2000
3 / 2.5
Q Not Operational Q Below Threshold
,Permitted E3 Certified E3 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: ..
Farm Name: r 5........_IC P County:._Vp......................'.......................
....................... ............................. .................................................. YI
OwnerName: .............. Cr..q_`._..........^..r................................................................ Phone No:..............................................................
Facility Contact:
Title:
Phone No:
MailingAddress: ..................................................................................................................... ..................................................................................... .
OnsiteRepresentative: .... VQ.�L..:...._..r....................................................... Integrator..._%1(..`.r,p4,vA✓tvv.f
.......................................................
Certified Operator: ................................................... ............................................................. Operator Certification Number: ........................... ........
...._
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =• =, =- Longitude =• =' 0"
Design Current
Swine Canneity Pnnnlation
❑ Wean to Feeder
Feeder to Finish
ZigU
Q
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Po uladon Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons 1❑ Subsurface Drains Present �[❑ Lagoon Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
I❑ Spray Field Area
I
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 DW Q)
❑ Yes No
c. If discharge is observed. what is the estimated flow in gal/min?
P) 1�
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes U'No
2. Is there evidence of past discharge from any pan of the operation?
❑ Yes X No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes J'No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes 18 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: ................1.....................................................................................................................................................................................................
Freeboard(inches): 3 I
5100
Continued on back

Facility Number: 3 I -ZSq Date of Inspection 2 00 Printed on: 10/26/2000
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
6 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
XNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
$(Yes
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
IgNo
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
,QNo
11,
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
JeNo
12.
Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
J9 No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
ZNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
ONo
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
JjrIVo
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
jo No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
t<Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
29 No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
M No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
Yes
N6 No
(ie/ discharge, freeboard problems, over application)
❑
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
19 No
24. Does facility require a follow-up visit by same agency? ❑ Yes 19 No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? []Yes Z No
I. . . . . . . . . .5.0. . ..Glen. . . . . . . . . . alt[tllg 1}fIS,VISIt. Y,UI} W1��•I'eCgIVC i.0 t�Uft�1Q� ,
:�:�cories orideitce:abotikthisvisit:�:�::�:�:�:�:�:�:�:�:�:�:�:�:�:�:�:�:
Comments (refer to question #): Explain any YES answers and/or any recommendations•or any other;commeuts w:F —
Use drawings of facility to bgtterexplainsituations. use additional pages as necessary): -
8, 9erA;t— I cak.r OPI L OL Ses b Pi+ AregS. �
IR. Need 1'9'jCj rreeboa( rC6011J, N12CA 2000 so;l -FCS*t Vse wys4e
anal�Sls ataarr
ed w�IL, (06 Actyl of
6c5:nn;�� 19/{N elllowgrce ffoy4 wA,(4e, r
1c,w%
e,C'0"4 huecl)
Reviewer/Inspector Name
s
Reviewer/Inspector Signature: 4 C4_'a li, ) 9q/%" ASA Date: I L III IOU 5/00

Facility Number: .3 1 —25q Date of Inspection /Z T {: 00 Printed on: 10/26/2000
.Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ,9IYes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes &No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes Xj No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No ,
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
Additional Comments. and/or Drawings:.
/VoIG 14yArciP%+
(o Is
me)4 Th WaSle,
Plavt. Gror.det—s
reeprOU SkcW
tiLA-'Ant -Zr
7an•d
8 ciJ a 4o4cil
of Iy,SaLleJJ
l,.x►s-je p/.al.,
1AJ a,S 16,5 azres• r'rewor'S records liyd"n4f
Rand 10 as G -4o4Gl IZ.25 AGfiJ�* W4i In SIVWS
13.3 o L*T5- Was -le rla&I need,t Jo be s;�rted hd dd%eA
owner rnnd Feol,n;Gaj r�er ial;s�.-rte ' Iy Grop w; 14
P4JN rare etVcl aloe II'C44;o+1 W "lotp i i S C-0 -11.
� ages
Foy e1l1-f,e1ds. CLVA hkve all crop-s J ql m 5h-I be
ploonlm zkdded 4z, rlgn, Piave �e�in�T tat sec1i61 &4 AnA
owlie-✓- -!r: 5h 4 olc 4- Ylew pla n
No�'G: Was�e Plat, had Y✓ICtrp11—','f-une t,., :•'1G�aW oT.l cam , SoMe
ap�lii<c.};o,.,r oeevn^eA i�Tv(�. �ollol„/ Wi+wjoWl %+� lO%ah•
5100

