310400_INSPECTIONS_20171231

NORTH CAROLINA .�.J
Department of Environmental Qual

I1
(Type of Visit: QCom iance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Arrival Time: r A _� Departure Time: County: Region:
Owner Email:
rf
Phone: J
^ / Title: Phone:
fit,
Onsite Representative: '` r C" F f I ��� r Integrator:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Certification Number: 1 J g Z 6 s3
Certification Number:
Longitude:
Design
Swine Capacity
Wean to Finish
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
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Dr. P,ou1_ ,
Design
Ca aci
Current
$o ,
Dry Cow
Non -Dairy
I I I Beef Stocker
Farrow to Finish
ILayers
Gilts
Non -La ers
I
jBeef Feeder
Boars
Pullets
I
jBeef Brood Cow
Other
Other
Turkeys
Turkey Poutts
Other
Discharges and Stream Impacts
1. is any.discharge observed from any part of the operation? ❑ Yes L.d Ko [DNA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify 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
❑ ❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
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
2/4/2015 Continued

Facili Number: 73 f - jDate of Inspection: 14
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
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes o ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
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
9410,❑ 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
0 No ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
EfNo ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
NA
E�NoO.
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[�❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Required Records & Documents Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
10 ❑ 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
NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers ❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
J 000 0 NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
0-5o ❑ NA
❑ NE
Page 2 of 3
21412015 Continued

Facility Number: +r f Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes VNo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check El 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 VfNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No FrNA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes O 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 ]jNNo ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
3 L Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes Z"No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes FNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ NA ❑ NE
Comments (refer to"question#): Explain any YES answers and/or any additional recommendations or'any otheicomments
Use•drawings of facifity to, better�explain.situations .(use.additional pages as necessary).
S9 -� eGr r �. f Lu't- �w.a� lc
0 73�
Reviewer/Inspector Name: pOV � 1 Up.,4 Phone: � �� _
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412015

€ a, --Mivision of -Water Quality w �
Factli#yNutnber:e J DDtvision of Soil'a nttWaterConservatton 4
�.
:, .. 0 Other..AgencY
Type of Visit compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Arrival Time: ild _2E21 Departure Time: County:
d/ Owner Email:
Facility Contact: Title:
Onsite Representative:_ �+
Certified Operator: CJ
Back-up Operator:
Location of Farm:
Phone:
Phone No:
Integrator: 6
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0 = S Longitude: [= 0
Region:
M Design Current- Design Current _ Design Current; -
Sw�nep Capacity; Population Wet Poultry Capacity .Papulahon_tsCattleCa cityPoperlahon:
❑ Wean to Finish ❑ La er L ❑ Dairy Cow
❑ Wean to Feeder
-Layer er
❑Dai Calf
❑ Feeder to Finish
.r
` ❑Dai Heifer
w ❑Farrow to Wean
Dry Poultry
„k ❑ Dry Cow
❑ Farrow to Feeder
y ElNon-Dai
�; ❑ Farrow to Finish
❑ Layers
El Beef Stocker
❑ Gilts
`<' ❑ Non -La ers
• El Beef Feeder
u ❑ Boars
• El Pullets
' ❑ Beef Brood Co
❑ Turkeys
u Other'
❑ Turkey Poults
❑Other
❑ Other��
Number�of 5ti�u,�ctures..
T
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Page 1 of 3 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 [�io ❑ NA ❑ NE
a. If ves, is waste level into the structural freeboard? ❑Yes VNo ❑ NA ❑ NE
Structure I Stntcture 2 Structure 3 Structure 4 Structure ? Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
4
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes JZ 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 VNo ❑ 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 2fNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 9(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 9N0 ❑ NA ❑ NE
maintenance or improvement?
Waste application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E?No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes E�No ElNA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ElFrozen Ground ❑ Heavy Metals (Cu, Zn, etc.) rr
[:]PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to lncorpomte Manure/Sludge into Bare Soil
[:]Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�?No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
17No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,
❑ Yes
[;rNo
❑ NA
❑ NE
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
VNo
❑ NA
❑ NE
IComments (refer to question#): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
a r r G Tiv d r� ✓`5 %5� J t? J C/I r
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date: x ffpZ
12128104Z Aondnued

/l
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes &No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [XNo ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
UNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
E
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
2fNo
❑ 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
WNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
Yf No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
VrNo
❑ 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?
00
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
VN o
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
7J 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
ONo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
��No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3
12128104

evision of Water Quality
Fa-.Nurnbeir 3� �tJ 0 Drvtsion of soil and Water,Conservation .� .
wa+-
.
Type of Visit compliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit Routine O Complaint O Foliow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: i Arrival Time: if d Departure Time: County: Region: 6-11
Farm Name:/ Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: Integrator: %�'/ff__
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
n°
Latitude:
Back-up Certification Number:
Longitude:
0 = [ = it
Design . Current
Design Current Des gnCurrent
�..Swtne �, �Capacaty 'Population
�; Wet,Pou! ry
m
-'Ca ac"ity, Po ulahon�- Caitie x � Capac ty opulation '
P P
❑ Wean to Finish
❑ Layer
El Dairy Cow11
-
ElWean to Feeder
J❑ Non -La er
ti ❑Dai Calf
❑ Feeder to Finish
° ❑Dai Heifer
Farrow to Wean
*� m �;"
Dry Poultry w
❑ D Cow
"
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
� ❑ La ers
�❑ Beef Stocker
El Gilts
❑Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl
-
"Other,
❑ Turkeys
❑ Turkey Poultsp
.�.n
❑ Other
tw ❑ Other
Numberx°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 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No El NA El NE
El Yes XNo ❑ NA ❑ NE
❑ Yes XNo ❑ 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
P�No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
VNo ❑ NA ❑ NE
Struc ure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[ No ❑ NA El NE
(ie/ large trees, severe erosion, seepage, etc.)
✓
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
PrNo ❑ 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
E& ❑ 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
VNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
ZNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E5 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
VNo ❑ NA ❑ NE
0 No ❑ NA ❑ NE
No ❑ NA ❑ NE
oNo ❑ NA ❑ NE
Comments (refer'to question #),: -Explain any YES answerseand/or any:reconiin6ndations or any other comments
.Use: drawings of facility -to better explain situations. (use. additional pages as necessary}
rc o /aa �aAL
Reviewer/Inspector Name w`` Phone:
Reviewer/inspector Signature: / Date:
Page 2 of 3
Continued

Facility Number: �� — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes x1c) ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VO ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
ZNo
❑ 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
El NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
X'No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�(No_
❑ NA
❑ NE
25,
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�No
El NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
XNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
VN o
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
9(No ❑ NA ❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ZNo ❑ 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
ko ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
3I.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
VNo ❑ 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
ZNo ❑ NA ❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No ❑ NA ❑ NE
Additional Comments-and/orDrawmgs:-
Page 3 of 3 12128104

Division of Water Quality
L
acility Number / 0 Division of Soil and Water Conservation
O Other Agency
Type of Visit �
Reason for Visit
Date of Visit:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
iance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Time: parture Time: I� County:
Title:
Owner Email:
Phone:
Phone No:
Integrator: 1241
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
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
Latitude: a e = 0 Longitude: 0 o 0,=«
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
_ ❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Cattle
Design Current
Capacity Population_
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Nan-Dai
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Cowl
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?
El Yes [I No El NA El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection94��7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes No
El NA
El NE
a. If yes, is waste level into the structural freeboard?
❑ Yes No
❑ NA
[I NE
Structure I Structure 2 Structure 3 Structure 4
Structure
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 57
5. Are there any immediate threats to the integrity of any of the structures observed?
`No
❑ Yes ���No
❑ NA
El NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
❑ 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 th at, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �No El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes of l iVo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes- ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
.0 N* o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
3N(o
El NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
��o
ElNA
ElNE
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
io
❑ NA
❑ NE
Reviewer/Inspector Name / Phone: r
Reviewer/Inspector Signature: _ Date:
Page 2 of 3 l

Fgcility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes VNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ElNA ElNE
the appropirate box. ❑ WUp ElChecklists ❑ Design [IMaps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
[I NA
[I NE
El Waste Application ❑ Weekly Freeboard ❑ Waste Analysis El Soil Analysis El Waste Transfers Annual
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Ye 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 o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes o
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes o
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
El Yes FNo
[I NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32,
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
[I Yes No
❑ NA
❑ NE
Page 3 of 3 12128104

F
AIK
_ -vision of Water Quality
Facility Number O Division of Soil and Water Conservation
- O Other Agency
Type of VisitCoommpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Z Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 7 Arrival Time: eparture Time: County: Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: Integrator: �_
Certified Operator: Operator Certification Number:
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
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: ❑ o = 4 = 4f Longitude: = o = 6 = «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity. Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy 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?
B
❑ Yes ONo ❑ NA ❑ NE
❑Yes
El No
El NA
El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
2fNo
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
12128104 Continued

Facility Number: — ,Q Date of Inspection Ili/ 6
J �
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes 2fNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes 04o
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 9 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 1,YNo
❑ 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 El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes /❑-No ❑ NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) //
9. Does any part of the waste management system other than the waste structures require ❑ Yes [�No ❑ NA El NE
maintenance or improvement? /
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 5,No ElNA ElNE
maintenance/improvement? /
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑,No El NA El NE
El Excessive Ponding El Hydraulic Overload El Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) /
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
PfNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
❑'No
❑ NA
El NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
1/ .No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
El NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
El Yes
,�,/No
No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
c=ur+ d- a rC"
Reviewer/Inspector Na**' Phone: — 417 �
Reviewer/Inspectoeignature� _ Date-.-,. w34 D
.r i7 %28104 Continued

FAcility Number: 3/ 0 Date of Inspection
Required Records_& Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ONo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes []'*No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps [3 Other
21, Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
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 pen -nit 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?
Comments and/or Drawings:
❑ Yes
ONo
❑ NA
❑ NE
❑ Yes
[;YNo
❑ NA
❑ NE
❑ Yes
o
[I NA
[3 NE
El Yes
rNo
❑ NA
❑ NE
❑ Yes
ZNo
❑ NA
❑ NE
❑ Yes
[�No
❑ NA
❑ NE
❑ Yes GrNo ❑ NA ❑ NE
❑ Yes ['No ❑ NA ❑ NE
❑ Yes
[;kNo
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE
❑ Yes
[. No
❑ NA
❑ NE
Page 3 of 3 12128104

I/
Type of Visit {2'Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit XrRoutine O Complaint O Follow up O Re€erral O Emergency 0 Other ❑ Denied Access
Date of Visit: Q Arrival Time: ' Departure Time: County: L/Z Region:
Farm Name: _faro Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: 6—La� �a1�
v
Certified Operator:
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
Boars
Other
❑ Other
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0 = ' = Longitude: = ° = 1 "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
�. ❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
[EllTurke Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Dumber of Structures: E
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
[:]No
❑ NA
❑ NE
❑Yes
El No
❑NA
❑NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Facility Number: 3 — Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
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
(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 ❑ 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 Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) �r s%
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination
, ❑ Yes
❑ No
❑ NA
❑ NE
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
t?omments (refer to question #) Expla�'a9
YESanswers arid/or any recommendations or any other comments.
Use drawings of facilitytob r eap! situat,anc(usead"ditional pages as necessary}:
cG��/ f
a�f "ewl aL aea "-- y
z�.. lG-7 C T
ReviewerAnspector Name ✓ , Phone:
Reviewer/inspector Signature: Date: 4(�
12128104 Continued

Facility Number: ' — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
❑ NE
General Permit? (iel 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
Acldiponal Comments:+'and/or Drawings _ _. .`_: :=ram z3�k ;.
12128104

Division of Water Quality
IFacity Number 3 / �Q� Q Division of SC oil and Water onservation
0 Other Agency
Type of Visit ()-£empliance Inspection O'Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit fC)-Rbutine 0 complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Time: Departure Time: County:
;�o Owner Email:
Facility Contact: Title:
Onsite Representative: lililll/"i^.
Certified Operator:
Back-up Operator:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o ❑ I ❑ « Longitude: ❑ o = 6 ❑ If
Design
Current
Design
Current
Current
Swine
Capacity
Population
Wet Poult y Capra ty
Population
Ca ie: ; .. "Gaaci
Population
D.
❑ Wean to Finish
iry Cow
❑ Wean to Feeder
iry Calf
❑ Feeder to Finish
airy Heifej
Farrow to Wean
9 000
d
©� Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
on -Layers'
❑ Beef Feeder
❑ Boars
❑ Pullets
❑Beef Brood Co
❑ Turkeys
Uther
❑ Turkey Pouits
❑ Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
r
Z No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
,B N
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
ETNo
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: — 00 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
;dNo ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
V1No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
[]Yes
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
/UNo
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
❑*o ❑ NA ❑ NE
through a waste management or closure plan?
/
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
2No El NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
El Yes
�No El NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[�No El NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�XNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
P!(No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ 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,ONo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes /ZNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[] Yes <,o El NA El NE
17. Does the facility lack adequate acreage for land application? ❑ Yes LdNo NA ❑ NE
18. is there a lack of properly operating waste application equipment? ElYes [ - LJ NA ❑ NE
_
Reviewer/Inspector Name l , Phone:
Reviewer/Inspector Signature: OF Date: 4`-
121281af Condnaed

Facility Number: 31 — {/Q' Date of inspection z
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 2rNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes P-ITo ❑ NA ❑ NE
the appropirate box. ❑ WDP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
L2"Ro
❑ NA
❑ N£
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
O-NO
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
L�'IQo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
PNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
E No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA_-t 13
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
_[2No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
;:�No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
�;Ko
31.
Did the facility fail to notify the regional office of emergency situations as required by
El Yes
�,�
{TNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewerhnspector fail to discuss review/inspection with an on -site representative?
El Yes
,—,�
-t om}�o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No ❑ NA
❑ NE
Additional Comments and/or Drawings:
/ i XIIIIZ-
.12128104

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint Q Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Tune:
0 Not Operational Q Below Threshold
[Permitted Certified E] Conditionally Certified © Registered Date Last Operated or Above Threshold: ....._.. _ ......
/Farm N e:....._....
............................... .............. -................. .................... ......... ........... ... County :....... ... j02Wj��............
Owner Name: _...�..- ... _....................
Mailing Address:
Phone No:
Facility Contact; ................................. ........ Title: ... ............ --............................... .......... Phone No:
Onsite Representative: 2. "�?— ._ .- - . _... - - ._......-. Integrator:........................................................................._...........
Certified Operator:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse
r Deign -Curre
7wlfle f�unamfv epnnniuf
- •— .- .-.. _ Operator Certification Number:.. ......................................
Latitude • 4 44 Longitude 0 6 «
El Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Design Current' Design Currrent
GPoultry ci i Po eilat<onr Cattle Ca aci Po elation,
❑ Layer "', ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
J.
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes eNZo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ N
2. Is there evidence of past discharge from any part of the operation? ❑ Yes LJ'.o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes �rNco
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes o
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier: _.....`.......... ............ ..... .._._._.
Freeboard (inches):
12112103 Continued

Facility Number: — Date of Inspection f
V
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 maintenancerimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste A lication
10. Are there any buffers that need maintenance/improvement?
11. is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Gam/ SQY 1366 J IV�TLL E
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑Yes 7No
❑ Yes
❑ Yes NO
❑ Yes
❑ Yes No
❑ Yes 01C.
❑ Yes No
❑ Yes
Ef&
❑ Yes
❑ Yes
❑ Yes
Too
❑ Yes
❑ Yes
No
/Xo
❑ Yes
❑ Yes
N[ N
'
ElYes
❑ Yes
VN
apger Co
{grsex,
eao�s m
EMx:p, laainrn�
_'
arty,o) asro: r
zuya
sttio a]fn_e.
cyom-ymam,aFinal^
on_1.;.:.a
_45or
;Uag- erse
s_ emdmraenwtin.s�off facr'h�ntyet#t)er sa.�,b;teon_s�{uswe._ ad,s nmeceenssdZaFyirepot.e.�-s:ma
,, , .o,l�df��Ce.yor
tom_
.,.;,N...rv_.,�
�
An,■ / VV COO 5_ YeVlc- C rVC>-,
Reviewer/inspector Name WA: t­1:
� �. :� � _ �f
Reviewer/Inspector Signature: Date: f'i 2ay
12/12103 1 V Continued

Facility Number: Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes i70<
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes E - 1,41:1
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ZN
28. Does facility require a follow-up visit by same agency? Yes N
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ElYes o
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
l2/l2103

(Type of Visit OCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for VisitdRoutine O Complaint O Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number 31 cf p bate of Visit: Time: 9 S
O Not Operational Q Below Threshold
0 Permitted © Certified © Conditionally Certified © Registered
FarmName: ......°i''�.... .........................................................
Owner Name: rOW ,-.l G a'd ----------
Mailing Address: .... ........................................ ....
Date Last Operated or Above Threshold: . .. .. ...... ..
County: _ v
PhoneNo, _._._---------------------------------- -
Facility Contact: ...........................................................Title: .............................. Phone No:
Onsite Representative: �� °'1�G] e_-_-_-_-_-_-_-------_-_--- Integrator: _-_ -` t s 0-_ G"t w0*1' —,A
Certified Operator:
Location of Farm:
Operator Certification Number:
R(SwIne ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 Longitude • C�` �µ
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
ZapO
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons [] Subsurface Drains Present ❑Lagoon Area I[] Spray Field Area
Holding Ponds'/ Solid Traps i No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑Yes 0'�Io
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ffNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ONo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......... /._____________
Freeboard (inches): 3

U'NUNUI
Fa<ilityrlumber:/
Date of Inspection Z it O L
aunruzueu
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?
❑ Yes ONO
❑ Yes allo
❑ Yes J:fNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes P, No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ONo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes 'ONO
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN j2r}Iydraulic Overload Yes ❑ No
12. Crop type n 5
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? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes 2"No
16. Is there a lack of adequate waste application equipment? [:]Yes E3No
Required Records & Documents
17. Fail to have Certificate of Coverage &, General Permit or other Permit readily available? ❑ Yes O'No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes �No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ,[No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ff No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ,0 No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes .0 No
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 J(]-Ho
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments` of t q sash n #) EI'latn an 4YES-,a sswers'and/o any ecotnmen tions.or:"an yother�comments. .�� `
- ?:
.
Useidrawmgs of facility to better°explain s�tuat�ons (use additional pa es°as necessary`). - ,
- []FieldCopy Final Notes Ra.
�1. i'�1l s !c� �►�� �� are less -��t4� q� � cre and ; � ap f��r�r �L,� f
''
�tn��o 1v;4 -,ou.i �1 d,-aU j:G oie, lee14; -1; riced
-fv �e 1,7AVG-�17e5� rUl1S eVIiry�-ted�¢`rSCOY1
TG d� C ✓"m i �� 74' -� �d 7 S4v Lt �O� 6C 1 i �''t'T`7C�d Ir?r ! 7 -f It e ! 6 Q
1�Vc✓ G lr 4G C, j ' C rdG',-�p� /2GOrGt!-1 C� f8 Lwe lr
r
�
Reviewer/Ins P ector Name�ut'ii�
dux �L �w r
Reviewer/Inspector Signature: Date: 2
r

Facility Number: Date of Inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atfor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ,®'No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ONO
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 xj 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 -2'flo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes E-No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional Comments and/or Drawings:
t r = -
A 1, je,44G �! e q C4-�J C�1 e-i e- f M i rta ; a'� �S-ho t11 d be a e n e a > ire FaC 1 i y.
J
5/00

Type of Visit -OCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit i( Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date or Visit: Time: �
Q Not Operational Q Below Threshold
Z Permitted © Certified [3 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
Farm Name: ,7a/',V1 ..4f ZG County: y ..2�. �P1.:>............... ................. .......................
Owner Name: sY",Owr' s 0 C �i✓O 1 � ` Phone No
I...I-....I........................ .... ............................... _. _.... _....... _...................
Facility Contact:
Title:
,,,.. Phone No:
Mauling Address: ........... ....... ...................... r_
OnsiteRepresentative:..... �.'�_�.n....WeS4On................................................. Integrator:_grc€../Y►'jr 'or CA", ir. ............._....
Certified Operator:
Location of Farm:
Operator Certification Number:
XSwine ❑ Poultry ❑ Cattle ❑ Horse Latitude • �• �64 Longitude • ° &
Design 'Current Design Current Design Current
'Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
Farrow to Wean 2OOD
❑ Farrow to Feeder : ❑ Other
El Farrow to Finish Total Design Capacity
❑ Gilts
[I Boars Total SSLW.
5 Number of Lagoons ❑Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
Holdrng=Ponds--/ Sohd Traps In No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at. ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If dischargc 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?
❑ Yes ;9 No
❑ Yes gNo
❑ Yes 0 No
h!q
❑ Yes P4 No
❑ Yes $4 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes PLNo .
01/01/01 Continued

Facility Number: -71 — y-QQ Date of Inspection t $ Q
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes IdNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .............. �................... ...................
Freeboard(inches): .......... _..........................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6" Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes ,� No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? [:]Yes J9 No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes JWNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes )A No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes J4 No
11" Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes KNo
12. Crop type C a { H , w 11 G t Sovl i^, j trct i ^
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ;KNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes g No
b) Does the facility need a wettable acre determination? ❑ Yes jj4 No
c) This facility is pended for a wettable acre determination? ❑ Yes 6No
I5.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
17.
Are rock outcrops present?
❑ Yes
ng No
18.
Is there a water supply well within 250 feet of the sprayfield boundary? ❑ Unknown
Yes
❑ No
99 On -site A Off -site
Required
Records & Documents
19.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
24 No
20.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
14 No
21.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
ONo
22.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
19 No
23.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N No
24.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
g] No
25.
Did Reviewerlinspector fail to discuss review/inspection with on -site representative?
❑ Yes
J9 No
26.
Does facility require a follow-up visit by same agency?
❑ Yes
O No
27"
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
X No
Odor Issues
28.
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?
29.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
No
01/01/0I
Continued

Facility. Number: 31 0 Date of Inspection 4 �
36. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. 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.)
33. Do the animals feed storage bins fail to have appropriate cover?
Printed on: 1 /4/2001
❑ Yes IgNo
❑ Yes N No
❑ Yes J9 No
❑ Yes A No
34. Do the flush tanks lack a submerged fill pipe or a permanenthemporary cover? ❑ Yes )9 No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
Ol/0l/01

Facility Number S —LftJ6 Lagoon Number ......... Lagoon Identifier
0 Active O Inactive Latitude 35 � �$ Longitude �$ R0
By GPS or Map? GPS ❑ MaP:1 GPS file number: 3 j 00
35. Surface Area (acres):
36. Embankment Height (feet):
37. Distance to Stream:
38. Water supply well within 250 ft of the lagoon?
❑ On -site ❑ Off -site
39. Distance to WS or HOW (miles):
40. Overtopping from Outside Waters?
41. Constructed before 1993 NRCS Standards?
42. No verification of adherence to 1993 or subsequent
NRCS Standards?
43. Was groundwater encountered during construction?
44. Depth to Groundwater:
45. Spillway?
Tnad uc 4C
46. Marker?
47. Immediate threat to the integrity of the structure?
48. Freeboard & Storm Storage Requirement (inches):
"� Are rock ovt+c,rofs- P-resent--} ?
'less than 300 tt Q 300 ft - 1440 ft Q greater than 1000 ft
O Yes 0 No
0<5 05-10 310>10
O Yes JgNo O Unknown
O Yes X No O Unknown
O Yes 0 No O Unknown
O Yes O No. J9 Unknown
NF Unknown
O Yes % No
5 Yes J6 Now �p { O Yes 19 No
2 0 .g
No!

Facility Number -1 --- LfOo Lagoon Number ._ 1...... Lagoon Identifier ........ ............ ....
__. � . _._._..._._..... �..
19 Active O Inactive Latitude 35 E� aLongitude ?g pU0
By GPS or Map? GPS ❑ Map GPS file number: 3 i 00
35. Surface Area (acres):
36. Embankment Height (feet):
37. Distance to Stream:
38. Water supply well within 250 ft of the lagoon?
❑ On -site ❑ Off -site
39. Distance to WS or HQW (miles):
40. Overtopping from Outside Waters?
41. Constructed before 1993 NRCS Standards?
42. No verification of adherence to 1993 or subsequent
NRCS Standards?
43. Was groundwater encountered daring construction?
44. Depth to Groundwater:
45. Spillway?
=.A7."deqvq4C
46. Adeqttst& Marker`?
47. Immediate threat to the integrity of the structure?
48. Freeboard & Storm Storage Requirement (inches):
49. Are rock o vt}C fofS Fr,esen4 7
- 2-
)fftess than 300 ft Q 300 ft - 1000 ft O greaser than 1000 ft
0 Yes ONo
0<5 05-10 )1§>10
O Yes 9 No O Unknown
O Yes X No O Unknown
O Yes 0 No O Unknown
O Yes 0 No J9 Unknown
f$f Unknown
O Yes U No
s Yes A 5 Now �o r
O Yes 35 No
20,L1
Not

Facility Number 31 -- 673 Lagoon Number _ _..... Lagoon Identifier - .............. _ ___... _....... _..... _............
Active 0 Inactive Latitude Longitude Mg Fol-7-1 3 3
By GPS or Map? KGPS ❑ Map GPS file number: 2 a (pi$
35. Surface Area (acres):
36. Embankment Height (feet):
37. Distance to Stream:
38. Water supply well within 250 ft of the lagoon?
❑ On -site ❑ Off -site
39. Distance to WS or HQW (miles):
40. Overtopping from Outside Waters?
41. Constructed before 1993 NRCS Standards?
42. No verification of adherence to 1993 or subsequent
NRCS Standards?
4.oB
jK less than 300 ft O 300 ft - 1000 ft O greater than 1000 ft
O Yes 9No
0<5 '05-10 3Q>10
O Yes fi6 No O Unknown
O Yes O No O Unknown
O Yes O No O Unknown
43. Was groundwater encountered during construction? O Yes 0 No X Unknown
44. Depth to Groundwater: 36 Unknown
45. Spillway? O Yes 39 No
1�tde r,�4-fie
46. �e Marker? 'Yes 0 No . '. Sr"t
47. Immediate threat to the integrity of the structure? 0 Yes )? No
48. Freeboard & Storm Storage Requirement (inches): Z p ,L4 '
qq. Are rock o&,4r_r,,fs Not

Type of Visit O Compliance Inspection) Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 31 400
Date Of Visit 5-1U-20llil Printed on: 5/16/2000
r Not Operational O Below Threshold
Permitted M Certified 13 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: .............
FarmName: IFaxm.#20 ........................................................................................................ . County: D.uplin. ............................................... WiRQ.........
OwnerName .................................................... .................... Phone No: 9.10.-796.18.QQ..........................................................
Facility Contact:
Title:.......
... Phone No:
MailingAddress: P.B.Q1.48.7............................................................................................. Wars.m.-N.0 .......................................................... 18398 .............
Onsite Representative:........................................................................................................... Integrator: Itrot.'.Ql.Cal�vluna,.Ir�G..................................
Certified Operator: Da.Yid...................................... Tctt'......................
Location of Farm:
Operator Certification Number:.18795.............................
............................................................................. ......................................................................................................................................................................................
io tlt_ai aisoa,..Qn.Weai.�isd. .....................
............................................................................................................................................................................................................................................................... .
® Swine El Poultry El Cattle ❑ Horse Latitude 35 " 05 43 u Longitude ---I• 08 16 u
❑ Wean to Feeder
❑ Feeder to Finish
® Farrow to Wean
2000
1975
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes 19 No
Discharge originated at: ❑ Lagoon ❑ Spray Field El Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes N No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes Z No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes N 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 N No
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes X No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...................................
Freeboard('inches): ...............29.................................................................................................
.......................... .................................... ....................................

Taciilty Number: 31-400 Date of Inspection Printed on: 5/16/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes N No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan'? ❑ Yes N 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 N No
S. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes N No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes N No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes 0 No
11. Is there evidence of over application? ❑ Excessive Ponding N PAN N Yes ❑ No
12. Crop type Soybeans, Wheat
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes N No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes N No
b) Does the facility need a wettable acre determination? ❑ Yes N No
c) This facility is pended for a wettable acre determination? ❑ Yes N No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ W JP, 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?
f 'No'vi�olaii&fis' air".&frciericies-vvere:rioled:du' ing ttiis'visrt:: �''ou w' 91:receivje no fiirtti& : -
r�irrPrrinpi�Priri* ahin�it'kliis•vieiiF•_' • . . . . . . . . . . . . . . . . . . . .
........... ... ..... ... .... ..
I 1 & 19 - Fields 4 2 & 3 have hydrolic and PAN over loading due to hurricane Floyd. Will refer to DWQ to justify.
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
N Yes ❑ No
❑ Yes N No
❑ Yes N No
❑ Yes N No
[J Yes N No
❑ Yes N No
❑ Yes N No
L
r
Reviewer/Inspector Name SohnttAbg -

1 'Facility Number: 31-400 Date of Inspection 5-10-2000 Printed on: 5/16/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes N No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? O Yes N No
29. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes N 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 N 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 N No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes N No
32. Do the flush tanks lack a submerged fill pipe or a pennanendtemporary cover? ❑ Yes N No

0—
0 Division of Water Quality
Q Division of Soil and Water Conservation
0 Other Agency
Type of Visit QLCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 8 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number b th
Date of Visit: 8 23 O[1 Tiptoe: 30 Printed on: 7/21/2000
3 1
Q Not Operational Q Below Threshold
Permitted 0 Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name �4 Z D County:..U..rl'.`1.........................................................
......................r^........................................... ...... .............
Owner Name: / dt J ✓1 �� b y C-
�.5...�...... .......... t..f......'!............................................... Phone No:.................
FacilitvContact: ..............................................................................Title:....................... .............. Phone No:...................................................
MailingAddress: ......................................................1..........................._.._.............................................................................................................._...... ..........................
'Onsite Representative: .d.Q;... 4..W.4......14.4.V.;.!1... keS�e...................... Integrator, ..6v,,a u„
..... f...........................
Certified Operator:.........
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �' �� C�:� Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Ca aci Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer JE1 Dairy
❑ Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
Farrow to Wean 10,00 JJS6
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons pq Subsurface Drains Present r
Holding Ponds / Solid Traps ID No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water (if the State? (If yes, notify DWQ)
c. If dischargc 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 ; Structure 4 Structure 5
Identifier: ........................................._.._........................................................................._............_
Freeboard (inches): .31
5/00
ty Field Area
❑ Yes ANo
❑ Yes
No
❑ Yes
No
A'q
❑ Yes
(rNo
❑ Yes
;R No
❑ Yes
No
❑ Yes VJ No
Structure 6
Continued on back

Facility Number: Date of inspection Z3 0 Printed on: 7/21/2000
" 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes X No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ONo
(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 'Ec5 No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes �4 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ;S No
NN'aste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes Q`No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN IS Hydraulic Overload D$Yes ❑ No
12. Crop type W hea4 j 5-014 60 Yj S
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 KNo
b) Does the facility need a wettable acre determination? ❑ Yes PNo
c) This facility is pended for a wettable acre determination? ❑ Yes �9 No
15- Does the receiving crop need improvement? ❑ Yes No
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available'? ❑ Yes )� No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes PP5No
19. Does record keeping need improvement'? (ic/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes RfNo
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 ;W No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ONo
23, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ZNo
24. Does facility require a follow-up visit by same agency? [-I Yes No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes "FrNo
0: ISO •yiWhti6ris:or• deficiencies •mere n6ted- d&hig #his:visit: - Yoir will •teeeiye irio further
�corres• oridertce:abotitf;th']'sit:-:::::-:•:•:................ ::•.-.-.- .....-:::::•.-.-.-:-
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):
i�. {��iraUli�C dVerjoAd,.17 llgf oCGurr�pt �v��rLC sow.e ��,✓ficctfiOrLeven-�s,
L�� svr2 -�o-�pr✓]aw hyd��v]�L .I.�d;ny >rq¢�s 9;t,�n �� w�s-�e Pl�t�
17. • Cue rcn-4I7 1mve OLJq !'1 ed CP✓+',f ,'e., e, W Gevd-, AA j/e 4 G,y)9,,,,ed-Peert14
1LLM riece 'ds • Q��� �'1 hiew Ce✓711' iceA C O-f 6&ve✓44Sj
Je 6BYi�'✓Rf 7'Er►'t'1/� 7/
f eeP wr-4k ,neror,e1s • /
r
IReviewer/Inspector Name sf vt p w cl } Al auj � + S I
Reviewer/Inspector Signature: 8Z30 Date: o 51001

Facility Number: 3l — LfQQ
Date of tnspection I I 3 Ot7
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
0 No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
9No
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
P' No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
fVNo
32.
Do the flush tanks tack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
;R No
Additional.Comments and/or. rawings
3/23/99

- Division of Soil and -Water Conservation Operafiion » :Review
O Division of Soil and-* at& Conservat,on,;.Compliance Lispeetion
E Division of Water Qiiahty - Gontpltance li`spection
TO'Other Agency - 0perahofl•Revrew _ _ -
Q Routine ® Complaint Q Follow-up of DW2 inspection Q Follow -tip of DSWC review Q Other
Facility Number Date of Inspection Zl
Time of Inspection r 24 hr. (hh:mm)
10 Permitted © Certified © Conditionally Certified 0 Registered 0 Not Operational I Date Last Operated:
Farm Name. D f D 1,J,n j �r rv, �z to ........................................................
..-..-..r...........................................................................
Owner Name :............1S�a. !." ..-QT...C�. o i �r10t Phone No:..............................................-.........................-.-......
........ .......................
FacilityContact: .............................................................................. Title:............................... .............. Phone No:
MailingAddress: ...................................................................................................................................................................
Onsite Representative. ` "'+t7 U; nSeri Uf/S 5;,.,.,fr►s�b�+F UAI111 Integrator:... r� ....1%!^ f... .i...CS'. Ohl'^/! ................_
Certified Operator:,._'DA �! l f Operator Certification Number:
....................................................................................... ..............
Location of Farm:
A.
.......................................................................................................................................................................................................................................................... ►
Latitude e ° 4 Longitude • C ' 4
" Design Current . ;; .,:;..' Design- Current Design Current" :=R
`-Number of Lagoons © - Subsurface Drains Present ❑ Lagoon Area Spray Field Area
Holding Ponds /Solid Traps ❑ No Liquid Waste Management System
Discharges & Stiream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field J@ Other
a. If discharge is observed, was the conveyance man-made?
h. 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. Dices discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard(inches): ............7.................................................................................I.......... .
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
P9 Yes
❑ No
23 Yes
❑ No
JR Yes
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
D3 Yes ❑ No
Structure 6
❑ Yes ❑ No
Continued on back

Facility Number: a — Date of Inspection 2i
6_ Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
[:]Yes
[:]No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Re uired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22_ Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
29 Yes
❑ No
23. Did Reviewer/Inspector fait to discuss review/inspection with on -site representative?
❑ Yes
9 No
24. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
.: Io yiolations:o defieie�cies were npfed d*titing ihis.vesit: Yoir wt�l ieceaye o fuither
tomes• ondeitre: ah4uf thi$ visit.
.c mments (refer to quest<6w#): Eizplw any YES:answers and/or any recommendations ! rfan other comments:=
y
Use,dirawings of facilityato- ietter--explain situations (use additional pages as necessary) -- yr
1. �es pvIt cemf /al %44 of 5���� � fl-19 . 09c P44or• j A Gk4r,e `
l h�U rm2 LS hat he had eArl, ey4,00ia yy • 6_46 _rIT&
5i)e heclrl. He- sq,,d
rfC� al��l wets 4 �&Is~ rn
P; e d:1 G�1gr eG� /hid �h AdV"4ce.VI) ter4 �1CjG��h
0 aC t 'Y-�0 iG/ea V 1 ;-fit:�e 1IJ s jkk
hd *ifs -Ae 6/aPZ4 �pi ee US II ncgr 'roil �w pl. A.t.4s.
q d
ReviewerlInspector Name j -�'o Y> 2 t.✓rt: -%y�LL = I
Reviewer/Inspector Signature. Date: 2 9
j`�e4n n kele Gx ZQ,] 3/23/99

Facility Number: — D Date of inspection Q
Odor Issues
26_ Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
❑ No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
(:]Yes
❑ No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
❑ No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing'or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
❑ No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
❑ No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No
Additional omments an . or ravings:
`#. 60#L,lo4n em Inter and 4k9{'ff&-d
!a opYl Gould lx /owe-'-cgl AO /2 AM M 4i'nC d AT
4o black r')i4,v1 A4A lei✓#� -t<'4rw, .
dU 40 -<Iq As ►'►2vCC WaJ4e "tS
�.� A 14e an Si4e a S ►no e q t
pQs�1ble. ��eW��S jS 90;A. -rO re^.ove t/Qf4e ^prat 4,4611
�(Jacen� �o resido-r4;A1 heu.res,and �v ;n4o - ,eUs or d14Gl,
dowers fear 7� 1s d��G�, WT be blec eA 4o ,rare-pd
72. �rowhs .�a;leor �e �la�r-f y '�GJ4} o,f' 1a96an S-�a-lrJs q►�dl
AreafIrt'+ neO 4.0 s-tta; 9V r;pc. $eowh f ki 1t P764W y
V W 4 e.l' o n 9O IVX) Jr4A SOS Olot l4900M. 900
31Z3199

Division of Soil and` -Water Conservation -Operation Review
P
Division of Soil and Water Conservation _Coinpliaace inspection _ s
® Division of Water Qualit ya=.Complianee,Ii�sPee tion ,
g
13,Othei- Agency OperahonaRevtew
10 Routine O Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review ID Other
Facility Number Date of Inspection �Q
Time of Inspection 1 i Db 24 hr. (hh:mm)
IM Permitted [3 Certified [3 Conditionally Certified © Registered [,- Not Operational Date Last Operated:
FarmName: ........... a.r. ....................................................................... County:........_. o)I-k......................................................
nA
Owner Name: ................{ Di.✓ n ... B... CQ.�.D'`......._..._..................... Phone No: ....... ...............
_.......-......................................_ ._...
FacilityContact: .............................................................................. Title :......... :...................................................... Phone No: _..._...._.._...... ...............................
Flailing Address:
.......................................................................................................................................................................................................... ..........................
Onsite Representative: V , /lSdVt
....... Integrator:...... One J.!i....................................................
................................................................
Certified Operator: .............................................
Location of Farm:
Operator Certification Number:.........
____________� _
Latitude �o �� ��� Longitude
Swine
Design Current =
Capacity Po ulation:= Poultry
I"s r ... _
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
gn Current
city, Population ;. Cattl
r�
Design Current "`LL
�Nuinber of Lagoons ❑Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 10 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was die conveyance man-made?
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: !
Freeboard(inches). ......... .........................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
]& Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
❑ Yes ❑ No
Continued on back
3/23/99

Facility Number: �l — , �[� Date of Inspection
6. Alre:there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7_ Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
VIM
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14, a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
I5_ 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?
(iel 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?
0: No yiglafigns:oT cleficier�cies ryere►9tet3 dirr>tnghis:visit; Yoir witl reeeiye no further
. • correspondence. abouf this visit.. •
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes It No
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes ❑ No
:,omrnents (refer_to questifiit #j: rEzpWiii any YES answers and/or'any reeoinmendations or -any other comments:
Use drawings of facility w better"explain situations (use additional -pages as necessary)
i
2. T2v�P4vrcd ve-r q.� �vvTA;viol
" Co( �n/A34e lnl h;/c�L )e'hHered heekrby
,rur-bloc dra,-,rt . [, ^Ae i✓ 40 to e)4 Ol1TA .�,"o." rll/�ais
dr'.�►r1. Clear LTfrccealvres bna beep vfdh Arr'y'%1-
Vt44 had ;een re)o.`.red- (.Jas4e ir} pt; ,,:k fvMPed 6rk
ir4a SfrA% -rp;dds Av1A .S4ijl ov? oi�. �;��� h�aC beer► �ia�krGt 4a
rove ��r�►�e>r 1'"'Pe4s, i,�ja Usii�-� �Sal"'tp�eS Lllere
Zz.�P �T i-�i � ci�AA 8F di�G�trAB L✓�► �n ��Ir►rs�
Reviewer/Ins ector Name p df1 te.+i{
Reviewer/Inspector Signature. Date: *7
3/23/99

.0 Division of Soil and Water Conser afson .- Operation. Review A '=
h Division of Soil and•Water Conservation -;Compliance Inspection
Division of Water Quality "",'Compliance Inspection -Y
Other Agency Dperatio Review
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 1 9!6()24 hr. (hh:mm)
Permitted 0 Certified 13 Conditionally Certified © Registered C] Not Q erational Date Last Operated:
I
FarmName: ........................ ZCi..........---...................---•.-•---•.........................._.................. County:..... ...................................... .......................
i L
OwnerName: ....................11.-.R a�.S....�. ......lt�rL............:.........-...-.............. Phone No:.....��1�,.zgk...... wo .........................................
Facility Contact:..........�1.nN!'11�......vlwC4. ....................... Title: Phone No .......
Mailing Address: P I ......... ..."Vw �. ....� ............................ 4.$.......
l a ............? ........................ ,.......i� ...T- �... .
Onsite Representative:.......... fh1i......V.(ANO.Y......................................................... Integrator:......... t!dlt.]I}...........................................................
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
►�......l�x' `...sti.�...-.. a E -..... ...lid �... Q :..... its ....u�r. ...... ....t................................................................................
........................................ .................................. ..................................................................................... .......................................... ................ ........................
. .
Latitude 0 & 4 Longitude • ° 0«
Design Current Design Current Design Current
Swine .:_ Ca achy Po elation Poultry Ca acity Po ulation .Cattle Capacity Population,.
❑ Wean to Feeder ❑ Layer ❑Dairy
.'[]Feeder to Finish _ ; ❑Non -Layer ❑ Non -Dairy
Farrow to Wean
- ..
Farrow to Feeder
❑ Other
rFarro
w t.. Finish Total Desi&7 Capacity
iltsoars 'Total SSLW 7,�Cr,
Number of-LagoonsSubsurface Drains Present © Lagoon Area Spray Field Area
Holduig Ponds / Solid Traps ❑ No Liquid Waste Management System
:.. -
Discharge- & 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 than -made? ❑ Yes [P No
h. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ® No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon s stern? If yes, notify DW ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 StruCture 5 Structure 6
Identifier: ,, II
Freeboard (inches): ............. 2-`f............. ......... ...... I................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes �0 No
seepage, etc.}
3/23/99 Continued on back

Facility Number: Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
. elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type /-ri1WIJlnlntd Cf51Ini�.�
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAW -MP)?
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?
0: Rio-viol'atioris :or• deficiencies were noted• during this:visit; • Y:oi} will teceiye lid ruf ftr :
co rresporideRce. a 46f this visit_ . , . . . . . • . • . . . . . . . . . . .
❑ Yes q No
❑ Yes 19 No
❑ Yes F No
❑ Yes q No
❑ Yes V1 No
❑ Yes [� No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes [P No
❑ Yes No
❑ Yes [M No
❑ Yes ® No
❑ Yes R1 No
f
❑ Yes [�j No
❑ Yes y No
❑ Yes IP No
❑ Yes FM No
❑ Yes �? No
❑ Yes P No
❑ Yes 0 No
Com-inents (refeir to question:#): ~Eieplain"any "YES answers and/or any recommendations or any other comments.
Lise,drawiiigs of"faciltty to better explain srtuations (use additional .pages as"necessary
)
i
No C1t I%CC'1 an
�� - -
Reviewer/Inspector Name i p e _
Reviewer/Inspector Signature: "- �_ . G Date:
3/23/99

• Facility Number: 3 —
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
P 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
W 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
I 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
F%A No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
[7No
rttona omments and7or Drayt*&
3/23/99

.7_7777M777,
❑ Division of Soil and Water Conservation
❑ Other Agency
�
Q
��'��
®Division of Water QuaLty
Routine G Complaint O Follow-up of DWQ inspection O Follow-u of DSWC review O Other
Date of Inspection �}
Facility Number
Time of Inspection 24 hr. (hh:mm)
© Registered KI Certified E3 Applied for Permit I$ Permitted 13 Not Operational i Date Last Operated:
FarmName 5� .......... WI-q............................................................. County: ............ .c1$�.iu�................................ .......................
p � t
Owner Name: ......................3 fr,?Y)...�...`a , ........ alir&,_............ ...................... Phone No:.....°.t�'t ...` ` � .. g......................................
Facility Contact �.s-e m-x ...... 5! 5i9� .. Title: ................................................................ Phone No:...................................................
Mailing Address: ............Q....vrr.....i Rj........
T.......................................................... .......�A j�.1t5�t...fi..IQJ L.............................
Onsite Representative: ....... ..4%. t]3w ....... Dq v..15t........................................................g Q .
Integrator: ......... hlYlR...................
Certified Operator; ..................................................
Location of Farm:
Operator Certification Number..
............ 1�.... ... u1..... iu U.-I. ...................................................................................................
................... .. .....I...... .............----....----............--.....----.------......
Latitude • 6 " Longitude • 4 0"
Design Current s
Design ,Current `
Design Cur"ent
A `Sommer, '' Capacity ;Population
:PauEtry
Ca acit Po ulation Cattle,
p Y- p r
Ca acet
F Y Population ..
❑ Wean to Feeder
x ❑ Layer
❑ Dairy
❑ Feeder to Finish
-' ❑ Non -Layer
❑Non -Dairy
Farrow to Wean
❑ Farrow to Feeder
❑OtherI
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
Is
-
❑soarsTotal
:. SSLW
Subsurface Drains Present jE1 Lagoon Area I pray Field Area
No Liquid Waste Management System
g�=
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
® No
2. Is any discharge observed from any part of the operation?
❑ Yes
® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
( No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
No
S. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
7/25/97

Facility Number: I I —
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes 0 No
Structures (Lagbons.Iloldine Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes � No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(ft): ..••---......, 5............... ...................... ...............................................................................................................................................
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? ❑ Yes No
12. Do any of the structures need maintenancelimprovement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crap type %: Sf T...... k% ....-------�fG^v*-
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0• No.violations°ar deiicieinc'ies:were nated'during this.visit.• Youm'ill receive no'further
correspQndeitce ai out-this:visit:- :: . :
Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes [P No
❑ Yes 0 No
❑ Yes QI No
❑ Yes ® No
❑ Yes R No
❑ Yes ® No
M Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes [A No
1z. AV40- OLVOV'. rtt cat vmrlS 4-OVIJ �
r-ewled, , + _l
ziZ . `�" C Oi1Ei.C'} � �' l e"'d i 2 4-9, -- rW Vjd be 16JIW OQ - ` -k- ST trC(" tf V5e / Ijkl,
Ca1Gv�a�-i�y `#�l-s. h`�Yvnq�-- bh �hce5, �.-ar�coti.� `� ir'{'►�Q-C-ien iv��oYrv��-i an Sti'lo��� �� jr..
7/25/97
viewer/Inspector Name
ewer/Inspector Signature:
Date:

r .
❑ DSWC AnUna"I Feedlot OperatFon Review
xz ®DWQ Animal Feedlot 4pelratian`S�te �nspectlon yh
O Routine G Compiaint O Follow-up of DWQ inspection O Follow-uo of DSWC review O Other .
Date of Inspection 47
Facility dumber
Time of Inspection 13 ' D El Use 24 hr. time
FarmStatus: Total Time (in hours) Spent onRe%iew
or Inspection (includes travel and processing)��
Farm Name: F rA)c Za — County: �sz� l-----
Owner
Name: r s s j •r, s c4 C-R r D 1 , h _ n C. - Phone No: 6_0 D
Mailing Address: c, - 4 _ ] L� C_ _2 $ 3 9 Q
OnsiteRepresentative: �. — Integrator: 93= 1&2 el S r C;:�=.
Certified Operator. _D aOperator Certification Number:
Location of Farm:
Latitude Lan;nude
❑ Not Operational Date Last Operated:
ripe of Operation and Design Capacity
5wtne + Poultry - Namher ' Caftie E x mm
:. -
...::.r,=umber ~ .Number
❑ Wean to Feeder
-
10 Laver `:' ❑ Dairy
❑Feeder to Finish
[] Non -Laver ❑ Beef
Farrow to Wean
7, o a o�
Farrow to Feeder
EI Farrow to Finish
Other Type of Livestock
3 :..
".�:�` �.^.'�'^'� i4P°4� � �
� �,.•-/.�f �a � �..;.,.�.X�i�.+� � �:,
.- sa.. .M.':`
--�c.. e�.h _ y.
..-^�y-.t=�R' ���-".. - -.3
1�rumber of Lxgsiaas f HoldtngPonds: a u; ❑ Subsurface Drains Present ":
M
o Lagoon Area ❑ Spray Field Area
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes RNo
2_ Is any discharge observed from any part of the operation? ❑ Yes ® No
& If discharge is observed, was the conveyance man-made? ❑ Yes ES 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-al/min?
d- Does discharge bypass a lagoon system? (If yes, notify DWQ) [I Yes [No
Is there evidence of past discharge from any part of the operation? ❑ Yes &No
4. Was there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes [SNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes 9No
rrmntenancenmprovement?
Continued on lack

6. Is facility not in compliance with any applicable setback criteria?
7. Did the facility fain to have a certified operator in responsible charge (if inspection after 111/97)?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laeoons and/or Holding Pandsl
9. Is structural freeboard less than adequate?
Freeboard (ft): Lagoon 1
Lagoon 2 Lagoon 3
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenancehmprovement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping Ievels?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or rmo&f entering waters of the State, notify DWQ)
IS. Crop type
16. Do the active crops diner with chase design--ted fn the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for land application?.
18. Does the cover crop need improvement?
19. Is there a lack of available irrigation equipment?
For Certified Facilities Ouiv- -
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal_ Waste Management Plan in any way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
i ❑ Yes
ONo
❑ Yes
IS No
❑ Yes
IR No
❑ Yes
Z No
Lagoon 4
❑ Yes
ISNo
❑ Yes 0 No
❑ Yes 0 No
❑ Yes ® No
❑ Yes 9 No
❑ Yes KNo
❑ Yes 9No
❑ Yes 9No
❑ Yes R\To
❑ Yes
f H No
❑ Yes
® No
❑ Yes.
[[No
❑ Yes
[SNo
❑ Yes
Ea NO
L o g o c 10% w a, I t H e d s t-o b e. ✓v%� o �Aj e-ct .
b >~ e ,r- w" S 'a. c. ; 1" t y } o o E` Z.,1 o o r) . e v d e— c-e-
WaS c�Se.rj e-a. 1 �1
Reviewer/Inspector Name
Revirver/Inspector Signature: � (� r ,.� p,ti Date: 7-9
cc. Division of Water Quality; Water Qrralitp Section, Facilhy Assessment Unit 11/14/96

„� „r,,.., 'cc ..<a g” t, -a ,c» s ..,� _ U �+;-/- st - ' -> -' r - ^ - ... •'" - � � a wo c
`- DSWGAnal imFeedlot Operation Review'
Q
:DWQ AniFnaIFeedlot operation Si>Le Znspectlon
Routine lComplaint�O Follow-up of DWO inspection O Ft)iloNv-up of DS«`C review O Other
Date of Inspection
Facility Number 3
Time of Inspection ` Use 24 hr. time
[� _ Total Time (in hours) Spent onReview
Farm Status:,.._ ..._.... _..—.._ - lor Inspection (includes travel and processing) �--
Farm Name. ZO County: ZX-)lir, .........
Owner Naive:.... _ Ys�t.il .S d. _ C��r�UY ..._ .... .._ ..._ Phone No:.._Lq!_DL,. -.`-?.3_`�i,?o ..... _ — -- ...._
Mailina Address � - -L �• "
OnsiteRepresentative: { ASc...... -- ik2.... ..... —.-...--..... Integrator: ...... .��c'.6v's!.�--__0� ................
p _ Operator Certification Number:- ZSS
Certified Operator. �-�-----...-•--------...._-...
Location of F'arni:
Latitude 3 •C4�� Longitnde77• G� I G,
Not Operational Date Last Operated:
type of Operation and Design Capacity
General
1. Are there any buffers that need mainterianceiimprovement? ❑ -Yes ® No,
2_ Is any discharge observed from any part of the operation? ❑ Yes ® No
a. If discharge is observed, was the conveyance man-made? ❑ Yes ® No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes No
c. If discharge is observed, what is the estimated flow in gal/mia?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) El Yes No
i. Is there evidence of past discharge from any part of the operation? ❑ Yes Dj No
4. Was there any adverse impacts to the w•ate-s of the State other than from a discharge? ❑ Yes ] No
5. Does any pan of the waste management systems (other than lagoons holding ponds) require ❑ Yes ® No
maintenance: improN•e:nent?
Continued on ha,k

6. 1s facility not in compliance with any applicable setback criteria?
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/1/97)?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons and/or floldin- Ponds
9. Is structural freeboard less than adequate?
Freeboard (fi): Lagoon 1 Lagoon 2 Lagoon
10. Is seepage observed from any of the structures?
I I _ Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any -of the structures lack adquate markers to identify start and stop pumpip_g levels?
Waste .application
14. Is there physical evidence of over application?
(If in excess of «'MP, or runoff entering waters of the State, notify DWQ)
15. Crop type �. _:.._.Cbi�—�
16. Do the active crops differwith those designated in the Anirrral Waste Management Plan?
17. Does the facility have a lack of adequate acreage for land appiication?.
18. Does the cover crop need improvement?
19. Is there a lack of available irrigation equipment?
For Certified Facilities Only-
20. Does the facility fail to have a copy of the Animal Waste Management Plan readiy availaeie?
21. Does the facility fail to comply with the Anin-.al.W-ste Management Plan in any ay?
�?. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/Insaector fail to discuss review/insnecaon with owner or operator in cha*¢e?
rGc1�: Lac d ��.
❑ Yes (4 No.
V
❑ Yes 10 No
❑ Yes 9 No
❑ Yes LK No
Lagoon 4
ci,A�� C�b�t•���a (r\ � i f{,��s r � � l u i }�(n: S vJt:rz C�v�y .
❑ Yes ® No
❑ Yes ® No
[I Yes 91No
❑ Yes ® No
1OM11@
❑ Yes
No
❑ Yes
No
❑ Yes
( No
El Yes
No
❑ Yes ($ No
❑ Yes R1 No
❑ Yes [ig No
❑ Yes R1 No
❑ Yes ® No
Reviewer/Inspector Name
Reviwer/Inspector Signature: �� �y �„� �r Date:
i
Division of Water Ouality, Water Quality Section, Facility Assessment Unit ' I ' 4In`

'� Routine 1KComplaint O Follow-up of 211'inspection O Follow-up of l)SWC review O Other
Date of Inspection
Facility Number 3 Time of Inspection
`lam —_.I Use 24 hr. time
-- Total Time (in hours) Spent onReview
Farm Status::...— 5�...._ ..W _....... _ .. _......._..... or Inspection (includes travel and processing)
Farm 1Vante• ?�k?!'� S -- -- .... County:. ""-'T�1h............. ................... .
Owner Name:
Phone i\o:.._.C.:.LU_j... �r._..a.` .........
Mailing Address:. � k.� L .......... ..
Onsite Representative: 11i1Z ..... �Ltc2.... .._..... _ ............. _ _..... Integrator:.........L?!?C!:5.....a _.�?hFs........... .......
Certified Operator: _. { t�sL.. i 4 ...... _..-................................_ Operator Certification Number:.:aa
Location of Farm-.
Latitude 3S • �° ©u Longitude �• ok ! Gcc
❑ Not Operational Date Last Operated:
< T}•pe of Operation and Design Capacity
Shy''. �, i - "-.-xY V-
5�trn �= .. Nt mb W. Poultry . dumber �Cattie � � Number, ~
�; ❑ Wean o Feeder fr
WtFdEl Laver Dairy
❑ Feeder to Finish. El Non -Laver , ❑ Bet-f R
Farrow to Wean y
"" 0a�;
ire �-._
El Farrow to Feeder ' sus s tw��
Farrow to Finish _ A ❑ Other Type of Livestocl. _Nls
1`Iiimberof Lagoonsx/'oliiing'onds ❑ Subsurface Drains Present .
r
W r rti g r� ❑ Lagoon Area ILI Spray Field Area
4
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DW"Q)
:.n�. Is there evidence of past discharge froth any part of the operation?
�r
4. Was 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?
❑ Yes ® No,
❑ Yes ® No
❑ Yes
® No
❑ Yes
0 No
❑ Yes
No
❑ Yes M No
❑ Yes [K No
❑ Yes l2 No
Confinued on back

6. Is facility not in compliance with any applicable setback criteria?
❑ Yes
N No
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/1197)?
❑ Yes
J No
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
[kj No
Structures CLa2oons and/or IloldinQ Ponds
9. Is structural freeboard less than adequate?
❑ Yes
09 No
Freeboard (ft): Lagoon 1 Lagoon 2 Lagoon 3
Lagoon 4
_.....
................
10. Is seepage observed from any of the structures?
❑ Yes
01\10
I I . Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
11 No
12. Do any of the structures need maintenance/improvement?
❑ Yes
M No
(If any of questions 9-I2 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels?
❑ Yes
® No
«Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.- Crop type -T _ CGi h
16. Do the active crops di#i-erwith those designated in the Animal Waste Management PIan?
17. Does the facility have a lack of adequate acreage for land application?.
18. Does the cover crop need improvement?
19. Is there a lack of available irrigation equipment?
For Certified Facilities Onlv- .
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal.Waste Management Plan in any way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/Inspector fail to discuss reviewfinspection with owner or operator in charge?
❑ Yes ® No
❑ Yes
P9 INTO
❑ Yes
M No
[1 Yes
: CC NO:
❑ Yes
No
- ❑ Yes No
❑ Yes
®No
❑ Yes
®h'o
❑ Yes
R] No
❑ Yes
® No
Itx143 vv0 . 06 ;&-4 i" 04r_6s. Ail Ji�ws oem C-Vla
Reviewer/Inspector Name � , w ¢�
-r-ra.0 e
Reviwer/InspectorSiguature: Date: ��12�gZ
Division of Water Quality, Water Quality Section, Facility Assessment Unit 11/14/96

a
10 Routine Q Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review Q Other
Date of Inspection 313197
Facility Number 31 400
Time of Inspection 13:45 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: QrWed (ex:1.25 for 1 hr 15 min)) Spent on Review 2.5
or Inspection (c s travel and processing)
Farm Name: County: W. IR ,?.-.-...
Owner Name:._.......Phone No: 9XQ:j9'3-3fi0Q.....W.,.
Mailing Address:
OnsiteRepresentative: Saniya. al aaa................. .......................... .................. ...--- Integrator.B.LQmVs..Qf.CArQHw............... ........................
Certified Operator. JDAW............................... ...... THY................................... .....-- Operator Certification Number: 18.7M ............................
Location of Farm:
Latitude 35 ' OS ' 43 u Longitude F 78 • 08 16
❑ Not Operational Date Last Operated:
Type of Operation and Design
General
1. Are there any buffers that need maintenancefimprovement?
2. Is any discharge observed from any part of the operation?
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoonAolding ponds) require
maintenance/improvement?
❑ Yes
N No
❑ Yes
N No
- ❑ Yes
N No
❑ Yes
N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
1

6. is facility not in compliance with any applicable setback criteria? ❑ Yes ® No
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/l/97)? ❑ Yes ® No
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 structural freeboard less than adequate? ❑ Yes No
Freeboard (ft): Lagoon 1 Lagoon 2 Lagoon 3 Lagoon 4
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? ❑ Yes ® No
12. Do any of the structures need maintenanceJimprovement? ❑ Yes ® No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels? ❑ Yes ® No
Waste Ai/plication
14. Is there physical evidence of over application?
❑ Yes
® No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type .... ...................................................................
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
❑ Yes
® No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
® No
18. Does the cover crop need improvement?
❑ Yes
® No
19. Is there a lack of available irrigation equipment?
❑ Yes
® No
For Certified_ Facilities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
® No
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
❑ Yes
No
22. Does record keeping need improvement?
❑ Yes
®No
23. Does facility require a follow-up visit by same agency?
❑ Yes
® No
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes
® No
looked good. Need to be wary of field drain at the toe of the lagoon wall.
---------------
Reviewer/Inspector Name
Reviewer/Inspector Signature:, „ Date: , �� q `?
A�

Jw
, N

Site Requires Immediate Attention:
= Facility No. _,� 14gKD
DIVISION OF ENVIRONMENTAL MANAGENIENT . 1:-7 coo 23�
A.LNIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 4t ' 3 ,199,6
Time: l/-y J 19
Fain Name/Owner: ,t v ►%L 5 _p ,� Jl r n Fr4ef,&, -,H z v
Mailing Address: ?0 (3 0 Y- _ qF< 7
County: _ Do,-f21 �. - -22
Inter?-atoT 0 C_. = Phone: 0.0
On Site Representative: "viA&L! ����+� Phone: Ve 7 1170
Physical Address/Location: t& L s S 0*, _ ,•, FA r S rn-I ! t-
r
Type of Operation: Swine A Poultry Cattle
Design Capacity: 2c3o 2� Number of Animals on Site:
DE1�I Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Lonmitude: Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient ueeboard of 1 Foot _ 25 yea.- 24 hour storm event
(approximately I Foot + 7 ipches)efZ or No Actual Freeboard: �Fc_ Inches
Was any seepage observed from the lagoon(s)? Yes oKo"as any erosion observed? Yes orQD
Is adequate land available
``for
}} sprav'�s or No Is the cover crop_ adec_ua.e?<0or No
Crop(s) being utilized: t4tl •
Does the facility meet SCS r✓inimum setback cr'_teria? 200 Feet from Dwelli:?g�r No
100 Feet from Wells' F;Por No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o'-"'
Is animal waste land applied or spray irrigated within 25 Feet of a USGS INInD Blue Line?<:17or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? CQ or Nb If Yes, Please Explain. ���- e,,of-c
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on speciric acreage with cove: crop)Z!P or No
f 7/I
I Spector Name
L
Signature
,:c"Fscilitv`Assessment Uni: Needed. -

z
t-k4 y /i7�so
„_ — ---4—

6ite Requires ImmtcLiate Attp-nnon: -ye5
Facility No.
DIVISION OF ENI-VIRON-IMENTAL MANAGE-,N1ENT
ANIMAL FEEDLOT OPERATIONS SITE, VISITATION RECORD
0
DATE. 3 19
Time: Ll"Oo fl
FarmName/Owner: clq-2�/(.-7 A FA-erv, �zq
Mailing Address: L-4/fi R E; fi-c � _,7
County: P
&-7 6 Integrator: C_- Phone: a
On Site Rtprcseritative-.- 6VAyiZekl r+_- —Phone: -7
Physical Address/Location: � 110-0, CL X_ U-7
7
Type of Operation: Swint Poultry Cattle
Design Capacity: ZCA5c-7 Sc 1.Number of Animals on Site:
DENM Certification Number: ACE DEM Certificanon Number: ACNEW
Latitude: Longitude: Elevation: Fet�t
Circle Yes or No
Does the Animal Waste Lagoon have sufficient 'lletboard of I Foot + 25 YeLqz 2A hour storm eve -it
(approximately I Foot --t- 7 ipches efE!�_?or No Actual Fre-.board: 1. Inches
I 4-F
Was any seepage observed from the lagoon(s)? Yes oo�vas any erosion observed? Ye's or�
Is adequate land available for soravz2PS or No Is the cover crop adeause')(!9or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet fi-orn. Dwellhnq�r No
Wells? or No
100 Feet from Wells?
Is the animal waste stockpiled within 100 Feet ofUSGS Blue Line Stream? Yes o
- within 1SGS' -Line .0
Is animal waste land applied or spray irrigated with' 25 Fett, of aU Tylap Blue zy7or IN
Is animal waste discharged into waters of the state by man -'made ditch, flushing system, or other -
similar man-made devices? 6Z or N6 If Yes, Please Explain- VL4-vo-K
Does the facility maintain adequate )Waste management -records (volumes of manure, land applied,
spray irrigated on spedific acreage with cover cro.p)� or No
Additional Comments-e /I
C?
14s6ecto-r Name/
Signature
Facih[v-Assessment Unit
V
s, Ai%,hments_if Needed.

Site Requires Immediate Attention:
Facility No. 3 f -DQ
DIVISION OF ENVIRONTIv ENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
0
•
LJ
Farm Name/Owner:
Mailing Address:
County: QW21
Integrator.
Po Pao-/
rows 5
On Site Representative:
Physical Address/I
Type of Operation:
DATE: If Z3 , 1995
Time: I U : b
2r5 �v IUG
Phone: ZC(3 — 3Co06
Phone: 2q3 - 3&00
Poultry Cattle 9 Farrow - We -a"
Design Capacity: ZU00 G�W 5 Number of Animals on Site: - 2C'�0
DEM Certification Number: ACE DELI Certification Number: ACNEW
Latitude: '�5 - 05- ' Longitude: 7� ' 023 Elevation: Feet
Circle Yes or No '
S wine ✓
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches)cy3eor No Actual Freeboard: Ft_ S Inches
Was any seepaae observed from the laQoon(s)? Yes or N Was any erosion observed? Yes No
Is adequate land available for spray? Yes r No Is the cover crop adequate?. or No
I I 7 I' I
Crop(s) being utilized:
Vm
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Ye or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o(No)
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o@:5) 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)? es r No
Additional Comments: _ ec6rc_ 5_ o n Ga &%
Letu,•s - --
Inspector Name
cc: Facihiv Assessment Unit
AC� _
Signature
Use attachments if Needed.
4-'