310335_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

k l �5D
ivi. inn of Water Resources
f FacllityNumber . ®Division of Soil and Water Conservatiar�
®,Qther�,Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: {Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: �j Arrival Time: Departure Time: `(}j County: Region: Region: 1
Farm Name: .LJ t P &1- *cS
Owner Name: ��Tr 4:I `i�Ja-Vc'
Mailing Address:
Owner Email:
Phone:
Physical Address: JUL 2 0ZQ
Facility Contact: v c �,� ��Q CV 1: h Title: I�9r@�r 1_Q1ity
Onsite Representative: t , m�ngto +4egio a�1or,
p Integrator: a
Certified Operator: CJ - 4 47."vcs Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Current
x Swine..
Capacity Prop.
Wet Poultry
Capacity
Popp
Cattle Capacity P.op. -
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
L
l
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
1] , P.oultr,
Ca aci
P,o ,
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
E��
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
E5-NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
E3-I A
❑ 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 DWR)
❑ 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
j No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facili Number: - Date of Inspection:Tu-
Whste Collection & Treatment —
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [�I�o ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No [B' 1A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): fir'( �-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
1__l Ko
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
PAre there structures on -site which are not properly addressed and/or managed through a
[4-Y"e's
❑ 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
[[ - o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Q-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
02-1Qo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[10
❑ NA
❑ NE
maintenance or improvement?
I I . 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 ❑y Evidence of Wind Drift ❑Application Outside of Approved Area
12. Crop TYpe(s): e 4 I'Iisr�1©'`[ , G _ %I�E U fW
13. Soil Type(s): 1U +Y1 r
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [3'"F4o ❑ 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 D Yes []No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
D Yes [ZrNo ❑ NA ❑ NE
[:]Yes [�rNo ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ENo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Ef 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 [lo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes G!fNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [?fNo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Fac MXY Number: 31 - Z3 U I Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes D-Ko ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes rr> ❑ NA 0 NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes 42-I�o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Q' o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
�
0 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
ED-1Q
❑ 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
/
[Z]'f�O
❑ 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
[J_bLe-
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Io
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
6No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[9 No
❑ NA
❑ NE
Crimments (r efer to question;#) Expl3 � any YES answers'and/or any addi tonal reco mendationsItrr':any other eommen#c
Use drawings �of 6 ' iO to :better explarn:sttuations�(use additronal;pa es� as necessary} _ _ aa.� _
W, 6 r'r�', n
�'y�l
--�T
c_eft q fu- 305r )8 �
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone: T� '
Date:
21412015

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: j2Moutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Z
Arrival Time:M.-6C1 1
Departure Time: County:
it L Region: G
Farm Name:
Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: J c3e, LQ=k1 Lm{-
Certified Operator:
Phone:
Phone:
Integrator: / �+
Certification Number: ! /$ / 9
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
Swine
Wean to Finish
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Deslgn C*urrent
Cable C•apaeity Pop.
Da'y Cow
Wean to Feeder
I
JNon-Layer
I
Dairy Calf
Feeder to Finish
Design
Ory, P,oult . Ca aei P,o
Layers
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
r
Poults
Other
Beef Brood Cow
HTukeys
Otherurke
Other
Discharees and Stream Imuacts
1. Is any discharge observed from any part of the operation?
❑ Yes Ei No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes_,,ffNo
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ 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 DWR)
❑ Yes )2"No
❑. NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes �Noo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑Yes o
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3
21412014 Continu

[Facility Number: - c3 Date of Inspection: ZA2 /
Waste Collhetion &
_Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: /
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3�
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
O-No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. -Do any of the structures lack adequate markers as required by the permit?
❑ Yes
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?
T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
C'No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals {Cu, Zn, etc.
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
91 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2�No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[�TNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
,[?T-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ONo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
(D"No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
ZrNo
❑ 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 L?rNo ❑ 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 „E!fNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Inspection: a't
24. aid the"facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
J0 No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
ONo
❑ 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
Pa'No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
P-'No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes)2]'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
�/ j 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
2<0
[DNA [3 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
ONo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWNIP?
❑ Yes
ZNo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
[:]Yes
L�'No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�a`No
❑ NA ❑ NE
Comments.(refer to question ft Explain any YES. answers and/or any additional recommendations..'©r an other comments;
Use drawings of facility'to better explain situations (use additional pages as necessary). ; ,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 9101,
Date: 3

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: QfRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: :G PM County:
Farm Name: o Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Region:
Integrator: Certification Number: -Iql Lao14
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
I JNon-Layer
I
Dairy Calf
Feeder to Finish
b
Dairy Heifer
Farrow to Wean
Farrow to Feeder
D , P,oultr.
ILayers.
Design
Ca aci
Current
P,o ,
Dry Cow
Non -Dairy
Farrow to Finish
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other Turkey Poults
Other I A -
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 ZjNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes [:]No
❑ Yes ,ETNo
❑ Yes ZNo
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
Page 1 of 3 21412011 Continued

Facility Number: - Date of Inspection: - f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes NVo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes T❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Oe
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes P!fNo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes / No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA [] NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 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 VrNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes V No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes VrNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.))
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13, Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes ;Zj No
❑ Yes n/ 'No
❑ Yes PTNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes FTNo ❑ NA ❑ NE
❑ Yes ZJ No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
LA No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
VP 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.
C] Yes
❑ No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall 0 Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
ZNo
❑ 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
21412014 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes VpNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes RJNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes P No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes VfNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ 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?
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 KNo ❑ NA ❑ NE
❑ Yes 21 No ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
❑ No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
KNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
ONo
❑ 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 nec6sacy).
Reviewer/Inspcetor Name: 7 iW- 4-1121
Reviewer/Inspector Signature:
Page 3 of 3
Phone: - 36�(,1
Date: 'W' 1i5��
214120M.

I
i
A
Division of Water Quality
Facility Number ®- ® Division of MOM Water Conservation
0 Other Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: J611outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: '��Ioro Arrival Time: Departure Time: County:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Region: 'V
Facility Contact: Title: Phone:
Onsite Representative: �� Integrator:
�{1�
Certified Operator: _ se Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Swine
Wean to Finish r
Design
Capacity
Current
Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Dairy Heifer
Feeder to Finish
Farrow to Wean
Farrow to Feeder
D,ry P,ault .
Layers
Design
Ca aci
Current
P,o
Dry Cow
Non -Dairy
Beef Stocker
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other Turkey Poults
Other Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 2fNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes ❑ No
❑ Yes 2 'No
[:]Yes 5�'No
❑ NA ❑ NE
[DNA ❑NE
❑NA ❑NE
Page l of 3 21412011 Continued

Facility Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes J?rNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [] No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I a
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Ej 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
RfNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
iJ 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
6No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance a]ternatives 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
6] 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
en No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
VrNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
VT No
❑ NA
❑ NE
Required 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
EfNo
❑ 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 ;a No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and i" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 2fNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
o ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