.E3Division of Soil and Water. Conservation -Operation Review _
E3 Division of Soil and Water:Conservation Compliance Inspection �. '
Division of Water _ - - Quality - Compliance Inspection
Other Agency -;Operation Review h ( '_
® Routine O Complaint O Follow-on of DWO inspection O Follow -tin of DSWC review O Other
Facility Number I Date of Inspection 1 11-dfe-9q
Time of Inspection FT-b-p-1 24 hr. (hh:mm)
Permitted IN Certified Q Conditionally Certified E3 Registered 0 Not O erational Date Last Operated: ..........................
�/ t
FarmName: ... .�.........!-.rv.\.................................................................................. County: ...... ,,....!1,?.U-V.............................. ........ .......
Owner Name: ...L.YGS.1..4rj........... .....1..... .................. Phone No:.....�..1 t7�...5 ^01.2 .......................
JJ ........ ..
Facility Contact: C.n�7;6.j.._^..1.I1��Q.��..���..1l� M41A........Title: .... Wu!%�.......... ............................ Phone
No: ...................................................
Mailing Address: .... tiltJ...Gw.. ti(!] �.%hKIr1C�_�. t...e-tiit.Y1!~1�..�...I.Y.LI r
Onsite Representative: y............. L1..I.. JJJJ................................................. Integrator:........................................................................................
Certified Operator: ................................................... ............................................................. Operator Certification Number: ...... 1...7.. ...............
Location of Farm:
Latitude =• =' =•' - Longitude =• =' ="
-: Design Current.
-;- "`�_ - Design; Curren[- - ` Design Current
.Swine -=" °. _.Capacity Population
Poultry,:Capacity Population Capacity Population ,_
.` ❑ Wean to Feeder
❑ Layer ❑ Dairy
Feeder to Finish 2,K8'D
. ❑ Non -Layer I I':: ❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts,
>. ❑ Boars
Total.SSLW
`Number of Lagoons
- ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area -
"-,Holding Ponds / Solid Traps E:=
❑ No Liquid Waste Management System _
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard(inches): .........a` ........................................................................................................................ ............................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes [g No
❑ Yes
li ' No
❑ Yes
X No
NIA
❑ Yes
No
❑ Yes
® No
❑ Yes
1A No
❑ Yes [4 No
Structure 6
❑ Yes ANo
Continued on back
3/23/99

Facility Number: Date of Inspection ��-
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
(kNo
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
M No
9.
Do any strictures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
(0 No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
W No
11.
Is there evidence of over application? ❑ Excessive Ponding [IPAN
❑ Yes
19 No
12.
Crop type _jJ1
1 ryt , �Nptr� �D��tIYVA4-1
13.
Do the receiving crops differ with those designked in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
EKNo
M.
a) Does the facility lack adequate acreage for land application?
❑ Yes
4No
b) Does the facility need a wettable acre determination?
❑ Yes
(,� No
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ W UP, checklists, design, maps, etc.)
❑ Yes
[S(No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
JM Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[4 No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
"No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
R No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
W No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
CANo
.. i.. Yi91'afiotis;oi• deficiencies •were itofed dirririg this:visit: • Yop will receive Rio: further: •' •'
: - corresporidcilee: aboatahis Ylslt. : ; : : • : . • : • : : • : : : - : : : ...
Use drawings of facility to better explain situations (use'additional•pagesas necessary
W/fj4q41L /w5 heen hisrlrlik (- ire 15 Afrca t A-gmlls .:l )'-ee -wy.
/t'tte47S 76'14, XeAA6& aOZTt
!9 ups Sa;/ 445Js.
jr�e1ds Aavt beevl ever -,seeded wJ Rye a&l ,j of 54rtce has fq dwe/bp•c,/_.
Reviewer/Inspector Name
Reviewer/Inspector Signal
Date: //,Al
3/23/99

Facility Number:3 — Date of Inspection©
Odor Usucs
N/*,26!Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
N/A-- �Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes XNo
❑ Yes Z No
❑ Yes C No
❑ Yes (9 No
❑ Yes DtNo
` es- :
AdditionalComments omments an or rawmgs.
3/23/99

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality �I
IDate of inspection I '9 jjV
Facility Number
11) Time of Inspection 24 hr. (hh:mm)
Registered 4 Certified Applied for Permit 13 Permitted 10 Not Operational j Date Last Operated
r _ 1/
Farm Name:... �.! ..7 ^5.......^...?............................................................... County: ......... +�.� pl�.�
OwnerName:........W ..W 4�.....\ ...�............................................... I............................. Phone No:...........................................................................
FacilityContact: ............................................ ................................. Title:................................................................ Phone No:
MailingAddress: ..................................................................................................................... ..................................................................................... ..........................
OositeRepresentative: .... ..........�.._1�....................................................... Integrator:....a-!.�.J. r
................................................................
Certified Operator:............................................................................................................... Operator Certification Number;.........................................
Lqcation of F rm:
.... r�..r... '^S.. W....... .............. ........r.....'..................................... �'.`.^......... .....:. ... .....:-5i...................... ............. .1.`.:�.......... ``.�..
c,- .........,...IQ........................................................................................................... .
Latitude O• =, =" Longitude =• =' ="
Destgo „;Current �' ' ' Design Current ; e Design ' Current'
° Swrue Capacity" Population Poultry Capacity Population '' Cattle -Capacity Population
"❑ Wean to Feeder I0 Layer ❑Dairy
Feeder [o Finish gCl ❑ Non -Layer - ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity,
a ❑ Gilts
❑ Boars Total SSLW
`Number of Lagoons f,Holdmg Ponds 10 Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area €
i ❑ No Liquid Waste Management System
c�
General
1. Are there any buffers that need maintenancelimprovement?
❑ Yes
CKNo
2. Is any discharge observed from any part of the operation?
❑ Yes
fq No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
N No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
kNo,
c. If discharge is observed, what is the estimated Flow in gallmin?
1F
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
N No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
WNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
Wo
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[�No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
O No
7/25/97

fi
Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ONo
Structures(Lagoons.Holding Ponds, Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
%No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Freeboard(ft):............ 1. ................................................................................. 9...............................................................................................................
..
10. Is seepage observed from any of the structures?
❑ Yes
W No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
((Yes
No
12. Do any of the structures need maintenance/improvement?
Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
OjNo
Waste Application
14. Is there physical evidence of over application?
❑ Yes
R(No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
r
15. Crop type...................._:'�.........................................................................................................................................................................:.....:................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
f Yes
❑ No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
' [gN0
18. Does the receiving crop need improvement?
❑ Yes
gNo
19. Is there a lack of available waste application equipment?
❑ Yes
N No
20. Does facility require a follow-up visit by same agency?
❑ Yes
JWNo
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? -
❑ Yes
"" No
22. Does record keeping need improvement?
ayes
❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
O(No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
19 No
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
No
No.violatitins-or deficiendes.werenotedduring this:visiC Noii4illreceive•noftirfbe-
correspptidepce abouf Phis:visit:: ; :: ; ::: • ; : ; :: � : • ; • : ; : � ::::: :
tntaents (refer to gtteshon. Explata anp YES aoswers�andt an recommendanow or any othencomments
;Ilse drawtrtgs of factGty�t better' eaplatn sttnaaorts. (ttse adaratattal pages as necessary) ; �
�,
�a Remove, %-J" + i -ptJ ' �S'
p
`cam
aai s,l l�s�s, Y,.o�e S"�hse
►-�.
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: _—,���_ Date:

❑ Division of Soil and Water Conservation ❑ Other Agency
(&Division of Water Quality
10 Routine O Complaint �.Eollow-up of DNVQ inspection 0 Follow-up of DSWC review 0 Other 1
f
Date of Inspection 26
Facility Number Z
Time of Inspection 24 hr. (hh:mm)
E3 Registered Certified [3 Applied for Permit E3 Permitted [3 Not Operational Date Last Operated: ..........................
�j ........
Farnt Name: .............�/...........Q..................................................................................County:.c`..... .. In
............ .....................................................
{� q
Owner Name:... ..e!.�......................... ............................................ Phone No:.......2.0:. ......Z ,1.
Facility Contact:.r,%............. �i.Y..Y.kFi............... Title:...[.Y..!:(,{�.Lft ......Z�.................... Phone No: ......_........................................
! N F/
Mailing Address:.....(........ ..fYl 1Fi�!/i�........✓ .G[.......%. W... ...... .......
Onsite Representative: ... : .............................................. ........................................................ Integrator:.l.:�....... _: ( .....................(...................................
Certified Operator................................................................................................................ Operator Certification Number: ..... !.�.."":...':............
Location of Farm:
Latitude =• =' =" Longitude =• =' ="
- Design: Current
Design _Current Design; Current
Svrme '= Capacity Population,
Poultry > - ,.Capacity ;Population SCattie a CapacityPopulation w ,
❑ Wean to Feeder1
10Layer > ❑Dairy
er to Finish
❑ Non -Layer '. ❑Non -Dairy
:ram ❑ Other' :.': _� ti
k
❑ Farrow to Wean
,.
❑ Farrow to Feeder
Total Design Capacity
❑ Farrow to Finish
❑ Gilts
- _ Total SSLW'
El Boars
d
Nambe[ of Lagoons / Holdin gp`Ponds❑Subsurface Drains Present ❑Lagoon Area I[] Spray Field Area
❑ No Liquid Waste Management System 1 r_ -'
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated Flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
Continued on back

Facility Number:
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
,ia'No
Structures (La2oons.Holdine Ponds, Flush Pits, etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
AYes
❑ No
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure
6
Identifier:.............................................................................................................................................
......................................................................
Freeboard(ft):...�i........................................................................................................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
if No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
R No
12.
Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
I[No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
99No
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15. Crop type -------- AT-7-
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
❑ No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
❑ No
18.
Does the receiving crop need improvement?
XYes
❑ No
19.
Is there a lack of available waste application equipment?
❑ Yes
❑ No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
22.
Does record keeping need improvement?
❑ Yes
❑ No
For Certified or Permitted Facilities Only ,
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
❑ No
❑ No.violatioitsor deficiencies were noted during this,visit..You wilt receive ito ftirther
...........................................................
cornspoodenm ahout this _visit..',
�G:'/Oul�vp i!?�jaG Cv�+y%-•A� /1�2: �'i..� /L/��r�
Cv Iry -� x✓t- I.xx �" S �t�,er.,C, cvec-!Gs kv C.o�� w ,'lTn. � ntr,.1. p .
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: ,/ Date:

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
of DSWC review
Date of Inspection ) - 50-�i
Facility Number ZS
Time of Inspccaion -'Q: 24 hr. (hh:mm)
E3 Registered ).Certified +� Applied for Permit IRPermitted JE3 Not Operational Date
tepe Last Operated:..,,,,,_.....
Farm Name: t� ' V County:�V......................................... ...........
n _ ,
OwnerName:........f.✓I.+:Q._i_ ...:...................._iA%�s...................................... Phone No:.................................................................................
Facility Contact- -..6..&p_j v ..... . L. .� .. Title: .... Q..W ..................... Phone No: ....Z-2 _..�4`ZZ
Nfailitt Address:..... _2.,�+' jA:�.................................................................
g l _............ ?..R..><c....... ... x7.........jZJ.A:t1G�..............[........I.?� C
- 1l
Onsite Representative:...3. d� ...........k9 ,C. .........................._ Integrator: ............ ... ...:'�,p:...........................................
Certified Operator:..... ............ ...... 1 4................................ Operator Certification Number:.........................................
Location of Farm: J
Latitude =• =` =" Longitude =• =` ="
Design Carrentx'Design ,Current Design<� Carrent
Swore_<. `• CapacAg Population Poultry �Capaciry Pppulahon _Cattle Capacity Population
❑ Wean to Feeder ❑Layer ';-, ❑ Dairy
eeder to Finish 2 Z 3 5 ❑Non -Layer �; ❑Non -Dairy
❑ Farrow to Wean ❑ Farrow toFeeder ❑ Other
❑ Farrow to FinishTotal Design; Capacity,
`❑Gilts
❑ Boars a Total SSLW
Nambecof LagtwosJ HolthngPonds� ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
e ❑ No Liquid Waste Management System"
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge ori-inated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated Flow in-aVmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any pan of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any pan of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes
lallo
❑ Yes
RNo
❑ Yes
ll No
❑ Yes
14 No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
,ayes
❑ No
❑ Yes
EJ No
❑ Yes
®'No
Continued on back

i
r
Facility Number: —-
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes J4 No
Structures (Lagoons.Ifolding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes ($No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(ft): ...... L!.......................................................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes !aE' No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes 10 No
12.
Do any of the structures need maintenance/improvement?
❑ Yes
Q No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
® No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
® No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ......L..?..P-.!1-%......SA.�'C U�..................................................... ..... VOA-J'L- 4. -e_
...............................................................................................................
Wt. '24T
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? Yes
❑ No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
0No
18.
Does the receiving crop need improvement?
fiZYes
❑ No
19.
Is there a lack of available waste application equipment?
❑ Yes
FJ No
20.
Does facility require a follow-up visit by same agency?
® Yes
❑ No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
22.
Does record keeping need improvement?
❑ Yes
(jj No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? CR Yes []No
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes ❑ No
correspondence about this visit::.:
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7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: ___ _ _ _ Date: JCS U`

State of North Carolina
Department of Environment
and Natural Resources
Wilmington Regional Office
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Division of Water Quality
January 9, 1998
tfifOlu[I]'7•11` 1 tl�l
NOTE TO FILE: 31-257
FROM: Andrew G. Helminger A(W
SUBJECT: Complaint Follow Up for King K-8 Farm
7&A
NCDENR
NDRTR C^RouNA DEPARTMENT OF
ENVIRONMENT AND NATURAL RFSOl1ROF5
The DWQ-WiRO office received two anonymous complaints in late July of 1997 that waste was
being discharged into drainage canals at the King K-8 facility. In response to the complaints, two
visits were made by DWQ to examine the roadside canals adjacent to this facility. One visit
occurred on July 23, 1997, and the second occurred on July 30, 1997. No evidence of waste was
observed in ditches on either of these dates.
S:\WQS\ANDYA\31-257.NTF
127 North Cardinal Dr., Wilmington, North Carolina 28405 Telephone [phone] FAX [phone]
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Routine *Complaint 0 Follow-u of DWQ inspection 0 Follow-u of DSWC review 0 Other
Facility Number 31 .... 257 Date of Inspection 3/17/97
__— Time of Inspection 14:00 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: p[1jfICt1(ea:1.25 for 1 hr 15 min)) Spent on Review
Inspectionor (includes ve ce
Farm Name: KjpgFa[my.If�,£...___—_____-------------.. County: DuplutY1jRQ _
Owner Name: G[tig._...._._....__..__._.__.. King._.._.......__._._.___.__.__.__._._.. Phone No: 285:.2b9.2...... _.__._............. ..................... _
Mailing Address: .12k_Cxarland.King.A.d.................... ....... ._................ ............. _ .LeaclteY_NC.... »._........... .... .......... ._......... _._. 28.969.... _... ....
OnsiteRepresentative: Craig.Kingjr. .................................. _...... _.... _....... ... .......... Integrator: lndepelttreat............................................ ..... ......
Certified Operator. Craig......_..._....._..._..........._ King. .... ... ..... _.............................. Operator Certification Number: .1Z24Q...............
_.._...._.
Location of Farm:
Latitude 34 • 48 53 Longitude 77 • 42 54
Not Operational Date Last Operated:
General
1. Are there any buffers that need maintenancelunprovement?
❑ Yes
® No
2. Is any discharge observed from any part of the operation?
❑ Yes
® No
a. If discharge is observed, was the conveyance man-made?
❑ Yes
0 No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
® No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
® No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
® No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
®No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
®No
maintenancelmtprovement?

6.
Is facility not in compliance with any applicable setback criteria?
❑ Yes
N No
7.
Did the facility fail to have a certified operator in responsible charge (if inspection after 1/l/97)?
❑ Yes
N No
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
N No
Strgctures_(Laptooas_and/or Holding Pondsj
9.
Is structural freeboard less than adequate?
❑ Yes
N No
Freeboard (ft): Lagoon 1 Lagoon 2 Lagoon 3
.......... _..... 1..9........... _...................
Lagoon 4
10.
............. ...... .... ......... ................
Is seepage observed from any of the structures?
........ ................ ..........
❑ Yes
N No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
® Yes
❑ No
12.
Do any of the structures need maintenance/improvement?
® Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adquate markers to identify start and stop pumping levels?
❑ Yes
®No
Waste ARR!L
14.
Is there physical evidence of over application?
❑ Yes
N No
(If in excess of WMP, or runoff entering waters of the State, notify D WQ)
15.
Crop type.................................X?................ _........... ............. CQM.(U1gQ.&.Q13i4..............
16.
Do the active crops differ with those designated in the Animal Waste Management Plan?
❑ Yes
N No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
N No
18.
Does the cover crop need improvement?
❑ Yes
N No
19.
Is there a lack of available irrigation equipment?
❑ Yes
N No
For Certified_ Facilities Only
20.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
N No
21.
Does the facility fail to comply with the Animal Waste Management Plan in any way?
❑ Yes
N No
22.
Does record keeping need improvement?
❑ Yes
N No
23.
Does facility require a follow-up visit by same agency?
❑ Yes
N No
24.
Did Reviewer/Inspector fail.to discuss review/inspection with owner or operator in charge?
❑ Yes
N No
1/12. Runoff waters have created an erosion channel on outside of lagoon wall. Although this situation does not currently threaten the
ttegrity of the structure, it could create problems later. It was recommended to the operator that this erosion be fixed.
was also recommended that the vegetation on the lagoon wall be mowed.
Reviewer/Inspector Name
Reviewer/Inspector Signature: