310476_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

Type of Visit: 0 Co anee Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency 0 Other O Denied Access
i w�.aw^ram i
Date of Visit: ( Arrival Time: Departure Time: 103o County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ff Title: Phone:
Onsite Representative: ef`C CL �r'z'Z.-/� Integrator:
Certified Operator: Certification Number: d 3
Back-up Operator:
Location of Farm: Latitude:
Certification Number:
Longitude:
S 'ne
Wean to Finish
Design Current
Capacity Pop.
1 `LQ0
Wet Poultryll
Layer
Design
TV Me 1
Current
op.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
I INan-Layer
Dairy Calf
Dairy Heifer
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D , P,oultr,
Layers
Non -Layers
Design
Ca aci
Current
P,o P.
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Gilts
Boars
Pullets
I 113eef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Page 1 of 3
21412015 Continued

Facili Number: JDate of Inspection: !G t
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E�No_ ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 `Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes No ❑ NA ❑ NE
[—]Yes ❑ N ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental hreat, 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 E-No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No ❑ NA ❑ NE
maintenance or improvement?
Waste_ Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes.] No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes PNo ❑ 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 2 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes ] NNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes rNo❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ff'� ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes - ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes g�Noo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: -Lf 76 jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [:kNU— ❑ 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 �.;N ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No �❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No ❑ NA ❑ NE
❑ Yes 7`' ❑ NA ❑ NE
[:]Yes No ❑ NA ❑ NE
❑ Yes Ej No ❑ NA ❑ NE
❑ Yes No ❑ NA
❑ Yes No ❑ NA
❑ Yes No ❑ NA
❑ NE
❑ NE
❑ NE
Reviewer/Inspector Signature: ��-���--�'l Date: '-2--
Page 3 of 3 21412015

J
Type of Visit: 4outine
pliance Inspection Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral Q Emergency 0 Other 0 Denied Access
Date of Visit: 1 V5 t7 G Arrival Time: Departure Time: O County: Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: PC. re /( 61:1 L__1 Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number: U n *
Certification Number:
Longitude:
Design Current
Design
Current
Design
C«urrent
Capacity Fop.
Wet Poultry
Capacity
Pop.
Cattle
Capacity
Finish
7Feeder
La er
Dai Cow
Feeder
Non -La er
Dai Calf
o Finish
Dairy Keifer
Farrow to Wean
Design
JDryCow
Farrow to Feeder
D , P■oultr.
Ca acit
P,o ,
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turke Poults
Other
10ther
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes D40 ❑ NA ❑ NE
❑ Yes
❑ No
[DNA
0 NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
eNo
❑ NA
❑ NE
❑ Yes
ff No
❑ NA
❑ NE
Page I of 3
21412015 Continued

Facili Number: - % Date of Ins ection: r-
WaSte Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 5 6 � L 3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ,[i] No ❑ NA [] NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a [] Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes E3'1�o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
O Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes P3'1To'
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land 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 ibs. ❑ 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 ZNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes .❑-ITO
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application'?
❑ Yes ff No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes �o
❑ NA
❑ NE
Reouired 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 ,f 7rNo ❑ 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 tfn No ❑ NA [D 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-C7No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [] Yes _Q-No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: 3 1 jDate of Ins ection: 3 3 tyli
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
JD'TN-o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
E�No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No ❑ NAB❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No J'NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
ONo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
� o ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
J " o ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Yes
[:]No ❑ NA ,E51q_E
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑Yes
No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑Yes
El�"o ❑ NA] NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No ❑ NA ❑ NE
Comments (refer to question.#): Explain any.YES°answers and/or, any additional recommendations or any other. comments..
Use drawings of facility to'better explain situations (use additional. pages as necessary).,
Z_ a o a C ! i t,S D SS . 4le- S�� /` G � �i �i✓ ii��'
Li 1 IR f ?C�C_ iwtt t [ • P11(b -f� i �✓n t J"..�-
�n
�p�Mi..•,.�6a An— a ! 4
V W�L
�p�.� n ir/�r�•I S
fin
�an i -<) {l h� I�
ryrft�_ 1 � C> y n_ 4
Reviewer/Inspector Name:
'fVr
Phone: I (n •7? C 7 3 "
Reviewer/Inspector Signature: �4.✓ Date: ? 3 f'- /6
Page 3 of 3 2/4/2015

Type of Visit: UCo Hance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time:L_ C1: ' County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: j� /� Title: Phone:
Onsite Representative: Q e iL (� {J C o w /► _ Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. C*attle Capacity Pop.
Wean to Finish 1260 2109 Layer Dai Cow
Wean to Feeder
Non -La er I
alf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Dai Heifer
Design C►►urrent Dry Cow
Dr. P,oultn C•a acit P+o f. Non-Dai
Farrow to Finish
Lavers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
El
QtherI
Other
Turkeys
ITurkevPoults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
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
No
❑ 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
LJ No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facilit Number: 3 - 6 1 jDate of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?: _
Designed Freeboard (in):
Observed Freeboard (in): 24 Z Y
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?
Structure 5
�o ❑NA ❑NE
❑No ❑NA [3 NE
Structure 6
❑ Yes ✓❑ No ❑ NA ❑ NE
❑ Yes IrJ 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 E31N o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes E No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes []"No ❑ NA ❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes DNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [Zf No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
u No ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[]]-No ❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[:rNo ❑ 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 [Zf No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge'? ❑ Yes dNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes B'No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

OC
Facility Number: '3 - y Date of Inspection: $`
i4. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA 61NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
❑ Yes E�`No ❑ NA ❑ NE
❑ Yes ]fNNo ❑ NA ❑ NE
[:]Yes NNo ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes 0 No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes EJ�No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [J o
34. Does the facility require a follow-up visit by the same agency? ❑ Yes WNo
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question'#/):'Explain any:Y-ES answers and/or?:any additional reeomme�dations or any�other+comments � �°� r � �s°
Usedrawingsof facility to: :better explain situations (use�addionap age . ._. .. ,:; — `
Reviewer/Inspector Name: P V # e—L (P '�^e / Phone: _I4 7? 1 7-) o Y
Reviewer/Inspector Signature: Date: / 5—
Page 3 of 3 21412015

Type of Visit: 9fcompliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine__O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
_
Date of Visit: ��
Arrival Time: j;L15PAJ I
Departure Time:®
County: Wl,� Olh/►
Farm Name:
1d
Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Title:
Phone:
Phone:
Region: Vy
—.&
Integrator:
Certification Number:CQ
r nb
Certification Number:
Location of Farm: Latitude: Longitude:
rFeedertroFinish
Design Current
apacity Pop.
Design Current Design Current
Wet Poultry Capacity Pop. Cattle11Mapacity Pop.
Layer airy Cow
Non -La er airy Calf
airy Heifer
Farrow to Wean
3
Design Current D Cow
Dr, P.oultr. Ca aci P,a , Non -Dairy
La ers Beef Stocker
Farrow to Feeder
Farrow to Finish
Gilts
Non -La ers
Beef Feeder
jr=0ther
Boars
ji
Pullets
Beef Brood Cow
her
Turkeys
Turke Pouets
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
.I E
❑ Yes gNo [3 NA ❑ N
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[]Yes []No
❑ Yes .TNo
❑ Yes in —No
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3 121412011 Continued

Facilit Number: 31 - qP7k jDate of Inspection: — hj—
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: a+
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):�_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[:]Yes ❑ No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes oNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes PNo
. ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes Vr'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes RTNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes JTNo
❑ 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 FTNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes FEI-No
'"'
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes VTNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes P[ No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VTNo ❑ 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 ;�J'No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes A No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes G!rNo ❑ NA ❑ NE
Page 2 of 21412011 Continued

1`acili umber: -4rV6 I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes a� No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes to—
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ,I No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ff No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes Z 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
2: 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
VNo
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
P 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
V' No
❑ NA ❑ NE
33. Did the ReviewerlInspector fail to discuss review/inspection with an on -site representative?
0 Yes
VI No
❑ NA ❑ NE
ReviewerlInspector Name: Pho. :' 025�
ReviewerlInspector Signature: Date:. d :,l,.tLl �• .
Page 3 of 3 21412011

(Type of Visit: Q Compliance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: GrRoutine 0 Complaint 0 follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: omghn
Farm Name S�-�p�gr,Jtf\ �i— Owner Email: ^'�-
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: la 1. ft* (w
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Phone:
Region:
Integrator:
Certification Number: Q031b
Certification Number:
Longitude:
Design. Current
Design
Current
Design
C►urrent
Swine.
capacity
Pop.
Wet Poulkary
Capacity
Pop.
Cattle
Capacity
Pap.
Wean to Finish
Layer
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
�"
DairyHeifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
DrD P,oult :
C
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Qth_er
Turkey Poults
Other
10ther
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes 2'fNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA []NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes [] No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) [] Yes ❑ No ❑ NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [] Yes 6No [] NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

c,
Facili Number: - Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ONo
a. If yes, is waste level into the structural freeboard? ❑ Yes [] No
❑NA ❑NE
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?: w
Designed Freeboard (in): 1115
115 l •
Observed Freeboard (in): L401. Ll
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes VrNo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [6No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ' ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes VfNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land 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 Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 5eNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [gNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes Pr No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes [?rNo
❑ Yes ;ff No
❑NA ❑NE
❑NA ❑NE
19, Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
CZNo
[] NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
grNo
❑ 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.
❑Yesa
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
0No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
CPrNo
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

L
Facility Number: -IA"16 I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[3 No
[] NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
ZNo
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
ZfNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[;�No
❑ NA ❑ NE
Other Issues
29. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[:]Yes
C�rNo
❑ 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
G!rNo
[] NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
3 1. 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
ETNo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ZNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
/Z No
❑ NA ❑ NE
Comments.(refer to question #): Explain any YES answers and/or any additional recommendations or any Ether comments.
___j
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of
Phone:a �61-2aa
Date: 5
21412011

(Type of Visit: We mpliance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: � Arrival Time: Departure Time: County: Region:
Farm Name: 6(LC ?_- I + 9 Owner Email:
Owner Name: Z t� C1 6q_Gt k_W Phone:
Mailing Address: I0 qorL S70C r %V (-,. H ea t 'K.8 (105 F_ i 4l L'L" /Nt:�' C L C/ S(F
Physical Address:
Facility Contact:
Title:
Onsite Representative: �� t Q(LOLAW Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish Layer
Design C*urrent
aitle 1opacity Pop.
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D , P,oult t Ca acit P.o P.
Lavers
DairyHeifer
D Cow
Non -Dairy
Beef Stocker
Beef Feeder
Gilts
Non -Layers
Boars
Pullets
Beef Brood Cow
Othe
Other
Turke s
urkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
O(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 the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
[]No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
rNo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: —Z "1 - N Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
XNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[DNA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): I �. 5. S
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA
❑ 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
d[ f Wind Drii�ft--%Application Outside of Approved Area
12. Crop Type(s): 50A 12L.1a� S(f,
❑ NE
13, Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yeso
Z
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists 0 Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes X No ❑ NA ❑ NE
El Waste Application Q Weekly Freeboard 0 Waste Analysis 0 Soil Analysis Q Waste Transfers Q Weather Code
[] Rainfall ❑ Stocking ❑ C�p Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No [3NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ 9 Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: Date of Inspection: j
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
Yes ❑ No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes No
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
No
❑ YeslNo
❑ 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 other comments, d
Use drawings of facility to better explain situations (use additional pages as necessary)._:
CA 4; cZ44T) 0,4 DLAE N
�laalii ►.o
coI1311) a. 5
a. y
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
2L & C_'
G Ig L�L I F- T,HGGLE
Phone: 9 j C 9� p` 7
Date; rQ 11 Ia
21412011

Division of Water Quality
Facility Number 3 ! L/ O Division of Soil and Water Conservation
0 Other Agency
Type of Visit &Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit *Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: 0 %V Region:
Gam P�¢cww I`�a
Farm Name: qncrrx `1 Owner Email:
Owner Name: GZopyALb �'(CCC `�(LO(_yA/ Phone: q /G-9)85--�9 d6
Mailing Address: /t J"7 s� S � C_ti_C A_� `` �-' Vw __ LI—C--.v � O� Ey ,—.)Ci
Physical Address:
Facility Contact: (� Title: Phone No:
Onsite Representative: �`-�L `t—����! Integrato
Certified Operator: AL-� �E��� �� Oper�t'orCertification Number: QW3� 0
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =' =' = Longitude: = ° =' =
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Disc, homes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Daft
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: F7
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
o
[INA
❑ NE
ElYes
tNo
❑ NA
❑ NE
12128104 Continued

Al
Facility Number: — `7 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: (ACOONA, 6
❑ Yes �(No ❑NA ElNE
ElYes ❑No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?: c
Designed Freeboard (in): `I
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 XNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes KNo El NA [I NE
maintenance or improvement?
Waste Apolication
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 KNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu., Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window
� El Evidence of WindDrift El Application Outside of Area
12. Crop type(s) Fe_scLu= [� Src z—
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
Comments (refer. to.questi,on.#): Explain. any YES answers andl6r any recommendations dr'any other;comxments�
.Use drawings of facility. to'.better explain. situations. (use:additioina(pages a sineeessary):=
T
Reviewer/inspector Name
r4 , ; �, 3'1 � _;fit f�till— ; `'
Phone: ��U ' 76 3qq
Reviewer/Inspector Signature:
Date:
Page 2 of -12128104 Continued

Facility Number: _L1 Date of Inspection 11
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. El WUP 0 Checklists
0 Design 0 Maps El Other
❑ Yes 'ko ❑ NA [:INE
ElYes , lj�No ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
• ❑ Yes
XNo
❑ NA
❑ NE
0 Waste Application ❑ Weekly Freeboard 0 Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ A nuai Certification
El Rainfall ❑ Stocking ❑ Crop Yield El 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections 0
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
ElYes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
o
❑ 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?
El 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
ANo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
KNo
[INA
ElNE
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
qNo
❑ 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
4 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
PCNo
❑ NA
❑ NE
Additional Comments and/or Drawings:_-.' g
c�ug�l� oua 9.X:A
A,
w.A - a
DIDSIn (3.19g
,C)lIglo G �qo
�7*10
1n11 T1AL 1 oc� ca��, � ara 1NFAc-L
Page 3 of 3 12128104

31 H '41(a
Type of Visit 7Routine
pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: l $ Q Arrival Time: Departure Time: County: �d'� Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: VV�T �Pw•iinJ
Certified Operator:
Back-up Operator:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = d = Longitude: = ° = & = "
Design Current
Design Current
Design Current
Swine
Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
❑Non -La er
❑ Dairy Calf
91 Feeder to Finish IZJc4 1-4vO
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder I
El Non -Dal
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑Gilts
Non -La ers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cow
❑ Turke s
Other
❑ Turkey Poults
❑ Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
2No
❑ 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
❑ NA
ElNE
2. Is there evidence of a past discharge from any part of the operation?
1-1Yeso
W[—]o
[I NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
;rNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

r
Facility Number: 31 — 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: L,.�crd0w / .l C-^ (raAr✓ Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 21 20
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
UNo ❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
�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 t eat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
t3 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
Z
9. Does any part of the waste management system other than the waste structures require
❑ Yes
P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
cation
10. Are there any required buffers, setbacks, or compliance alternatives that need
ElYes
WNo❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
;2 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14, Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
El No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
Vo [-INA
[INE
17. Does the facility lack adequate acreage for land application?
❑ YesrN
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA
❑ NE
�..-.�; d '"x. f��§�kd�$ a'-:
Comments (refer to qucst�an.#) Explain any YES answersandlor�any�recomrnendati6ns or,any:idther cornments'F � y ;;
y*..'i';«i�_,*.fa �;-"i$v. R, F a xr'
Use drawings 6i facility't better expl*y Attiations (use additional pages'as necessary). , 5,q1 1;
y e ,az: �<+,dk' brr,i d�'i na a
i
T
Reviewer/InspectorName
a,,' ;� tf� E� , Phone: 4i0 --
3g
ReviewerlInspector Signature:
Date:
12128104 Continued

Facility Number: `aj —C�7(� Date of Inspection 18
01
Required Records & Documents �,
19, Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E14o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design
g El Maps ❑ Other �
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes E4 ❑ 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 Inspection�No
Weather Code
22. Did the facility fail to install and maintain a rain gauge? El Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes dNo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
❑ Yes
'o El NA
El NE
El Yes
El NA
El NE
❑ Yes
VNo❑ NA
❑ NE
❑ Yes
Ld No ❑ NA
❑ NE
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes L2'No ❑ NA ❑ NE
❑ Yes E No ❑ NA ❑ NE
❑ Yes 2 No ❑ NA ❑ NE
❑ Yes Cjlo ❑ NA El NE
El Yes [ / No ❑ NA ❑ NE
Cl Yes12/No ❑ NA ❑ NE
t �
AdditionalCornraents andlor Drawings
AL
12128104

916
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 'U Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: i. 0 Arrival Time: Departure Time: County: IDIALAJ. _ Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Phone:
Title: Phone No:
Onsite Representative: 43"r e&zwo Integrator:
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: =' =' = Longitude: = ° =' [� "
oil
esign
14M
CurrenWk t Design Current
Design Current
Swine Capacity
Population Wet Poultry Capacity Population
❑ La er
n-La er
'L'2.�
Cattle Capacity Population
FW'an to Finish
❑ Dai Cow
Wean to Feeder
❑ Dairy Calf
Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dray Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Layers
❑ Non -Dairy
❑ Beef Stocker
❑ Farrow to Finish
❑ Non -Layers
❑Beef Feeder
❑ Gilts
❑ Boars
❑ Pullets
❑ Turkeys
❑ Beef Brood Cow
Other
❑ Turke Poults
❑ Other
❑Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
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
o
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
YNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facilily Number:
Date of Inspection L t U
Waste Collection & Treatment
4. Is'storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: L A&W?-J 1 t _A GaGA) 2
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 Ie 3 S
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes [No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes CeNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [C No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes C�No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes P4 ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 2(N ❑ NA ❑ NE
maintenance/improvement?
It. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ElNA ❑ NE
1LJ too
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes E]k ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes dNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes VNo ❑ NA ❑ NE
Reviewer/Inspector Name
Pho
Reviewerllnspector Signature: 0&1
L Date:
Page 2 of 3 112128104
Continued

FacHity Number: 31 Date of Inspection D
Required Records & Documents
19. 19id the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the approprrate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
❑ Yes 21'No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
21,
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Ld No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
Rain Inspections ❑
Weather
Code
22,
Did the facility fail to install and maintain a rain gauge?
❑ Yes
�No
❑ NA
❑ NE
23,
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Id No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
YNo
❑ NA
❑ NE
25,
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
2�No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
(
❑ NA
[I NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
VN
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [�Ko ❑ NA ❑ NE
29, Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ld 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
EI/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
2 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
�,
El NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
KN
❑ NA
❑ NE
Additional Comments and/or Drawings
Hw
Page 3 of 3 12128104

Type of Visit OrCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit (�Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 11 'So Departure Time: County: Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: 13rL-C T 43IL66401 Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Sack -up Certification Number:
Latitude: 0 0 E:]' 0" Longitude: = ° = ' =
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish %Z�c. o J'j 00
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ 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?
Design Current
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number. of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes LI No ❑ NA ❑ NE
❑Yes
El No
[I NA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
/
VNo
❑ NA
❑ NE
El Yes
❑ NA
❑ NE
12128104 Continued

1
Facility Number: 3 t --q-71G Date of Inspection tL u
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes L'J 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: LA _AA arJ---
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 31 yl /
5. Are there any immediate threats to the integrity of any of the structures observed? El0 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 QVo ❑ 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 ffNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes DrNZo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) J
9. Does any part of the waste management system other than the waste structures require ❑ Yes E 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)
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
P'flo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? ❑ Yes
❑ NA
El NE
17. Does the facility lack adequate acreage for land application?
El Yes
,"No
MINo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Ld No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name �a t'j Phone: /2J % �! C — 73 Lf
Reviewer/Inspector Signature: Date: t a
12128104 Continued

rr
f
Faeility Number: 31 — �{'1(, Date of Inspection I ► a
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 3 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes LI No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[1- o
❑ 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
�❑
ETNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
VNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
L'J No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
DNo
El NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ Na
E NA
❑ NE
Other Issues
28,
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El Yes
�,�
L"No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
B No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
f
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
E No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 I.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[�No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
0o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
Zo
❑ NA
NE
Additional Comments and/or Drawings:
12128104

Q Division of Water Quality
Facility Number Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit 0 Ca pliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit [ Routine O Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: i13'b Departure Time: County: DUAL )— Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: I Title: Phone No:
Onsite Representative: &2-Ct S"2?WJo _ Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: = 0 01 = Longitude: 0 o = ` = "
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to finish
❑ Wean to Feeder
91 Feeder to Finish 1-L GO ! Z42b
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non-Layet
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population .
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reachcd 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 O No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
0No
❑ NA
❑ NE
❑ Yes
�io
❑ NA
❑ NE
12128104 Continued

Facility Number: 3 ` t{1(, Date of Inspection
.Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes JZNo ❑ 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: (A Gg tJ 1^ VAGm.,ki 1-
Spillway?:
Designed Freeboard (in): 19 , .S 19 • J
Observed Freeboard (in): S 2_ Z—g
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ffNo
❑ 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
[I NA
El NE
8. Do any of the stuctures lack adequate markers as required by the permit?
El Yes
,ENo
�J 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 Ai mlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes E No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes D No ❑ NA ❑ NE
❑ 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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ Yes
�10
❑ NA
❑ NE
0,<oo
❑ NA
Cl NE
<
El NA
El NE
,L.,
LdNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
�A Go�ti l .Z5 Q A VL+J C S w� b E R�wtakjQ) . S wI) G E � uay lit . k:*CP COPY 4) f
50Zs srAAn,Pt FS L'`�LCbi 'FLAA .
Reviewer/Inspector Name N p Phone: lbIT 6 —73
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: Date of Inspection q a
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes L" No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes dNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes l" No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
E: No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
QNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Ello
ElNA
ElNE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
[ 'No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Y ""
❑' NA
El NE
27.
Did the facility fail to secure a phosphorus toss assessment (PLAT) certification?
El Yes
❑ No
[-I KA'
❑ NE
Other Issues ,,�� ��//
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes I2'No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
B o
❑ 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
ETNo
❑ 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
ETNo
❑ 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
❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
,❑..,Noo
L-� 'No
❑ NA ❑ NE
Additional Comments and/or Drawings:
12128104

Jr
Facility Number F ?j 1 4-1L
V'Division of Water Quality
0 Division of Soil and Water Conservation
Other Agency
Type of visit 6
;/Routine
pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Z { d IO Arrival Time: ® Departure Time: County:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: -& &0L,-w
Certified Operator:
Back-up Operator:
Location of Farm:
Design. Current
Swine Capacity Population .
❑ Wean to Finish
i
❑ Wean to Feeder
® Feeder to Finish I -L
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish I
❑ Gilts
❑ Boars
Other
❑ Other I_ T
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: 0 e = f Longitude: = ° ❑ d
Design, Current
Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design Current-
Cattle Capacity' Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
i
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes 17No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes CJ No []NA ❑ NE
❑ Yes �(No ❑ NA ❑ NE
12128104 Continued

1
Facility Number:-3-
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: l t..AA-MA/ 2—
Spillway?:
Designed Freeboard (in): �4, �� •�
Observed Freeboard (in): ^ 7
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes RNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
El Yes 1 No ❑ NA [INE
j
❑ Yes ❑ No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ff No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 2 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) �(
9. Does any part of the waste management system other than the waste structures require ElLJ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste_ Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 2 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ffNo ❑ 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) f"F_ZC_0E Cc) (3EdZ-4%AU0 A SCrO
13. Soil type(s) R A
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
YNo
❑ NA
❑ NE
E�No
❑ NA
❑ NE
No
❑ NA
❑ NE
Ldl o
❑NA
❑NE
No
❑ NA
❑ NE
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other. comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
.Lt.) P660 �5� AWV%L�ssS FoIZ- 3w1_ �� SEAT:
GOOD F6� � -' �!L?ab� �,rb
A F'T&L, F t(VWL(= C>AT(- , L USED �N�_
� ►1 �6rZ. d&CA f"&U4)
Reviewer/Inspector Name -- ---- -�
- - Phone: Cqa
Reviewer/Inspector Signature:
Date: 2-13 lo
Page 2 of 3 12128104 Continued

Facility Number: 3 — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
l�
❑ Yes
o
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
21.
Does record keeping need improvement? If yes, the the appropriate box below,
es
❑ No
❑ NA
❑ NE
El Waste Application Weekly Freeboard Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
Rain Inspections [I
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
[IYes
L/J No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
IJ 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
El No
LJ 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
0NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
E� NNo'
El NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
[2 o
❑ 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
[f]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
ETNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
<o
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12128104

I
a
Type of Visit �f Compliance Inspection 0 Operation Review Structure Evaluation Technical Assistance
Reason for Visit iC? Routine O Complaint O Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: r Departure Time: 2 County: �Alw Region:
Farm Name: /1A �Q��/1i / d. �� Owner Email:
Owner Name: �i� f'�. &A;�ocod Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
/} r
Onsite Representative: Lr/`I •f�(/y'S Integrator: RDcc1G`� '
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o = 1 = If Longitude: = ° = 4 0 4{
MILIDesign -orCurrentSwine pacity P,ulation
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish Z0I9
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Discharges & Stream Impacts
• t
Design Current
Wet Poultry Capacity _Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys d
❑ Turkey Poults
❑ Other
et
t' Design Current
Cattle C
apa
c
ityMiUlatiioen.
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
Nur of Structur
El Dry
mbees:
Cow
�
[INon-Dairy
El Beef Stocker
❑ Beef Feeder
El Beef Brood Cow
Is any discharge observed from any part of the operation? ❑ Yes 1VNo ❑ 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 ONo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes XNo
❑ NA
❑ NE
other than from a discharge?
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 A No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Struct re � tru7;4��)
Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 7f%L� 2-
Spillway?: A4 /l!p
Designed Freeboard (in): /9,'S f�
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �gNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes EZNo ❑ 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 [PNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ElNE
(Not applicable to roofed pits, dry stacks and/or wet stacks) 10
9. Does any part of the waste management system other than the waste structures require ❑ Yes �dNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 9No ❑ 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 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
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 determinations[] Yes
PNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
1;7No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
VNo
❑ NA
❑ NE
/>✓FP ­ER /Zo M� , ; �sV-5 c7zo.�
Ze�-2 iaA-1 .
Reviewer/Ins ector Name f ` ° "{ ° ' k #* aY p �r a:.. Fhone: O -395,3 i
Reviewer/Inspector Signature: Date: 05 Z aS
12128104 Continued

A . � '
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes X"No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below, ❑ Yes P!(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
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
'9No
VNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
,VNo
XNo
❑ NA
❑ NE
26.
Did the facility mail to have an actively certified operator in charge?
❑ Yes
VNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
PNA
❑ 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
PNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
El NA
[I NE
If yes, contact a regional Air Quality representative immediately
!r
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
X No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
XN o
❑ NA
❑ NE
Additional Comments and/or Drawings: „
12128104
12128104

-
.�.: 4 - n 9�"� �"� i.. q. r� ' •r s4tt�s -..�iL3 R i 3-„>�s- !4x c f{ -. Nnw § M € r tx +a �� 3} �c ti ;� s s re�_.gy s M 6 �a -tS
,d3� I � �-i39� € � €�� s E�i4:t� � s(a 44 n } i 3�sf-� ; ��fl � t€ � 1 �� �€€� E 4s�§ ��ia�a 1�•i� 4§`98}yg SU,{1 „. N'.. _ {- -i � - h r +' � { ¢ ' }.• S i :a .
s5€. � .��.- ..� ,Rl�at,... a_... i a S. ,s -- 3�... s, �3:-i. s, au-»„>! , b. r....on,- ,§i a,€„<� , , 3 #,.�I 1_,.,"� 4:.� i : _'. W _ � �. s. .. i:.:at t3 �. • .�t�:^ 9
IType of Visit QlCompliance Inspection O Operation Review O Lagoon Evaluation I
(Reason for Visit /0 Routine O Complaint Q Follow up Q Emergency Notification Q Other
Facility Number Date of Visit: O Time: //�T
O Not Operational O Bel
U Permitted 0 Ceeerrti�fied 13 C�,on�diition/ally 7Certified [3 Registered
FarmName: ....... k6&..... 1 ! "!'.........{__ ..........................................................
OwnerName: ..... .. i �rY................. ........ i w.........................................
Mailing Address:
© Denied Access
Date Last Operated or Above T reshold: .........................
County:..............4 1%p r......................................I...............
PhoneNo: .......................................................................................
FacilityContact: ............................................... .......... Title; ................................................................ Phone
'No:
I...................................................
Onsite Representative. ..R...... c?...... .'!::..�.................................................... Integrator: ... .........1►�l�.iW�V.............................. .................
CertifiedOperator: ................................................... ........ I ........ I ............................. Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle - ❑ Horse Latitude Longitude �• ��°
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 11I0
Discharge originated -au ❑ 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 J�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? [ISpillway ❑ Yes No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............... I ................. .......................................................................................................................
r.
Freeboard (inches): ,5 2,6
12112103 Continued

Facility Number: — (� Date of Inspection ! 0
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes o
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes �'hT0
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? 0Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ANo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ZNo
elevation markings?
Waste Annlication
10. Are there any buffers that need maintenance/improvement?
❑ Yes A No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes XNo
❑ Excessive Ponding ❑PAN ❑ Hydraulic Overload ❑ Frozen Ground [ICopper and/or Zinc
12. Crop type �Epe Cc- '_ e_ .54ft U-
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes 51No
I4. 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 N
Odor Issues
/
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
�
❑ Yes No
liquid Ievel of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes ❑'No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes 7No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes/No
Air Quality representative immediately.
Field Copy ❑ Final Notes
7.)
CA &o# IdAu-s A160 t�a l.�E
CLC�rLC�
of f3�s��Ef,
,)
Co C WD
A-d7-9
�'Fc�r��s ��o r UP -fd VA-.
Reviewer/Inspector Name U
Reviewer/Inspector Signature:
Date:
7111112 /n4

PJ
Facility Number: — Date of Inspection
Renuired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? Yes ❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oel WUP, checklists, design, maps, etc.) ❑ Yes No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes PINo
❑ 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
No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
o
Y-P
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ YesNo
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
o
28.
Does facility require a follow-up visit by same agency?
❑ Yes
No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
o
trio
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
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 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
1211.2103

Type of Visit ,Coompliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ,v Routine O Complaint O Follow up 0 Emergency Notification 0 Other ❑ Denied Access
F_ Facility Number 3J Date of Visit:
Permitted [3 Certified [3 Conditionally Certified [3 Registered
Farm Name: &,e I �r`D1.�/✓} j�j Z ��
Owner Name: re!)
Mailing Address:
Facility Contact: Title:
T
Onsite Representative: . cite re k a 'r' Qwl_,_
Certified Operator:
Location of Farm:
Time: 0 C
Date Last Operated or Above Threshold: _
County: D Ve
Phone No:
Phone No:
Integrator: Brewi'3 O( 64+-014^c,
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 06 ff Longitude 0' 01 0 °°
M
Design Current
a W 111C L;avaciry ro uianon
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Gilts
of Lagoons , ,r.
.
i°/
Tr
Solid Traps
Design Current Design Current
Poultry capacity ;Po ulation Cattle Capacityz Population
❑ Laver I I ❑ Dai
❑ Non -La cr ❑ Non-Dairyj
❑ Other is
Total Design Capacity
Total SSLW
ubsurface Drains Present 11LJ Lagoon Area
aste
Discharges &tream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection 84 Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: D d _ A)et-j
Freeboard (inches): 3 2 l
❑ Yes
�No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
XNo
❑ Yes
❑ No
❑ Yes
/NO
Structure 6
05103101 Continued

Facility Number: -7 1 — 4 r7 Date of Inspection 3 ! z
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
I L Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Croptype C✓' C Gf ✓11
Yp 1 L✓L1 _ -
13. Do the receivingcrops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other 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?
2 t. 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?
❑ Yes dNo
❑ Yes R(No
❑ Yes ONO
❑ Yes /2TNo
❑ Yes ONO
❑ Yes ZNo
❑ Yes ;�rNo
❑ Yes ONO
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes IzNo
❑ Yes g(No
❑ Yes ONO
❑ Yes Id No
OYes ❑ No
❑ Yes ;TNo
❑ Yes ONO
❑ Yes ❑ No
❑ Yes XNo
❑ Yes 00
XYes ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Coiinments?.(irefer to gaestlon #) Explain4hy-YE&answers and/or any recommenditions nr`any-other comments-'
t r
Use drawings of faciii to better explain situations, (use�additibnaltpages as
g ty ` p necessary} [ Field Copy ❑ Final Notes
.,.
�: a , � � 4 , {i
.lar"
1 q . Need/ �e des;3nA �e Ae p"leer /`ece;v;'�5 Grog an -�te so;l sa►�1es.
/V¢¢Di 4o k-rer Flo, sie otro4c even f �%eld beok 6r
�-
IPie
wle- ked af' keep, t-1 i„ I -All
�� � S �� ✓ •tip Je �sUs T Gump keep,
Ae awn.er a,3 441'.r ono con �vs'on
about wk�`ctL � �drn.n� c�r,ect i eLs cyflf ,4o . A yv A j- � � of fie
2a01 4"CebvIpirly mco{'dj, qre ✓ e-) an -s;-fie AVXA tleee� be, elc_enf)
Reviewer/Inspector NameI`
Reviewer/Inspector Signature: Date: i n
05103101 v Continued

-Facility Number: I' — Date of Inspection 3 Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ 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 ,21"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 -PlNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes O'No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
itiona...:.omments and/or rawmgs:..; .1:'" ", ,,,.
19 .�rnn}) .�er�d ►ti,e ce�� es QF alJ f�,e 2on j� .E',�eeboG��l r�'Gp✓'d1
�r'o>r bo4� Ja)oanf.'Pe stjrG 4,0 ()Xe n wa.-she Qnet Y�iJ
LA1:4h f n bD d� y1 Or arf l t'Cg4 6►, e ve n4~s-fo- ce leu l4e
VN a ff l; e d o n -�-� r��-�-Fo,•�1 s-
2S GDG are
M 1 +/��e��e/ca fP G urr�►'1 � 13zp AOIS
ei- L✓ --Ofn T6 Y~t�
5 a !1CA o s bamnos ' n Are;1 '2P
�W �a ,' sa �t nS r!-s �v n�-��t✓`e � ��
� ,.►,, P a so � �-e s� reGer^'t �.cnv(a-�r'oh4 .
p l q-i rl ele''4 4; v e .Sot.7 s p[ a �► ,'S w r e o ff Q►.
fel li yd,^an� bas I's . We -PAW acres should rye dnvle l
jv11a1-4► do�� ��;�� sha")X be 19✓4 Iin
•-/Lie LA.1-10OW laP1 t recards .rk-,uld be 4v
-the LvMabfe CV,e-f pie-fcfv�i✓lq
IUoa'� : p I an.s +o cl eAri el,11 sludge o-�' a be vt4 54v to (oo4 dep �,4
�ro Q14 1 goeah ih vev .u-fowre
J
5100

Facility Number Date of Visit: Time: /100
Q Not Operational Q Below Threshold
0 Permitted © Certified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: ..................
Farm Name: ...G.�//'C6....farzuq.�;....�:Y..Z................... ........................... County: �if.0�►..'`......................................................
.....
17'
OwnerName:...........? re 01 I-Vc'�K.................................................................... Phone No: ................................................................................. _.....
17
Facility Contact:
Mailing Address:
Title:
Onsite Representative: ) C' / le nvv, Pc%V r S
................................................................
CertifiedOperator: ................................................... .............................................................
Location of Farm:
PhoneNo: ...................................................
Integrator: ,,.„.„r Ownr S of Ga D I r yt g
..................................................... .........
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 6 46 Longitude e 4 66
1
Desi
90, Current'
Cnnaeity Pnnuintlnn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Nuionber of Lagoons
,
xold,ng Ponds i SohdlTraps.
Design Current
Poultry- Ca aci :. Population Cattle„
❑ Layer I0 Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity L
TotaI:SSLW.a C
10 Subsurface Drains PresenUI0 Lagoon Area
J❑ No Liquid Waste
resign _Current
I
Es.
❑ Spray Field Area
g'
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes XNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes JYNo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes gNo
c. If discharge is observed, what is the estimated flow in gal/min? h J q
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ,E!fNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 21'No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ,ONo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes VNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ......4 .t".l. i!^!�.{�.r../UaNe 2 .... ..... ............................................................................................................. I........................
Freeboard (inches): 361
5/00 Continued on back

Facility Number: 3 ! — T �(c71 Date of Inspection l�
Sy' 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 �to
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
T Do any of the structures need maintenance/improvement? /0Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ONo
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 Iwo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes 'zNo
12. Crop type Cor►l,1 t4 k1E41a t SOtohors11S
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 JYNO
16. Is there a lack of adequate waste application equipment? ❑ Yes ONo
Reauired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes f'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.,ONo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) 2TYes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? Cl Yes No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes JZNo
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 /ONo
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 ;ffNo
1q Yi �i pis o d fc�e cie r0 P0(pd• 00h0g 4bis;v'Asjt;. Y;oo iv lj- eeoiyo 00 fpttbo • . .
rrespondence: ab;DU this visit: ;co • ................................... .
? . Need 4o ,,tow &etck s;de of or"q ;r�ql j�yoo•. anc�
J ��,g10 wto wQ� ,�octai ntJ
4,0 al�Qf.✓ O/ j {I eC.ti oa, u�' Cl r'k-e LA,#A �.
K weed 40 kgero .r"ee b aiv'oi rec o fd S -rev" b eT�t J♦ GL9 ooY1-5
O-rke-' 4c>'t n&l¢d Ot b aVC , -�tt irqG' 11� Vtd /'e("n.'Lf A"e UqP
lmp4 Q'� Ae bent i ��e� o- pea�f 4 PAave a[ooe well
n�a
Reviewer/Inspector Name, "�S�
. =.L. n ;� .f,s
Reviewer/Inspector Signature:yj/J�,lt„ Date: 10 Q J 5/00

FacUity Number: 31 — 6 Date of Inspection d QJ
,Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes XNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ['No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes fflPNp
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 JZNO
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes RNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? [] Yes ❑ No
ana , omments an or rawiin
At
J
5/00

'J 7
��Dtnsron of Water Qiiiahty
of Soil; and` Water Conservation
.Q'Divlslon'
Q,QtherAgency
is -c
'Type of Visit OCompliance Inspection Q Operation Review Q Lagoon Evaluation I
Reason for Visit ;K Routine Q Complaint Q Follow up Q Emergency Notification Q Other ❑ Denied Access
Facility Number fate or Visit: Time: Printed on: 10/26/2000
Q Nat O crat'tonal Q Below Threshold
JI(Permitted 0 Certified (3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: ........•......
Farm Name: r e tIJ r e 14 Z County:.D. ... /,-�
G...........................�...................................................................... ,............................................. .
Owner Name: �i fe� rQ rr o Los% Phone No:
FacilityContact: ...............................................................................Fitle:................................................................ Phone No:...................................................
MailingAddress: ......................................................................... . ............................................................................................................
Onsite Representative:.............VS lr!'t.�!!�,P%i ................................................ Integrator:.La1C.:4.'.i,r.✓..!J..:S..�T...��a..'+p./),)I °ti.............
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
JKSwine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 4 .6 Longitude �• �� �"
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
Feeder to Finish 12l,6 ❑ Non -Layer 1E] Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons 2 ❑ Suhsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. II'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. II'discharge is observed. what is the estimated flow in galhnin?
d, Does discharge bypass a lagoon system! (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structurc 2 Structure 3
Idctttificr; C IBA- 4 a Z
.....................................................................................................
Freeboard (inches): Z to 74
5/00
❑ Spillway
❑ Yes. %No
❑ Yes V1 No
❑ Yes No
❑ Yes g] No
❑ Yes ,K No
❑ Yes J0 No
❑ Yes iffNo
Structure 4 Structure 5 Structure 6
..................................................................................................................
Continued on back

Facility Number:3 — %_ Date of inspection Printed on: 10/26/2000
5: , Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes KNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes gNo
(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? fidyes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? J'Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes AdNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes S1No
11. Is there evidence of over application? []Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes JgNo
12, Crop „,.,..,._.....�P '�4 _rba_ �,•
5I l GCt -)'n
13. Do thereceiving cro s 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 ONo
b) Does the facility need a wettable acre determination? ❑ Yes J•No
c) This facility is pended for a wettable acre determination? ❑ Yes ff No
15. Does the receiving crop need improvement? ❑ Yes FNo
16, Is there a lack of adequate waste application equipment? ❑ Yes )!rNo
Reciuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available'? ❑ Yes 1�rNo
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 ONo
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 -13rNo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ZNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit'?
(ie/ discharge, freeboard problems, over application) []Yes 59 No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes XNo
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
'No
Rio yiQlWns or ilt feienc�es ire �tote� d>�tring �his'v�s t� Your ivii� �ee�i, , o fu th r
cories oric)Ceit e: atbarst this 'visit. .
Coimments refer En uestion # : Explaie any YES answers and/or any recom '
mendttitlnns or: any other 'comments
Use dirawing's of facility°to better explain situations. (use addi°.. A
tional pages as.necessary):
�. Fhj-4 Tailk )'5 ]ej1<►`h9> r9la*tlr leak.
[g. NeeA 4o kRve Faso Lv49 jC OpA Si S ih reee)rdJ
r+�lq+Cj, W �.5�'e ia1/! ' f � l,.fe#AL�G ac rr. +"►elf, . Use 6e-o; '!�1 � �2
f A M All ow roe tcee " t va,s4e I,� 1Aki 00.7 2Ck- 2V �
N e7E: i� pfp 1 ] e �1t c v +'��'�f �d ,50+ ► 4e.s�
N e7{: � )le 40 �ah-� Sov�E �t+�{Gq i�Srhg�i /a+h .SaoW 7a q�lo1r�r IU�•1�Lrsir'
Reviewer/Inspector Name ,.�-� ►1 C ttbq j
Reviewer/Inspector Signature: Date: 5100

Facilit+ Number: Date of Inspection t Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge M/or 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 PrNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes MNo
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? JaYes ❑ No
Additional Comments and/orDrawings:
5/00

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 31 476
Date of Visit S-IU-2oDt1 Printed on: 5/16/2000
O Not O erational O Below Threshold
IM Permitted N Certified E3 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: ..................
Farm [Name: Gxeg.Axon:11.X<4c2 ...................................................................................... ... County: A.upUn..................................................IRa.........
Owner Name: Ifs,..dreg.................................. Bro.wA......................................................... Phone No: 91.Qi2$9-322G..............................
FacilityContact: .............................................................................. Title:................................. ............. Phone No:
MailingAddress: P.Q.Box.48.7............................................................... . .......................... ..... arsaw.NC........................................................... 2A399 .............
Onsite Representative:..........
................................................ Integrator: ,,.................................
Certified Operator:Jeiremy..S ............................... Carr ................................................... Operator Certification Number: 20.16.8 .............................
Location of Farm:
.............................................................................................................................................................................................................................................................
Y.arlhwe�I.n>.Giinclsua�iat...Q� I'�sEst.sxtl.al.S1i X X4I. Apra,.!}�4.�rnilr.Qut�.n�.Ii.IQS.7........................................................................................
................................................................. .
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 • 52 ' 35" Longitude 77 " 54 ' 33 i'
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 D WQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge'?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3
ldentifier: .........lagoon.. L.......... ......... LagA.(u1.2......... ... ..........................
Freeboard(inches): ...............25...............................42.............................................
❑ Yes 9 No
❑ Yes ® No
❑ Yes ® No
❑ Yes 52 No
❑ Yes No
❑ Yes No
❑ Spillway ❑ Yes 0 No
Structure 4 Structure 5 Structure 6
............................................................................................................

Facility Number: 31-476 Date of Inspection 1 5-10-2000 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 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
(1f 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?
H Yes
❑ No
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
0 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
0 No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
M No
11. Is there evidence of over application'? ❑ Excessive Ponding ❑ PAN
Q Yes
0 No
12. Crop type Soybeans, Wheat
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
0 No
16. Is there a lack of adequate waste application equipment?
❑ Yes
® No
Renuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available'? ❑ Yes 2 No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes H No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes 9 No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 0 No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes H No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes H No
23. Did Reviewer/Inspector fail 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
:1�0: uioltttians: fir:d�ficiericies.... riot.... tu'ring f�iis visit:: titi �iviyi:receiv;e nn ftirNier
.f�hi'F'PC.13l1pl�P�PA �1lfttillt th;k`. i4vit. • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . •. •.
# 7 - lagoon # I - need to mow weeds on outside slope.
NOTE: lagoon #2 - during the operation review had 47 inches of freeboard. The lagoon design indicates the stop pump marker to be at
13.2 inches. Do not pump below the stop pump marker because you will be into the pennanant storage. Pump down was due to the
nstallation of a new gauge pole.
Reviewer/Inspector Name

Fa�iliV Number: 31-476 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 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,c. 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 H No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes CK No
J

"t ©Division Of so]I and Water.DllSel'VRtiOii �O eratlon�ReVlew �`<' t i,>a3' }�
[3Division of Soil and Water Conservation, '.Compliance Inspection '`= s 'i i 't" 'f
„ - t
ffPkAsion-of Water QU,aI[ty Complyance Inspection
` Other Agency Operation Review] �' �� ' }
k ... i i ..
!Facility
ine Q Complaint Q Follow-upof DW inspection 0 Follow-upof DSWC review Q Other
Number 3� 47L Date of Inspection
Time of Inspection E= 24 hr. (hh:mm)
© Permitted [P Certified [3 Conditionally Certified [3 Registered C] Not OperationalOperalia2!j Date Last Operated:
Farm Name: Gyt� %k4........' ...�. # - ... County:......140sr............................................................
............." ' �......... .....`-.............................................
Owner Name: ....................5.7.(fly!.......................................... Phone No:I........................................
Facility Contact: .............................................................................. Title:...................... ................ Phone No:
MailingAddress: ......... k.a..........60y.......... L .m....................................................... ......Lk&,6Q 1 N�: .............. ... ns..........
Onsite Representative: ......., n
....$.l;ei'1................. .., Integrator: . ...........................................................
Certified Operator:...................................•.,.......................................................................... Operator Certification Number: ..........................................
Location of Farm:
......QtS....... .1 .e......,�?.........� ........1....i.y.....01 .....tt ZUS..... n.......5,.....� 51-.................................................................
.................................................................................................................. .....................................................
Latitude =• =' i Longitude =' =` =11
Design Current., Design: Current Design Curient'
-
Swine oultry. ;Capacity Po ulatiCapacityPopulation Ption!. e
❑ Wean to Feeder ❑ Layer ❑ Dairy
Feeder to Finish ❑Non -Layer ❑Non -Dairy t.
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other Ii
❑ Farrow to FinishTotal Design Capacity i
O
s ❑ Gilts E 9,t
❑ Boars Total SSLW `
p ❑ No Liquid Waste Management System
Field Area
�Nutnber of Lagoons 0 ❑ Subsurface Drains Present ❑ La oon Area ❑ Spray
I3olding�Pondsl $blid'Tra s �'
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, noti fy DWQ)
c. if discharge is observed, what is the estimated flow in gal/ruin?
d. Docs discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes Qallo
❑ Yes
q No
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes M No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ,�,Zr
Freeboard(inches): ........... .............................'1.T............... .................................... ................................... ......................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes' allo
seepage, etc.)
3/23/99 Continued on back

�facilityFVumber: Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ® Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? QM Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Anolieation
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
® No
It.
Is there evidence of over application? [:]Excessive Ponding ❑ PAN
❑ Yes
No
12.
Crop type cufV\ _wtnnc.
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
CR No
c) This facility is pended for a wettable acre determination?
❑ Yes
© No
15.
Does the receiving crop need improvement?
❑ Yes
[A No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Reauired 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.)
ED Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
( No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
❑ Yes
No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
PNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[j No
�'Vo YiQI'a�igris oi• ci�ficieucie •vkre pQfed• cltjrr.>trig this'visit' • Yojk :wiil•tee iye iid fui•thr r '
corresporic�ence. abauti this visit::....... : :
Conatmerits (referlta gttestpin #):,,Explain' any:�'ES answers and/or•any-'recome;iEdations,or any otti'er coxaiments''" t
t
Use drawings of facility to better ezplain'situations (use' additional Pages as necessary) ( t `F,
4 a
(S :
1. E M IO^ &VQ. CN Gr. OJt� 6�� t,�k� 0{ t loe1. S ul toe 1` t t [ U CO F (S�'�2C}ef7 sae moc�Je� Cw.d 'l•�.- a.�rc�PY��P,tK-- V%rv'�p�t�
Q: \jZo .�rtc\ G�a�_`� �: �c�• i ; �.;� �ve e t�. ' e� t (,�. ' t ha�lop— t we .
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
3/23/99

1
1 L
Facility Number: 31 — t� 7�
Date of i nspection
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
R No
32.
Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover?
❑ Yes
[$ No
3/23/99

-
wE3 Division of Soil and Water Conservation E3 Other Agency
X z'
£� Division of Water Quality g
y,
may+ p
Routine Q Cam faint O Follow-up of DWQ ins evtion Q Follow-up of DSWC review O Other
Date of Inspection
I D—[:= -------------- j Facility Number
Time of Inspection a = � 24 hr. (hh:mm)
0 Registered Wertified © Applied for Permit ©Permitted 113 Not Operational I Date Last Operated:
FarmName: ..................C?KA ....... &rollin.......... ....... ................ ..... County: ......D.Loir....................................... .......................
Owner Name: 6,. .-----.�Y{?lalsl\ ............................................. Phone No: .... .- 01��:i..-. i 7
Facility Contact: ........ ...�tlW*, li!:k�................................. Title:................................................................ Phone No: ..� i4 .?��.�a. i ............
MailingAddress: ............ ...0 ,.... La ......`L............................................................... ...... ......................................... ... �. .!q.....
Onsite Representative:............ ,� ....a....s........... g
'5 �11 ................... Integrator �! �/.+� M�.S..........................................................
Certified Operator................................................................................................................ Operator Certification Number .........................................
Location of Farm:
sIL.............. s
..........fL..1.9.:.................I........I.........I. ....
.. ...... . .........
Latitude • 4 " Longitude ' "
sign Current Design ,. 'Current
aacity Population : ,-Poultry Capacity, Population
%,auie ,. a apacny YUPUMLiuu
.
❑ Dairy
❑ Non -Dairy
3 %,
Number of>Lagoo*s / Holding P6nds �� J❑ Subsurface Drains Present �1❑ Lagoon Area I❑ Spray Field Area
�. ❑ No Liquid Waste Management System
uR
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes 5 No
2. Is any discharge observed from any part of the operation? ❑ Yes G No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes [19 No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes M No
c. If discharge is observed, what is the estimated flow in gaUrnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes R No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes ® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ® Yes ❑ No
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: —
8. Are there lagoons or storage ponds on site which need to be property closed? ❑ Yes �O No
Structures La oons tioldin Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes is No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: t)i...... 2......1!+ ............... ...................
Freeboard(ft): ...........:�A............... .... I......... L4........................................................................................................................................................
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?
EP Yes
❑ No
12. Do any of the structures need maintenance/improvement?
® Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
V1 No
ff aste_Application
14. Is there physical evidence of over application?
❑ Yes
In No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type Carn............l A ................ qpd�,,.f............... ............... ....................... .....................................................................
I.........................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
M No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
M No
18. Does the receiving crop need improvement?
❑ Yes
® No
19. Is there a lack of available waste application equipment?
❑ Yes
® No
20. Does facility require a follow-up visit by same agency?
.J21 Yes
❑ No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
51 No
22. Does record keeping need improvement?
❑ Yes
C No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
iP No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[ No
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
No
0. No.vio'lations.or. defideRcies.were ntited,dtiring this.visit.• You:Weill receive•no:furtlier,
eorres'phhdeh0 A oid fhis.visit.: :: :
Usedrawlirigs of facility to'better explain`situatiatis (use additional pae ges asn cessary}•�� '"£:_ h
�"'1 `J""'`&E,�a.�aY.i.: K.A, r°°'^°xr.,k,'De'S#' .f ..,w, •sa:,.d:%p.',as., �,... .s <..$; .5`. ,R*e:,�4 ,. i;`: ', r,`'.:.s. ',+5:
�. C1lr�q.�r ��UG� l!Y'tr7'ii�C1U�1 Elm. loci lTb1 y n��Un^-� (OlclaitV y+�p.� rp �
Sru d� .. pFart6 �r ov��MV Irly�r S��U h�L tW+ CPe� 6- l7VbSS�f1` W&a IeWh j'
1
+ woo � `o� e�. a �iYt a� (a,a�;. � sk., 4 �L M*,W. Elroslnv-
ayri�s o r , rrvo� d \,kk
dtk4 W��1 S6dlj 1� I^evcs�t .
7/25/97
Reviewer/lnspector Name
' ` �.
'
I H<yv.
Jilrirt
.�
°
Reviewer/Inspector Signature:/
f,�%
Date:

❑ DSWC Animal F
t eedlot Operation Review Ufa
J® DWQ Animal Feedlot Operation Site Inspection
® Rot►tine 0 Complaint 0 Follow-up of DIVO inspection 0 Follow-up of DS1VC: review 0 Other
Date of Inspection td 4
Facility Number 3 �
Time of Inspection � 24 hr. (hh.mm)
© Registered 13 Certified Cl Applied for Permit ©Permitted JE3 Not Operational I Date Last Operated:
Farm Name:..�3...B.nr.+.t.jnL.................................................. County:...,D.,j,jil-et................................
Owner Name: .............. C.,.Sr7n.................. ... ?s'4.: t...................., ...... Phone No:.......................... ...........
Facility Contact:....................................................... . Title:
Mailing Address: .F.,Y0... . q's
Onsite Representative:.... ........La r r
CertifiedOperator:...................................................................................................
Location of Farm:
..............tt Phone No:.............
...... .....Y.�J.�^'�. pp!}...&k . ..................
Integrator:......�.?:S•..ril..s!!.. �........
Operator Certification Number;.
................
4?.....e.aS..,.�..;.c4,� ...c ..... .. 1..l..4,.1...,�.......c..Q..m.x�..,nr- ........................ ....... A
Latitude Longitude
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer E
Dairy
❑ Non -Layer airyIj
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons I Holding Ponds 9Subsurface Drains Present ❑ Lagoon Area
❑ No Liquid Waste Management System
JIKSpray Field Area
General
1.
Are there any buffers that need maintenance/improvement?
❑ Yes
9No
2.
Is any discharge observed from any part of the operation?
❑ Yes
RNo
Dischar-e orioinated 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
allo
5.
Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
IQ No
mai ntenance/i mprove ment?
6.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
EQ No
7.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
�No
7/25/97 Continued on back

Facility Number: •�
8. Are there lagoons or storage ponds on site which need to be properly closed'? ❑ Yes KNo
Structures „(La[!oons.told inu Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes MNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (ft): .................
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?
❑ Yes ® No
X Yes ❑ No
12.
Do any of the structures need maintenance/improvement?
Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum,or maximum liquid level markers?
❑ Yes
DD No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
KNo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ... G..Y..................................... 6.. „- ................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
No
17,
Does the facility have a lack of adequate acreage for land application?
❑ Yes
® No
18.
Does the receiving crop need improvement?
❑ Yes
® No
19.
is there a lack of available waste application equipment?
❑ Yes
® No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
21 No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
❑ Yes
f@ No
22.
Does record keeping need improvement`?
Yes
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
ANo
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
®,No
25.
Were any additional problems noted which cause noncompliance of the Permit'?
❑ Yes
59-No
® No.viola'dons or dericiencies.were-noted during this.visit.• Noum'ill receive fto' further'
correspondence Ah'oiit this:visit:•
. .. ...
Comments (refer to question #):.Explain any YES answers and/or any recommendations or;any other comments.
Use drawings of facility to better.exptain, srtuahins: (use additional piiges as necessary). s.
nr
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22-• QM- t
7/25/97
Reviewer/inspector Name
ReviewerAnspector Signature:
J" 1 Date: to f

•
Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time: 3
Farm Name/Owner:
Mailing Address: —
County:
�4
'M
Integrator. (3U C _ _ _ Phone:
On Site Representative: Phone:
Physical Address/Location: &C S k t t 4 L
Type of Operation:
Swine
Poultry Cattle -
Design Capacity: 4a- OU Number of Animals on Site: /D 00.
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: ? 9 3 Longitude: -7 ° �� { ' Elevation: Feet
Circle Yes or.No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) 9 or No Actual Freeboard: Ft._ Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate land available for spray? fle:;;r No Is the cover crop adequate? Yes or No
Crop(s) being utilized: T, j_�_
Does the facility meet SCS minimum etb cn eria? 200 Feet from Dwellings? Yes or N
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet'of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments: i (inn �M \ n C - ' � o1,,_ D6,,ad -✓yMU V l -/J -
0 1,-,�__
Inspector Name -
Sign t e
cc: Facility Assessment.Unit
I
Use Attachments if Needed.

du Site Requires Immediate Attention:
Facility No.: 7, J — (p
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 7b , 1995
Time:
Farm Name/Owner; (IF Q C> L CQWv �!
Mailing Address:
County: —� L+,. -
Integrator: _s? n�,,, cal— i��ti----_- _ Phone:
On Site Representative: _ N Phone:
Physical Address/Location: UA/ .•.&. C-S9 [�•�F,�„•••.,,, i'l� Vlntio�SL.6 th V Sy
Type of Operation: Swine —s_z Poultry - Cattle
Design Capacity: in L40 Number of Animals on Site: 1,2 C7
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) Yes or0 Actual Freeboard: f) Ft. t* Inches
• Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes otiv
Crops) being utilized: Does the the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments: o ;A-
Inspector Name
cc: Facility Assessment Unit
Signat
Use Attachments if Needed.

Q J cS L
•
Site Requires Immediate Attention:
L Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 'cT- -�?-3, 1995
Time: 1(�.5
Farm Name/Owner:
Mailing
County:
Integrator: 'f �h rprlMn Phone:
On Site Representative: " -- Phone:
Physical Address/Location: i� o -5_,` j�C'� ►� I l Ll Q 2-4 U -na 4 I 3�_ _ s - cf�
Type of Operation: Swine `� Poultry attlek�
Design Capacity: _I -. /o Q _ Number of Animals on Site: /A 60 .
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: -341_° -0—' 3Y" Longitude: �* �-3-12 Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) 6 or No Actual Freeboard: 3—Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or(9 Was any erosion observed? Yes of V
Is adequate land available for spray? (9 or No Is the cover crop adequate? neor No
Crop(s) being utilized: ' _ � 49ESCAAM._
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? es or No
100 Feet from Wells? L�Ror No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes `C1
Is animal wasteland applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes 06
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o(2!,o If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Inspector N
(3 e,&&
Signature
cc. Facility Assessment Unit
Use Attachments if Needed.

0
OPERATIONS BRANCH - WO Fax:[phone] Jul is 195 12:06 P.03123
ane icequxres 1,rnuicuwLc ��......,..
Fa,iiity Number:.3/
SITE VISITATION RECORD
DATE: :2 / 2 _, 1995
Owner: t� 2.10 w ,o^_^�-- FaFm Name:
County: •� --
Agent Visiting Site: Phone: 916 - 9 G. - 4 1
Operator: Phone:
On Site, Representative: _ -- V i, k-S D _ Phone: 0 f 3 - 3 GO Z)
Physical Address: — I Vn r. �` 1-<, -- �. S A2 .g± _ M� �,�„ � �„ e m
Mailing Address:
Type of Operation: Swjue ✓ Poultry Cattle —
Design Capacity: 1 A L1, a Number of Animals on Site: 11t40
Latitude: -4 —' " Longitude: • •`° '
Type of Inspection: Ground Aerial
Circle Yes or No
Does the Animal Waste Lagoon have suf Icient keeboard of I Foot f 25 year 24• hour stone event
(approximately I Foot+ 7 inches) Yes or& Actual Freeboard: Feet _Lj_ Inches
For facilities with more than one Lagoon, please address the, other lagoons` freeboard under the
comments section.
Was any seepage observed from the lagoon(s)? Yes o No as there erosion of the dam?: Yes a No
Is adequate land available for land application? Yes or'No Is the cover crop adequate? Yes or No
Additional Comments:
Fax to (919) 7I5-3559 Si�4atere of A95ilt