1
Faci[Lq Number: - jDate of Inspection: y)` j
24. Did the facility fail to calibrate waste application equipment as required by the permit ❑ Yes J�TNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No [] NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes e] No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues T
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?
If yes, contact a regional Air Quality representative immediately,
34. 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 Rn No 0 NA ❑ NE
❑ Yes 21 No ❑ NA ❑ NE
❑ Yes J6 No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes LZ No ❑ 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 0 No ❑ NA ❑ NE
Commints (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/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: "�"�T1
Date: (�
21412011

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 0 Denied Access
Date of Visit: Arrival Time: ® Departure Time: County:
Farm Name: �°� FASI l S Owner Email:
Owner Name: C—_(LL-k L � A U % S Phone:
Mailing Address: OR-) 6aQ..,�,j Ca>;}-T r- b"ll C-L-, ! x L Q-S `4 a
Physical Address:
Facility Contact: Title:
Onsite Representative: Lku4 LANI &K _ Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number:
Certification Number:
Longitude:
Region:
Design Current
Swine Capacity Pap.
Wean to Finish
Design Current
WeFuNtrw Capacity Pop.
Layer
Cattle
DairyCow
Design Current
Capacity Pop.
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
Der P,oulte. Ca a�ity P,o ,
Layers
DairyHeifer
D Cow
Non-Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Gaw
Other
Other
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes X
No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facility Number: - 3 Date of Ins ection: J
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No ❑ NA
9No
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 1
O(
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No ❑ NA
0
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes]. No ❑ NA FINE
(not applicable to roofed pits, dry stacks, and/or wet stacks)T,
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes A
No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
Q WUP 0 Checklists ❑ Design Q Maps ❑ Lease Agreements
U Yes IN No U NA U NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
Q Waste Application ❑ Weekly Freeboard ❑ Waste Analysis Q Soil Analysis Q Waste Transfers
Q Rainfall ❑ Stocking ❑ Crop Yield Q 120 Minute Inspections Q 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
Page 2 of 3
❑ NA ❑ NE
Weather Code
,[] Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
21412011 Continued

Facility Number: --m - n57J Date of Inspection: 5711710
24,,Did tHe`facility fail to calibrate waste application equipment as required by the permit? ❑ Yes rNo
o ❑ 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
XYes [:]No
❑ Yes [:]No
❑ Yes ANo
❑ Yes jj No
❑ Yes No
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes Py No
❑ NA
❑ NE
�NA
❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Application Field ❑ LagoonlStorage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 0 No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes D�No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 9No ❑ NA ❑ NE
Comments (refer to question.#): Explain any YES answers and/or any;additional recommendations or any other comments.
Use drawines of facility to better exolain situations (use additional oases as necessarv). -
c 6 1 C_ A�� vE
-�-a rn,4� � �:X
C GL)9 r Jb n/ bL&6- �l
uJ/,V&AA F1 6di
c�po�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: p' C
21412011

' Division o'f Water Quality
11111 facility Number 731 - 335 Division of Soil and Water Conservation
s0 Other Agency
Type of Visit: Compliance Inspection O Operation Review O Structure Evaluation O 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: Departure Time: County: Region:
Farm Name: �� �i 12m Owner Email:
- -- {Q5ai 5UFs-(a13-7
Owner Name: JIFF E Q� �� L%� S Phone: C95a% 59& - _40ag (c�)
C\
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
/'N IC Hi LC _ %VC .1-N&IS _q �
Phone:
ante rotor:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design
Swine Capacity
Current Design Current
Pop. Wet Poultry Capacity Pop.
Design Current
Cattle C*opacity Pop.
Wean to Finish
La er
Da Cow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D Poul , Ca aci_ P,o ,
,
Layers
DairyHeifer
Cow
Non-Dai
Beef Stocker
Gilts
Non -Layers
113ceffeeder
Boars
Pullcts
I
lRef-fBrand Cow
Other
Turkeys
Turkey Poults
INHOther
Other
Discharges and Stream Imuacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
[:]Yes [�No ❑ NA ❑ NE
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 No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: - 5 Date of Inspection: j !
. w
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I of
Spillway?:
Designed Freeboard (in):��
Observed Freeboard (in): �� Q
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.) -0
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes V(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
S. 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) KN
9. Doesany part of the waste management system other than the waste structures require ❑ Yes o ❑ 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 kNo ❑ 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?
U Yes
0 No
U NA
U NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
�No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
] No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ YeskNo
No
❑ NA
❑ NE
the appropriate box.
QWUP ❑Checklists 0 Design 0 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 0 Weekly Freeboard 0 Waste Analysis Q Soil Analysis ❑ Waste Transfers Q Weather Code
0 Rainfall ❑ Stocking Q Crop Yield [ 1120 Minute Inspections 0 Monthly and I" 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 9 No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: j - r3 Ds ection: f
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes kNo
o ❑ 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 provide documentation of an actively certified operator in charge? ❑ Yes 1A No ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ NoVNA
NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No
❑ Yes No
❑ Yes j No
❑ Yes �(LN0
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes >fNo ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations.or anyother
Use drawings of facility to better explain situations (use additional pages as necessary). 7
Pi31►1 < '*-+ I. R
ACM/o C).s(9 �� }�
-Solt- O�-T
G� �l y g cA TTA1�=� Q
A f40V cQ aNC roGZ-
W19Qf rI Foil G
pZ&- _ /0 S c,, L - C0(-L-C'
(� 1 �-15 TCD w/ el- tA�wITT
G� ' r,s f�l4s )r' (L i C)
t
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
0
p-cc,r--- . S
Phone:
Date: Lgjm�
21412011

Faeilitv.-Mimber 31 33 5
l.r
Type of Visit 1ACompliance, Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: © Departure Time: County: U JV Region:
Farm Name: '� t` � Owner Email.
l b r7g t°�-.to 3-4ti
Owner Name: ���Flre(zLA, L U)S Phone: QSQ-S'�(o-�la�`2LtZ
Mailing Address: " ��� Color 8 'P1N� ILL ' • C �� a
Physical Address:
Facility Contact:
Title: Phone No:
Onsite Representative: �r LRIntegrator: q
Certified Operator- IFEfQ-� 1 )A U )S Op�orcertilication Number: j�,
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 0 e= I 0 u Longitude: ❑ o❑ 6❑ 46
Design Current.
Df
Capacity .,Population
M1'r .e
Poultry-f C l
❑ Wean to Finish
_.
❑ Layer
❑ Wean to Feeder
❑ Non -La er
Feeder to Finish
Farrow to Wean
Dry Poultry
El Farrow Farrow to Feeder
ElFarrow to Finish
El Layers
El Gilts_
ElNon-Layers
❑ Boars<
❑ Pullets
❑ Turke s
Other � -
❑ Turkey Poue
❑ Other
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy_
Beef Stocker
Beef Feeder
Beef Brood
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 pSl No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑NA
❑NE
El Yes
❑No
❑ Yes
❑ NA
❑ NE
❑ Yes
'KNo
P(No
❑ NA
❑ NE
12128104 Continued

Facilky Number: — S Date of Inspection (0 O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 9No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: i
Spillway?: n
Designed Freeboard (in):
Observed Freeboard (in): ]!p�
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
XNo
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
0(—No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below
❑ Yes No
❑ Yes qNo
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑NA El NE
❑ NA ❑ NE
❑ PAN ❑ PAN > 10% or 101bs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop W Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) COLN T S' 2 E G" <S G m 4 C�� C 1 I 1 1 C-L F 7T
13. Soil type(s) M(,t-119-t-U ILL.E
v v
14. Do the receiving crops differ from those designated in the CAWMP? El Yes VNo ❑ 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 ZNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes _j;dNo ❑ NA ❑ NE
Comments (refer fu,question:#): Eacplain.any_.YES -answers and/or any recommendations or any other Comments;,-,_ a
'.'
Use drawmgs of faciiity_to better explain. situations: (use additional pages as necessary): 5
Reviewer/Inspector Name
MASDA�(�/Nt✓ S -_ Phone: c1%d ' ►�`��a�
Reviewer/Inspector Signature:
Date: (9Z OO
Page 2 of 3 12128104 Continued

Facility Number: 335 Date of Inspection
_Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes NNo ❑ NA ❑ NE
the appropriate box. El WUP ❑ Checklists 0 �] Maps
Design
g p ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ✓ `l4No ❑ NA El NE
0 Waste Application El Weekly Freeboard El Waste Analysis El Soil Analysis El Waste Transfers❑/nual Certification
0 Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections El Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes XNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes VNo ❑ NA ❑ NE
24, Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
❑ Yes
No ❑ NA
❑ NE
❑ Yes
No ❑ NA
El NE
❑ Yes
XNo ❑ NA
❑ NE
❑ Yes
❑ No >�A
❑ NE
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:
❑ Yes XNo
❑ Yes `<No
❑ Yes J<No
❑ Yes )�No
❑ Yes No
❑ Yes No
El NA El NE
El NA El NE
❑ NA ❑ NE
❑NA El NE
❑ NA ❑ NE
El NA El NE
� 7 C- 54Cr 5 Ay rjC� e r
SET GoP�a F Iblo QJG covoa- pcA-, w/RECaQp
S-C\c -,>9>IMS OiCgc►rue
it •1D A 01 S C A WAS
Page 3 of 3
1212&104 A cal

Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason far Visit Q -Routlne O Complaint O Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: y pr`r Arrival Time: d Departure Time: �� County: 1%✓ Region:
Farm Name: 'bq y, T-7 Mg Owner Email:
�� F FE �- �- a5-5t.o&-�133� Ch
Owner Name: �AU(�l��y Phone:
Mailing Address: of s-r �(A�N CGA'T d A L1_ , /VC Do S _"cZ
Physical Address:
Facility Contact: i Title:
Onsite Representative: Jar LANs oz_ ,_ Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ o = I Longitude: = ° = � = {!
Design Current
Design Current Design C►urg'
Swine Capacity Population
Wet Poultry Capacity Population Cattle Capacity Population
Finish
❑ La er
❑ DairyCow
o Feeder
❑Non -La er
El Dairy Calf
to Finish ��
El Dairy Heifer
to Wean
rFarrow
Dry Poultry ❑ D Cow
to Feeder
❑ Non -Dairy
to Finish
rs❑ Beef Stocker
Feeder
ts❑Beef
❑Beef Brood Co
ElTurkeys
Other
❑ Turkey Pouets
❑ Other
El Other Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �No
❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Cl Yes
�kNo
❑ NA
❑ NE
❑ Yes
[�No
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: j — 33S
Date of Inspection
OF
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3
Identifier: I ID
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �d S
❑ Yes )No
❑ Yes El No
Structure 4 Structure 5
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes A No
❑ Yes ANo
El NA El NE
[3 NA ❑NE
Structure 6
❑ NA ❑ NE
❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes K
No ❑ NA ElNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
RNo
❑ NA
❑ NE
mai ntenanceli mprovement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
VNo
❑ 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 El Application Outside of Area
�C (.0
12.
Crop type(s) AR-- y
PE - I t t t tLE -Fr ( P� S C iS, f 4r.1) CG a-,v (A)N e4
-r SR
&
Q_cp�
13.
Soil type(s) Aln" X-K / ► 1 A R U LAN Ac.L7fZ u U 1 c-Le
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
ANo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
PNo
❑ 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
KNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
ONo
❑ NA
❑ NE
Comments (refer`�to question;#) Explain any YES answers and/orranyrecommendati_ons,or any other comments.
m,
«Use,�drawmgs�of facthty #o better explain s�tuahons (use additional pages.�as�necessary3�; -�
Reviewer/Inspector Name jvE S
Phone: 90-_494(04394
Reviewer/Inspector Signature: CkYrqVWICZ" . O ilYt
Date: la�ldq
Page 2 of 3 12128104 Continued

Facility Number:3)S Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Covera e & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. 0 WUP El Checklists ❑ Design g � Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
0 Waste Application ❑ Weekly Freeboard 0 Waste Analysis ❑ Soil Analysis [] Waste Transfers ❑/nnual Certification
❑ Rainfall Q Stocking El Crop Yield Q 120 Minute Inspections Q Monthly and 1" Rain Inspections ❑ Weather Code
22, Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comm' ents and/or Drawings:.'
N Gca T�:, c_uk -R-" T CO C-
❑ Yes
10 No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
;B�qo
❑ NA
❑ NE
❑ Yes
NNo
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
❑ No
;kNA
❑ NE
❑ Yes
9No
❑ NA
❑ NE
❑ Yes
;lqNo
❑ NA
❑ NE
❑ Yes
gNo
❑ NA
❑ NE
❑ Yes
KTNo
❑ NA
❑ NE
❑ Yes
0,No
❑ NA
❑ NE
❑ Yes
)dNo
❑ NA
❑ NE
��� coy( o 9 6 t G
Q 1C, ,4c„r;U+�
L.L}(a.00W �)CS1.GNS — ONLt,. SGE I 'N 43«t'K,
Page 3 of 3 12128104

31 H 33
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: /c� Arrival Time: Departure Time: County: C.A X Region:
Farm Name:
Owner Email:
Owner Name: � E F F L,4013 Phone:
Mailing Address:'
Physical Address:
Facility Contact: Title:
Onsite Representative: A �/47✓!
Certified Operator: Na V l
Back-up Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number: 1 r8i
Back-up Certification Number:
Latitude: = o Longitude: = ° 0 t E__1 «
Design Current
Swine C►apacity Population Wet Poultry
Design
Capacity
Current
Population
Design Current
Cattle Capacity Population
❑ Wean to Finish ID Layer I
i Cow
❑ Wean to Feeder I 110 Non -Layer
❑Dai Calf
❑ Dai Heifer
ElD Cow
ElNon-Dairy
❑ Feeder to Finish
ElFarrow to Wean Dry Poultry
ElFarrow to Feeder
❑ Farrow to Finish ❑ Layers
❑ Gilts ❑ Non -La ers
❑ Pullets
❑ Boars
ElBeef Stocker
❑B eef Feeder
❑Beef Brood Co
❑ Turke s
Other ❑Turke Paults
ElOther ❑ Other
number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes % No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes]
No
❑ NA
❑ NE
❑ Yes]
No
❑ NA
❑ NE
12128104 Continued

Facility Number: -31
Date of Inspection O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �Z 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:
Spillway?:
Designed Freeboard (in): 49.5 19 • S
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 1% 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 %No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes bko ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes g No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes iA No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ FAN ❑ PAN > 10% or l 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 KNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No Cl NA ❑ NE
ON
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 0 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 IRNo ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments..:"
Use drawings of facility to better explain situations. (use additional pages as necessary):
D� F t X ECzc�1SION AJZGuND WZAfN F20r-%-FL-b V_C--CE'7 a71c�r
Dp Fl NlSff SPA10 ACC V Q & I wl<0�74?torij BACK
SPA, �u\
c�.�Ec� s �K p�z�wLnrT�l� �w� g�M1uDA �Mres a� i
Reviewer/Inspector Name 111 AA,1 AID - 41AIF S' 1 Phone: 9/0 -` '% -W
Reviewer/Inspector Signature: Date: (-D I -
Page 2 of 3 12128104 Continued

1
♦1 ,
Facility Number: 3 —335 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ElNA ElNE
the appropriate box.
ElWUP ❑Checklists El Design El Maps El Other N,
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 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 ;9 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes k No ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes A 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 X 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 -P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes P(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] No
❑ NA
❑ NE
Additional Comments and/or Drawings:
C o C .f ?ck I
6 e T A u 6 A1vAu1 (­ "cab FQCZ �a �-
� c-
Page 3 of 3 12128104

Facility, Number 3
Division of Water Quality
0 Division of Soil and Water Conservation
Q Other Agency
Type of Visit JJCompliance Inspection -- O Operation Review O Structure Evaluation
Reason for Visit f Routine O Complaint O Follow up O Referral O Emergency
Date of Visit: I Arrival//Time: s!i Departure Time: i County:
Farm Name: iCJ Owner Email:
Owner Name: c_7GFi� AdZ'S _ Phone: _
Mailing Address:
Physical Address:
0 Technical Assistance
Q Other ❑ Denied Access
Region: C.4/1Z161
Facility Contact:
Title:
Phone No:
Onsite Representativel�sdlV�%
G/9/�L�
Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: [—] o 0 Longitude: = 0 0`=
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
IV Feeder to Finish
El Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La er Eli
❑ on -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
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?
t. ■
❑ Yes to No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes XNo
❑ NA
❑ NE
❑ Yes ',,&No
❑ NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection•
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes/ZNo ❑ 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: l006Z_ 6Q �1
Spillway?: /yo All
Designed Freeboard (in): 5 aQ/
Observed Freeboard (in): T& (y'Z/
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 XNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? El!!J Yes , No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ZEi 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 XNo [INA ElNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes /No ❑ NA ❑ NE
maintenance/improvement?
IL . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ YesXNo ❑ 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
ElOutside of Acceptable Crop Window ElEvidence of Wind Drifl ElApplication Outside of Area S,I•CIO Uej1s6EEP�
12. Crop type(s) r JoYB�/smuo,q
13. Soil type(s) /110,
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �No
15. Does the receiving crop and/or land application site need improvement? ❑ YesNo
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? El Yes No
17. Does the facility lack adequate acreage for land application? El Yes ' No
18. Is there a lack of properly operating waste application equipment? El Yes No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Z/_;F/fj 7 JO'rG T S T -) , Vlel -::� 4/
❑NA El NE
❑ NA ❑ NE
[I NA El NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Name Phone(%V)
Reviewer/Inspector Signature: Date: l2 Cv O
12128104 Continued

i
Facility Number: 3 Date of Inspection CO
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes zNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes XNo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Ye/sEl
No El NA El NE
El Waste Application El Weekly Freeboard El Waste Analysis El Soil Analysis El Waste Transf Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes �No
❑ NA
El NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes XNo
❑ NA
El NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes �i No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes No
❑ NA
ElNE
26. Did the facility fail to have an actively certified operator in charge?
ElYes P No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes ONo
❑ NA
❑ NE
Other Issues
29. 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
❑ YesNo
❑ 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
El 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 ZNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
12,128104
12,128104

Type of Visit 19 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit JK Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Q Arrival Time: Departure Time: County:
Farm Name:— V� �i9�%QM S _ Owner Email:
Owner Name: _ ��J Cff .1/�✓yS Phone: _
Mailing Address:
Physical Address: _
Facility Contact: /f Title::
Onsite Representativei9ii1i,'_
n
Certified Operator: OFF`Ailz�
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
P one No:
Integrator �ic�
Operator Certification Number:
Back-up Certification Number:
r
Region: I �0
Latitude: = o ❑ 6 = Longitude: [::] ° ❑ 1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
_ ❑ Layer
1 ILI Non -Layer I EEJ
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharees & 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 Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures: a3I.
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 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
/No
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE
12128104 Continued

{� F*
Facility Number-, —
Date of Inspection I d/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
;KNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes
❑ No ❑ NA ❑ NE
S cture 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier. Z_
Spillway?: P D
Designed Freeboard (in): ,
Observed Freeboard (in): 1,6 2-z7
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
A No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
V1 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? to Yes
❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ yes
No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ 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 �/ind w ❑ Ev/idence of Wi Drifl ❑ App/liicaation Outside of Area
12. Crop type(s) "Aww'M' f ml ) e. (.f)",
13. Soil type(s) 14fl //1ML1 y /f&
14. Do the receiving crops differ from those designated in the CAWMP? El Yes ,_,,JNo El NA El NE
15. Does the receiving crop and/or land application site need improvement? ElU,Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑ Yes 0 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes 9No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes Z No ❑ NA ❑ NE
�T�i✓/J �i�✓�zP,� /n2 r%�G�anl #Z, (��� �N,< �Ir..L� �uS��Y.�).
Reviewer/Inspector Name I Phone: Q —
Reviewer/Inspector Signature: Date: 2
12128104 Continued

E .
Facility Number: j` j, j Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP 0 Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes VNo ❑ 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
[XNo
❑ 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?
❑ Yes
0No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
VNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Yes
❑ No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[/No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
0 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
VrNo
❑ 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
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
ox'o�� 14e�pl'o ho"z-'end
S,
1�PRl�S Fad- �r ,8ak —450 ��/� LAGS �Z /►� vf/Gr�ro��r�
A�P�� 1 Al�- ono dip
A/o /,/*0 f�
12128104

Type of Visit Chi Co liance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up Q Emergency Notification Q Other 0 Denied Access
Facility N her Date of Visit:
Permitted Cer 1tified (0 Conditionally Certified 13 Registered
Farm Name:
Owner Name:
Mailing Address:
j / Time: �t?
10 Not Operational O Below Threshold 1
Date, Last Operated or Above Threshold:
County: , , „..» ... ._ ....� _..._.
Phone No: 4 a D
Facility Contact: ___ . _ . _.. ---Title: _ _ _. Phone No: _ . ---- -- -
Onsite Representative:.W !�I T �1��%5 . .. _ Integrator.
Certified Operator.
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ horse Latitude 0 4 " Longitude • �«
Mcharses , Stream hu acts
1. Is any discharge observed from any part of the operation? ❑ Yes Cr/No
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
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
❑ Yes
BNo
L
❑ Yes
0111
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: �.+�------.. .�I.__.........._
Freeboard (inches): ___ 3 3-1 w
12112103 Condnued

Facility Number: S1 — Date of Inspection 1 S
5. ,Are there any immediate threats to the integrity of any of the structures observed? Oe/ trees, severe erosion,
❑ Yes
No
seepage, etc.)
6. Are there structures on -site which are not addressed and/or managed through a waste management or
properly
❑ yes
MWO
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
S. Does any part of the waste management system other than waste structures require maintenancerimprovement?
❑ Yes
!moo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
elevation markings?
Waste Aviplication
10. Are there any buffers that need maintenance/improvement?
❑ Yes
C-}3�0
1 I. 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 CSC,/ (!4SGO
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
o
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
�;<O
b) Does the facility need a wettable acre determination?
❑ Yes
c) This facility is pended for a wettable acre determination?
❑ Yes
0
15. Does the receiving crop need improvement?
❑ Yes
L7 No
16. Is
Yes
No
there a lack of adequate waste application equipment?
❑
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ yes
MrNo
liquid level of lagoon or storage pond with no agitation?
IS. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
<No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
L�No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
olc
Air Quality representative immediately.
c refer to q n r � YFs arara#yi -or-an— �k�th
Use Of. faes'l'ety,to, better exp!$�t `ntudv_ as.,(�e's�tihm<! pages as ar�ar3'? 0 Field c Final �r F Copy F' Notes
� dn> ,tea 6, onJ DD ce w-rrNv& G morass cow E,,.• t,.art.K 2 ,
,� k.c�P (�,op�' pF St,i1d�E -';UP-VCN�6aS 8i i,, 7� f C•a1�.bS
3y, j cAt�r64A7Zt0d Ta Dah)6 ASAP, SEND Cory
3 5,) G R.dP 1Lt6 LjD N C"- S V a�j APOZOVU Fes'
A► L*L JZC-Uti S.
Cap j W�@R-�ALZ�� �'�W� Z,rJT6G�t-AT�ft-,
T
Reviewer Peu- r Name d -
Reviewer/Inspector Signature: Date: 11 It $ a
12112103 Continued

Facility Nuwber: ... Date of Inspection I 1
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?
(iel 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?
Oet 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 notee. which cause noncompliance of the Certified AWMP7
NMES 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 fors need improvement? If yes, check the appropriate box below
Mocking Form ❑ Crop Yield Form ❑ Rainfall ❑ inspection After 1" Rain
❑ 120 Minute Inspections [Annual Certification Form
❑ Yes Uo
❑ Yes o
❑ Yes E No
❑ Yes
❑ Yes 7Nq,
❑ Yes JN
❑ Yes
❑ Yes [No
❑ Yes [ o
OYes
❑ Yes
7No
ElYes
L o
Erfes
❑ No
'
❑ No
7
❑ No
12112103

40
f 5j
Type of Visit loriCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit RFRoubne O Complaint C)Follow up O Emergency Notification 0 Other ❑ Denied Access
Facility Number Hate of Visit: l 3 DZ Time:rO SOD
Not Operational 0 Below Threshold
©Permitted 0 Certified [3Conditionallv Certified © Registered Date Last Operated or Above Threshold:
Farm Name: �P t D Feiy- S County-
Owner Name: ` 1V Dot V ( Phone No:
Mailing Address:
Facility Contact: '�] Title: yy� Phone No:
Onsite Representative: W TcJ A V S Integrator: _
Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 01 0" Longitude • 0�
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: _D D ---
Freeboard (inches): 3 O rj O
05103101
❑ Yes ZfNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ff NO
❑ Yes ErNo
❑ Yes ZNo
Structure 6
Continued

i
17,
r I Facility Number: 31 — ,335
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7_ Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste AnDlication
❑ Yes ZNo
❑ Yes )eNo
❑ Yes ONO
❑ Yes 2 No
❑ Yes ZNo
10_
Are there any buffers that need maintenance/improvement?
[:]Yes
ZNo
11.
is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
ZfNo
12.
Crop typea,ii+n vLL�� Hct.� �Nt�i 1� G rG i Cow r1 �_� �g7 , scs EaCq Llf
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
ONO
14_
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
0Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15_
Does the receiving crop need improvement?
❑ Yes
.El No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
;D-No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
jZrNo
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)
OYes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
gNo
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?
❑ Yes
JZ No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
J2fNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
ONO
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ONO
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments',(refer to:questios #): Ezpli" arty YES adi*ee iindior_any recomthendations or any_amer comments.
_
ilse:drawtr►gs of faciltty to better.eitpla�n � #uattons (Dse atWrtion — pages'as uecessary) 0 Field Copv N� Final Note., 4
1L1. r_T del;, ,_,,-eat 4he weff461c, qC�te de4c.✓ totcr 1'01-, lejqe►- TO /►^e. PAVI'S'
a wWgIle a;c�P deley,�tlr C,�iIo4, o,,eeds Jo 6e dare -4,r 44e t/,; , olnd
4> c T4 d1,,,0.s?G �3tgn he�Gi`S o A/-"#eY+ e}rCnrdinrnll� . Also) 4Lte
re6dr,js srheulef be ker acc.Or-d1•.c,17 r.�oh Gn1 l/�le� �cr• p�' �11e
weHii n/-res .
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 I Continued

• Facility Number: 31 —335 Date of Inspection
dov Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below 'Z3 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 JzNo
30_ Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan bladc(s), inoperable shutters. etc.) ❑ Yes ,�'Vo
31 _ Do the animals feed storage bins fail to have appropriate cover? ❑ Yes .4E!f No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? 10 Yes ❑ No
'Additional Comments and/or Drawings:, =
1 F 1 eqce Go)"14eA 41, C0 <-� o4e e.b4,q �
car G� �e lG, o6i1 design,�o�►�cc� of, �o,r 4ke S."ezo
aciaare nbnd I<¢el 4�iI ]t'T�o�n.�}�'pF. �✓��� 4),e
i� . �rec6oC�i{'Oi rcca►-�s a�� nod' ava,'lable �,. r�,s�oee�,oh.
0ve--,11. -]-lie-IA c,1,,-Fy 'f;�&Id G✓'6r arc well kept.
05103101

Division of Water Quality''
,•
0 Division of:Soil-and Water Conservation -- __ v
0 Other Agency
b
- e
of Visit OCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit .ice Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number ,y # 3 Date of Visit:
Permitted © Certified © Conditionally Certified 0 Registered
FarmName: ...... .�.'�....0 ..'...!' 1..5.............................. I......................................
Owner Name: v ' S /..................................v'
..... 1. . .............
. . . . . . f.. ... . . ... . . . .
r1 Q Time: ��Printed on: 7/21/2000
0 Not Operational 0 Below Threshold
Date Last Operated or Above Threshold : .........................
County.P�eej :.............................................................
Phone No :.......................
FacilityContact: ................. Title:................................................................ Phone No:...................................................
MailingAddress: ............................................................................................................................................................................................................ ..........................
Onsite Re resentative:.WT `�`S Integrator•�` ...........................I. ............. .......... .................................
Certified Operator:
Location of Farm:
.................................................................... Operator Certification Number:..........................................
(Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 6 C4 Longitude • d 64
Design Current
S*inC:_ ratiarity Pnnnlatinn
- Wean to Feeder
Feeder to Finish
z
Farrow to Wean
Farrow to Feeder
Farrow to Finish
El Gilts
Boars
Design Current Desrgo.; Cbrrenit
Poultry CapacityCapaclity Po uladon Cattle.
-.Capedtj__ Po elation
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design -Capacity
Total SSLW
Nuenler oi.Lagoons CZ� ❑ Subsurface Drains Present ❑ I agree Area Spray Field Area
Holding Ponds/ Sottil Traps ID No Liquid Waste Management System
DischaMSe & Stream Impacts
1. Is any discharge observed from any pan of the operation?
Discharge originated at: ❑ Lagoon El Spray Field El 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?
Structure I Structure 2 Structure 3
Identifier: ................ ................I ............ Z
..................
Freeboard (inches): 2-8 2 5-
5100
❑ Spillway
Structure 4 Structure 5
❑ Yes XNo
❑ Yes �dNo
❑ Yes R NO
17(A�
❑ Yes ONo
❑ Yes J 'No
❑ Yes 'Of No
❑ Yes 4 No
Structure 6
Continued on back

Facility Number: 31 —335 Date of Inspection 3 Z D Printed on: 7/21/2000
a,
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ONO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes eNo
(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 M No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes VNo
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 ;KNo
11. Is there evidence of over application? r❑ Excessive Ponding ❑ PAN ❑ Hydraulic Oveload ❑ Yes J9 No
12. Crop type &,- Y A lkJ^�4.�( 6eQ_;0\ .6r-k I L4 f keA4 1SQ1rbe—AOft
13. Do the receiving crops differ with thole designated in the Certified Animal Waste
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?
Plan (CAWMP)? ❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 0 No
❑ Yes �ffNo
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?
yiolatigris:or• ddid nc�es •were noted• during this:visIC • Y:oir Will•reeeiye iio further
. , correspondence: abouk this visit: -.::
❑ Yes XNo
❑ Yes P No
XYes ❑ No
❑ Yes IXNo
❑ Yes rNo
❑ Yes Jallo
[:]Yes jffNo
[:]Yes 'WNo
❑ Yes XNo
omments (refer to question"#): Explain any YES answers and/or any recommendations or any other ca�nments: ry
se:dravvicigs of facility to better explain situations.' (use additioial pages__as necessary) . -•_
TreC���rr'I reGdrdl Jeri G✓� -�� .
w lieci4 e_,r or 'is e.0,i A; n) t-w.1j . 0L/e-ro, li / 4 ✓ac,,>M 51-ve/l
..
Reviewer/Inspector Name W
Reviewer/Inspector Signature: Date: Z 0 j S)W

Facility Number: 3 —3 3 Date of Inspection I s /Z 171, I Printed on: 7/21/2000
Odor Issues `�"��"
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge M/or helow ❑ 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 ;TNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 0No
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 fXNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
5/00

D�ns�on of Water Quahty r
H�vtsion of Soil and=Water Conservation t „
- ` T <t �`Other`Agency r
jM
Type of Visit KGompliance Inspection O Operation Review O Lagoon Evaluation
L A p O Follow up O Emergency Notification O Other ❑ Denied Access
Reason far Visit O
Routine Complaint — -_ __--� Printed on: 7/2112000
Date of Vkit:'LA Time: `' /: t
Facility Number 3 3
erational 0 Below Threshold
Permitted , Hzed © Condinonally Certified u Registered
Name: _.......... .r....l.. �1��'Ytr`
Date Last Operated or Above Threshold
County:...........Dylly.\ ...
�Farm ...........
OwnerName: ...................................................
........................................................................
Phone No:.......................................................................................
Facility- Contact: ....................
Title:
MailingAddress: ................................ ...-.............. .........- .....,
Onsite Representative:..............- .-..j%{
Certified Operator:....
Location of Farm:
Phone No:
Integrator:.... %f ..............
I---------------------------
Operator Certification Nom er:..........................................
wine ❑ Poultry []Cattle ❑ Horse Latitude �' �° Longitude �•°'
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
eder to Finish ❑Non -Layer El Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ID Subsurface Drains Present ❑ Lawn Area ID Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ YesNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance ratan -made`'
❑ Yes
❑ No
b. If &,clarge is'observed, did it reach Water of the State' (If yes, notify DWQ)
[] Yes
❑ No
c. II' 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
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
CNo
'�
Strtte:turc I Structure 2 Structure ? Structure 4 Structure 5
Structure 6
Idcn[ificr: ............�..�.. ....--.-; 3..f..-.................. .---------- ............. .... :..................... .......... ... ......... .................. ...... .....................................
Freeboard (inches):
�
5100
Continued
on back

Facility Number: — Date of Inspection Printed on: 7/21/2000
5. Are there any i nfmWiate threats to the integrity of any of the structures obse ed?Owlrees, severe erosion, ❑ Yes K No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closureplan? El Yes �No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ONO
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes &o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes KNo
Waste application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes &No
12. Crop type P&L-) 1 - —
13, Do the receiving crops diff with those de1signated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
.: N.-*Watiotis:or- &rJe n.... were pt. d. during this:visit.-'Y'o>ix will -receive 06 further .:.: .
correspondence: aboutithis visit : :::::- : :::
❑ Yes 'ET; —
❑ Yes `(M140
❑ Yes `�o
❑ Yes '5To
❑ Yes o
❑ Yes �No
❑ Yes
&o
Yes
❑ No
El Yes
❑ Yes
No
o
❑ Yes
4No
❑ Yes
af4o
❑ Yes
�No
❑ Yes
Ko
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 )`
Reviewer/Inspector Signature: _ — "W'
-�LLX a
Gk / G,•� r/2 12
loll Date: / f vZ U(J 5/Ot7
r

EM"n".. �
Facility Number:
—
Date of Itvcpection Printed on: 7/21/2000
Odor Issues
26. Dces the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge A�Jor below
d Yes
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
)6No
29. 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
KN0
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
ONO
31. Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
0I0
32. Do the flush tanks lack a submerged fill pipe or a peirrtanent/temporary cover?
9--yes;
❑ No
J

, .
�v
- 13 Division of Soil and' Water Conservation -'Operation-Review
Division of -Soil and Water Conservation CompHance Inspection
Division of Water Quality .Co piffi ce, Inspection
x
�13Other. Agency, Op erationi';Review
.x:.
Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection
Time of Inspection © 24 hr. (hh:mm)
0 Permitted [] Certified © Conditionally Certified 13 Registered [3 Not Operational Date Last Operated:
Farm Name: (� County:...........a........� h
...... 1�..-........................................................................... ..................--..........- .......................
Owner Name:.......-Ll..-..-.....- Phone No:.. .................. .
Facility Contact: ........ Title: ......- .......................... Phone No:...................................................
MailingAddress: ............................................................................................................................................................................... ..........................
1 W\�
Onsite Representative:.YV..1...:L+�i...�s. Integrator:......... ................
CertifiedOperator : ................................................... ............................................................. Operator Certification Number:..........................................
LocAtion,of Farm: , — I . ( r _ C\ . [.
....:.w,r ..... .....1.5 a.............:......................................................................... ......I�
Latitude �' �' Longitude • �� �t
--Swine
Design Current Design- -_Current Design Current
Capacity Population ==Poultry Capacity.. Population Cattle Capacity Population
❑ can to Feeder
eeder to Finish
rj
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Number —of Lagoons,.. -. ❑ Subsurface Drains Present ❑ Lagoon Area I0 Spray Field Area
--.-Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Dees discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? N Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes WNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes D(No
Structure ] Structure 2 Structure 3 a Structure 4 Structure 5 Structure 6
Identifier: [G//
Freeboard(inches): ............T? ............. .................... ............I..........I....... ................................... ..
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes KNo
seepage, etc.)
3/23199 Continued on back

535
Facility Number: -3— Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenarice/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
❑ Yes JKNo
91Yes ❑ No
❑ Yes j25No
❑ Yes KNo
❑ Yes 9No
❑ Yes 0 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? XYes ❑ No
15. Does the receiving crop need improvement? ❑ Yes KNo
16. Is there a lack of adequate waste application equipment? ❑ Yes W No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes allo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) XYes 0 No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes 5rNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes EfNo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes (&No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ,kNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes S9No
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 r0fNo
yiolaitgnis:oT def cieuciJ .were J . 4. duikift �bis'visit. - Yoir iv1 Lteeeiye do furthrrr ::::�
coriesp6l ide... abauk this :visit_
Comments:(refer too=question #): Explain any YES' answers and/or any recommendations or any_ot)ber comments.,
s_ - - _ _
Use drawings of facility-to=better explain situations. (use _pages as necessary)
`a ,A.-
c,G _
w1117 cam- �i �. . C c� e- its `ry a ��i � �c g e
�� Ye.bKf tl`Ues�s � �z f-ewsc-Pd� �+�..-�, (�,-T� l��r: 1n.tee�� c�-, t�►r`Q�~-t,.��i ►,Q�d
"-,-• , \ c
2w jtGt� 0-,
3123/99

r' Facility Number: { — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below [:]Yes $�No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes P No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes j 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 RNo
31, Do the animals feed storage bins fail to have appropriate cover? ❑ Yes kNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? KYes ❑ No
Additional omments;-an o_r _-Drawings:
��
`
yy ' C
3/23/99

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality '
Routine O Com laint O Follow-u 9 of D1V ins ection O Follow-up of DSNVC review O Other
Date of Inspection
Facility Number 31 3. Time of Inspection 24 hr. (hh:mm)
© Registered V1 Certified [3 Applied for Permit 13 Permitted Not O erational Date Last Operated
FarmName: .............D.±1......��.�rVM...._............................................................................. County:....Dqkr........................................ .......................
Owner Dame: A t .....bA.ihs............. Phone No: 84%.&:..Cp u...................................................
Facility Contact: .......... !l T.........) . N......... I ........... I........... Title:...
r .
Mailing Address:......L�i.........��CY1CQ��...�►.........................
Onsite Representative: .......(ts%:T......... w0A...
Certified Operator;
Location of Farm:
.........................I ..................... Phone No: r11.i� ��t. -. 5� �...............
th I ... ii.1,l...t.14S:::� ..................................... ..........................
�a
......... Integrator:.....�y. .............................................................
........ Operator Certification) Number. .........................................
1x.....15:...41n.... b�.. ..... ....LSi ..p..kt ......�.2t Fk,....s........................................................................................ +
....................................... .................. ................. ....... .............. T
Latitude �•,� ��� Longitude
General
1. Are there any buffers that need maintenancelimprovement? ❑ Yes ® No
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 gaUrnin?
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 M No
❑ Yes q No
❑ Yes No
❑ Yes F11 No
❑ Yes ® No
❑ Yes ® No
❑ Yes Q3 No
❑ Yes 09 No
Continued on back

Facility Number: -- 3
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (I.,agoons,Holdina Ponds,,Flush_Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes 155 No
❑ Yes 0 No
Structure 1 Structure ? Structure 3 Structure 4 Structure 5
Structure 6
Identifier: -.._..- `........................................ .................................................
.................. ..............L.... ......................
...................................
.Freeboard (fty :8 .k A ................. ................................... .................................... .....................................
...... I.............................
10.
Is seepage observed from any of the structures"
❑ Yes
Q9 No
11.
Is erosion, or any other- threats to the integrity of any of the structures observed'?
❑ Yes
® No
12.
Do any of the structures need maintenance/improvement?
Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate: minimum or maximum liquid level markers?
❑ Yes
® No
Waste .application
14.
is there physical evidence of over application?
❑ Yes
[A No
(if in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ......41^mV a ............... ihowr� ..g. �i�.................Car..r<.........-..1J ".......... .�t..F1�x,.
"
16,
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW,MP)?
❑ Yes
No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
j} No
18.
Does the receiving crop need improvement?
Yes
No
19.
Is there a lack of available waste application equipment?
❑ Yes
No
20,
Does facility require a follow-up visit by same agency?
❑ Yes
$ No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ® No
22. Does record keeping need improvement? Yes ❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes $NNo
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes No
25. Were any additional problems noted which cause noncompliance of the Permit'? ❑ Yes No
0 No violations or deficiencies were rioted during this. visit..Yo'u will receive no further
correspondence ii4oitt this:visit
_Comtnents.(refer to question #}: Explain any YES answers and/or any recommendations or any oilier comments
Use drawings of facility to better explain'situations. (use additional pages as necessarv):
`
IL• 1<rss.pe• Grtay or- lrvLr j Ite WA p� 1aIoan �L ��pllof! be OL-1� rtsecj [
�
We +tt�tdtd, 1rnl,Cf_j�rt ;r lr��act� �k-z Sl�wts�t) �cr1• eS=Sint a I oo,.
lS. t'aa�f�l I t,d�vLs��v_►1r�J L� � t .30JJ s of
'T Sd��Ls
7-2-�.{ � 4t s Fran.-&,k-At, ?6-x s�+ OIbt 1A S�rj fr ar�d -S.i}
te. CO& t of 6%,V t1 £ram e� rikh%',
7/25197
Reviewer/Inspector Name W,
Reviewer/Inspector Signature: Date:/9

z
❑ DS WC Animal Feedlot Operation Review
"i.
®DWQ Animal Feedlot Operation Site Inspection4
m
10 Routine 0 Complaint 0 Follow -tip of D"' I ins ection 0 Folloiv-uE of DSIVC review 0 Other
Date of Inspection $�
Facility Number 3 a Time of Inspection j3_ 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: [] Registered ❑ Applied for Permit (.ex:1.25 for 1 hr 15 m1n)) Spent on Review
® Certified [,� Permitted or Inspection (includes travel and processing)
0 Not Operational I Date Last Operated: .................................................................................................................................
Farm Name County: O...................................... .....
fYR....................................... ..
Owner Name � 9 � .... Phone No:
Facility Contact: .... J .L lttrA'1�........... Qlllt�'S..................1. Title:...........if.ln.2�e1�................................. Phone No:..
p
i\latlinv Address:.Capmk............. ..,........................................................ .....��+.](1 ..i ��..1.... L..................................... ...Z .....
Onsite Representative: ...... {l!%.- .... au.`r.S........................................................... _..... Integrator:........ �........................... ............... I .......
......
Certified Operator :................. .. Operator Certification Number ......... �.. ..........
Location of Farm:
.TF.U.... U-M-D ... .......... A+........ tftoOU�l ......TvYr.....{.t. ..Qr..............SR...d
..... ...... ......LYE .... �....�...
.`.S irs...A.Wrtin....lr .....o4o....SR..I....1,....Ft x.-n...... �.... a: ..rn�.(�5....,an..... 1f..�it� ...Cr.. ..,.............I...........I............... .
Latitude C�0 9 .4 Longitude • 4 ��.4
Type of Operation Design ,.'_:,Current` .j Design' ' "Current Design Current
Swine Capacity; Population - - -Poultry Cxpaetty ;Population Cattle Capacity Populateon -
❑ Wean to Feeder ❑Layer JE1Dairy
Feeder to Finish ❑ Non Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ` ' Total Design Capacity
❑ Farrow to Finish
Total SSL W
❑ Other
Number of Lagoons / Holding Ponds r�-Z ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray field Area
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
M 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
No
c. If discharge is observed, what is the estimated flow in eal/rnin?tj
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
El Yes
No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
K:No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
Wo
maintenance/improvement?
4/30/97
Continued on back

Facility Number:
3 —
.335,
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? El Yes No
1
7. Did the facility fail to have a certified operator in responsible charge? ❑Yes No
I' 8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ® No
Structures (Lagoons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes $3 No
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
..... ...........
10. Is seepage observed from any of the structures? ❑ Yes [%`No
11. Is erosion, or any other threats to the integrity of any of the structures observed? M Yes ❑ No
12. Do any of the structures need maintenance/improvement? Yes ❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes ® No
NVaste Annlication
14. Is there physical evidence of over application? ❑ Yes M No
(If in excess of f
WM-P,, orunoff r runoentering waters of the State, notify DWQ)
15. Crop type .............VAU5 d...}? t"try/dA............................................. .`.'!!..�.....3.11'.e1 ........................................................................... .......................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? [IYes CRNo
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 fait 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?
11112— 6+4P5:or., a)rtar% 0-- i rtr%w wall a noon if I
3o,,f_ axtA s sko,4j be, rese.JeJ. kft6�
1?roded c mp 6ck �;ILt� G � szsce+deri. tvw' ..r W&U
M pe-G Y-A C rcl� S iul� me -to" raved
2-4-- V36.w so;i 4.0J way cjAalys(s 5601J.10e-
Reviewer/Inspector Name
S
skovlj be. �;kW
13 oppc, # 1 s 1, UO
of born 4 tnoor►S
❑ Yes
[$1 No
4 Yes
❑ No
❑ Yes
® No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
No
❑ Yes
No
RrYes
❑ No
ty other counts.
f
..� s.. . �.... �..
w 14, C'I'Ll a.. � rcw". A
br- eX4,4d ,id 4tt
,. ovlj W_ Owed,
Reviewer/laspector Signature:
Date:
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit' 4/30/97

Site Requires Immediate Attention:
Facility No. - 3 3S
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: °1 , 1995
Time: (v 3 S�
Faun Name/Owner: 1J � (�
Mailing Address: 2 f I
Integrator. Mk Phone: 2r -7 d !1
On Site Representative: gle Yne✓eA �� ! _� i Phone: �J
Physical Address/Location: _ eeir is- l,G,0ZP ,g-t :d K__ ; Pc-17 ^- .tic' f.e i.Ss/
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 1� _ O2i ' S 1 Longitude: ��° _� ' - Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm ��event J�
(approximately 1 Foot + 7 inches) gor No Actual Freeboard: ,Ft. 7 inches N&v
Was any seepage observed from the lagoon(s)? Yes 060 Was any erosion observed? Yes or No
Is adequate land available for spray? e or No Is the cover crop adequate? &Z�or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No'
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map -Blue Line? Yes or No
Is animal waste discharged into waters of the state -by man-made ditch, flushing system, or other
similar man-made devices? Yes ora If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with. cover crop)? Yes o<
Additional Comments: ,.,,u 2rfv
n ou,- C
A. -
Inspector Name
IM AA
W V -
Si lure
cc: Facility Assessment Unit
Use Attachments if Needed.

J U.1 LU ':J�, 1 : U8
Site Requires mediate Att6ntion
/
Facility h}'umber: �CM•
SITE VISI IATION RECORD
DATE: - 0 , 1995. T
Owner: .5 Farm Name:
County.
.5
Agent Visiting Site: R'G Phone. -'2 9d, - ac
Operator. ,. _ __.....— - Phone:
On Site Representative: Phone:
Physical Addre$$- I 11 o r trc l; � �s � ? J'T 9 /
Mailing Address:
Type of Operation: Swine Poultry Cattle
Design Capacity: .3 67-. Number of Animals on Site: 7.
Latitude: _ 4 LongiCude: a "
Type of inspection: Ground Aerial
Circle Yes or No
. Does the Animal Waste Lagoon have sufficient freeboard of Foot + 25 year 24 hour storm event
(approximamiy 1 Foot+ 7 inch Yes{ No Acw' 31 Freeboard; Feet Inches
For facilities with more than one lagoon, please address the other Ia.-oons' freeboard under the
comments section.
VWas any seepage observed from the lagoon(s)7 Yes or No Was there erosion of the dam?: Yes or No
Is adequate land available fvr land application? Yes or No is she cover crop adequate? Yes or No
Additional Comments: