310260_INSPECTIONS_20171231

NORTH CAROLINA'd�
Department of Environmental Qual

(Type of Visit: UCom ce Inspection U Operation Review U Structure Evaluation U Technical Assistance I
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergencv O Other O Denied Access
Date of Visit: Arrival Time: // Departure Time: ® County:
Farm Name: - 47 d 6,y in Feed m if ✓P y Ld-W Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Phone:
Phone:
Integrator:
Certified Operator: W t •� /Q � D - M AI r aw-d y Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Region:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dai Cow
to Feeder
Non -La er
DairyCalf
Pn
er to Finish
$
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
Dr,+P,ouI Ca aci_ P,a
Layers
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
TurkeyPouets
Other
Discharges and Stream Impacts
1. Is any discharge observed from any par[ 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 ZNo . ❑ NA ❑ NE
❑ Yes ❑ o NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes W
❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412015 Continued

Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
i Facili . Number: Ai - a /o jDate of inspection: 12'
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes o ❑ 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;No
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
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment
threat, notify 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
maintenance or improvement?
❑ Yes ❑ NA
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 777��� No ❑ NA
❑ 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
❑ Yes No ❑ NA ❑ NE
❑ NE
❑ NE
12. Crop Type(s): `V4F_!'M L,,d F{ ) MLj r4 t' I S
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
gggggg////// ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2N NA
�❑
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
N ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
�rX❑ NA
❑ NE
the appropriate box.
❑ WUP El Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfer ❑ 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 [—]No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - 16 o jDateof Inspection: i2--4
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
I 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
❑1N ❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
NoNA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
ZNo
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
❑ No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or 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/or any additional recommendations or any other comments. I
Else drawings of facility to hetter exnlain situations tuse-additional'nanes`as necessarvl.
SI'�dSQ Siir✓mil )vo—
OOC . 3 ((1 --0 (1
CiF�lbr941 c,-, 15 Sc<Ac.,1oc) E--6 rlalc14 /L /("/7
d -�b 4cectr4h, l y i'2G Dr. d Wry 5+e 14'v l ys'1 S enr)
-t" 212"'Z (=J/2h..S. pe-rIn i fzP Lev{ S (.tSin� iS�C�r �
F07 - 5191. i d r a-//E
Reviewer/Inspector Name:
Phone: 4 11 79 / yLo d
Reviewer/Inspector Signature: I3I AjzK 7C4lQ 1/ Date: / 2 _L1
Page 3 of 3 21412015

'I ype of Visit: (7 5Pn pliance Inspection U Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ( Arrival Time: Departure Time: -D `J County: Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: / I Title:
Onsite Representative: W t �' 'f rf�( mkrCa(�V
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Phone:
Integrator: p
Certification Number:
Certification Number:
Longitude:
Swine
Design
Capacity
Current
Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dai Cow
Wean to Finish
Wean to Feeder
Non -La er
Dai Calf
eeder to Finish
5"6o
f 0
Dai Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
Dry $oultry Ca aciP.
Layers
D Cow
on- airy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
I
Pullets
I JBeefBroodCow
Other
Other
I
Turkeys
Turkey Poults
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 Q-IVO L7 NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[-]Yes ❑ No ❑ NA ❑ NE
[-]Yes e idt�f❑ NA ❑ NE
❑ Yes 23<0 ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: 2 Date of Inspection: r 2/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ergo� ❑ 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: Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): S
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 4o ❑ 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 ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the perrrvt? ❑ 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 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ffNo ❑ 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 i❑ 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 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes N ❑ 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 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 N ' ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

IFaciHty Number: 31 - Date of Ins ection:
24.-Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EfNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Y o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [—]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -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 0 No ❑ NA ❑ NE
❑ Yes ZNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ Yes
EfNo ❑ NA ❑ NE
❑No ❑NA ❑NE
[—]Yes [24'o ❑ 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 additionalpages as necessary).
S Q1,PP/CU 41�1'1 OAR�P 0
of j0"'CC-
F uce/w�c jp
jI CR 5'C
Reviewer/InspectorName: /'116y ef ('-�// C.._c_
Reviewer/Inspector Signature:
'Fo r
Phone: q(� 796 %J v�-
Date: <<< 2i //'6
Page 3 of 3 21412015

(Type of Visit: O Cory{iliance Inspection Q Operation Review O Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency 0 Other O Denied Access
Date of Visit: 1 5Arrival Time: ® Departure Time: County:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
kkret
Title:
Latitude:
Phone:
Phone:
Integrator:
Certification Number: .
Certification Number:
Longitude:
Region:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design
Cattle Capacity
Dai Cow
C+urrent
Pop.
We to Feeder
Non -La er
Dai Calf
eeder to Finish
o 0
Dai Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dp P,oultr,
La ets
Design
C_a achy
Current
P,o
D Cow
Non-Dai
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
lBeef Brood Cow
Other
Other
Turke s
Turke Points
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DW R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DW R)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[—]Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [nNo ❑ NA ❑ NE
❑ Yes [ o ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: Date of Inspection: O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
er 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: 1 2
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): L(0 C-to
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Elf 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
ONo ❑ 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
NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
,—,�❑
I yrvo ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes
0<0� 1:1 NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
D4,o_�❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
0_5�01__] NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved
Area
12. Crop Type(s)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No _ ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 ❑ NA
7
E❑-No
❑ 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
�--��
E]" ❑ 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 ONo ❑ 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 ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

[Facility Number: jDate of Inspection: Zrs /J
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
No ❑ NA ❑ NE
Io ❑ NA ❑ NE
❑ 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 ❑3 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
n 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
ffxo ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
; ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ NA ❑ NE
FNo
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑ 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 exvlain situations (use additional paces is necessary).
.. ..
^�� A-- 4-1, j re C o/4S l.D o % iAo C .
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
t- / ft Va
Phone: 1 (o 774 7�
Date: t a2 rr 1L
21412015

6
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: b / Arrival /Time: Departure Time: County:
�TT! may{ yY-1- Region: v 1
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: L 014&e d (I Ij ii2c),J4
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Phone:
Integrator:
Certification Number:
198 SO ate`
Certification Number:
Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Wet Poultry
La er
Non -La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Da Cow
Da Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dr. Pooutt .
Layers
Ca aci_
I
P,o P.
Da Heifer
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
I
Pullets
I
Beef Brood Cow
Other
Other IOther
Turkeys
Turkey Poults
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 ErNo ❑ NA ❑ NE
❑ Yes No
❑ Yes No
❑ Yes 0 No
❑ Yes jffNo
[-]Yes EJ'No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3
21412014 Continued

Facility Number: Date of Inspection: Z /
Waste Collection & Treatment
4. Is storage capacity*(structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 1
11S[o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [(�Io ❑ 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 P'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 .!:fNo
❑ 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 —a No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes C" 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 FkNo
❑ 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 nj' 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 pi No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes .l No
❑ 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 >o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes [a No
❑ NA
❑ NE
Reuuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes j:jNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes EErNo
❑ 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 ❑i'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 P No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes VNo
❑ NA
❑ NE
Page 2 of 3
21412014 Continued

('�.) 14 /N
id/411ly
!•a/
b/!a
h 3 8 `�
Reviewer/Inspector Name:
Reviewer/Inspector Signature.
Page 3 of 3
Facili Number: Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ZNo ❑ 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?
❑ Yes
❑ Yes
ONo ❑ NA ❑ NE
P No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ONo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ONo ❑ NA ❑ NE
❑ Yes 121No ❑ NA ❑ NE
❑ Yes 6 No ❑ NA ❑ NE
[:]Yes PTNo [DNA ❑ NE
❑ Yes ff No ❑ NA ❑ NE
[—]Yes ONo ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.:
Use drawings of facility to better explain situations (use additional pages as necessary).
,5 (�P� sur� ex • c vi-\ 11 a o 1
• G �oI->o� cw,&U .56 b44r_� '- 'LS2
C)CA 0)0 / 9 ,Fn r sv�' ;tQ r y .
• Frrn I oo1Cs eXcellen-i�
Phone: A)
Date: !
2141244

Type of Visit: jMompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Ffr-_j_0F__j5jArrival Time:Fj7L)0PA7A Departure Time: :Oil M County: Region: v
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: —
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Owner Email:
Phone:
Phone:
Integrator: F.
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
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
Dairy'
ai Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dry P,o_uL
Layers
Design
Ca aci +
Current
P,o
Cow
Non-Dai
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
El 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)?
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 4rNo ❑ NA ❑ NE
❑ Yes ❑ No
[-]Yes [-]No
[:]Yes ❑ No
[:]Yes No
❑ Yes Ej No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 21412011 Continued

Facili 'Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ONo ❑ 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: Li L -a
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes KNo ❑ 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 P�No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes 2TNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes V 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
[3Excessive Ponding ❑ Hydraulic Overload [3Frozen Ground
❑ Heavy Metals (Cu,: 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 ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes
No
❑ NA
❑ NE
[:]Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
;2 "No
❑ NA
❑ NE
❑ Yes
?No
❑ NA
❑ NE
❑ Yes
ZNo
❑ NA
❑ NE
❑ Yes
kj'No
❑ NA
❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [—]Yes k] No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ID No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facitif Number: Date of Inspection: —
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M 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? ❑ Yes P No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes VfNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Application Field ❑ Lagoon/storage Pond ❑ Other:
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 PTNo ❑ NA ❑ NE
❑ Yes ;�TNo ❑ NA ❑ NE
[:]Yes J!fNo ❑ NA ❑ NE
[—]Yes ?rNo ❑ NA ❑ NE
❑ Yes
[71 No
❑ NA
❑ NE
[:]Yes
[;d No
❑ NA
❑ NE
❑ Yes
[�J'No
❑ NA
❑ NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations. or any other comments.
Use drawings of facilitv to better exulain situations (use additional oases as necessarv).
Reviewer/Inspector Name: �.5-�=t1n U6611
n A _ _'.7%
Reviewer/Inspector Signature:
Page 3 of 3
Phone: o'62-34 LroC�; )�
Date: -ICI-1 -�
21412011

(type of visit: � Uompliance inspection u uperanon xevtew u structure Evamanon U I ecnmcat Assistance I
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Timer Departure Time: F fU County :11(�[.J jv Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: n * /y�/T/iit/llee::
Onsite Representative:, ` /� �1 ��-1� /yy� ✓ /)-tu�G-PLU,
Certified Operator: W 1H E{� N �. 1 � 1 ia�L6,Z13
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
.0o) a
Certification Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Design C•uarent
Capacity Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Da' Cow
Wean to Feeder
Non -Layer
Da' Calf
'
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
0
Dr, P,ouI
Layers
—02-5196urrent
Ga aci_
P,o P.
Dairy Heifer
Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I
lBeef Brood Cow
Other
Other
Turke s
Turkey Poults
Other
0
Discharges and Stream Impacts
Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: _
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA O NE
[:]Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili N ber: (00 jDate of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑Yes No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: C
Spillway?:
Designed Freeboard (in): '. S
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
J
❑ Yes I XI No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? "''''iiiiii���ttt
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
p�
❑ Yes Intl 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
Evidence of Wind Drift ❑ Application Outside of Approved Area
❑ Outside of Acceptable Crop Windo�w7
' +❑
12. Crop Type(s): Se,
13. Soil Type(s): be -Op
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes IyI No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes 'i7�j No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes 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.
0 WUP ❑Checklists❑ Design r❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes X
No ❑ NA ❑ NE
0 Waste Application Q Weekly Freeboard 0 Waste Analysis Q Soil Analysis ❑ Waste Transfers 0 Weather Code
Q Rainfall Q Stocking ❑+ Crop Yield ❑ 120 Minute Inspections Q Monthly and V Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes I XI No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain minbreakers on irrigation equipment? ❑ Yes P No ❑ NA ❑ NE
Page 2 of 21412011 Continued

Facili N mber: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ 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 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes iANo ❑ NA ❑ NE
Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes `p No ❑ NA ❑ NE
and report mortality rates that were higher than normal? �-C
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes *t�tNo ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes o ❑ 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? ❑ 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).
—tA(&6UNj4"I LuO 4—, 500/0 - jttg JL4 /O R7 L490/0 — �x RNS 170 C CLA,7 Sony
gUA_NGe A:-, pIg-!> Ofr'rµc t�Eg2
au e�LWT/OA( 9) (31 f
U -7
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 9 �Q G9tny� 7
Date:
2/4/2011

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: NRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: )IhIJ Arrival Time: Departure Time: County: U/V Region:
Farm Name: L �M [K)INF(LEh I tQ(ZC-Ab!� C-A7 9 A Owner Email:
Owner Name: L� 6i�g(LCA�H / [� r \Phone: 910�I-9frS/�-S701-4/C�i
\,Mailing Address: 3� S$ �E.rIw W PU,9C-C"/` C- 9SLI(o o
Physical Address:
Facility Contact:
Title:
Phone:
OnsiteRepresentative: IJJIA/FQ0-s ( 1Q.R-EADtI Integrator: Certified Operator: s.AV , )y pe t= V-� �. (11 A V e A V.,)(A Certification Number: I13pc
S6
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: Longitude:
Finish
Design Current
Capacity Pop.
Wet PoPop.
M.N.
La er
urrent
Design Currenne
Cattle Capacity Pop.
Dai Cow
Feeder
Non -La er
Dai Calf
o Finish
:j460
Dai Heifer
o Wean
pFarrowtoFeeder
to Feeder
Finish
I) , P ulto
La ers
Design
Current
D Cow
Beef Stocker
Non -La ers
Beef Feeder
Pullets
BeefBroodCow
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes 11 No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No [DNA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 21412011 Continued

F;cility Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �kNo
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Structure 1 Structure
2 Structure 3
Identifier: CC
Spillway?:
Designed Freeboard (in): 0, , S
Observed Freeboard (in): 5c>
❑NA ❑NE
❑ NA ❑ NE
Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes b� 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 No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? Tq
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 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): L.L.
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
QWUP ❑Checklists QDesign ❑ Maps ❑ Lease Agreements ❑Other:
❑ Yes No ❑ NA ❑ NE
Q Waste Application Q Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ baste Transfers 0 Weather Code
Q Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections Q 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 No ❑ NA ❑ NE
❑ Yes]
No
❑ NA
❑ NE
❑ Yes
ANo
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes N No ❑ NA ❑ NE
❑ Yes PQ No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

F;11li Number: ` > ( - & O jDate of Inspection:
i
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No NA ❑ NE
27. Did the facility fail to secure a 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
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes 0 No
❑ Yes VLNo
❑NA ❑NE
❑ NA ❑ NE
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 #): Explain any YES answers and/or any additional recommendations or any, other comments ; ' ,
Use drawines of facilitvto better exolain situations (use additional paves as necessary).
t
"o.A. 1 9-
1 0h I (P (�
gla�l/a 63 50
L'oly 'T L s
Ft�ct� 1 TRACTS �`i31 4-4 i '4- NEeD -tumour LI-JS-11 PC,.a,P).uC ,—o
56CwN64,T� w(Xloati F-AI S
�OR ; E C� �i(FLD io 1AICL- OE SCCwuEF}>
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
I
Phone: —l��j "n74� I4394
Date:
21412011

Type of Visit 'Compliance Inspection Q Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine ,0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
I )
Date of Visit: p Arrival Time: �Departure Time: County: -aa4ey_ Region: _�
Farm Name: L
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: (zt-aa I�
Certified Operator:
Back-up Operator:
Location of Farm:
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: ^ o^ n o n n L _ I I I � Longitude:
a
y xt•* s " .✓' w 90..vd
Design Current s DesigrA Current 'Design Current
Seine iff ktty Population � Wet Poultry Cap city Population '"`Cattle Capacity Population
`�
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
S ❑ Non -Layer
❑ Dairy Calf
.'.
❑ Feeder to Finish
❑ Farrow to Wean
-- :a -
f "'may aTM'`�-,n
Dry=Poultry ,,,.. N,�„ -
"' - -.
�„ ❑ Layers
❑ Dairy Heifer
❑ D Cow
�'
❑ Farrow to Feeder
❑ Non -Dairy
El Farrow to Finish
El Beef Stocker
F°
❑Non -La ers
❑ Pullets
❑ Turkeys
❑ Gilts
[I Boars
❑Beef Feeder
❑ Beef Brood Co
Number of Structu[es:
❑Turkey Poults
❑Other
❑Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes L2'No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
/ONo
❑ NA
❑ NE
❑ Yes
j'No
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ;NNo ❑ 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): 21
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes JP.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 UNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes j'No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ yes P'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 PNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ;:�No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes P'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
L:�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 acre determination ?
❑ Yes
L2' No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
ONo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
2No
❑ NA
❑ NE
Comments (refer.to question;#): Explain any YES answers.and/or,any recommendationsior any other comments
Usedrawings of"facility"to better explain situations. (use additionatspages`as necessary):`-""'
Reviewer/Inspector Name Phone: ,0" —
Reviewer/lnspector Signature: /Cj`.h Date:
Page 2 of 3 12128104 Continued

Facility rJumber: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA 131NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ,BNE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA []NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
P-NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
W NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
L2'NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
0'NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
E 1VE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
ya NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
C�No
❑ NA
Al NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
2NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
RNE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
�2 NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
8 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
J No
❑ NA
❑ NE
Additional Comments and/or Drawings:
J7�2e� �i�... { i.•�J, /17.� %rrw.2 S // rowty"
cla-te Av o44 e
�4.� gyp/ w
c�/ � 1
/
r-r. �3la.ec wr%Mr. fj/o,✓n_ /R/:
alto( .lblt 4y�� d!O 6 2 s a�;rFieri w.li F.,of1 J
.Salo{ Xe 4JOU&/ Call _5'0'~AR— else.
Page 3 of 3 12128104

type of visit 'Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit 1,611outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: ® Departure Time: County: U Al Region:
Farm Name: L _� W LAD W F�LEi� (Y�1362EA�L-t tMK Owner Email:
QI
1-14I0
Owner Name:. 1t� I %i/Q�rchl-M�� Phone:c�9t-I
Mailing Address: .�LSJ2S C_t t1W�S ULIfiFIL :J.�Ci�,/K d6y�lf1
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: I W IAt%QA% M149-9—AIN Vl Integrator:
1-3 J lT,
Certified Operator: (\� I P4 A26n 00199h. EA �u Operator C� r . cation Number: � R
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: [� o = [� Longitude: 0 o [� ' M
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 X No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
0
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ElNA ❑ NE
El Yes No ❑ NA ❑ NE
12128104 Continued

$acility Wumber:3 1 — Date of Inspection W,
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes )No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): : C)
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes KNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes 4No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes )4No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes V�No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) ,(
9. Does any par of the waste management system other than the waste structures require ❑ Yes hll No El NA El NE
maintenance or improvement? T�
Waste Auolication
10.
Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�No ❑ NA
❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
,No ❑ NA
`
❑ NE
❑ Excessive Ponding El Hydraulic Overload ❑ Frozen Ground El Heavy Metals (Cu, Zn, etc.)
r
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift ❑ Application Outside of
Area
12.
Crop type(s) S C1 (ilF Q_6N�
13.
Soil type(s)
L4TR NUJLLE
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0 No ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
XNo ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
10t, No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
KNo ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
4No ❑ NA
❑ NE
Comments (refer to question #):
Explain any YES answers and/or any re comniend`a'tions or an other comriients
yt. .... �.r.:r
Use drawings of facility to better explain situations. (use additional,pages'as necessary):
Reviewer/InspectorName
/tJQ/�`.C, "1'/.�l�r"'°�"�n Phone: tZ— T7 '+3'0�'
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12128104 Continued

FacilitNumber: 3 -- O Date of Inspection li
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ICI No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ElNA ❑ NE
the appropriate box. 0 WUP 0 Checklists ElDesign 0 Maps [IOther
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard 0 Waste Analysis ❑ Soil Analysis ❑ W/Ste Transfers ❑ Anal Certification
El Rainfall ❑ Stocking 0 Crop Yield El 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain minbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32, Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes �� �N"o
❑ Yes' Ip,(vo
❑ Yes ANo
❑ Yes )ONo
❑ Yes No
❑ Yes No
❑NA El NE
❑ NA ❑ NE
El NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
El NA El NE
❑ Yes
� No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE .
❑ Yes
No
❑ NA
❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
Additional Comments and/or Drawings: . -a., . r •'..::
w•A� I a
(9/OnVI10
A LX, QslL pNALIc� Is HAS QG4,D/ SC7/7
A got r_ S�p�
Page 3 of 3 12,128104

IType of Visit Mcompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit Routine Q Complaint O Follow up O Referral O Emergency 0 Other [I Denied Access
Date of Visit: OF Arrival Time: Oc Departure Time: County: JPt-1 N Region:
Farm Name: L � -*�� 1 N FGZEi� I t it4 �i �F%O�� Y g2m Owner Ema
Owner Name• n�
�-b 1 I lav g4z—).C� Phone: G�') 91d -on- 5'7-9'-/
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: W I N f-(tEV') 1 1 1M�AQfc1Qb(A
Certified Operator: U )1 /V i�, LA
Back-up Operator:
Location of Farm:
Latitude: nn
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
=„ Longitude: =oa
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes []No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes X No []NA ❑ NE
[]Yes �LNo ❑ NA ❑ NE
12128104 Continued

Facility Number: 3 1 —,Q&Cj
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 cture I Strure 2 Structure 3 Structure 4
Identifier:
Spillway?: Designed Freeboard (in): 19,
, �s R•5
Observed Freeboard (in): �� r� 9_
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 VNo
❑ Yes ❑ No
Structure 5
❑NA ❑NE
❑NA ❑NE
Structure 6
❑ Yes [ No ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes XNo El NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes q No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes Y4No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soiltype(s)
L F_
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
No ❑ NA ❑ NE
No ❑ NA ❑ NE
IdNo
❑ NA ❑ NE
Id No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
1 Phone:
Reviewer/Inspector Signature:
Date:
12128104 Continued

Facility Number: 3 ( — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? []Yes [--]No ❑ NA b� NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes XNo ❑ NA ❑ NE
the appropriate box. 0 WUP 0 Checklists El Design 0 Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes XNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑�lnual Certification
0 Rainfall ❑ Stocking ❑ Crop Yield I] 120 Minute Inspections 0 Monthly and 1"
Rain Inspections El
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes No
❑ NA
❑ NE
-23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes IgNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes �%No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
10 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes]
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�kNo
❑ NA
❑ NE
UL-
1 t. Cc?x,ijl�pu''r `INO C��BF CtxCiiLENi co�wp�2mti. Zwts�o,q
CO L-t&-P-lou 'UkE 9010
12128104

Division of Water Quality /
[I - 1. L I ----- -- Facility Number 3 O Division of Soil and Water Conservation ✓/11
---- - - O Other Agency -
Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit y Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Qg Arrival Time: ® Departure Time: County: LI Region:
Farm Name:
Owner Name: _
Mailing Address:
Physical Address:
Facility Contact: Title:
OnsiteRepresentative: U_)wr(Lats mf+iLGAtYA
Certified Operator: WINFa.cD �. {MA(Lr=.4Dtl
Back-up Operator:
Location of Farm:
J❑ Wean to Finish I
❑ Wean to Feeder
®Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number: 1 9 850
Back-up Certification Number:
Latitude: =o =' =" Longitude: =o=,
Design Current
i WetPoultry Capacity Population
��' ❑ Layer
I; - ❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Cur
Cattle Capacity Popul
] Dairy Cow _
] Dairy Calf
] Dairy Heifer
] Dry Cow
❑ Beef Stocker (i
❑ Beef Feeder Y:
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
12128104 Continued

Facility Number: 3 I —
Date of Inspection �(D
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: I C/Xl
Spillway?:
Designed Freeboard (in): 19.S i 19.5
Observed Freeboard (in): L4 b 1414
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 N No
❑ Yes ❑ No
Structure 5
❑NA El NE
❑NA El NE
Structure 6
❑ Yes [x No ❑ NA ❑ NE
❑ Yes DqNo ❑ 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 Qq No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes L'8�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 O(No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 14 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ofNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
�No
❑NA
ONE
No
❑ NA
❑ NE
KNo
❑ NA
❑ NE
MNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
FA2A& LiDc-'1c4 6C)On.
Reviewer/Inspector Name P- I Phone:iDry.S
Reviewer/Inspector Signature: Date: 9��Co Qp
12128104 Continued

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

Facility Number a.( d
V Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 C,00mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit V Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County:. _41110& d Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: Wxt,�rpvo t'1' Akc- iyy?
Integrator:
Phone No:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o =, = Longitude: = ° = I = u
Swine
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
1' ❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
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 2(No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes ICJ N ❑ NA ❑ NE
El es No ❑ NA ❑ NE
12128104 Condnued

Facility NumDate of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: L#�i 0-6.11 I LA G aaiL -L
Spillway?:
Designed Freeboard (in): /%, j' M, S�
Observed Freeboard (in): 9 K
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 2<01 ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes El No ❑ NA ❑ NE
ElYes 2/No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental eat, notify DWQ
7. Do any of the structures need maintenance or improvement? El Yes VNo
El NA [I NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes E4No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑Yes No ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
di o
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
CJ No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
[)'o
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
40
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
[yNo
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
14,) Kr=EP COPY CIO L + ER n.T-p w EEc fu0j- E(.✓or aNL
of Y a lr. GZ c- L-Lc-CNS-( w.ZT�4 ZC Ga R i f
Reviewer/Inspector Name fi N 1 q _ Phone: 9 /d 3,7 ' 3 fl
Reviewer/Inspector Signature: Date: 4 p
12128104 Continued

Facility Number: 31 — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
❑ NA ❑ NE
Yes El No
❑ Yes No
❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections El Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
ElYes
2 No
ElNA
[-INE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
L ?<N000
ElNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
Yes
El,
o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
/o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
Dyes
El NN°,
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
LINO
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
eNo
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
"
❑ 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
EKo
❑ 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 2<o ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application) ,�,/
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? El Yes 2 /pp [I NA El NE
33. Does facility require a follow-up visit by same agency? ❑ Yes 7 o ❑ NA ❑ NE
Comments and/or
I2128104

M
(Type of Visit d Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
(d Reason for Visit "Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: /6 O Arrival Time: ® Departure Time: County: PUP(<ZA) Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title:
OnsiteRepresentative: WMtJ-R.En MAB-CADI Integrator:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude: n 0
Phone No:
Operator Certification Number:
Back-up Certification Number:
=" 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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes l No ❑ NA ❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
0
No ' ❑ NA
[I NE
❑ Yes
❑ Yes
—❑
[� o ❑ NA
[-INE
El Yes
No ❑ NA
❑ NE
12128,104 Continued

i
Facility Number: 13 E6 Date of Inspection 1� d
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure-2 Structure 3 Structure 4
Identifier: 1A �-DA/% 6A (SIN 7-
Spillway?: rr qq
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 0NNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes N/o ❑ NA ❑ NE
❑ Yes ff No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑Yes ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes � ❑ 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 � ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 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) a' ( 1-' Io S 670
i_ 13. Soil type(s) dN Ate(✓._i, I✓F
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [2(No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? Ejy/es ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 9X0 ❑ NA ❑ NE -
17. Does the facility lack adequate acreage for land application? ❑ Yes P�go ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes &4/0 ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
c . ti-rrd D& ti/Eio coloraot. o Fa2C 6-"z5cf.
�c con r'S 3:.Pj
Reviewer/Inspector Name I —169tj p Phone: 9/0 , / L %
Reviewer/Inspector Signature: Date: / S D
Pope 2 of i 1212RI04 Continued

1.
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ZI36 ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes YrJNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Lam] No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
El Yes
_,❑
O No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Q<o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
El? NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
Yes
Eld
,
In/No
El NA
NE
26.
Did the facility fail to have an actively certified operator in charge?
ElE Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
VNo
❑ NA
❑ NE
Other Issues
/
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El Yes
El N
El NA
El NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
ElYes
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
ElLJ Yes
��
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
/N4
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
9
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Comments and/or
Page 3 of 3 12128104

Type of Visit *f Cyyt�ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit J6 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Accesss� � ,,�
Date of Visit: Arrival Time: ©� Departure Time: ; County: Region: n
Farm Name: / � �� /7X 'o i Owner Email:
Owner Name: /�D ��/far✓%ltf�� 74''// Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:, Phone No:
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: M o F- M Longitude: M ° M,
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity
�Population
7
�. ❑ Wean to Finish ! ❑ Layer I 1'
❑ Wean to Feeder ❑ Non -Layer
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ DryCow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
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 PNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes to No
❑ NA
❑ NE
❑ Yes XNo
❑ NA
❑ NE
12128104 Continued

.�.
Facility Number: — Date of Inspection IYY/Yi/fJ� I
Waste Collection & Treatment T7��
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 Str cture 2 Structure 3 Structure 4
Identifies � L+�
Spillway?: Vt/
,Designed Freeboard (in): 2�r
Observed Freeboard (in): 32
❑ Yes /No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
5.
Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes �No
[I NA
El NE
(ie/ large trees, severe erosion, seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed
❑ Yes
V(No
❑ NA
❑ NE
through a waste management or closure plan?
If any
of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWQ
7.
Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ 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
I[J No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement? 10
,,..,,tt,,
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ZNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > lo% or l0 Ibs ❑ Total Phosphorus []Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes A No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
ONo
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'! El Yes
No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
'V
A No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
�fNo
❑ NA
❑ NE
,5ort, (Fs> eC~7- L95 7-o /, S 7p.v Gzm E /cam NF_ _ ox o,
;¢ Stgzo /.0 Z,-,%A 14t­ G44,45 /�o�ro i�' /�'l,�ac, 24W5,
>..:, ,.ecs -�xw.yam
Reviewer/inspector Name �' �t, _ Phone: —
Reviewer/Inspector Signature: / a r / Date:
C
12/28/04 Continued

Facility Number: — Date of Inspection ( /
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WIJP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes ONo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ONo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
XNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
VrNo
❑ NA
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
El No
,,,..❑NE
ElNA 1,,,(((NE
Other Issues
/
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Ej 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
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
�No
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
�No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
gNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
,ElNo
❑ NA
❑ NE
Additional Comments. and/or Drawings:
> �ufi�; ? j �.�c t/ Ago D,✓c� �� /�'lo.✓>,� �,- C�r�r,..
12128104

(Type of Visit A Compliance Inspection O Operation Review O lagoon Evaluation
for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 3 I Date of Visit:
APermitted zCertified 0 Conditionally Certified [`Registered
Farm Name: .... ``--ljjJtl..P.:.�f`1��XaLQC/---
Owner Name: ... !Q...... .W.I.A.Finel.... 1.:.. a ad1 ...... .................
Mailing Address:
Facilitv Contact: ..__....................... _....... .........._...._._._.......__Title:.._._.__.._...._..-
Onsite Representative: -Ij�-f J.A_ ifjtp.._ _
Certified Operator: ............ ......... ............ ............
Location of Farm:
Ul Time:
Not Operational O Below
Date Last Operated or Above Threshold:..
County:... �o r11t1�F„j.L!)._........
�__._
Phone No:
_.__....._._---...__. Phone No: ........... _............ ........ _._.......
Integrator: _Ra-rii.(oY_I._5.1t:1i,1 ajrJ._..
Operator Certification Number: ._ ........................
_._....
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =* =' =" Longitude =• =' =11
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes '0'610
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? []Yes ,t�J 1vo
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 gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No2. Is there evidence of past discharge from any part of the operation? ❑ —
Yes 4o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 2'190
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes VKo
Structure l S ctAe 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...... ........ _._.�/__._.____ ..__..___.---....___.... __..._._..--.--_---- ---------•------...._..... .
Freeboard (inches):_ 7
12112103 Continued

Facility Number: 3% — Date of Inspection 5/sZp/Q yry
5� Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
Q'No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
Yes
�1Vo
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
2rNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
O No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
❑'No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
2rNo
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
.2T40
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type 3P.fmU n CWai) ) .Sllgr�C,01ICC4eed 1
13. Do the receiving crops differ with those designated in the Certifi Animal Waste Management Plan (CAWMP)?
❑ Yes
, 2rNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
;24go
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
J21Vo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
f4o
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
YNo
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
R<O
Air Quality representative immediately.
Comments (refer to gnes6on #) lt; pl n anyYES answers and/or ny mommendahons'or auy other rnmments
Use drawings of faality to beiter explain srboabons (use dt6onal pages as necessary) 0 Field Copy ❑ Final Notes
Reviewer/Inspector Name b ; _ �` _$
Reviewer/Inspector Signature: _ Date: O
a�/awn v✓ l.V/N{/14C0

Facility Nam Date of Inspection
Required Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
J240
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
2rNo
23.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
ONo
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
j'No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
O'No
26.
Fail to notify regional DWQ of emergency situations as required by General Pemtit?
ONo
(ie/ discharge, freeboard problems, over application)
❑ Yes
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
J3'&o
28.
Does facility require a follow-up visit by same agency?
❑ Yes
❑'No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
PNo
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
;3 fes
❑ No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
O'1Go
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
12"No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
eNo
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
eNo
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
ONo
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

r
Type of Visit to Compliance Inspection O Operation Review 0 Lagoon Evaluation - I
Reason for Visit 9i Routine O Complaint 0 Follow up O Emergency �N/ottiifiica—tionn O Other ❑ Denied Access
Date of Visit: Time:
Facility Number Haz=10"Not'
Not O erafional Below Threshold
Permitted ❑ Certified 0 Conditionally Certified 0 Registeerred Date Last Operated/y
orr Above Threshold:
Farm Name: LO ! L.t! n i )4%_IIJ / /'h4e..4D L.� BALM County: �/ /4`PLd
Owner Name: L. o �( lf�nlF/IF.,lJ // I/}Q Elks Phone No:
Mailing Address:
Facility Contact: /►� Title:
Onsite Representative: A1;zwF12 e0 Agghn5�
Certified Operator:
Location of Farm:
Phone No:
Integrator: PJr
Operator Certification Number:
0Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 0. 0- Longitude =' = =`
vrngu rr
Swine = Capacity.
- ❑ Wean to Feeder
❑ Farrow to Finish - Tot81
❑ Gilts
❑ Boars
Present
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure Structure 5
Identifier: 2
Freeboard (inches):_ ..7
05103101
❑ Yes 1[I No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑,,,tit No
❑ Yes
l,/ I No
❑ Yes
/� No
❑ Yes
A No
Structure 6
Continued

Facility Number: — Date of Inspection
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
[,Tj No
6.
seepage, etc.)
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
El Yes
No
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
TTTTTTj�"""" No
9.
Do any strictures 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
11.
Is there evidence of over application?. ❑ Excessive Ponding El PAN Over ad
❑ Yes
,,,�VNo
L,q No
12.
/4,/►Hydraulic
Crop type yL'L._!�� //t{/ �/%f} I �i�.Q/9-2h% //Y// Q �D�
/
13.
Do the receiving crops differ with those designated in the Certified Animal WastAlanagernent Plan ( AWMP)?
❑ Yes
No
14-
a) Does the facility lack adequate acreage for land application?
ElYes
No
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
I
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
II NO
II
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
. /
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
21-
Did the facility fail to have a actively certified operator in charge?
❑Yes
,,����rrrNo
I,� No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
/
(ie/ discharge, freeboard problems, over application)
❑ Yes
CYNO
23-
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
�_J!INo
24.
Does facility require afollow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
'
El Yes
No
No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
Comments!(refer to question #):,Ex -plain 2 A-y YES answers aad/or.any recommendatiou`s or.anp other:eo_mments.
bettersit
Use drawings of facility to ezplatn sitnatioas. (use addtaoaafpages as necemrv) = - `� Field Conv_'❑ Final Notes
/8 vtc 5 J"�ANo Avg
Zoo ,o/��✓/em s F Ez.✓c l�s�o 4 ✓ 2-2s,
2 �S t� P9i✓�� Fit X FknUwV.4- DV
lq)4j'6 400_01 F
Reviewer/Inspector Name r _
O
Reviewer/Inspector Signature:
tr�
OS/03/OI
if E A- s,-� /�i✓q� Ysss�
-_ Rrs--
_. -Date:
Continued

Facility Number: 3 — (J Date of Inspection "
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
XNo
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?
El 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/orrDtawings _-
s-'e,e AIWy5 s I�r�o F4 l D s '6ry ee 111Vb A r7FR H
AA�� AJ 4NA-5I3r5,
MMU
O5103101

r
u
Type of Visit 0 ompliance 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: r% ZS I Time: ► 330
Facifity Number S 1 Z 6
E3 Permitted Q /Cerrtfified O Conditionally Certified y�0 Registered
Farm Name: 4- Lf__� ,' lArl �Li ! `���
Owner Name: ............... `.............................................
/e �QLc
....�. _w.:.� ...._�..............-........... y.......................
FacilityContact: .............................................................................. Title:..........................
Mailing Address:
Date Last Operated or Above Threshold: _
Phone No:
Phone No:
OnsiteRepresentative: ... y,�Y,x..✓.1...'..:.L.Q�.`4:........................................ Integrator::p{e✓`Li�Ur1 S�!>Gi:�G]r_._. ......._ ....... .... .........--
Certified Operator: ..................................................
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattie ❑ Horse Latitude O. 0' 0'° Longitude =• =1
=
`.
n
utscnarees o: Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
'2
Freeboard (inches): 30 Z 1
5100
❑ Yes )ZrNo
❑ Yes �No
❑ Yes )3No
/ d
❑ Yes No
❑ Yes EfNo
❑ Yes ,EPNo
❑ Yes No
Structure 6
Continued on back

Facility Number: % — Date of Inspection % Z
$. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes yJ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes �No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes 'oNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes'oNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑YesEfNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over application? ❑l!Excessive / Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes Ej No
, 12. Crop type 6rl_104'� NZkV j S;'1`i/l /9,5,1-1 /—
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes .0 No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes ❑ No
b) Does the facility need a wettable acre determination?
❑ Yes ❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes ❑ No
15.
Does the receiving crop need improvement?
❑ Yes No
16.
Is there a lack of adequate waste application equipment?
❑ Yes No
Required Records & Documents
-
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes )EfNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
—/
No
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes f[]3Qo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes M!o
/s
21.
Did the facility fail to have a actively certified operator in charge?
❑ Ye .Y] No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes dNo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes 21140
24.
Does facility require a follow-up visit by same agency?
❑ Yes�o
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ YesieNo
0. :.:...:.... . this:visit; - Y;o(t will-i•eceiye ilo: fnt flier ::::I
ytpt�(tptis;ei deficiencies wgre pgti' it(triitg
:: coriesporideuce abotitithis:visit: :: ........................: .
_: __ _- - _
Comments (refer to gaestion #): Explain any YES answers and/or any recommendations or any other eommegty 3
Usedrawingfiotytobeteexplasituations. (use addiona`pages as)`
7tic fM114 lJ very well /<e�f. 0' Fe svrv- f6 Lse w,�j_sje gg4ys;
d �t�eai w;11t; 60da l�J o� y calk ah eve 3 Opt �l�e �12� L'J•
Reviewer/Inspector Name phe rn`/ • /`Lg�klT1
Reviewer/Inspector Signature: O u _ Date: 4T5 O/ 5100

Facility Number: 3 2 Date of Inspection 2.Sd
i
Odor Issues -
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? []Yes -ErNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 'E3'90
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 -,ET'No
1
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 'IT&o
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes _0-NO
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
S/00

• - Division of Water Quality
Q Division of Soil and Water Conservation
0 other Agency-
-
(Type of Visit ® Compliance Inspection O Operation Review. O Lagoon Evaluation
Reason for Visit\Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number ( Date of Visit: Time: Printed on: 7/21/2000
l O Not Operational Q Below Threshold
Permitted 0 Certified [3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .......................
1�
FarmName: t 3.................................................................. County: ........ .�11.............................................
OwnerName: ................................... . .............. ................................... . ................................... Phone No:
Facility Contact: .............. _........................ _.................................... Title:
Phone No:
MailingAddress: ........................f.....................................................................................................................
.............................................:._........
OnsiteRepresentatit � !><` Flst..__.__.__.,,_.............._ Integrator..,,,_ ....... ...................................................................... _........
Certified Operator: ................................................... ....................................................... ..... Operator Certification Number:...................... I...................
Location of Farm:
❑ Swine []Poultry ❑ Cattle []Horse Latitude Longitude �• �< �«
Design Current
Swine Capacity Population
❑
Wean to Feeder
Feeder to Finish
d
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
U❑ Layer ❑ Dairy
❑ Non -Layer I I IF] Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ® ❑ Subsurface Drains Present ❑ Lag-nn Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
vtscnartes m .cream rmpacrs
1. Is any discharge observed from any part of the operation?
❑ Yes
P(No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
El Yes
❑ No
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ)
❑yes
❑ No
c. If discharge is observed. what is the estimated now 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
V No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
CK'No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
XNo
Structure I Structure 2 Structure ? Structure 4 Structure 5
Structure 6
Identifier: .........................................................................................................................................................................................................................
Freeboard (inches): L1 3
5100
Continued
on back

Facility Dumber: lk—aq Date of Inspection Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 15r{Ajo
seepage, etc.) "l
6.. Are there structures on -site which are not properly addressed and/or managed through a waste management or �,/
closure plan? ❑ Yes 1d 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
XNo
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
N No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? _ -
❑ Yes
_kNo
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
&No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
tpNo
12.
Crop type 1 I Spy
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination? -
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
fie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation,freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
fie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
L J' .....atio .. .........were noted• ditrilig t.... s.. • You ... i e... a Rio f.. t.. r' •'
.. correspo deike'ahotif this visit
❑ Yes MNo
❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
QYes ❑ No
❑ Yes P(No
Z 2 l
❑ Yes ); No
'WYes ❑ No
❑ Yes P�rNo
❑ Yes P�No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
❑ Yes bdNo
❑ Yes ONO
❑ Yes A'No
❑ Yes XNo
6� Qv 5 6 ck_ �,� - LQ_ dcss;_LfsZ _ ..
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
5100

RacilFty Number: 3 —' Date of Inspection O ep Printed on: 7/21/2000
Odor aSS
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
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?
❑ Yes P(No
❑ Yes TNo
❑ Yes �fNo
❑ Yes gNo
❑ Yes 1�110
❑ Yes 1No
I Aaatnottal ibmments and/Or Vrawings:
�'QeP
L-V\
5100

of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Dn for Visit) Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: 10-17-2000 Time: 1200 Printed on: 10/202000
Facility Number 31 260
'•" •^°^ -^ �•^�^°^--�^^-•^•^•��-� -A� O Not O erational Q Below Threshold
Permitted M Certified [3Conditionaflv Certified ® Registered Date Last Operated or Above Threshold:
Farm Name: LDA'..jnfm&Maceady..Eaml_................. _............. ...:...................... County: D.u[din.................................... WjR0..-.._.
Owner Name: LDa_S.Winfred------------- rs"=---------------- --------------------- Phone No: 91U385.5.72.4_LRinfttdl...........................
Facility Contact----------------•-•---------------------TRIe: _ ------ Phone No: ----•-
Mailing Address: 3.3(I.CJuress.CreekR0ad................................................................. Wallace..lYC................................................. .......... 28.46.6 ..............
Onsite Representative: Dmmer......................... _.................................. _....... Integrator: A.o uOJlF..ailna.......................................
Certified Operator:.Wiufred __ __ __ __ __ __ __ __ Maready__ __ _. __ _ __ _. _. __ __ __ Operator Certification Number. J285II
Location of Farm:
East of Pin Hook. On South side of SR 1827 approx. 0.6 mile East of SR 1831.
19 Swine ❑ Poultry ❑ Cattle ❑ Horse Iatitude '•J4 Longitude € 77 43F 58
ursenarees A stream impacts
1. Is any discharge observed from any part of the operation? ❑ Yes M No
Discharge originated at: ❑ Lagoon ❑Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes E] No
b. If discharge is observed. did it reach Water of the State? (If yes, notify D WQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gaUmin?
d. Does discharge bypass a lagoon system? (If yes, notifyDWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes M No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? - ❑ Yes M No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes M No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ....._.._.._.._.._.._.._..._.._.._.._.._....................................._.. ._.._.._.._.._.._. _.._.._ -.._.._....._.._.._....._.. ...._.._.._....._....._.._
Freeboard (inches): -- -- -- --43-- -- -- -- — -- -- 30_ -- -• -- - -- -- -- -- -- -- -- -- -- •- -- -- -- -• -- -- -- --

IUU
conruzuea on vacn
Facility Number. 31-260 Date of Inspection 10-17-2000 Printed on: 10/20/2000
6'. Arethere any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion; ❑ Yes CK 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 JR 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
Z No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
Xi No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
Z No
Waste Application "
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
JR No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12.
Crop type Coastal Bermuda (Hay) Small Grain Ovetseed
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
®No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
16.
Does the receiving crop need improvement?
® Yes
❑ No
16.
is there a lack of adequate waste application equipment?
❑ Yes
lR No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
Z No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
H No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
® Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
®No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
JI No
24.
Does facility require a follow-up visit by same agency? -
❑ Yes
®No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
No violations or deficiencies were noted during this visit. You will receive no further
correspondence about this visit.
5. Back field sprigged this spring. Continue efforts to improve by keeping field mowed every 2-3 weeks until established.
eep up with lime requirements for 1 ton/ac or more. New field pH needs to be maintained at 6.5. Grower should avoid
verseeding this field if at all possible this year— based on levels of lagoons should be possible.
9. Need to keep overseed on separate IRR-2 form using 50 Ibs PAN from waste plan. Fallow application windows for both
raps listed in plan. No records for applications to overseed last winter.
Cont. ->
Reviewer/Inspector Name DeanHuW64 395-3900 X-226

nevre.. crimspecwr ��guaw re: Late: -
Facility Number. 31-260 Date of Inspection 10-17-2000 Printed on: 10/20/2000
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
0 Yes G 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 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 [K No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes CKI No
32. Do the flush tanks lack a submerged fill pipe or a permanenthemporary cover? ❑ Yes R No
No copy of report left on -site — will send copy within next week.

10 tcounne 0 t-omptamt 0 ronow-up of uvvV inspection 0 rouow-up of uswe review 0 Vtlter
Facility Number
Date of Inspection
Time of Inspection ® 24 hr. (hh:mm)
Permitted E Certified 13 Conditionally Certified p Registered
of perattona Date Last Operated:
Farm Name: LD.,&.W..infred.Maready.F.arm.............................................................
County: Duplin WiRO
OwnerName: L.D.......................................... Maready ....................................................
Phone No: 296-2121....................................................................
FacilityContact: ...............................................................................Title:.................................:.............................
Phone No:....................................................
n1aitingAddress: 330.Cypress..C=Pk.Rxtad.................................................................
W.allacr..N.0 ........................................................... 28466 ..............
OnsiteRepresentative: ..........................................................................................................
Integrator:Dogtvnod.Farms....................................................
Certified Operator: Winfred.D .......................... Maready ..........................................
Operator Certification Nuiiiber:19.8,50 ............................
Location of Farm:
Latitude ®•®° ©,, Longitude ©• ETET E-59-T
estgn _ urrent-
Swine . `;Capacity Population
poultry
esign urrent- - estgn urrent
Capacity'Populatiori Cattle _Capacity Population
-'
Wean to Feeder
- ` ❑ Layer
'. p on- ayer
❑ Other
I' ❑ airy
IpNon- airy 11
Total Design Capacity5,760
-
_ ` Total SSLW- 777,600
® ee er to mts
❑ Farrow to Wean
❑ Farrow to Fee er
❑ Farrow to Finish
p Gilts
p Boars
- .. Number of Lagoons . �
❑Subsurface
rams resent ❑ agoon rea ❑ pray Fieldrea
Holding=Ponds ! Sohd Traps ❑ o
iqm aste anagement ystem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? 0 Yes 0 No
Discharge originated at: ❑ Lagoon ❑ Spray Field p Other
a. If discharge is observed, was the conveyance man-made? p Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) [3 Yes p 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? p Yes p No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes p No
Waste Collection &'treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): ...............19..............................2.0............................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes []No
seepage, etc.)
3/23/99 Continued on back

I
(Facility Number: 31-260 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?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Pending p PAN
12. Crop type
❑ Yes
p Yes
❑ Yes
p Yes
❑ Yes
p No
p No
❑ No
p No
p No
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
p No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
p Yes
p No
c) This facility is pended for a wettable acre determination?
p Yes
❑ No
15.
Does the receiving crop need improvement?
0 Yes
p 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?
p Yes
p 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
p No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
p Yes
❑ No
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?
p Yes
p No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
p No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
p Yes
p 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
p No
4'. o.vtotations,or'defieiencies.were'nuted'during.thisvisit.'You'will,receivenofurther.'.'
............................... .............. ........
eorrespotidek . about this visit:
freeboard, no problems observed.
non-DS W): Lagoon # I in excellent shape with very good grass cover, no erosion, lagoon appears to be lined.
on 92 has excellent grass cover and is in good shape all around. No recommendations at this time.
walls are in excellent shape.
Reviewer/Inspector Name '—
Reviewer/Inspector Signature:

....._ ..........................
"tiiCooN �
Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream Siope,xH:1V
Embankment Sliding?
(Check One, Describe if Yes)
Seepage?
(Check One, Describe if Yes)
Erosion?
(Check One, Describe if Yes)
Condition of
Veeetative Cover
(Grass, Trees)
Lagoon Dike Inspection Report
5 a-_ 41 c r 1'r k
4t(1,6
Frames of Inspectors
Freeboard, Feet
_i i'I, ,WCV7
nt1,,r_ A-,,-
e Top Width, Feet % (�
r I Downstream Slope, xH:l V
Yes_ No e�
Yes No--Lq3_00
,e t
Yes No /
a rOJ n Cl 1.)1
Did Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes X No
Engineering Study Needed? Yes A Ng _
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes
Other Comments (_,A C/>r�_ , ti e ti r e /l a
C(
No
c_--dv��ti

M

Lagoon Dike Inspection Report
Z� (
Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Fe et.
Lagoon Surface Area, Acres
Upstream Slope,xH:IV
Embankment Sliding?
(Check One, Describe if Yes)
Names of Inspectors /I A2,4111 /7
Freeboard, Feet 0l/ 4-
ee- 4 c- Top Width, Feet
Downstream Slope, xH: 1V
—Yes No
Seepage? ----Yes ",/- No_ 50, L
(Check One, Describe if Yes) _7
Erosion? Yes No
(Check One, Describe if Yes)
Condition of
Vegetative Cover
(Grass, Trees)
I',— �
Did Dike Overtop? Yes
No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes No
Engineering Study Needed? Yes NQ,
Is Dam Jurisdictional to the Dam Safety Law of 1967? —Yes No
Other Comments
rol
Ale, e- ly r r- /

W
J

f_ric,DC/J #' Lagoon Dike Inspection Report 3126o
Name ofFarm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream Slope,xH:1V
Embankment Sliding?
(Check One, Describe if Yes)
Seepage?
(Check One, Describe if Yes)
Erosion?
(Check One, Describe if Yes)
Condition of
Vegetative Cover
(Grass, Trees)
Did Dike Overtop?
e �. n C,,PS ��, n a �X v
q1,((«e A)C 2,�,Qe6 2I I
Follow -Up Inspection Needed?
Engineering Study Needed?
e
Names of Inspector b /,71,j(� W7
Freeboard, Feet
e G Top Width, Feet %Q
r I Downstream Slope, xH:l V_ �j r I
Yes _,X_No
Yes_No_-L-13on,
Yes _-/L No r c c o a K,-- Ue/
� r i
rv.ln
_Yes %, No If Yes, Depth of Overtopping, Feet
Yes X No
Yes A NQ-
Is Dam Jurisdictional to the Dam Safety Law of 1967?
Other Comments
,rw
eC O
Yes No
,, ' C h c
C (,)v o.—�

s r J`
V•\ K

L/a��goon Dike Inspection Report
Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Names of Inspectors
AM-0
Structural Height, Feet
Freeboard, Feet
0 -
Lagoon Surface Area, Acres
!�LP2 c c
Top Width, Feet
Upstream S1ope,xH:1V
Downstream Slope, xH:IV I
Embankment Sliding?
Yes >C No
(Check One, Describe if Yes)
Seepage?
—Yes _No--.L
(Check One, Describe if Yes)
Erosion?
Yes No
(Check One, Describe if Yes)
Condition of
q
c p !
11
T
Vegetative Cover
(Grass, Trees)
Did Dike Overtop? Yes --/—No If Yes, Depth of Overtopping, Feet _
Follow -Up Inspection Needed? Yes _� No
Engineering Study Needed? Yes NQ'
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes No

✓e

i
r"
p
O-Division of Soil and Water Conservation'- Operation
0 Division of Soil Water Conservation - Compliance Inspection:: '
[)]-Division of Water Quality -.Compliance Inspection
E3 Other Agency - Operation Review
Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-u of DSWC review 0 Other
Facility Number ( Z4
Date of inspection Z t 9
Time of Inspection LLSI,.60 24 hr. (hh:mm)
Q Permitted 0 Certified ❑ Conditionally Certified E3 Registered Date Last Operated:
Farm Name: .........Lc..1L..........
-�A:'''A"""J`��,tYSA......... W .�..._ fM........................_ County: .........L+t, ll.........................`............. ....................
OwnerName: ........�..V.._.....Maw.vµ.............................................................................. Phone NO: .._��110..1._L8.5. 3�...'.7.......................................
FacilityContact: ....................................................................... Title: ................................................................ Phone No:...................................................
MailingAddress:....... �(,.%.............. 15S_5........ c.Y..ul........' 3....................... ...............04A..4L4.t..Nc ............................... . L6........
Onsite Representative:.......w.i.C�1'R:`U............ U<............................................... Integrator: ..... bbswast.�.........................................................
Certified Operator:........... W.".!1.�ttfl......... ?..... ...... ! "..y................................. Operator Certification Number:..........................................
Location of Farm:
Latitude =• =' =11 Longitude =- 0' =l1
ow.uc a.,apacuy rnpurauon
[]Wean to Feeder
14 Feeder to Finish 1G0
❑.Farrow to Wean
❑ Farrow to Feeder
F 1 Farrow to Finish
Boars
Poultry Capacity Population Cattle Capacity Population
❑ Layer — I ❑ Dairy
❑ Non -Layer 1 ❑ Non -Dairy
❑ Other
Total Design Capacity S o
Total SSLW
Number of Lagoons JEI Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges $ Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
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 Waters []Waters of the State
c. If discharge is observed. what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system?
2. Is there evidence of past discharge from,any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection R Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4 Structure .5
Identifier: k 2
Freeboard(inches): .............?................................ LB...................................................................................................................
❑ Yes IP No
[]Yes
❑ Yes
NI
'm No
CP No
❑ Yes'
®No
❑ Yes No
❑ Yes No
❑ Yes �3 No
Structure 6
1/6/99 Continued on back

acility Number: — j,(QO Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any pact of the waste management system other than waste structures require maintenancehmprovement?
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application'? ❑ Ponding ❑ Nitrogen
12. Crop type ............... 4Cvrr..t/.dC........................
S.W..Ye..I.�...�YLLlIt�
Z II
❑ Yes [A No
❑ Yes [9 No
❑ Yes [g No
❑ Yes §§ No
❑ Yes N No
❑ Yes No
❑ Yes No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 0 No
14. Does the facility lack wettable acreage for land application? (footprint) [2 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
M 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.)
P Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
(}C] No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
/IYL-1 No
0' NO..vialations'or. llefciencies .were noted during tliis'visit:. You will.re�eive no ftirttier
eorrespbtidehee;about;thisvisit.:..........:•. ; ;.; ; ;.;.;.;.:.;..;..;•;•;....;... ;•;.. .
Comments (referto question_#)::.Explain any YES answers and/or any,recommendations or any other comments "-A
Use drawings. of facility to better explain situations. (use additional pages as necessary): s
14. C.r, Wikk 'be ' &wt 4( piRlbo6m"Y"450, (J U-,% �L allc/uit� CS I'Ve �ej L z1z 19' �
-' WUVI 4,.A '(2-`F�C� o c*tc, Q C l 't Us, -, �7 [o or �Kn1
p1J. J
_ A poe 1Vta� tAves actJrOw actee�5e �F t+elJS l °[ Z CtninvS houses
le. �Do
r- 3Urn Se+ o� S.s �lJ Lie-
00
cords
Reviewer/Inspector Name RA" (,_ �� A-e h,.� . , ... 't '•_
Reviewer/Inspector Signature: W 4L. ., `J Date: Z J I I ( qs 11/6/99

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
Date of Inspection I 9'G
Facility Number
Time of Inspection_ 24 ha (hh:mm)
13 Registered JA Certified E3 Applied for Permit O Permitted JE3 Not Operational I Date Last Operated:
..........................
FarmName: ......... ............................................................................................................ County:..... ` ?\�....... ....................... ............. _........
L(� + Ma. lo-S--Say
Owner Name:..........Y......_.... ...............��.._.. Phone No:........_......._............._................_...................................
((................................
Facility Contact:.._�h��a..... // ......,� I....... Title:..._ ` ' ..,..��..tt..../.................... Phone No: ................................................ _.
Mailin Address: ..'es5_�!:�."`........._���« +`�... �.i6li......................................................................................
Mailing Address: 1 /....... .. t..........
OnsiteRepresentative: .... ??_� �(S_S�'el\..LV` R!.............................. Integrator:....�
Certified Operator: .................................................. ....... _.................................................... Operator Certification Number:.........................................
Location of Farm:
%.. v... ....)_ ...... . � ........��.. y...... .eta.
.............................................................................................................................................................................................................._................
Latitude 0.010" Longitude =• 0' 0"
Resign Current --
Design .'Current: estgn Ctiirrent D
,.
9wme Cappdty" Population
w
Poultry ' Capacrty'PoQulation _Cattle, Capacity Pop'nlatwn.
_ .. ..
eeder❑Layer
, ❑DairyFinish ❑Non -Layer ❑Non-Dairy
>.�
Wean
❑ Other
DestgnCap
Feeder
VGilts
FinishTotal
Total SSLW =
1��.,`:
Number of Lagoons L Holding Ponds
® ❑Subsurface Drains Present JET Area ❑Spray F�e1d Area `
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenancelimprovement?
Yes
❑ No
2. Is any discharge observed from any part of the operation?
❑ Yes
lANo
Discharge originated at: ❑ Lagoon ❑ Spiny Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
E5No
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 gal/min?
N 1�
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
1f No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
allo
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
O No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
M No
maintenancelimpro vement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
MNo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
16 No
7/25/97

Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes P No
Structures (Lagoons.11oldin2 Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes 14No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Freeboard(ft):........2....................................a
...................... ................................... .................................... .................................... ....................................
10. Is seepage observed from any of the structures? ❑ Yes PI No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes j9No
12.
Do any of the structures need maintenance/improvement?
XYes
❑ 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
[E(NO
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
0 No
(If in excess of WMP or runoff entering waters of the State, notify DWQ)
15.
Crop type ... ..... ...............................................................................................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
b No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18.
Does the receiving crop need improvement?
($Yes
❑ No
19.
Is there a lack of available waste application equipment?
❑ Yes
($( No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
9No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
IN No
22.
Does record keeping need improvement?
M Yes
0 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
KNo
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
1¢y No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
eEj No
............... ......................
correspondence about this:visit.
�T �\Q�s , E5"� . (mow P\ 81 t, c C' fr—
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: _CA — Date:

DSWC Animal Feedlot Operation Review
DWQ Animal Feedlot Operation Site Inspection
LAX
P,
Facility Number Z
0 Registered 10 Certified C3 Applied for Permit 0 Permitted
Dale of Inspection
Time of Inspection
24 hr. (hh:mm)
Not Operational Date Last Operated:..._ ..........................
FarmName: ............%:`.I'.w......._tx.r.........................................................._........._.... County: ......�voi.m....................................... ................
OwnerName:..._ .J.b.�.......nt. Y..MJ.,.�-............................................. I ........ I.................. Phone No: ... (q)02.X5...�.r...................................
W...tY�1fK. .
Facility Contact: ............Jt!A M.4.................... Title:........Q/r.?tsK....................................... Phone No:.�S�.Q. r.S1&4.
illailingAddress: .... 36&...... C )1T?W$......_C{k���.......tSV................................ �IiR�IGG�..).../ L........................................... ...2f4hk......
1
Onsitc Representalive:.,..01r^....1.......,.t..� t0V.................................................._ ...Integrator...._. kteCk)(j............................................................
Certified Operator:.......t/ !.i�{7XPl......1 .RbYfQ ./........................................._.......... Operator Certification Number:...._ 11M .....................
Location of Farm:
ram. .... 1:_!1Q.Inies......... F". ?....hk-..t .rn.....2 t.� ..... \ ,.._sA..nQ.. ..Pkt...u.. 1.... ......_rid .....or.........
.M......is.....Z.s...r>:tLts....or..........)Qlj t,..... siJ.e.......f�la�'J...................................................................................................................
Latitude =• =1 =" Longitude =• =' =41
n� 1srq
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Poultry Capacity Population Cattle
❑ Layer I Dairy
❑ Non -Layer I❑Non-Dais
❑ Other
Total Design Capacity
Total SSLW
I 'Number of Lagoons / Holding Ponds 2- 10 Subsurface Drains Present J1❑ Lagoon Area I❑ Spray Field Area
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
2. Is any discharge observed from any part of the operation? ❑ Yes $a No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed. was the conveyance man-made? ❑ Yes P No
b. If discharge is observed, did it reach Surface Watcr? (If yes, notify DWQ) ❑ Yes W No
c. If discharge is observed, what is the estimated flow in gal/min? nl /k-
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) El Yes §9 No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes 0 No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes l4 No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ® No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 19 No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes W No
7/25/97 Continued on back

Facility Number: — 25I
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
16 No
Structures(Lagoons.Holdine Ponds. Flush Pits. etc.1
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
FSLNo
Structure I Structure 2 Structure 3 'Structure 4
Structure 5 Structure
6
Identifier: ..........'...�..................li....................................................................................
..........
......................................................................
Freeboard(ft):.........2:.5 .......................................... ................................... ........................... :........
.................................... .....................................
10.
Is seepage observed from any of the structures?
❑ Yes
KNo
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
19 No
12.
Do any of the structures need maintenance/improvement?
NYes
❑ 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?
QYes
❑ No
Waste ADDlication
14. Is there physical evidence of over application? ❑ Yes IN No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ) _
15. Crop type .......... eyY!IVrY.1........................................... ...... fa%WA.................... ................._COM.................................5.4w.6.............................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? I tA Yes ❑ No
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency? -
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
Nwviolationsor deficiencies were noted during this'visit..You'Will receive no further .
correspondence about this visit.
❑ Yes WNo
❑ Yes ® No
❑ Yes ®No
❑ Yes 10 No
❑ Yes 1KNo
§kYes ❑ No
Yes ❑ No
19 Yes XNo
❑ Yes J� No
M-Trkw4- wntl k (oq alit\) s('t« be. March, -
K &a ,— boas, 'SVION KAW vvkAyy m.
sol6r.t,'s P64J Nell XSsTW'i'a) AV- ems +W Mt. CAr.l .# D:SIjINLf Sol "4W
�,- cofrrcYtans. 1
Zz. > m aLv,, a }o ioe Sa ee) or. rxt7�5 � be ��a+ fJ� a corns ae es a n eViWni
�as sieu�d b� T,. ceri�ed ��r~n• U���e Wos�-e satr�le eNnolYs;s. l�ujoel, desegr- shoald
e ?� P�aV. • �abel jr�oo.. 1y� S�nw jreeor�S• ' `
Np Cer}ito�tG�� or. Si�C. �.et}i{i/tp[lt9n 6�tt�t1U1 be On Si 7/25/97 _
Reviewer/Inspector Name
Reviewer/Inspector Signature: 6A,,;—, / �AJnr Date:

•
•
•
Site Requires Immediate Attention: V
Facility No. 3I -15�
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATION SITE VISITATION RECORD
DATE % 1995
Time: � v
Farm Name/Owner: C_ • e
Mailing Address:
County: Dv/
Integrator: L111"
On Site Representative: _
Physical Address/Location:
Phone: �2�
Phone: a J
Type of Operation: Swine V Poultry _ Cattle
Design Capacity: 127&0 %OP Number of Animals on Site:
DEM Certification
Number: j'ACE DENI,t
Certification Number: ACNEW
Latitude: L' �L" Longitude:° 0� " Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon hav icient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches Ye r No Actual Freeboard: '* Ft. Inche
Was any seepage observed from the agoon(s)? Yes or�Was any erosion observed? Yes r N
Is adequate land available forNray? Yes or No Is the cover crop adequate? . es r No
Crop(s) being utilized: f ,C 1q_)J/fc— nccc, t C.Ty/Y
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? es r No
100 Feet from Wells? e r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Ivlap Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or
Additional Comments:
Inspector Name
cc: Facility Assessment Unit Use Attachments if Needed.