310328_INSPECTIONS_20171231

NUH I H UAHULINA
Deparfinent of Environmental Qual

Um e
�rva
tion
Irype of Visit: AD-e-ompliance Inspeection. 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: GrIfoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: t 7, 1 T-- n e-- Phone:
Mailing Address:
Physical Address:
Facility Contact: 6�17 E> P e--t— Title: Phone:
Onsite Representative: Integrator:
Certified Operator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
W e a n
Wean to Finish
to Fi
apa
C_= 1H --
-cmat
.4 6. '10 PM
I ILayer I
Dairy Cow
t
7�4
W e a n to N
Wean to Feed�r
:C2;�D -3—VOy jNon-Layer
I
Dairy Calf
Feeder to Finish
F e e d e r to t
q qyc�
Dairy Heifer
r r w to
Farrow to Wean
a 0
r r 0 w to I
.Farrow to Feeder
F a
R-PyRiTuIlt aci
TPAC VVYMER-Op.
Dry Cow
Farrow to Finish
I
ILayers
Beef Stocker
Gilts
Non -Lavers
Beef Feeder
113cef
Boars
Pullets
Brood Cow
oth111111�
li e I
er
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure Applicatio-n Field F-1 Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
E] Yes F.
.OLNo DNA [:] NE
OYes.
ONo
[DNA
ONE
0 Yes
0 No
D NA
0 NE
0 Yes 0 No 0 NA 0 NE
0 Yes ;&No NA 0 NE
Yes _5g..Vo NA [:] NE
Page I of 3
21412015 Continued

lFacifity Number: Lpate of Ins2ection:
F Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
Yes
JH[ No
NA
ONE
a. If yes, is waste level into the structural freeboard?
Yes
[3 No
NA
NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ':�V-Z
5. Are there any immediate threats to the integrity of any of the structures observed?
Yes
[4No
E] NA
NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
Yes
JEq No
E] NA
NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
E] Yes
JE-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?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
5a_No
NA
NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] Yes E[No F] NA
F-1 Excessive Ponding [D Hydraulic Overload [:] Frozen Ground E] Heavy Metals (Cu, Zn, etc.)
F-1 PAN [-] PAN > 10% or 10 lbs. OTotal Phosphorus E] Failure to Incorporate Manure/Sludge into Bare Soil
M Outside of Acceptable Crop Window E] jEvi ence of Wind DTift [:] Application Outside of Approved Area
12. Crop Type(s): (!�jo
13. Soil Type(s): 0-- 111�wl-114jl
0 NE
14. Do the receiving crops differ from those designated 'in the CAWMP?
[]Yes
RNo
F] NA
0 NE
IS - Does the receiving crop and/or land application site need improvement?
0 Yes
I&No
E] NA
0 NF_
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
0 Yes
allo
F] NA
0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
Yes
fallo
[—] NA
NE
18. Is there a lack of properly operating waste application equipment?
Yes
fallo
E] NA
NE
Reguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes
10 No
0 NA
NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Ej Yes
01-No
0 NA
0 NE
the appropriate box.
E1WUP E]Checklists 0 Design 0 Maps [:]Lease Agreements 00ther:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. C-] Yes _EDNo
0 Waste Application E] Weekly Freeboard E] Waste Analysis 0 Soil Analysis [] Waste Transfers
r-1 Rainfall [:] Stocking E] Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? 0 Yes MNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—] Yes P"o
NA [:] NE
Weather Code
0 Sludge Survey
[-] NA NE
E] NA NE
Page 2 of3 21412015 Continued

lFacility Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
Yes
0 No
F] NA D NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check
0 Yes
F;7'1 No
D NA 0 NE
the appropriate box(es) below.
DFailure to complete annual sludge survey D Failure to develop a POA for sludge levels
F� 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
Wo
[:] NA [:] NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[:]Yes
allo
D NA D NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29, At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
0 Application Field 0 Lagoon/Storage Pond F1 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 5g-No DNA D NE
[:]Yes EFNo [:] NA DNE
Yes " F�_-2--No 0 NA [:] NE
D Yes EK�No [-] NA [:] NE
[::]Yes [E-No
0 Yes 29,No
D Yes CZ�No
[:] NA 0 NE
0 NA ONE
0 NA [:] NE
Comments (refew'. to question #): Eyptain any YES answers�and/or any additional; recomniebdAtloiis� or,any other- comments.
tiseArawings of facifity to,bette'r explain. situafi6iii �usi'idifitional. pages"its nectessary)."
-7
,kl,gC.(
') W v
7�7��
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
Phon
Date:
21412015

Facility Number
-4EYOD"i'vision of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit -Mompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit O'Routine ()Complaint OFollowup OReferral OEmergency 00ther [I Denied Access
Date of Visit: Arrival Time: Departure Time: County:
I I I
Farm Name: LA 4M fA&MS— Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone No:
Onsite Representative: "ef Integrator:
Certified Operator: - - - - - - Operator Certification Number:
Back-up Operator:
Location of Farm:
S%ine
Wean to Finish
i��ean to Feeder
reeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish -
Gilts
Boars
Other
10 Other
Back-up Certification Number:
Region:
Latitude: =0 =I Longitude: =0=6
Design Current Design Current
Capacity Population WetPoultry Capacity Population
10 ayer
10 Non -Layer
Dry Poultry
ElLayers
El Non -Layers
El Pullets
E] Turkeys
El Turkey Poults
10 Other
Discharges & Stream Impac
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure [I Application Field El Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity PopWation :'I
El Dain� Cow
El Dairy Calf
I
El Dairy Heifej
El Dry Cow
El Non -Dairy
El Beef Stocket
El Beef Feeder
El Beef Brood Cow,
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?
E
El Yes FerNo El NA El NE
0 Yes
[ZNo
0 NA
El NE
[I Yes
WNo
0 NA
D NE
[:1 NA
El NE
El Yes
2fNo
[:1 Yes
ZI No
[:1 NA
El NE
El Yes [;2No [:1 NA EINE
12128104 Continued

Facility Number: 3 Z3 ;ZAP I jDate of Inspectio
5:1 IQ it, a I
Wastj Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes NE
,Z] No E] NA
a. If yes, is waste level into the structural freeboard? []Yes V�No 0 NA NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 2
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? Yes JZ No F] 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 E] Yes V(No E] NA Ej NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? F] Yes Z No [:] NA NE
8. Do any of the structures lack adequate markers as required by the permit? []Yes JZ No E] NA NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste mana gement system other than the waste structures require Yes 0"No 0 NA NE
maintenance or improvement?
Waste ADDlication
10. Are there any required buffers, setbacks, or compliance alternatives that need Yes V No NA NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. Yes No NA NE
0 Excessive Ponding 0 Hydraulic Overload [:] Frozen Ground [:] Heavy Me6ls (Cu, Zn, etcF
n PAN [:] PAN > 10% or 10 lbs. Total Phosphorus E] Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window [] Evidence of Wind Drift E] Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
E] Yes
No
Ej NA
E] NE
15. Does the receiving crop and/or land application site need improvement?
Ej Yes
No
E] NA
C] NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
Ej Yes
No
E] NA
0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
Yes
[A No
0 NA
Ej NE
18. Is there a lack of properly operating waste application equipment?
Yes
EjNo
NA
E] NE
Reguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes
[Z No
NA
[:] NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Yes
�(No
NA
Ej NE
the appropriate box.
C]WUP E]Checklists E] Design [:] Maps Ej Lease Agreements E30ther:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. E3Yes A No
Waste Application E] Weekly Freeboard [:] Waste Analysis 0 Soil Analysis E] Waste Transfers
Rainfall E] Stocking E] Crop Yield [] 120 Minute Inspections E]Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? El Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? E] Yes PNo
NA [:] NE
Weather Code
Sludge Survey
NA NE
NA NE
Page 2 of 3 21412014 Continued

Facility Number: I jDate of Inspection: cf5 L?
Ila
24. Did the facility fail to calibrate waste application equipment as required by the permit"
d,
LJ Yes
No
EDNA [:] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
0 Yes
(6 No
D NA E] NE
the appropriate box(es) below.
0 Failure to complete annual sludge survey Failure to develop a POA for sludge levels
r-1 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
E] NA D NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Yes
[Zf No
E] 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
pertnit? (i.e., discharge, freeboard problems, over -application)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field D Lagoon/Storage Pond Fj Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? D Yes [21 No DNA D NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? D Yes No D NA NE
34. Does the facility require a follow-up visit by the same agency? D Yes No D NA NE
Comments (refer to question#): Explain any YES answers and/or any additional recom endations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
0 Yes [Z No D NA D NE
D Yes U1 No D NA 0 NE
DYes [6No DNA DNE
D Yes [X No [:] NA DNE
r154et IV k22�-Qr) lo c4w r\j I t- Aj Z_
41-e e,01_4:�4y C?"!�
-7
_Z'�;PZ 7
Phone:
Date:
1214h 0 15

'I'ype of Visit: f<:�rompliance Inspection U Operation Review U Structure Evaluation UTechnical Assistance
Reason for Visit: PAutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 13 //x// rt-Arrival Time: I 70i 5� ' �Veparture Time: County: Region:
Farm Name: el - Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: C
(-P4P.- Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Wean to Finish
Wean to Feeder
94,0()
Layer
yer
ANon-La
t
Dairy Cow
Dairy Calf
Dairy Heifer
—
Feeder to Finish
t-x IWO 0
_
Farrow to Wean
I
Layers
i
- - - - - - - - -
Dry Cow
Non -Dairy
Beef Stocker
,Farrow to Feeder
Farrow to Finish
Gilts
INon-Layers
Beef Feeder
Beef Brood Cow
Boars
Pullets
er
Turkeys
Turkey Poults
Other
Discharges and Stream Impact
1. is any discharge observed from any part of the operation?
Discharge originated at: D Structure El 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 Yes 4DNo E] NA [-] NE
[:]Yes
JD -No
D NA
[:] NE
0 Yes
QNo
D NA
D NE
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?
D Yes J3-No
D Yes -ETNO
0 Yes E;�-Ko
DNA [:] NE
D NA D NE
[:] NA [:] NE
Page I of 3
21412014 Continued

Facility Number: - .4 Date of Ins ecflon:3 2-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ZYes�No ❑ NA ❑ NE
}` a. If yes, is waste level into the structural freeboard? ❑ Yes 0 No [] NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: I
Designed Freeboard (in): (qpp -
Observed Freeboard (in):� — 4
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 [2-No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes L]�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?
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 0 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 Jallo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes [:INo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes 0 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes a 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 EJ�No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes ❑ No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes [-]No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" 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 ❑ No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

IFaciUty Number: - Date of Inspection: IX
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ,Epo ❑ NA ❑ NE
25. 4 the fiac lity out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Flo ❑ NA ❑ NE
the appropriate box(es) below. T
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
2$. 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:
❑ Yes [,],No
❑ Yes T
❑ Yes ;;[No
❑ Yes PNo
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes ,"No ❑ NA ❑ NE
❑ Yes 4:fNo ❑ NA ❑ NE
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 T❑ No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [:]Yes No ❑ NA ❑ NE
Comments (refer to question # ): Explain any YES answers and/or any additional.recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
` pe/1' .5q Ar h sh �ie�6aQTo,/ lee
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: Z
ZZ
21412014

Type of visit: APJCompliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 16Routine Q Complaint p Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: - -14 Arrival Time: 2: _q_5jK Departure Time: County:
Farm Name: V. 5. Owner Email:
Region:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: S Y-e-er M pure_ __---_ Integrator:
Certified Operator: Certification Number: '�Rq9LIPZ oZ
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Swine
Finish
Design Current
Capacity Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Design Current
Cattle C*apacity Pop.
Dai Cow
Feeder
Non -La er
DairyCalf
o Finish q
DairyHeifer
o Wean
Design
Current
Cow
Farrowo Feeder
Dr, P,oult .
Ca aci
P,o
Non -Dairy
o Finish
Layers
Beef Stocker
Non -La ers
Beef Feeder
Pullets
Beef Brood Cow
Turkeys
Other
Turke Pouets
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes )2TINo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes 6 No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[]Yes
PNo
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
PT_
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
ff No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[:]Yes
dNo
❑ NA
❑ NE
of the State other than from a discharge?
\ Page 1 of 3 214,12011 Continued

r
Facility_Number: S1- Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E!rNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes J!5-No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: A0 d^ 5L L L-
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �p ���
03
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ZP 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 DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes flJ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes VfNo ❑ 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 f 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? 1
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ I / I 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 [6No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 6 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 7No ❑ 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
VI No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
qrNo
❑ 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
❑ 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 KNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? (—]Yes �(NO
❑ NA ❑ NE
❑ Weather Code
Sludge Survey
NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

r
Facility Number: - Date of lns ection: - -J
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
[2(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
ZNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
pNo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
VfNo
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
0 No
❑ 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
ZNo
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[�f 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 VNo ❑ 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).
Reviewer/InspectorName: ` ,Gl'h� Phone: aJ9-361- agio
Reviewer/Inspector Signature: �uy�4� ��,�r Date: rI -
Page 3 of 3 2/4/20II

Type of Visit: Q 7Routine
pliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: O Complaint O Follow-up O Referral Q Emergency Q Other Q Denied Access
Date of Visit: 3 l8 3 Arrival Time: crCa[] Departure Time: County: L ,ilJ Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: l5 REE6-_ 1 V Loan-S Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Design
Gapacity
Gurrent Design C►urrent Design Current
`` p. Wet Poultry Capacity Pop. Cattle Capacity Pop.
can to Finish
I I Layer
iry Cow
can to Feeder
226b
606
1 INon-Layer
I
i Calf
Feeder to Finish
9 (0
690
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design C*urrent
p . Poul Ca aci P,o .
Layers
Diy Cow
Non -Dairy
Beef Stocker
Gilts
Boars
Other
Other III 10ther
Non -Layers
Beef Feeder
Pullets
Beef Brood Cow
Turke s
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 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 [f o ❑ NA [] NE
❑ Yes
❑ No
❑ NA
[] NE
❑ Yes
0 No
❑ NA
❑ NE
[—]Yes rl�o
[] NA ❑ NE
❑ Yes❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: Date of Inspection: 1$
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [] No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: WOW I LA6,60iy 7
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1-100 �333g
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes �No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify 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 [Z�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 [AINo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
�-�/
❑ Yes o
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes : `ro
❑ 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 CAW -MP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes [f No ❑ NA ❑ NE
[/]Yes ❑ No ❑ NA ❑ NE
[—]Yes �j`No ❑ NA ❑ NE
❑ Yes [2r"No
❑ Yes [3/No
❑NA ❑NE
❑NA ❑NE
Required Records & Documents
No
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 To
❑ 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 eNo
❑ 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 o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes No
❑ NA
❑ NE
Page 2 of 21412011 Continued

Facflitv Number: - 2 Date of Inspection: 3
A Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �FNo
]Ko ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ 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
[71No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
dNo ❑ 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
E2(No [DNA ❑ 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
dNo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[E(No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
ElYes
No ❑ NA ❑ NE
Comments (refer to'question ft Explain any.YES answers and/or any -additional recommendations 'or any other,' comments.:; _
use drawings of facility to better explain situations, (use additional'pages as necessary) ,
7.) PLV..:c WALK QC-[D5 50*.XE G",55 GouCR__- �110sl— _
tom)
S�dry a- .D 1j + 5" 94WC
Z,j LCUCLZ
A 6ovE 36 oa. CAO Nor uSc F6R— VJAs�'L
CN(ALuATL ,
Reviewer/Inspector Name: V OH W rA 04C_ _-, PhoneLal))V6 "2 J b
Reviewer/Inspector Signature: Date: 3 }
Page 3 of 3 214, 2011

' 'Division of Water EQuality
Facility Number I� - LJ O® Division of Sol! and Water Conservation
OO i ther Agency
Type of Visit: Compliance Inspection Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: so Departure Time: County: 1 JV
Farm Name: LU - 5 . FWTf t}&WS �_-71gam 5 =0 oC Owner Email:
Owner Name: w- 5. 1 ' I ATT#C--w5 �/4 M % 1'Xic Phone:
Mailing Address: J u oJ_° + 0'mE{.S S LX/ , (/l R (L t.,
Physical Address:
Facility Contact:
Title:
Phone:
Region:
Onsite Representative: �c ! ' ' 00(Z.� Inte rator:
Certified Operator: — Z,(., 6/A/S dV Certification Number: —7 9 r 3
� �1,�r1�7�-1 C.1� � IiT��'
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design Current
Design Current
Swine Capacity Pap.
Wet Poultry
Capacity Pop. Cattle
Capacity Pop.
Wean to Finish
La er
iry Cow
Wean to Feeder
on -Layer
iry Calf
Feeder to Finish
airy Heifer
Farrow to Wean
Design Dry Cow
Farrow to Feeder
D , P�oult
Ca aci_ P,o Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Beef Feeder
Beef Brood Cow
Gilts
Non -Layers
Boars
Pullets
'Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
7�
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
rNo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: - 3 Date of Inspection:
r 1.
Waste Colliction & Treatment XNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ NA [3NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 G S /KaU, N ]
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
1q.S , 5
tea_
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 No
❑ Yes 4NO
❑ NA ❑ NE
❑ 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 0 No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes "'"�{111No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) 1�
9. Does any part of the waste management system other than the waste structures require ❑ Yes] No ❑ NA ❑ NE
maintenance or improvement? `�
Waste Aoulication
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 q 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) �l� ��- �C-%� H+L_ l4� > 1)
13. Soil Type(s): t i,_)c�oCN A/C TOO/ /-� C
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.
❑ Yes dNo
❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
oro
��j�T{T
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes "mNo ❑ NA ❑ NE
OWUP ❑Checklists QDesign ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [] Yes 0 No ❑ NA ❑ NE
Q Waste Application [] Weekly Freeboard [] Waste Analysis Q Soil Analysis ❑Vaste Transfers 0 Weather Code
Q Rainfall ❑ Stocking Q Crop Yield [] 120 Minute Inspections 0 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 21412011 Continued

Facility Number: - j Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes JX 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 El 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 tX NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[] Yes
No
[] NA
NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
Yes
[ No
❑ NA
[] NE
If yes, contact a regional Air Quality representative immediately.
T�
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
Yes
�j No
NA
NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Yes
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 ##): 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).
u,---)-P -
iop01
$]Ivf11
9-,91) 0 S HC-_CT F06L 5C_r-&pUC SUtftUG!� aTl AU-o 1 cA(:�oov%J
" 6 CL UW 1 LC- C p LL- Or L GT VK C jvv O k-'N 1 F gIAT )C� 1 S 1 A) C0 XIPC + 19-vCC
6,910
S N1 NQ-
I,q 0.9& 0.%9
/, �)
1.�5
3. 9
D. -4
5
),S
1- S
. Chi C_ peS 1 G N 19-Tt 6-"i
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
wjL'L(3C IN f"AI - iOaAl�s
Phone: 9L _-3-07 &--"
Date: 3�"IYI -
21412011

Facility Number 3�
Division of Water Quality
O Division of Soil and Water Conservation
O Other Agency
Type of Visit Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: ®(' Departure Time: County: U � Region:
Farm Name: /� Owner Email:
Owner Name: 7 • 1''A7 meL,35 FA�MS /,wC Phone:
Mailing Address: d �S �I �—�—� " `�!U �C�R—� AC P FrYT3
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: GlEkq_ t ' `��Q r _ Integrator:
Certified Operator: fn5 7 iq5T I74$01V Operator Certification Number: 99'79S a,
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = 4 = Longitude: = o = ` =
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
ja(> ❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey 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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population'-,
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
[_1 NA
❑ NE
❑ Yes
V,
�o
❑ NA
❑ NE
12128104 Continued

facility Number: 3 -- Date of Inspection T f 11
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? El Yes ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes /❑No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 9c>1 t1 S in N r 'V a
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 7�9 Lf
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No [INA [INE
(ie/ large trees, severe erosion, seepage, etc.) 4
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes gNo ElNA [INE
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 ❑ WE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ElNE
(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 KNo ❑ 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) , �C Coaw S C LJ� ►.i E g -I 51 J
13. Soil type(s) i--n A U_-�o A Au
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes *o ❑ NA ElNE
15. Does the receiving crop and/or land application site need improvement? El Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes o ElNA ElNE
ElYes YNo ❑ NA ❑ NE
;Comments (refer to:queshon; #)::Explain any Yl✓S answers andlo"r anyt recommendations or any, othermments
Use drawings°of facility,to'better.explain situations. (use additional pages as necessary)-
N 6L,0 O1C_,S dF,701N9i� cr Q�� F 1c �o�v &/!f�) Q P )01d - N pe� R- Ci`lW6E
a 41C oEsjG14 AT)O r f�-(rw SEXJT iA[
IReviewer/inspector Name Amtwo Phone:
Reviewer/inspector Signature: Date: 71� 1 1
Page 2 of 3 12128104 Continued

.
Facility Number: 3 I -3,9 Y Date of Inspection i 1
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 appropriate box. El WUP 0 Checklists
0 Design 0 Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes )4No ❑ NA ❑ NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis ❑yaste Transfers ❑ dual Certification
0 Rainfall ❑ Stocking 0 Crop Yield Ej 120 Minute Inspections El Monthly and I" Rain Inspections 0 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
El NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
ElNA
[INE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
INo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
XNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No )ANA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
$No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
ElNA
❑ NE
and report the mortality rates that were higher than normal?
10
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
A 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
§4No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional�Comments and/or Drawings:
nUUjW)C>,Af D(Ae
e
u'. A.
� , 5�
a)ull a
1.CP 1,5
I
010c)
c9 (9 3. )
�`�
D-4
��i� ho
C3��j G�yj
o.51)
636
Page 3 of 3 12128104

Type of Visit 14 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Foilow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: 1 0 Arrival Time: i Departure Time: County: �'�M Region:
Farm Name: _� ) • 0gMY G-W 5 ER a �-14R OwnerEmail:
Owner Name: W •5- MoTTy6wSDM _ r1,qa-S JAI Phone: 110"?'jb'3q.O'Q
Mailing Address: 0�3 S LL �1} t<+�35 f ua �G
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: (_ �• �f� �0 3(3)V ------
Back-up Operator:
Location of Farm:
Phone No:
Integrator
Operator Certification Number:
Back-up Certification Number:
Latitude: Q c = { = « Longitude: = ° = 4 = u
Design Current
Swine Capacity Population
Wet Poultry
Design
Capacity
Current
Population
Design Current
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ DairyCow.
Wean to Feeder 0
❑ Non -Layer
❑ DairyCalf
Feeder to Finish {- S
❑ DairyHeifer
El Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Dry Poultry
❑ Layers
El Non-LayNetsers
El Pullets
❑ D Cow
❑ Non -Dairy
El Stocker
El Beef Feeder
❑Beef Brood Co
tter of Structures:
❑ Turkeys
❑ Turkey Pouets
JE1 Other
Other
❑ Other
I
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
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes J� N0
El Yes `;,(No
12128104
❑NA ❑NE
❑NA ❑NE
Continued

Facility Wumber: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 'VNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure��2}} Structure 3 Structure 4 Structure 5 Structure 6
Identifier: NZ
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): C9 C�:> 3o
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes U
❑ 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 A7No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes _2 No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ yes �No
❑ NA
El NE
maintenance or improvement?
\\
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes Aft?fNo
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes _E�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 et�No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes E(No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes MNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes _E3,No
❑ NA
❑ NE
Comments (refer to question #): -Eiplain anyYES answers and/or any i`ecommendattous or'any othergcominO ts.
a= * r.z
Use drawings of facility to better explain situations (use?additeooal pages as necessary) ., µ
i
Reviewerfinspector Name Phone:
Reviewer/Inspector Signature: Date: 3 �7 a
12128104 C.'ontrnuea

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes II No El NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ✓✓✓"` No El ❑ NE
the appropriate box.
❑ WIJP 0 Checklists [� Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application 0 Weekly Freeboard ❑ Waste Analysis 0 Soil Analysis ❑Xste Transfers 1:1,04nual Certification
0 Rainfall ❑ Stocking 0 Crop Yield ❑ 120 Minute Inspections 0 Monthly and 1" Rain Inspections ❑ Weather Code
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 JgNo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes !!�No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes _2No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes XNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes ❑ No
N VA
❑ NE
Other Issues
\\
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes X No
ElNA
❑ 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 XNo
❑ 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 ANo
❑ 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 Lq No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes ONo
❑ NA
❑ NE
Additional Coutments and/or ©rawrngs �`
OL
�1 J
12/2VO4

Type of Visit J:�Q Compliance Inspection Q Operation Review () Structure Evaluation Q Technical Assistance
Reason for Visit kRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: � j —� Departure Time: County: Lt � Region:
Farm Name: UO. 5 • T_A 2m S _W& Owner Email:
Owner Name: WSM
RR l ' � WrT14G t-IJ S EARmS hVC . Phone: 9 /0- 94d' 39cfl0g
Mailing Address: dJ5 �1L-Lt•l MR-1714Ci-.) _r--1►�_-TaR G�-1
Physical Address:
Facility Contact: �y� _ Title:
OnsiteRepresentative:\L'1Q-EE� 1.4 Id0Q_E
Certified Operator: ]P-mfe_ LS A-K��
Phone No:
Integrator:
Operator Certification Number: l3�
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: [� o [� d [� L1 Longitude: [= ° = 4 0 «
Design Current Design Current
Design Current
Swine Capacity Population Wet Poultry Capacity Population
Cattle Capacity Population
to Finish
ElLa er
❑ Dai Cow
PEan
an to Feeder
00
❑ Non -La er
❑ Dai Calf
Feeder to Finish
❑ DairyHeifer
❑ Farrow to Wean
Dry Poultry
El Dry Cow
El Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
Gilts
❑ Non -La ers
❑ Pullets
ElBeef Feeder
E Boars
❑ Beef Brood Co
❑ Turke s
Other.
❑ Turkey Puults
umber of Structures:
KE T Other
❑ Other
I I
Discharzes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �tNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
% No
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
Page I of 3 12128104 Continued

i
" 2
{
R#

Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: dSm a L- _ L A6Lfi r N :j
Spillway?: nn Designed Freeboard (in): o� 1 r9�� . S � q 1, 5
Observed Freeboard (in): �� d
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 property addressed and/or managed
through a waste management or closure plan?
❑ Yes 7.No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 4 No ❑ NA ❑ NE
❑ Yes 0No ❑ 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 06No ❑ 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 part of the waste management system other than the waste structures require ❑ Yes VZNo ❑ 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
J.No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
Crop type(s) S �tZ k-V a S
13.
Soil types) t
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
J� No
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
9INo
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
RLNo
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
C.No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
P-No
❑ NA ❑ NE
:Comments (refer to.questioh #) Explain any YES,answers and/or any recommendations or any,*other corn bents `
nUse drawings of facthty to.,tietter. explain°situattans (use additional pages as necessary) "
S 6aNG, 76 purr JN 'bq_0JN V LG To 9rz; -
c�? RSA iN F���-DS
.1
cc" q/6 - Loa -nq�l
Reviewer/Inspector Name jq. ea t _ S Phone: Ora -I'96 73Da
Reviewer/Inspector Signature: Date: 3ZZ 62 LO9
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes JkNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ;Z No ❑ NA ❑ NE
the appropirate box. ❑ W'Up 0 Checklists 0 Design ❑ Maps ❑ Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes �5No ❑ NA ❑ NE
0 Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ �aste Transfers ❑ j.nnual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield 0 120 Minute Inspections ❑ Monthly and I" Rain Inspections 0 Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
KNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
KNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
4 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
5�No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
0No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
CkNo
❑ 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
RNo
❑ 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
KNo
❑ 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
5ANo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
Wo
❑ NA
❑ NE
Additional Comments and/or Drawings:
L41 ID
cr,crC Cd4�ool�s '� S�^V� w TH` �1G�+aw�l�Gzl
�OOV mAbtcfz
-+ T4[f-
t� P V_'t� ucp-j z l�s oN
Page 3 of 3 12128104

Division of Water Quality
Facility Number 3 Sag Division of Soil and Water Conservation ,
Q Other Agency
Type of Visit t& Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit go Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: ® Departure Time: County: TN - Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: GaJE!,E(z__ 1' ,�/� `ooze_
Certified Operator: S A Nl 1 a Lee e &'pit u
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
gn,-t3,:�
Latitude: = e = t = « Longitude: [� ° =1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
5 goo 110 Non -Layer
Dry Poultry
La e-
Non-
Pulle
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population;
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes fi�No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
El Yes
0No
❑NA
El NE
❑ Yes
ONo
❑ NA
❑ NE
12128104 Continued

Facility ]lumber: 3 — ` Date of Inspection O O
Waste Collection & Treatment
N
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: J - iV a F S r^ -a�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): C9 L/ 3 ��
5. Are there any immediate threats to the integrity of any of the structures observed?
❑Yes No ElNA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes Dq No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes kNo ❑ 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 JUNo ❑ 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 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [:IPAN > t0% or ] 0 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
4 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
k'No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
gNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
X No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ItNo
❑ 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):
ReviewerlInspector NameG(pigly(A �' S Phone: To 47 6 ^'1 !;D4
Reviewer/Inspector Signature: Date: 31161a,5
12128104 Continued

. .%:
Facility Number: 3 Date of Inspection �r
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 9No ❑ 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 ❑ Desig
n ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes V 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 30 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 No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? El 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 O[No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
KNo
❑ 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
[X 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
XNo
❑ 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
1VNo
❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
0 No
❑ NA ❑ NE
Additional Comments and/or
Page 3 of 3 12128104

I
Type of Visit A Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 30 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access /f
Date of Visit: Arrival Time: �f�r00 Departure Time: r nty: �[/y��� Region:
Farm Name: �='���9fJ5 �i��1 S Owner Email:
Owner Name ��d� /• �I�%ft��—�� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: �DOR Integrator:
Certified Operator: /Y?Z/_'� AA - - Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o ❑ ' 0 « Longitude: ❑ ° 0 ' ❑
Swine "
Design ayYCurrent: �- Design Current
Capacity . Populahon Wet Poultry CPapacity Population
' ` Design Current
Cattie , Capacity Population
❑ Wean to Finish
❑ La er
❑Dai Caw
Wean to Feeder
ZOO
❑Non-Laye r
❑ Dairy Calf
Feeder to Finish
SF
El Dairy Heifer
Farrow to Wean
Dry Rout-,
El Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
El Stocker
❑ Gilts
❑ N ers
ElBeef Feeder
El
❑ Boars
Nets
❑Pullets
❑Beef Brood Cowl
_ -
El Turkeys
Other `I
❑ Turkey Puults
❑ Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes ❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes ❑ No
❑ NA
❑ NE
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)
❑ Yes ❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes 0 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes �No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Date of Inspection
Facility Number: % —325
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes XNo ElNA ElNE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Identifier: 15& /_e,
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in): 2.` 23 7 ?
Observed Freeboard (in): 3J� ,32 1360 32-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No ElNA ElNE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes o ❑ 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 P
No ❑ NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ 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/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No El NA ❑ NE
El Excessive Ponding El Hydraulic Overload El Frozen Ground El 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
(C7Z62r_�
Window ❑ Evviidence of Wind Drift ❑ A�pplicattiioon%Outside of Area
12. Crop type(s) 266&1aI )A 6v;Ig✓�� . &le'J li L/ 7
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 acre determination?❑ Yes No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes 2f No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment? ❑ Yes I d No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name !'6 09A5 Phone: O 27
Reviewer/Inspector Signature: Date:
12128104 Continued

4f . . L
Facility Number: Date of Inspection J -T
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA gNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check WYes ❑ No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists 4 Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes W(No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crap 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
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Q(No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
/ No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
A
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ONo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0
❑ NA
El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes
,_,,(No
ILJ 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
V(No
❑ NA
❑ NE
Additional Comments and/or Drawings:
127� n
7
�� 7����Z� ��Goon/
Q,✓ �' �c r Sza� Q`� JG�
-7
SNo T �v T O C�i�Gat7�`�S
12128104

�nBE
Type of Visit 7Routine
pliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: I ], t 3 Os Arrival Time: f' 13 O Departure Time: County: L)uPt'� Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: 7UC.RNCi3�LJ Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: = e ❑ ' ❑ Longitude: = ° = 1
4 0
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
Ta 7 5.❑ Non -La et
i
❑ Wean to Finish
® Wean to Feeder
X
®
Other
❑ Other - - -- -
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
ElTurkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current I
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
ElBeef Stocket
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures: E]
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 D4 ❑ NA ❑ NE
❑ Yes
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 I
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
ElBeef Stocket
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures: E]
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 D4 ❑ NA ❑ NE
❑ Yes
Number of Structures: E]
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 D4 ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
O NNo
El Yes
ONNo�o
❑NA
❑NE
❑ Yes
l§"No
❑ NA
❑ NE
12128104 Continued

4
Facility Numlber: 3 — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure
3 Structure 4 Structure 5 Structure 6
Identifier: (3 PQ ( 1
3N Z
Spillway?:
Designed Freeboard (in): 7
Observed Freeboard (in):a�-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
Q No
❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
�
D 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 environmentaZo
t, 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
E� o
❑ 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-N
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
EJ No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes
ldNo
❑ 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 Drill ❑ Application Outside of Area
12. Crop type(s) _ t3eJi.4V-% V ,C>A ( G) l red-li S S G p
13. Soil type(s) A U g W o t�
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
BIN o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
B No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[]
Yes
�'No
❑ NA
❑ NE
t7. Does the facility lack adequate acreage for land application?
❑ Yes
D- o
El
El NE
18. Is there a lack of properly operating waste application equipment?
El Yes
M0
❑ NA
❑ NE
oZci7 or;rA.ikj Gopr S JF LAG0ohJ QMSXCt1S,
a , V p0A10E Crc,e `?af_L D , itCE 'A "P ? ol_ Aw po W L, C_r_-( T, . d- S Toc-i Tio C> _K4ex 4 rt XD S'
p 62�T olJ TA6-5 OC-11-0 €ort.�5. ur YAv-(-, wArr6 AA)Ac,�Ss6, US:rn36 GRF6 5'(gEi►'\
Reviewer/inspector Name 74k,1 �AG�C- (� � I Phone: (910) 1 Gin 7 � 6
Reviewer/inspector Signature: L Date: 2 05
12/2&04 Continued

�Y
Facility Number: 31 Date of Inspection 1a 3 as
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 CA7Design
P readily available? If yes, check Yes ❑ No El NA ❑ NE
the appropirate box.
[IWUP ❑listsCheck❑Maps El Other
21.
Does record keeping need improvement? If yes, chec the appropriate box below.
El Yes
El No El NA [I NE
El Waste Application El Weekly Freeboard Waste Analysis El Soil Analysis
❑ Waste Transfers
Annual Certification
❑ Rainfall �2<ocking [;Kcrop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
2 No ❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
No ❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
Yes
❑ No ElNA
ElNE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
0 No [I NA
ElNE
26.
Did the facility fail to have an actively certified operator in charge?
ElYes
O No NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El yes
,❑l
ElIT No NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes D No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[a -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
e' o
❑ 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
EWo
❑ 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
®.Go
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
EU,,4o
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

Type of Visit 0 Go pliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number 2 Date of Visit: j L b '-line:
1"J Not rational C Below Threshold
Permitted Certified ©Conditionally Certified Registered Date -Last Operated or Above Threshold:
..`
Farm Name: .._ ii1WIAIA._6" :�� � _ _ -- - — County: 0! P[�
Owner Name:.. _ .. - .. -.� �.. Phone No:..
Mailing Address:
Facility Contact: ..... ------Title: ------ _. Phone No:
Onsite Representative: ,.. p_qz,_ _ F Integrator: —. MkL(LdL_
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 C 46 Longitude ' ' Du
swine _ <:(
Wean to Feeder
Syob
,5uo
Feeder to Finish
M
Farrow to wean
Farrow to Feeder
Farrow to Finish
Gilts
LEE
Boars
nt -
ti Cattle =i
hher
To`aTJ�`,Qny
t
- 1 Total SSIW
' N�ber ofLag«►ns_
Discharges 8 StreamImpacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[3'No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
❑ No
b_ If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
[]No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
ONo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
❑INO
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: _ QU, I _ LC_ Z,Z_ �L`! - 32—
Freeboard (inches):
12112103
Continued

Facility Number: — 3 2 Date of Inspection 1 U
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
No
seepage, etc.)
�. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ yes
�To
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
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
dN
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
No
elevation markings?
Waste_ Application
�Iqo
10. Are there any buffers that need maintenanceiunprovement?
❑ Yes
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
o
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type G5►n/ 5(r0
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWIvIP)?
❑ Yes
o
14. a) Does the facility lack adequate acreage for land application?
El Yes
rNNo
b) Does the facility need a wettable acre determination?
❑ Yes
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15. Does the receiving crop need improvement?
❑ Yes
ERI(P
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
Q
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ yes ["-NNo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes Ej No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes CY40
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 [IYes [3-N1 o
Air Quality representative immediately.
Field Copy ❑ Final Notes
Sc.v pc'�r Su R v E4 ice& r-,- n�vYt-� �-2 sVAWWs K;141A AyV%O VK 1. a C-6 0 To s u r3"a-T
7.) ���# NEEps 6a..ds}� G�p.►.SL-a7. r3�,�Z. r1E��S New MAr�.1LC�•
3�.) v-CEp. a�,D ar�u��� c2.ri�rca i�r�
i1PDATE APO G2or 14-t� Fan-, ,5 0o0f>
Reviewer/Inspector Name
ReviewerAnspector Signature:
Date:
iW A"V.

Facility Number: Date of Inspection l:✓
Required Records & Documents
•21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie! WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/mspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
EIrStocking Form 13�6rop Yield Form [3 Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections [Annual Certification Form
❑ Yes [(No
❑ Yes ZNo
❑ Yes [/No
❑ Yes 2No
❑ Yes ['No
❑ Yes`No
❑ Yes [dNo
❑ Yes [ No
[:]Yes [(No
EI/Yes ❑ No
❑ Yes ONo
❑ Yes RNo
❑ Yes [ rNo
❑ Yes ❑' 0
[?`Yes ❑ No
12112103

Type of Visit ,0 Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit O Routine O Complaint eFofow up O Emergency Notification O Other ❑ Denied Access
Facility Number 31 32 Date of visit:
0 Permitted [3 Certified [] Conditionally Certified [3 Registered
Farm Name: TQ S r o r -\ S rGtrua i,
w"ti .� 4nG/ "
Owner Name: �,4d
Mailing Address:
Facility Contact:
Onsite Representative:
Time: 3
Date Last Operated or Above Threshold -
County: �y _
Phone No:
Phone No:
Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ° K Longitude 0 6 OK
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Cap acitV Population
❑ Wean to Feeder ❑ Layer 1 ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer I ❑ Non-Dai
❑ Farrow to Wean _ _ ......: .
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ 13oars Total .SSLW
l
Nuinbe°r of Lagoons J ❑ Subsurface Drains Present JJEI Lagoon Area ❑ Spray Field Area
Holding,Ponds I Solid Traps ❑ No Liquid Waste Management System
Discharges && Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: - s""ta ll - Lai
Freeboard (inches): v
05103101
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Yes ❑ No
Structure 6
Continued

1
'f If
/ "
Facility Number: 31 —�2 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (iel 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 ves. and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do anv of the structures need maintenancelimprovement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do anv stuctures lack adequate. gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenanceiimprovement?
11. Is there evidence of over application? El Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
Yes ❑ No
❑ Yes ❑ No
❑ Yes []No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ W"UP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (iel 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 notifV regional DWQ of emergency situations as required by General Permit?
(ie. discharge, freeboard problems, over application)
23. Did Reviewer.gnspector fail to discuss review•iinspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes ❑ No
❑ Yes 'ONo
❑ Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
10 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
__,-.. __ - —. _.: _ .. ��— _�-.� _-: -._ _ •_-�.�_� = =—�� �-,.mar �t.s.::..16"�'w��-: t' ,�3t �� .._ :w6,+;�;-sKasC.:a� ��n.:,� :�. `�=k`.'._-i ^moo ?� ='�.._?�:�-..«..,. �. w_,�.0
to
❑ Field Copy ❑ Final Notes y
Th ;� i "t/ve c4 d a r► I-Va-S do n e 43' A /o //Q w v 4- -A e I y u .`d 1 e tre ! s i
4tiP I eons. A7r. 814J,0k"'d Vv11 ah ohe e-io bhp aerrivdg
10� e ld f Gfs GZ rrc�rEd - t�rert Z,/�tS hO r"LKhD fro —�1t i S eVQ�� U
4e &M WAS sA4Ve_6 e14 for lj 4 h4 -t 44C a'V11"1_1j' 0 ;q
0(0 of v 1 R�ed Ahd k-tse # d yo, 0144. W, #,e ses .��'- are
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Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
05103101
Continued

` Facilift Number: 3 — 32 bate of Inspection ! D
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 ❑ 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 ❑ 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
eA rvrve'I e✓�ew 4e, eeme o f-� ;-7 4i-e- r+ �n;�q Aki,4 oct vrel4ely de4ee>"i e `
1 "9'0"► levels as Ae pwic. m,* y ► of be set 1pY'B4V?e
�c�"!yl i� ��re �
s n04 S" P"19"17 4"e;�needs - 0 be r-e5'4 Gj� s/ai^•Ie 4-Me iK 44e
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-1�✓ vno "f-�rarrl e� ier►' Lle l� Qoh _ All 4 est P14nr newt
.F1'Qr C, k ' of as ked a
the �',e Id, � -�e l 41 -rho :ti &-� WAS lot le4 0-4
d r+'I S p 5
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l,�e iS he'4 -rya have axte'ss;✓e fovids-4) ir'vn0FflpVr.2plo IrCRi'r.o11�✓
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tv,,II O�-44e b,'� 1,ggie ? W4s Xk 'ubbcd a boctJ Owe Yvtosl-}4 f Qr,a,•
1 �S 9rOW h Vp g�d . �j'!ar'O�ie Gt�. 1 �'►��AU'1 rr3►'1 ��c w�J1 G� r* na
be V'I'uo(e . r rf/ 1 heed-j -lo be
+oI-e oP7i - h.'r err'-I>'c�l sr��4�,'a�t 1`f eve fang
be ,�.'1(cGY 4eaa-b>rass ti-s4ed , -A'.0k
o ��fLits Geopp✓a ipter �1✓f 44ri deq�'-,q t�}�a -r�tP �-eeren�"
y J
s,-�ve,-� 4h O1ytd �4Gc✓ �n��Ky20r� Gna✓�-� �'�n rs
p Isn hie 41",4 we. 1914ncttard se71 A44 fe;"Oy- 40 yvrda ?/'3/D3
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Sin d a ly. ,-ee 6,cv-d , •►
4ha4 MCA-_ ir�'`ee6ou, ;s !h SkVA 10tr'D4+q!
0510310I � � �� - trot r� S a r D� wet6+e to b cd a p ce r eve its
�� o�- �✓' e +j��r►���.c 4e Goi fcal 1�7 41\e b;9 let)&Oh .

Type of Visit impliance Inspection O o Revie Lagoon Evaluation
c,ec e �
lReasonforVisit O Routine O Complaint ;Follow up Emergency Notification her ❑ Denied Access
Facility Number Date of Visit:
Uf Permitted [3 Cer7"ri 0 Conditionally Certified 0 Registered
Farm Name: �S U
Owner Name: OLJZ� _AG%i1NC'IQdp
Mailing Address:
Facility Contact: Title:
Onsite Representative: &'�42
Certified Operator:
Location of Farm:
Time: �`
Date Last Operate" Above Threshold:
County: i(koL __Z!`)
Phone No:
Phone No:
Integrator:
Operator Certification Number:
[Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 4 " Longitude 0 4
Design Current Design Current Design Current
Swine Capacity Population Poultry Ca acity Population Cattle Ca acity Population
❑ Wean to Feeder O ❑ Layer ❑ Dairy
❑ Feeder to Finish ILI Non -Layer I I ILI Non -Dairy
❑ Farrow to Wean
ElFarrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding";Ponds I�Sohd Taps ❑ No Liquid Waste Management System �
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. 1f 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 A Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: # r -2
Freeboard (inches):
05103101
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
0Yes ❑ No
Structure 6
Continued

Facility Number: 7j —Wt3Date of Inspection
5. Are there any "immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered ves, and the situation poses an
❑ Yes
❑ No
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
❑ No
12. Crop type
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 faciliry 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
Re uired Records & Documents
17_ Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑Yes
❑ Na
18. Does the facility fail to have all components of the Certified Animal `Haste Management Plan readily available?
(ie/'Arup, checklists, design, maps. etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
2 L Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notifj, regional DWQ of emergency situations as required by General Permit?
(ie! discharge, freeboard problems, over application)
❑ Yes
❑ No
23. Did Reviewer;`lnspector fail to discuss reriew •'inspection with on -site representative?
❑ Yes
;2rNo
24. Does facility require a follow-up visit by same a"ncy?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
J © No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Goaimerifs (refer to'quesiion."`Ea<pl ary.YES'answers and/or any reconemeudafions or av��.oth,comments. y r x
Use drawings of facility, to better explain situations (use addEittonal pages as necessary) ❑ Field Copy ❑ Final Notes
'�
�i►�S�FC�z�IV o .�Ecr, D•� •PaG.Ess lam z,✓Cy
A.
Reviewer/Inspector Name ,-.�• ate. R .� :,Of
Reviewer/Inspector Signature: Date: Q
05103101 1 Continued

Type of Visit fi5 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit:
Permitted [3 mired 0 Conditionally Certified D Registered
Farm Name:
Owner Name: �`_!1[.tiZn� .UG&YC11 A Q
Mailing Address:
Facility Contact: /n� Title:
Onsite Representative: NL[ Al
Certified Operator:
Location of Farm:
Time:
Date Last Operat or Above Threshold:
County: 19GZ/11
Phone No:
Phone No:
Integrator: XWAAIIW
Operator Certification Number:
VJ Swine ❑ Poultry ❑ Cattle ❑ Morse Latitude 0 4 u Longitude 4 u
Feeder to Finish
Farrow to Wean
Other
Farrow to Finish
Gilts
Boars
Discharges & Stream Impacts
Field Area
1. 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 ❑ No
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes X No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑Yes No
Waste C llo coign & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway Oyes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure S Structure 6
Identifier: 'o" F/
Freeboard (inches):
05103101 Continued

Facility Number: — g I Date of Inspection
5_ Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes VfNo
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? oyes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? - ❑ Yes ❑ No
1 L Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type
13_ Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
[--]No
Reuuired Records & Documents
IT
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ;2rNo
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.
t. �L
''�10 Field Copy ❑ Final Not,,
Copy ❑ Final Notes
SPC0TzaN RFtq6tJA+S0 fYv7'f ��aN
OwnJER,
HAI) 1uA60 7' LoA..R GA�vD� r `�''7II�LDcJ12 N /7 61110 / 111,11 AA)1►' 7-,qC_
�fi un10 InE}nlnlFRr /I I ZIR Pffy �`�'45 S �sQr.Q A� D v Znl� /7 �a5. Ai-�
a!��SfS
Reviewer/Ins ector Name
p • d.
Reviewer/Inspector Signature: D , Date:
05103101 Continued

1
i
-rw
FacilityNumber: Date of Inspection I D
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to dischargc at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30, Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts. missing or
or broken fan biade(s), inoperable shutters. etc.)
31. Do the animals feed stora_e bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover?
Additjonal Comments and/or Drawings:
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ )'es ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
ANo 30 DAY90 11
sky POA'5 FvQ 7 He dr-,,1e-1L
G�!/+4720n1j A�17uND G�C-aa n� �1 /���'� � �� (-i•�F� ��P,
n q r �rta �� A gxr DF SywF�Oi5 �/ r-e-
-A � /7PPF��
��/vI
Lam©"0;-:W E,
',L At o � eePr lJLId�%1
Z r, � �poeV G��
11Ny MOM 1*015L41.s ��
/vo7 zc�9),
4rcpp r,5 �0 ✓/`R /�G>F li�/i` -,� G�,� rIJL -f/i9S .�
2.�
05103101

Type of Visit aCornpliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit O Routine Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Z Date of Visit:
©Permitted 0 Certified © Conditionally Certified D Registered
Farm Name: PD S S 0"% n vt.G k
Owner Name: Edw'-\
Mailing Address:
Facility Contact: Title:
On site Representative: C d t"t "� e.'Yzka '7f
Certified Operator:
Location of Farm:
Time: = 30
Date Last Operated or Above Threshold:
County:
Phone No:
Phone No:
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' K Longitude e 4
Design Current
Design Current Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle Ca a city Population
❑ Wean to Feeder
❑ Layer
I
I
JE1 Dairy
❑ Feeder to Finish
❑ Non -Layer
I
I
JEJ Non -Dairy
❑ Farrow to Wean
--- -- - --
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSLW
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4_ Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: vrSe".9)
Freeboard (inches): 2-
05103101
❑ Yes ❑ No
❑ Yes ❑ No
Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Continued

r , ` _
Facility Number: 3 Date of Inspection
5_ Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑yes El 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 ves, and the situation poses an
immediate public health or environmental threat, noM, DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8_ Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate. gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Application
10. Are there any buffers that need maiiitenanceiimprovement? ❑ Yes ❑ No
11. Is there evidence of. over application? ,Excessive Ponding ❑ PAN VIiydraulic Overload Yes ❑ No
12. Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAVVMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
0 No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Re
uired Records & Documents
17.
Pail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
=: 18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design_ maps. etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (icl 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
27.
rail to notify regional DWQ of emergency situations as required by General Permit?
A�!rYes
❑ No
(ie.1 discharge, freeboard problems. over application)
23.
Did Reviewer rispector fail to discuss review/inspection with on -site representative?
❑ Yes
XNo
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
J © No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
-.a
Comtnents"(refer to gnesittrn 4)h. Ix_-O iti.any YES ansaversindlar�a nyymiiini6dattons ar say r�ter�commenfs. - '
Use drawings of facihty to better explain situations. (use addtttonal ges as n
pa❑ ecessary) Field Copy ❑ .... :,-j
Final Notes -
s.
�,_z ::_ :�x:�`v. �.xrs., ak,:s.,=- x....zs t,.. .•,.�r�;zs_-� cs.. .:,ate .-.s.�.�x-=- ��r��
i e , was d en e In 1V5'-0 27.L-►_A:e�I le zz Ga,��/a i yt � �'�►`, �• G,� ,�1�ve .
A00 LVA54C �nd '! y�1r�2[l�if' D'✓�i"�DQ����i /'O �1v1
Ap�O���q�1rG� �'VEn�- %ice?l�� j w�s-%c� /'11�Of!�'41ri'.rGk�i�'�eOl ,n�o �l�e r.✓•,�@ems
n�4he-54g4-e et lei --t,e 4,srh.gr l ;s g4eet Pri- We be a4 ]e �.-
I�DOQ gllorsr 7dte /� coy I v�j Uv�s Q} J2 i�e-d,eS - "'
-
Reviewer/Inspector Namepi1�%� , w ' c
Reviewer/Inspector Signature: Date: / q O 3
O5103101 Continued

f
f
Facility Number: 3) -.3 Date of Inspection / o
©dor 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 ❑ 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 ❑ No
3 L 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 Coiminents andfor�.Drawings.
:
O-r �n�e aa/`d 4� ��i 2 I � 3 �✓ i ov O 7/�iC � vy►.,,fi)✓L`� e. Vetii).
Mr -�2(/ c /le�vire�r�n
-�a fed -4 -Ae Lnc4r4 level , -AV-S n 1 e`f i e-q f "a,A L.�Jek 5 n4'qde .
e l e A s e- n eeAr Jo D e i Ss U ed
� ' �,,,,� jet v : r+� �e1 e✓4� � i'}-a�0 r+�.� �, -�� �, -�Lt r ,
05103101

1
i
Facility Number Date of Visit: Time:
Not O erational Below Threshold
IM Permitted d Certified O Coonditionally Certified 0 Registered
Farm Name: _ /�S5'kin /./ix t e4 / T,
Owner Name: Z5&A
Mailing Address:
Facility Contact: Title:
Onsite Representative: 010A0-
Certified Operator:
Location of Farm:
Date Last Operated or
Above Threshold: _
County: /Vkyy)r%-
Phone No:
Phone No -
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 ° OK Longitude 0 4
Design Current Design Current Design Current
Swine Ca acity P,o elation Poultry Ca acl P,o elation Cattle, Ca aci P,o elation
Wean to Feeder
�
❑ La er
❑ Dairy
® Feeder to Finish
❑Non -La er
❑ Non -Dairy
❑ Farrow to Wean
❑ Other 1.
❑ Farrow to Feeder
❑ Farrow to Finish
Total Design Capacity
ToMISS LW
❑ Gilts
❑ Boars
Number of Lagoons
Hording Ponds / Salid Traps
❑ Subsurface Drains Present
11EILagoon Area ❑ Spray Field Area
❑ No Li uid Waste Management System
Discharges & 5tream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes JS[No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes Q No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes jSINo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes jKtNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: r02 ,�iZr✓ _ ,6L0-Z
Freeboard (inches): _ _ Z� 31 _ R 013
05103101 Continued

l
Facility Number: j! — 3
Date of Inspection 1tZ
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
R1 Yes ❑ No
❑ Yes 9LNo
9Yes ❑ No
❑ Yes NNo
❑ Yes 9[No
Waste Annlication
10.
Are there any buffers that need maintenancelimprovement?
❑ Yes
ElNo
11.
Is there evidence ofover application? ❑ Excessive Pyyonding ❑ PAN ❑ Hydraulic Overload
❑ Yes
51 No
12.
Crop hype-
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
NNO
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
19 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
Reaulred Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
®.No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
0 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
El No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes 91 No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes [R No
24. Does facility require a follow-up visit by same agency? ❑ Yes [ZNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes SNo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to quesW8 Explain onVIYES answers�and/or-anyirec ommendiLtions=or any other comments
s
Use ilrawtngs of facility Ito better e4l iii sitaations: (use additionaltpages as necessary]
. ` ` . ;. r .� , ? y J , !- .,° . �. r _.-0 Field COUY
❑Final Notes
5, j r"s netd -t-P At eat e7"P a {ie c� s.i��- d� 4�500A 6LL' I
Amd
04 Sf# Pf�1�� ?61,77 �% '0 jvOA.s ��/ Z 1 /3LC / a/'� ��-v�can
4 need fo �c
t;`KPoe oe "L'/1i4eed V`-d"PBewvS4" -Yql' iA 04a—
ZVOon e.WeI6
h e"&
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
d z
05103101
C..
Continued

r
Facility Number: 3f —
Date of Inspection I TM
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
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 % No
❑ Yes No
❑ Yes No
❑ Yes JO No
❑ Yes RINo
❑ Yes 0 No
❑ Yes 9No
Additional Comments and/or Drawings
17► not Askve,12-die �ft1 ��r/acf 'f- A
*MeZ> �IteyeCyJo�l
No `I{/W & CKYI/en f f%?kp k)kth G�� d �� y�j� 4 ��5 ��dr t`7'C� �✓ �dDh �/�it�I3
—Nee,(
lra s f every 3•��� �d C6Uc4� a/l �oyhl�lrh,
-.Vef l a .dull ���y o�- �i4� �i GrJ lc rep
05103101

IType ofVisit )6 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other El Denied Access
Facility Number 31 3 Z 8 Date orVisit:
-W Permitted M Certified U Conditionally Certified El Registered
FarmName: ........... I ................... ... ................................................................
OwnerName:..... .....................................................
Facility Contact:
Title;
OI Time:
F0 Not Operationall 0 Below Threshold
Date Last Operated or Above Threshold: .........................
County; T.L'tq '
I'll,! !__ ................................... .......................
Phone No:
Phone No:
MailingAddress: ...................................................................................................................... .............. . . ........ ........................................................... ..........................
Onsite Representative.. ............. yk7 k
Certified Operator:..... Integrator . ........... YY ....... ... P i V.11.............................
........................ Operator Certification mber:...... ............................... _.
Location of Farm:
)Swine [] Poultry [] Cattle [] Horse Latitude Longitude
P
Design 'eurfrent
Swine ea_1D''acit*.'Population
❑ Wean to Feeder
I
r, Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
E] Boars
Nunnber of Lagoons L
Lagoon Area ❑ Spray Field Subsurface Drains Present k d Area
�--H@din9�poi* ­ Solid No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?❑ YesXNO
Discharge originated at: [I Lagoon [I Spray Field [] Other
C
a. If discharge is observed, was the conveyance man-made? El Yes �No
b, If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ) 0 Yes 16o
c. If discharge is observed, what is the estimated flow in gal/min? t, Iq
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) 0 Yes XNo
2. Is there evidence of past discharge from any part of the operation? [I Yes ffNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? [I Yes JZNo
V /I -B m -z 40
Ff C e- C1 M S FL6 Z '3 0
01/01/01 Continued

Facility Number: 3 j — 3? iG Date of InspectiPrinted on: 1 /9/2001 on
5.F Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes gfNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes )Z(No
(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? j2fyes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?. ❑ YesgNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level 1
elevation markings? ElYes XNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ONo
11. Is there evidence of over application? ❑ Excessive Ponding ❑f PAN ❑ HydraulicOverload❑ Yes f�No
12. Crop type 6e r -idh Gfa�e �✓"lail G'�a` "� f iDY'vtI wk2®1 [ 1 �1��io.nV
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management
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?
(CAWMP)? ❑ Yes "No
[]Yes gNo
❑ Yes XNo
❑ Yes 'zNo
❑ Yes / `No
❑ Yes Q"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.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21, Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
sre 00fed dun his'v!sjt;. ;Y;o0 wi-tee'iye oo fuij tbo -
corresTpoiideiiee: about this visit ... . ... .
❑ Yes j]No
❑ Yes PINO
❑ Yes wNo
❑ Yes No
❑ Yes j�No
❑ Yes ff No
❑ Yes ONo
❑ Yes �No
❑ Yes XNo
Comateats.(refer to question ft :Explain any,YES answers and/or ah recommendations ii any other comments.
Use of fariiii to -better ex lain situations. tise additional . es as n
dray np ty p ( P .._ necessary}
�..
�i,
N�� fa54 wotge Ingl ser C1'1 sod 46SI � or s aV�Q�a6�e for j,�slvec-f ah.
Ove ,,,0 ) 4b)e •Cac,l r17 and reCorp-f ,r-0 well J<ef ".
Reviewer/Inspector Name e)e( t G1 S a
d
Reviewer/Inspector Signature: Date: 5/00

Facility Number: .31 Date of Inspection MUM I Printed on: 10/26/2000
Odor -Issues
T
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 91�o
28. Is there any evidence of wind drift during land application? (i.e, residue on neighboring vegetation, asphalt, ❑ Yes zNo
roads, building structure, andtor public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes/T�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.) ❑ YesA!�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 ommen .an orDrawings: - - = -- -
J
5100

-. � -. - -. i� ,tom
_ILvtston of Water QtaE�ty ,� x
Q Dlvlslon of SoiE and Water Conservatron -��
`{ Q ,Other Agency:
R
rRe
eofVisit Compliance Inspection O Operation Review Q Lagoon Evaluation
son for Visit outine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: - -DD Time: Printed on: 7/21/2000
Q Not Operational O Below Threshold
Permitted © Certified � Conditionally Certified 0 Regist red Date Last Operated or Above Threshold
1 . .......
Farm Name: ........ 0 js_, �.-� County :............ ...
OwnerName:... ................................................
Facility Contact: ........................................
:Mailing Address: ................................
Onsite Representative: W.
Certified Operator ...............
Location of Farm:
......................... _............. Phone No:
.......................... Title:....�u -1 r~----------------
Phone No-
......... tegrator:..................... ....... ........
----.......I .................. I ........ ................. Operator Certification Number:
_ Iw
swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• �°°
Design Current Design Current Design Current
Swine Ca eacity Population Poultry Capacity Population Cattle Capacity Population
gm —can to Feeder 'Z D I JE1 Layer I I ILI Dairy
Feeder to Finish ❑ Non -Layer I 1 10 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lag,,-n Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacis
1. Is any discharge observed from any part of the operation? ❑ Yes <No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed. slid it reach Water of the State:' (if yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed. what is the estimated flow in gal/min'?
—
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
�<No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
tZNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less ban adequate? ❑ Spillway
❑ Yes
,RTNo
Structur l Structure Structurc t Structurq i Structure 5
Structure
5 �\
Identifier: ..........31................. ................... ................ ............3�...................._......Zi....... ........ .......... ............. ..............
Freeboard (inches): �� r ��� /Vw- .
S/00
Continued on back

F,acilit�Number: Date of Inspection / d Printed on: 7/21/2000
5. Are there any imm diate threats to the integrity of any of the structures obse ved? (ie/ trees, severe erosion, [l Yes Q!kNo
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
(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?
0(Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
KNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum Iiquid level
elevation markings?
❑ Yes
KNo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
�gNo
11. Is there evidence of over application? Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
No
%?❑
12. Crop C W5-
type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
XNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
5jNo
b) Does the facility need a wettable acre determination?
❑ Yes
wo
c) This facility is pended for a wettable acre determination?
❑ Yes
ANo
15. Does the receiving crop need improvement?
❑ Yes
XNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
ANo
Required Records & Documents
IT Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
XNo
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
CRrNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
10Yes
❑ No
20- Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
ZNo
21- Did the facility fail to have a actively certified operator in charge?
❑ Yes
Wo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes 4No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'? ❑ Yes Wo
24. Does facility require a follow-up visit by same agency? ❑ Yes Jl No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes P�(No
. . �Vo yi....... deficiencies -were rooted- during Ns:visit; - Voit will-Teceiye iid f'ueth&: -
:: cariespoiidence: about: this visit_' ......... . .:...:.:.:.. . .. .
Comments (refer to question #): Explain any YES answers and/or any recommendations or any.other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
7- �r- Ncvn c� k .w i vLc l OAK auv�- t - 7
j� Co wS Owl .
lot), A-o AzIle-
11�> k\D—S, ! L �
w
Reviewer/Inspector Name t• C y� L' �e r .—� 1
Reviewer/Inspector Signature: ��, !/.',, r,� Date: 0

Facility Number: — Date of Inspection Printed on: 7/21/2000
Odor Issues XNO"
2b. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge At/or below ❑ Yesliquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes /To
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 440
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 k[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 MNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes INVo
32. Do the flush tanks lack a submerged fill pipe or a peimanent/temporary cover? Yes ❑ No
Additional-Comments;and/orDrawings: -
J
5100

f
© Division of Soil and Water Conservation - Operation Review
© Division of Soil and Water Conservation-- Compliance Inspection
Division of Water Quality Compliance Inspection -
© Other Agency - Operation Review .
lip Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number 3 3 Lj Date of Inspection
,,,,,,,_ Time of Inspection 24 hr. (hh:mm)
10 Permitted 0 Certified ❑ Conditionally Certified [3 Registered JE3 Not Operational I Date Last Operated:
FarmName : ...........2>c6ktL�.................................................................. County: ......... buph.t^.................................... .......................
Owner Name: ............ Eawe t ......................... �� l�ltt7r ........... ........ Phone No:... `� !.4 .. L`i .-..! .x- ......................................
FacilityContact: ...........................................••--_._ ........................ Title: ................................................................ Phone No:
Mailing Address: ��.......- %iL�Cr .lRi'...... Yt{�?Ytil .. ..:........ .. .. 'S !il t ii ............................... 171vir.....
............ I.. .
� Rr�kNL..
Onsite Representative: ............ E)G.,� lt�t........... ........ Intevrator: M.�1G� ........................................................
Certified Operator:
Location of Farm:
Operator Certification Number
..............
Latitude • C 4 Longitude 0 • & "
Design Current
Swine Capacity Population
can to Feeder
Syoo
Q.Peeder to Finish
Qq
94 4
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Design Current Design Current
Poultry. Capacity Population Cattle Capacity Population
❑ Layer I ❑ Dairy
❑ Non -Layer I I ❑ Non -Dairy
❑ Other
Total Design Capacity p p q
Total SSLW
Numlfer of Lagoons ❑Subsurface Drains Present ❑Lagoon Area ❑Spray field Area
Holding Ponds /Solid Traps U �- ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes E0No
Discharge ori-inated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes q No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes 60 No
c. if discharge is observed, what is the estimated flow in gaUmin?
d. Dees discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes EA No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes t No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Stntcture 5 Structure 6
Identifier: BN' 1 f&N'Z 13t-C.— I Q[.c-2.
Freeboard (inches): �. Z7 ...............................
............ ................................................ .............. Z.................................................................................. ....
S. Are there any immediate threats to the integrity of any of the structures observed? (ict trees, severe erosion, ❑ Yes Ej'No
seepage, etc.)
3/23/99 Continued on back

FK.01 ty Number:. 3A —Ha 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? 1) Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenaricelimprovement? rO Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ,N No
Waste Anolieation
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
19 No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
ElYes
® No
12.
Crop type . &'CT-%jQ- - C.WA11 Q�� r&M /WiIkl( /SOV661-
, . •
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
VNo
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?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
❑ Yes j@ No
❑ Yes ® No
17..Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes
V 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) N Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes
OiPNo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes
R No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) El Yes
M No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes
0 No
24. Does facility require a follow-up visit by same agency? ❑ Yes
(9 No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes
No
No yiolatioris:oi• def ciencies were h6ted• dirrirtg •this: visit. • ."it iviil•i-eeeive ti6 further • "
corres• on�enee. agouti this visit. • • .... • • . • • • -
Comments (refer to quest<on #) Explain any YES answers and/orany recommendations or any other conunents� ti
pag Use drawings of facility to better explain situations (use additional es as nece ssary) - gyp=
7. Silt l� s a..,� s 4.ru bs s6ol 1,e (re oueD 40� otter J;([ wa l f 6�
f�LC-- j jotec+t'. FIL6k i;pES jr-, ��joor, shotJld be e)4(k4�t3 it BLC4(. Ev-oSior
o-im t, co Ccrs' ► "r o { 8 -C — Z (4L1 S kov 13 tDre �16 J at"--Ytb VT �I w
- �40us ir, 5 R-rlJ eayserg (01nn c8.*G s6U)3 b� "aiV4,
L�at �cjov� a Q5� r-r►�-` _Y-`e � ,�1 p
•5 6,r � i1t � �.
1oj• I w, C.o"rt' ? A A skoj�� � 1 kabel2.Q� on me c s 1�e�r�S
[,_p_gcor, L.-o i S -,W ul j �. rt�o�`r)e t�l�e�
Reviewer/Inspector Name '­
Reviewer/Inspector Signature:
Date:
3/23/99
r

Facility Number: Date of Inspection 1
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 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 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
d tional- omEnents-an or. • ` • — rawings
w
w
3/23/99

.3
Division of Soil and Water Conservation ❑ Other Agency IW
Division of Water Quality011
,
W��"1'_`1_ KK_, 5�
JQ,Routine Q Complaint Q Follow-up of DWQ inspection O Follow-up of DSWC review O Other J
rirr.rri.ryn+�
Date of Inspection
Facility Number
Time of Inspection ` 24 hr. (hh:mm)
D Registered Certified [3 Applied for Permit 'Permitted 0 Not O erational Date Last Operated:
Farm Name: ................possUI:........RASA,.V.1t1i......---..................................................... County: ......... DuA................................. .......................
Owner Name: L- Phone No: ... g1A\.G`' . ' 7Z7........................... ....
Facility Contact:... .................................:.. ..-. Title:................... . Phone No:
Mailing Address: ... �Q&.........�. .CC......i'+f ri.�k....tom.,......................... A.Y.. .;.. c....................... .' .9. ....
Onsite Representative :............... zzz .� .......................................... Integrator:.......!: U
CertifiedOperator:............................................................................................... Operator Certification Number:.........................................
Location of Farm:
.......................................................................................... �
..
........................................................................ ................ ...................... .............. .............................
Latitude �• �' "
Wean to Feeder
Ajp
® Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Longitude �• �� �11
x Design Current
Poultry Capacity P©pulation Ca
I❑ Non -Laver I I I:• ' I❑ N
J❑ Other
Total Design
TToi
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
EA No
2. Is any discharge observed from any part of the operation?
❑ Yes
}
tB No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
R No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
[,3 No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
5ONo
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
`p No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
'No
7/25/97
Continued an back

rj'ak'iiity tiurnber:
8. Are there lagoons or storage ponds on site which need to be properly closed'? ❑ Yes ;1No
Structures lLagoous-Ilolding Ponds, Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less.than adequate? ❑ Yes rA No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier............................................Z.......
.............. ....._....... g.n!....--•-................ !`x-:........................... I................ .... ........................
Freeboard(ft): ...... �°.. ......... ...................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes P No
11, Is erosion, or any other threats to the integrity of any of the structures observed'? ❑ Yes OD No
12. Do any of the structures need maintenance/improvement? (AYes KNo
(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 NNo
Waste Application
14. Is there physical evidence of over application'? ❑ Yes KNo
(If in excess of WM {P, or runoff entering waters of the State, notify DWQ)
15. Crop type .................mUll . ................. �......................ucr ......... . ....... MIN ................ .......... ........... .-...........
.
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW.MP)? ❑ Yes M No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes (9 No
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/]nspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit'?
( Yes
PN No
❑ Yes
EM No
❑ Yes
04 No
❑ Yes
59 No
Yes
❑ No
❑ Yes
CR No
❑ Yes
�} No
❑ Yes
No
0 No.violitions or deficiencies. were- noted- during this.visit. Yottwill receive no ftirther
correspondence ii oitt this'. visit'.,.
Cointnents:(refer;to:question #)- Explain any .YES answers and/or any, recommendations or any other continents R'
Use drawings o€ facility -to better explain situations- (use additional pages as necessary ):
r�r e,{{yit � t� ► it.a. us�-ll a F i �om� � 1 s ��,tl b �. ,rctre,rc�� . gm v.�.. s ►..�i
�f'e-
_1�
S6t� 6. C�-( aTcv-� or- MW0.fl 4 layo'n �.- StVvw
� ., {� V
`lsr'f
f-
t C .JJC'4Ulr��lt�ill� •�p -j 11ti �Y�1rQ.. ►�`W0� G�� �
zz. 4-omk sw„'(6 *- (Alcor,_ desrgr• £or- �a�ov,. � � sh`evP be-
rtcAo -.• Cot'mev t�it°1<' Cvrrcc�` 1?w (CJtr� � SI�tt3tlll! ioe ��txr� Of,, AJL Spy
7/25/97
Reviewer/Inspector Name'
-
Reviewer/Inspector Signature:_ Al Date:

_-....r•:c.:ri::i.rxs::>:-:aa::as:•:i;•:i.:i.r:ii.:r._.::;,.s.:;.a:<.:,r_:.,;r..-.;:<c:::.-_........ ............:� - .<a=:...:.__ -- ______-....._-_ - - - - -
Division of Soil and Water Conservation, Other Agency ® ❑
..:....:. ...
:0 Division of Water Quality
10 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection 1219/97
Facility Number 31 328
.... F
Time of Inspection 1504 24 hr. (hh:mm)
..
❑ Registered E Certified [3 Applied for Permit M Permitted JE3 Not Operational I Date Last Operated:
Farm Name: PaisunIlAranch...................... County: Duplin................................................ . .IRU.........
Owner Name: Ednia...................................... Va mbard................................................. Phone No: 9.10-2.934727.......-.......................
-•........................
Facility Contact: Edvvi n..flans w rd......................................... Title: .QIy=r................................................. Phone No:
Mailing Address:J.Q6i..Char1kF.rederic,Is..f3ji............................................................... W..ar Aw..N.C.......................................................... 28398.............
Onsite Representative: EdwJAl.Blamjzh4jrd...................................................................... Integrator:l!'lwrpby..lFa7ttlily..Farms.....................................
Certified Operator:.Edajn.J................................. Blanchard ....................................... Operator Certification Number: .18.Q02.............................
Location of Farm:
'1}x��asit.�xde..at�S�.�.10.fi«.a�p�ra�,.0w2�.ralle�.lan�r�tht.Alfi�t�teagR�ti.Ru..n�tls.�l;..11l�..................................................................................._....................
Latitude 34 58 04 K Longitude 78 ' 05 24 u
® Wean to Feeder
5200
5200
0 Feeder to Finish
4896
4896
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Genera
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation? -
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes ® No
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 0 No
❑ Yes H No
❑ Yes ® No
❑ Yes 0 No
❑ Yes D9 No

Facility Number: 31-328
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laeoons.Holdinz Ponds. Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3_ , " Structure 4
Identifier: P.QN,'.unrt.old.............P.miuAn.iAgm..................13NI.......:................... BN2:.............
Freeboard(ft):............. 12,5............. ..............6.5.......... ........... ........3,.1.f..........................2A.7..............
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate nnnimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
❑ Yes
N No
❑ Yes
N No
Structure 5 Structure 6
..............................................................
© Yes
® No
❑ Yes
No
Yes
® No
❑ Yes
N No
❑ Yes
N No
15. Crop type ..........................RyY................................................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste -Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement? -
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
AO -A' latibtls:dr.d'oficieffcies-Weee'noted_dui-ihkK�4iS•visit.:Wtf•VA1:rbCdve_nbfort•Ner.:.:.
.............. ... ..... ..... .... ......
•.corres.pandence it iout this:vasat. .... .. .
❑ Yes N No
❑ Yes N No
® Yes ❑ No
❑ Yes N No
❑ Yes N No
❑ Yes ® No
Yes ❑ No
❑ Yes N No
N Yes ❑ No
❑ Yes N No
12) Should remove debris from lagoon as is possible. Need to remove woody vegetation from lagoon walls. New lagoon has some +
minor erosion, should keep an eye on these areas until vegetation is established.
18) Has some fields still being established for expansion. Should work on these. Has had trouble with rye and replanted rye.
22) Need waste sample within 60 days of imgation.
24) Need design for original finishers & nursery.
7/25/97
RevicwerllnspectorNnme lCbhq 1111 lh�tgefald
Reviewer/Inspector Signature: Date:

Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Date of Inspection q
Facility Number 3 l 3
Time of Inspection 1. 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status- ❑ Registered ❑ Applied for Permit (ex:1.25 for 1 hr 15 min)) Spent on Review
❑ Certified Evermitted or Inspection includes travel and rocessin
❑ Not Operational Date Last Operated: _ ._. .... ......_.. .....�............... _..... _ ._.__.. _ _..... ..... ....
Farm Name:—f.4.L� ✓`'? .... Y1-
Land Owner Name: act w ` �. ............ Phone No: . ...................
Facility Contact ...-........................................................_ . Title: Phone No:
Mailing ............... ..� 5 ,...!J..C--...........--..—...- -2- --
Onsite Representative: .S c-a t ...L .c. s m.�a . Integrator: �...
Certified Operator: ............... ...._ ......_..... ..,...... ._ ............. __....._.... _ .... _ .. Operator Certification Number: _...... I �" 7
Location of Farm:
.Qan...2 ,Lf ...s .t`.� �-..a .....�5. 4 1.). A C�..i ..sx �.:�. �rra...i... 0.:..ZS_..Y+ai..... _ s!�a ,r In ..._� .t. ► . — ...... 4 .. .. ....... .... ..........
,�►.Ltd...5_K.�..l..L11.............. ..... .......... ................ ......... .... . ...... ......... ............... .._......_................ ..... .......... .
Latitude • ' Longitude • 4
Type of Operation and Design Capacity
Design Ltirrent�t Design Current us Design Current
Swinea� `Pouf r..: Cattlea , .
Ca p aci Po elation �g . ._5`A _ .Ga ac, -. Poulat,on• _,. Ca ac, m Po ulat,on�
Wean to Feeder Zv ax 10 la er r u. ❑ Da
ED Feeder to Finish Sri [I Non La er ❑ Non -Da
Farrow to Wean E ;'." , two'
Farrow to Feeder* Total D gnrCapac�ty IV 9441
Farrow to Finish T �S
❑ Other 4, m
3w
N„m.ber ofLagoons:I Hflldmg Ponds ❑ Subsurface Drains Present
❑ Lagoon Area ]❑ Spray Field Arear.
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ®No
2. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes 0 No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a Iagoon system? (If yes, notify DWQ) ❑ Yes ® No
3. Is there evidence of past discharge from any part of the operation? 9 Yes ❑ No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes KNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require ayes ❑ No
4/30/97 maintenance/improvement? Continued on back

Facility Number: a 3 —
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes ® No
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there Iagoons or storage ponds on site which need to be properly closed?
Structure aao ns and/or Holding P Lids
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure 1 Structure 2 Structure 3
10. Is seepage observed from any of the structures?
Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type
❑ Yes RNo
❑ Yes 56 No
❑ Yes 14 No
Structure 5 Structure 6
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes R1 No
ES Yes ❑ No
® Yes ❑ No
❑ Yes ® No
❑ Yes El No
® Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes (9 No
® Yes ❑ No
❑ Yes (9 No
Yes ❑ No
❑ Yes ® No
El Yes ❑ No
Conunents,(refer to quest�bn # Explain any YES:answers andlor any recommendahonsor any other comments
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Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

Facility Number:. •. —.%r Date of Inspection:
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4/30/97

................ _
❑ Division of Soil and Water Conservation ❑ Other Agency
® Division of Water Quality
_....... ...: :.:...... ..:..::.::.:::.::.:::::::::.:: <:::::n::n:
Routine O Cum laint O Fallon.•-u of DW ins ection O Folim►•-u of DSWC re%,icis Q Other
g Dwe of Inspection 817197
1 Facility Number 31 32$ #
Time of inspection 15:15 24 hr. (hh:mm)
Total Tinu: t in fraction of hour,
Farm Status: ❑ Registered ❑ Applied for Permit tex:1.25, For l hr 1, tntitt#) �'peni on
Certified 19 Permitted ur inNpectiun (includes tra%0 mid
[] Not Operational I Date Last Operated: ..............................................................................................
Farm Name: PQssMna.Brajach.................................. ------ County: Ruplin...................... -........................ ►RiSI.........
O" ncr Name: Edwim..................................... B.lanwil................................................. Phone No: 9.10:193=4721 ..........................................................
FacilityContact:............................................................. Title:................................................................ Phone No: ....................................... - ..........
Mailing Address: 306-Charli ftedericls.Rd............................................................... V4..OXSAW.NC.................. .................. ._...... .......... Z8398._...........
Onsite Representative- Ncnt,McLamb........................................................................... Integrator: Murph►.Tamil,yYarmm&.....................................
Certified Operator: Edwimi................................. BkuhArd ....................................... Operator Certification Mmber:.180.02............................
Location of Farm:
Qta.cax# side.ui.R.11Q �, a�ppxas..Q.2S. milc�.narkb .a> lnter�ectiumaralh SR.1X 13,.......................................................... -..........................................
Latitude F 34 58 -6-57 Longitude 78 €• OS • ; 24
1..:..:..Numbeirvf.La s�amx l.HaiaanigP.o' I 2 I..!11J Subsurface Drains Present IIU Lagoon Area JU Spray Ficid Area I. I
General
1. Are there any buffers that need maintenance/improvement? E: Yes X No
2. Is any discharge observed from any part of the operation? Yes No
Discharge originated at: Q Lagoon ❑ Spray Field ❑ Other
a. Ti'discharge is obsery ed,-%vas the conveyance man-made? E: Yes No
b. If discharge is obsetz-ed, did it reach Surface Water:' (li Yes- not!`. DWQ) J Yes No
c. Tf discharge is observed, what is the estimated no%v in gal/min? n/a
d. Does discharge b,, ass a lagoon system? (lfYes, noti& DWt)) Yes No
3. Is there evidence of past discharge from any part of the operation? Yes y No
4. Were there any adverse impacts to the waters of the State other than from a discharge? Yes E No
5. Does any part of the waste management system (other than lagoons/holding ponds) require $ Yes f No
maintenance/imp rovement :'

r
if `' ".
Faci€ity Number: 31-328
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures La tKrrtS :uidlor Holdina p(onds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard ([t): Structure 1 Structure 2 Structure 3
................L9..................................9.....................................................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
Structure 4
❑ Yes N No
0 Yes 0 No
❑ Yes N No
Structure 5 Structure 6
❑ Yes N No
N Yes ©No
® Yes © No
[:]Yes N No
15. Crop type ......GRashl> nxttu�a.ia�[aSS............................ Saybim.5.................... ........ Q.QMk'5i1AgPA-.Caraia).................................whoax................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ® Yes © No
17. Does the facility have a lack of adequate acreage for land application?
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?
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
© Yes N No
N Yes © No
❑ Yes N ivii.
® Yes © No
❑ Yes N No
® Yes [ No
❑ Yes N No
® Yes © No
3./ 5. It appears that waste leaked out of a joint in the aluminum irrigation piping and ran through a drainage path towards an adjacent ;
swamp. No waste was present in drainage path at time of inspection. (however, wash out area was observed from joint down and
through path). The aluminum piping should beset up so there is no future discharge from pipe joints into waterways.
11. / 12. Erosion was observed at toe of new lagoon (#2). This erosion should be corrected and area between lagoon wall and barrow
pit should be stabilized to prevent future problems. In addition, inner wall of new lagoon should be vegetated immediately to prevent
erosion. Also, vegetation ( including trees) should be cut on outer wall of old lagoon (41). Finally, bare area on outer wall of lagoon # 1
should be revegetated (area adjacent to barrow pit).
16. The certified plan calls for 13.5 acreas of bermuda infield # 1; however, soybeans are being grown. Your plan should be ammended
immediately to reflect these changes.
18. Correct weed problems in soybeans.
T
Reviewer/Inspector Name G Helltnr _ - -,;
Reviewer/Inspector Signature: Date: