310540_INSPECTIONS_20171231

NUH i H UAHULiNA
Department of Environmental Qual

�i�45 :
Fa I tyYNuf ikr:
2—wDtia-0—
b QDtAsyon;hof Water Qual ty t 4
bQ¢vr ,tl 3
:Dwlslon of Soil,andWater)Conservati
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit,,�TRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1 Arrival Time: �parture Time: County:
Farm Name: d` Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone No:
Onsite Representative: r �✓ Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Region: C_ .� rb
Location of Farm: Latitude: =1 o = t 0 ,1 Longitude: = ° = � 0
All
°l$��� ",� Design Current;lht ,Designs Ciirrentx i Design�P ��d.i:,:.��'; sett Po uahonW Wet= ouryCa act Populat�gd`,yy tCattle CaptcitPo Mhon;
o-tffr s py p:a�aC6cs t'r ::rc�� �t?':,'�, ,ati'.14 r-�';:ow.. Y..P-,.x�❑ La er❑ Non -La er ❑ Dai Calfr .sv t e4 E#❑ Dai Heifer
� RI k_iF j3f:� k j##� a,' ❑ D CowIl�Pulr'f}tm .x , rya to # ❑Non -Dairy
❑ La ers ❑ Beef Stocker
❑ Non -La ers�
t ❑Beef Feeder❑ Pullets❑ Beef Brood Cow4 Turke s:� t�+ .� + ❑ Turke Poults❑ Other ` ❑ Other .Numberof Structures.
a -�,T ,f te':. :i '� .;piY :is',��'7 7+
.
g
Wean to Finish
El Wean to Feeder
❑ Feeder to Finish
El Farrow to Wean
Farrow to Feeder
❑Farrow to Finish
❑ Gilts
❑ Boars
rr
Discharees &Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field [I 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 pas[ 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
❑ Yes 2054o ❑ NA ❑ NE
❑ Yes pNo ❑ NA
❑ NE
❑ Yes 2!o ❑ NA
❑ NE
❑ Yes PoNo ❑ NA
❑ NE
❑ Yes 2rNo ❑ NA
❑ NE
❑ Yes .2rNo ❑ NA
❑ NE
1 of 3
12/28/04 Continued

Facility Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
P a. If yes, is waste level into the structural freeboard? ❑ Yes [a No ❑ NA ❑ NE
Structuu I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): G J
5. Are there any immediate threats to the integrity of any of the structures observed? ;0�es (4pVo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) TT
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [,-,TNo ❑ 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 _P No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [ ZNo ❑ 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
21 No
❑ NA
❑ NE
maintenance or improvement`?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
CZNo
❑ 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
ONO
[DNA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
KNo
❑ NA
❑ NE
Reguired 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 [—]Design [] Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste4an s fers
❑ 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 � No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ONO
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permi . ❑ Yes KNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes eNo
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ZNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ONO
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes LEI" 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.
—9
`30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes ZNo ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes 1!!�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/[nspector fail to discuss review/inspection with an on -site representative?
❑ Yes o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
4 ffgf i 4✓d -t'oki U apt i'l l
'lox
,
-j44a/CrU�/ate
--'/
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
1n 4baxI
yBars�
cc-�­
Phone:—6 --
Date: f 2
/V X '>_
/4/201

Type of Visit:
Reason for Visit:
Date of Visit:
Farm Name_
Owner Name:
Mailing Address:
Physical Address:
mpliance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance
Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Arrival Time: /' , t? Departure Time: Cou
Owner Email:
Phone:
Facility Contact: Title: Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number: A6
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Region; Li
Design Current
Swine Capacity Pop.
Design Current
Wet Poultry Capacity Pop.
Design C«urrent
Cattle Capacity Pop.
Wean to Finish
La er
Dai Caw
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
Farrow to Wean
Design Current
Dai Heifer
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turke Puults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [2"No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ZrNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facility Number: jDate of Ins ection:
Waste Collection & Treatment
4.'Cs storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA [] NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
/j "No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
T�
6. Are there structures on -site which are not properly addressed and/or managed through a
[]Yes
❑ NA
❑ NE
waste management or closure plan?0"'No
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
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
[ XNo
❑ 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
[21 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
ONo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
PNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E(No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
P'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
ZNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ I20 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
0
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
�.>
o
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Inspection:
24. Did thq facility fail to calibrate waste application equipment as required by the perm ❑ Yes �No
25 Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes WNo
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 9.No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �No
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?
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes y No [DNA ❑ NE
❑ Yes PNo ❑ NA ❑ NE
❑ Yes KNo ❑ NA ❑ NE
❑ Yes KNo ❑ NA ❑ NE
❑ Yes
VfNo
❑ NA
❑ NE
❑ Yes
o
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations.or.anyk9ther. comments ,� $ ;- AN
Use drawings of facility to better explain situations use additional pages as necessary).
wA' N
{J 6rouar ddn`� %Q�reu� to1ay1 r�
l�/'AAA S7 c� J-e 'fit. irJ Co re cs� so
to % y
,r///
-s ad to '_3
b k K9_S C.-19 pl ce_c� a
��c �n sari
Reviewer/Inspector Name: Phone: q b
Reviewer/Inspector Signature: Date: I
Page 3 of 3 21412011

Type of Visit ,,V Compliance Inspection U Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit�outine O Complaint O Follow up O Referral O Emergency 0 Other El Denied Access
Date of Visit: Arrival Time: d, U Departure Time: County: Region: L✓�
Farm Name: �{�( "A' b i -2- Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: 'e, '" :;
Certified Operator:
Back-up Operator:
Phone No:
Integrator: IW
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = e = S = Longitude: = ° = 1 = 4f
�>'� e z. s tP.l -1 ti,Fr T ', ���rfA�,' r a;�. d ¢ E
!fa `tr t �� YI .: �d A.' ?'v i+!s;a'�" g�.laf,
¢ {,DCSlgrix e.',Cnrrent. a Designs , CUCrerit 93 1e. ' 'r SS� E r r ' Desl�,n� Gug�yent
_ f r, sF a./ : .� �l y ..- ®: r r'6Y 3 �t idY�..i[:{� iN�r .
,; Swine;_' �rCapacity8`.Rop'ulation te�sWetPbultryr� CapacrtyPopulation�Cattle� r ,.�t~apacity pop -
�. �xs �,.F� �a�ss lr.at.,:x� Sr..c.�'Ri=S''a,�� �_. a,_...rx-:�s
❑ Layer ` El Dairy Cow
❑ Non -Layer El Dairy Calf
z ,r �, r = ,Y ❑ DairyKeifer
Yj
Dry Poultry, 4 f ; k ❑ D Cow
r. ❑ Non -Dairy
F❑ Beef Stocker
i, ❑ Beef Feeder
❑ Beef Brood Cow
t
Others
❑ Other Number of Structures
:.y.g 1.7.-riff'-i E. i t: a. T� ,--8? -- :e-: ?. r.d'. �a r4t-a a-:? iT. �` � P 3
El Boars ❑ Layers
'El Wean to Finish
g
El Wean to Feeder
❑ Feeder to Finish
El Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑Gilts
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Aoults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation`?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El Yes
[I No
El NA
[I NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Pale 1 of 3 12/28/04 Continued

Facility Number: 3J—,50 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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: /
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? [] Yes ❑ No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ❑ No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 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 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
£r ,; ba-€.' <� jx,:*' 1i"fP•nY� , -�. rY#¢:3�,::'�its.'. to
Comments (refer to question'#) E'xplain any YES;answers and/6 r an, or an other comet nts�
Yrecommendations,
Use drawings of facility to better explain situations: (use `addrtiona[ pages_os necessary)-'
Reviewer/inspector Name , f r �� ':, x , / Phone:
Reviewer/inspector Signature: C_ Date: %24 Z/-j
1212R/Od' Continued

Facility, Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [�'No ❑ NA [:I NE
the appropriate box. ❑ WUP El Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard Oaste Analysis Voil 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
J2No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
.2rNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
0Yes
❑ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0'No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
WNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
,ETNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
2 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
�No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
;No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
ZNo
❑ 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
,�1
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
q No
❑ NA
❑ NE
Additional Comments and/or Drawings:
V A�
N
Z� 73 6
?AFA2
0. b1"
jqllo
0, 76
12 S_/4O
• /%1Ssl rig/s f'
,;Z
c/ o
�a ,6� ,¢s/�� Ave
/nor/ a� , cry v�p ZA�e_
Page 3 of 3 12128104 `.1

w
Type of Visit Q Compliance Inspection Operadon R
(61
Reason for Visit JQ Routine 0 Complaint 0 Follow up
evlew 0 Structure Evaluation 0 Technical Assistance
0 Referral Q Emergency 0 Other ❑ Denied Access
Dale nt1'iail: Arrival Time: Departure "Timie: ;0 county: v° - Region:
Farm Name: (AgkV //l /SAD Je5' -D+C Ah) ` 0'-/ AOwner Email:
Owner Name: Qom✓ 5' Phone:
Mailing Address:
Physical Address:
Facility Conlact:
Title:
Onsite Reor"entative: I Integrator:
Certified Operator:
Back-up Operator:
I..,ocation of Farm:
Swine
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Phone No:
Operator Certificalion Number: `
Bark -up Certification Number:
Latitude: = o ❑ 4 ❑ a Longitude: ❑ c = 1 = N
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
f ❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turke 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
❑ Dai Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes KNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Facility Number: 3l — s5
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?
Stntcture I Structure 2 Structure 3 Structure-1
Identifier:
spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes VNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structur,: ; Structure 0
❑ Yes )No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment I threat, notify DWQ
7. Do any of the structures need maintenance or improvement? El Yes Vo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
It. 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.) l
❑ PAN ❑ PAN> 10%or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop types) A61_40c14
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
El NA
El NE
18. Is there a lack of properly operating waste application equipment?
ElYes 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):
i
Reviewer/inspector Name ; i k Phone: It., -S-Y.2 At q �)
Reviewer/Inspector Signature: Date:
/1/16/U4 Gonnnuea

Facility Number: 31 —St(d Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes A 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
No
❑ NA -
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
ElNA
[INE
24, Did the facility fail to calibrate waste application equipment as required by the permit?
ElYes
No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
19.No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
'No
El NA
El 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
XNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
"'—No
ElNA
❑ NE
If yes, contact a regional Air Quality representative immediately
IN
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
I No
ElNA
ElNE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
XNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
XA
MNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104
12128104

(4,
Facility Number
vision of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 9^4;1piiance Inspection 0 Operation Review 0 Structure Evaluation
Reason for Visit �outine 0 complaint 0 Follow up 0 Referral 0 Emergency
Date of Visit: ftArrival Time: Departure Time:. J County:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone:
0 Technical Assistance
0 Other ❑ Denied Access
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region: L&AR
Latitude: 0 e = g Longitude: = ° = 4
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
E-1
Layer
Non -Layer
.Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turke Pouets
❑ Other
Dischar>zes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑Yes
El No
El NA
❑NE
❑ Yes
ETNo
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE
12128104 Continued

Facilit *Number: Date of Inspection �.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ErNo
❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
[�10
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?. -
Designed Freeboard (in):
Observed Freeboard (in): tV .
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[ZNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[jNo
❑ NA ❑ NE
through a waste management or closure plan?
4
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
RNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[,7No
❑ 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
W(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
ZNO
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
[:]PAN ❑ PAN > l0% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[;No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Z_No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ yes
FTNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
XNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
4o
❑ NA
❑ NE
Comments (refer tn•questi"on #}. >vxplain ariy 1'ES answers and/or any recommendations or any other comments.
I1sdi aw€ngs�goff cilitogb tter explain sikuatiuns. (use adds onai pages as necessary):
t
dtyl�? .- c A--t coin Gc/ R �f� �S wL rr p�
s /ZaS %ap4%eeal/ZZZ/oi:ot
ffiCr v v l�r,eoo�
C r 0 e-AcL .. �r/
iewerlInspector Name �Phone:iewer/Inspector
Signature: C Date:
E
Page 2 of 3 12128VU4- Conttnuert

Yacility`Number: 71 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 20'N' o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑lqo ❑ NA ❑ NE
the appropirate box. ❑ WUP 0 Checklists ❑ Design [I Maps [I Other
&C3
oesrecord keeping need improvement? If yes,a
the appropriate box below. ❑YesTo ❑ NA ElNE
Waste Application ❑ Weekly Freeboard aste Analysis ElSoil Analysis ❑ Waste Transfers ElAnnual Certification
ElRainfall ElStocking ElCrop Yieldinute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P-No ❑ NA ❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
;;?No
❑ NA
❑ NE
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
2
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
210
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Cl Yes
❑ No
❑ NA
E2NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
;iVo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
eNo
❑ 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
RrNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[. +No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
PNo
El NA
El NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
PNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
33
of ?q
r fit✓ � � �` lJ r'a v��n:s
12/28/04

Type of Visit Ptompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: ��y%,r o Arrival Time: Departure Time. County:
Farm Name: 71 �c%� ^ff— ��� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: e: o l s
Certified Operator:
Back-up Operator:
Phone:
/n Region: A4
Phone No:
Integrator
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = 6 = Longitude: = o = & 0 «
Design
Swine y Capacity
Current
Population
Design,, Current ' `
Wet Poultry Capacity Population
Cattle
Designs Current ..
Capty Pop.ulaton'
❑ Wean to Finish
❑ Layer
❑Dai Cow
❑ Wean to Feeder
❑ Non-Layet
❑Dairy Calf
❑'Feeder to Finish
A3
0 D
Dry Poultry
❑ Dairy Heifer
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Da Cow
❑ Non -Dairy
❑ La ers
❑ Farrow to Finish
❑ Gilts
❑ Beef Stocket
❑Non -La ers
❑ Beef Feeder
❑ Pullets
❑ Boars
❑ Beef Brood Cow
❑ Turkeys
.,,
Other
Number of Structures:
❑ Turkey Poults
❑ Other
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
E[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
ONo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Z No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: — sib 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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): (0l
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 ❑ No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below, ❑ Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ 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
❑ 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 questiow Explain any YES answers and/or,any, recomme ndatiitn's)or any other comments
,IJse druwm s of.facili}}.�,.to better ex fern sttuattons //use addtttonal ` a es asinecessa
=J. I► l p �+ t- i'y} -+F
ReviewerAnspector !Name � Phone:
Reviewer/Inspector Signature: Date: l G f
12/2S 4 Cnntinued

Facility Number: ! — Date of Inspection Q
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes An No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ,❑"'Yes ❑ No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists 'Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield F'120 Minute Inspections ❑ Monthly and 1" Rain Inspections ff Wcather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes ,0 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
.❑ No
ONA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
EjNA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
J2'No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
,2]�NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ErNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
D 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
12No
❑ 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
❑No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Commentstandlor Drawings: r
f fir& o S7/7 C7177771771s 7177
®de-
Co�'�t
12128104

Date of Visit: i i�(o Time:
Facility Number r'�
10 Not Operational 0 Below Threshold
Permitted dCertffled 13 Conditionally Certified © Registered Date Last Operated or Above Threshold:
FarmName: ..... Le,.lnl...I....... ............. ..._ ......_..._............ _ _ .__._ County: �uP .._ _ .........._ . »._ ..».».»........»..
Owner Name: _..__._._...._......_._......._ .
.Mailing Address:
Phone No: ................».»....._...........
FacilityContact: .._------ . .__. ...__. _ _... ......»......» Title :............._._........ _._._....._._..._..... Phone No: ...................... ....................
Onsite Representative ...... L A 9 .'�.. .1 4 �. ' S_...._._._..................__...... Integrator:
Certified Operator: .. . .......... . ....... . .. . ......... . .. . . . .... .. . .. __._._.._.__......._..__....W_.»._ Operator Certification Number: ..„ _.. ......._._W ..
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 41 Longitude • 4 64
Swine
' Desk► " `Curremt .. Deign, ,Cori
Canacitrr ponQlkthni•., Cattle ` Caaacity Ponds
Wean to Feeder
'' �
❑ Layer
Feeder to Finish
o"13�12
❑ Non -Layer
Ej Farrow to Wean
Farrow to Feeder
Other
Farrow to Finish
Z r t Total Desk
t rY
;r r
❑ Gilts
Boars
C
r
;II C8p8C1�',a
6W SSLW
Nupaberpo� Lagooz.ns
2
_L!
�lnlriii�a'�Pnnde'`1�.�7�d T-rantt L ;'T' nttf:.� _ _ ,.� o-t� •. tM.... ,.. _._
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
❑ Yes dNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
ENN/o
[I Yes
Q'No
❑ Yes
LdNo
Structure 6
12112103 Continued

Facility, Number: 51 — 540 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
[fNo
' seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
JNo
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
E� o
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
El Yes
['ro
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
1 No
elevation markings?
Waste Application
dNo
10. Are there any buffers that need maintenance/improvement?
❑ Yes
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
ENo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type & G MA (_G-)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
o
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
0
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?
[fYes
❑ o
16. Is there a lack of adequate waste application equipment?
q
❑ Yes
[NNo
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 level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 Hours? ❑ Yes TNo
o
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes
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 [ENo
Air Quality representative immediately.
Field Copy ❑ Final Notes
za�E 3 was MAIJJ ►NcC- fvrz
lls f sCL�) �AAs to ow of Sfi'ANt7 lG� iZ yvWtC 6�.
a3.� wwsr6 ArJ�F1�.`��
Gowo �n Go pads �t�oti A�� AFfi SA�vP(-G a(
Ma.ytN o MAY 'z,a04 o A h Ga 1�l EQA (� .
U�Gs��J LrV(__LS WAS 2,9 60 I-a3-a'/ 6 Vi2Er7 FirLccE�bflRU Si 36ri ►�
Z�. Z'I- dy �As -t.bu A>J� o►d u .q� otf Lt=V CL avT of 2E 0 AT
3g
eviewer ectorName � ! y 5 a - ' t7r ° a.„j,;t5 $;u E ¢ _�t ' 411
, a�3e:n ak..utYP/�.'iFY1, e.:.i :O
Reviewer/Inspector Signature: Date: tZ r3 0
I2/I2/03 C onnnued

Facility Number: 3 j .-�" Date of Inspection
Required Records & Documents
21. Fi l to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
E(No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.)
❑ Yes
No
23. Does record keeping need ' rovement? I es, check the appropriate box below.
dyes
❑ No
❑ Waste Application board rite Analysis ❑Soil Sampling
PP P g
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
iNo
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
[Q'No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems, over application)
❑ Yes
2<0
27. Did Reviewer/inspector fail to discuss reviewlinspection with on -site representative?
❑ Yes
L*oo
28. Does facility require a follow-up visit by same agency?
❑ Yes
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
VNo
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
L Na
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0 No violations or deficiencies were noted daring this visit. You will receive no further correspondence about this visit.
12112103

Type of Visit 0 Compliance Inspection t] Operation Review '0 Lagoon Evaluation
Reason for Visit o Routine 0 Complaint O Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number [late of Visit: // Time:E 10 00
Not O erational 0 Below Threshold
id Permitted ©Certified O Co�,ndiitionally Certified [3Registered Date Last OperatedorAbove Threshold:
Farm Name: K�,County: f✓�i°GzN
Owner Name: K%DU!G455 &Ms ' "� Phone No:
Mailing Address:
Facility Contact: Title: Phone No:
Onsite Representative: _ a�rl4f/LE� _ Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
JA Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 �• 0" Longitude ' 1
Swine Caesign, Ciirrentacity. Po ulahon�,,,.Poult'v Design Current Destgn Current
Ca achy Po ulation Cattle . .. Ga actf` Po uldtion
❑ Wean to Feeder I I0 Layer �, ; ❑Dai , z
Feeder to Finish jpjqp' ❑ Non La er I I JE1 Non Dai
❑ Farrow to Wean nN
Other t
Farrow t0 Feeder
❑ Farrow to Finish�
(� TotaYDesign,Capacity.
❑ Gilts I �
❑ Boars Tota�.SSM,
,
Number,of Lagoons , �, , ❑ Subsurface Drains Present ❑ Lagoon Area S ray Field Area �`'
`Ponds'/,Solid Fraps — — ¢
❑ Ne Li uid Waste Management System
flatd_
Discharges & Stroam Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes RTNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ZXNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes J[J No
glt�t e l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: li
Freeboard (inches):
05103101 Continued

Facility Number: / —5,1,0
Date of Inspection �/ 0
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9= Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Annlication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type \r710?Lr/7i4 / fT�4
❑ Yes 'VNo
❑ Yes VNo
❑ Yes No
❑ Yes No
❑ Yes INO
❑ Yes VfNo
❑ Yes ONo
• v y I
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? El No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
�fNo
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
)eNo
16.
is there a lack of adequate waste application equipment?
❑ Yes
ANo
R_eauitLd_R_ecords & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
XNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
P�No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
VrNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
VNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
VNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
j No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
f �] No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ONo
�() violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
f T` 3�M - j} EI { if(. It 'F f/ d... E, x i f f 33 • i f" 1(Z i ��� f 4 Ihi f1 d3 3a3, t !:
luomments.(reter to'guestion 3!) E�plaln any YE5 aas�ers„and/orjaaoy recommendations or,any„othEer comments.
better necessary") E €
Use drawtogs of facility to explain s�tuaboos. (use addiraextal pages as Field C
.,. i ,� .. � „ ,.�i_ a � �.�, t ids. � I
"r El onv ❑ Final Notes
�� /�ECo�v►-i r,.l(� f L xNG Fq� �N� Dn/ re{
f
A91V
�o ��n ;Q ���, L4enolr oaf Kz,
Reviewer/Inspector Name i�'� <'
Reviewer/Inspector Signature: Date:
O5103101 Continued

Facility number: 31 —5M Date of Inspection /2
dor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes [f No
ElYes [VN0
❑ Yes � No
❑ Yes �No
❑ Yes XNO
❑ Yes ❑ No
Additional Comments and/or Drawings:
��S�S.�t�,0 �/✓ % C�O�'ll�Gzltn/C/" �NSf� ®�►% l�/ZS!l /t
05103101

of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
for Visit Pftoutine O Complaint. O Follow up O Emergency Notification O Other I ❑ Denied Access
Facility Number Date of Visit:
13 Permitted 13 Certified [3 Conditionally Certified 0 Registered
Farm Name: .........I W ........:�?....1` W 2..............................
Owner Name: .... le.�`DL- de.S...... ra e.A--.t . .............................................
Time: �
Not Operational 0 Below Threshold
Date Last Operated or Above Threshold: .........................
County:.. atTJ, V{�...!..........................................................
PhoneNo:.....................................................................................:.
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
Mailing Address:
Onsite Representative:.... �!r� . lr''tt�tin/ 1..f s Integrator: ,env^ Y.......
I ............................................... .... ! ".1. V ...
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Morse Latitude • 6 46 Longitude • 4 44
Design Current,
Canac6 Ponlilatio'i
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design"Cr
Poultry ,Ca. as .'-Po elation Cattle Cu aci :PoN'
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other .
Total DesignCapacity
Total SSLW' .
Numbe'
r.ofLitgoons ❑ Subsurface Drains Present ❑ Lagoon Area ID Spray Field Area
Folding Fosids 1 Solid'Traps ❑ No Liquid Waste Management System
Discharges & Stream Im acts
1. Is any discharge observed from any part of the operation?
❑ Yes _'No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes ZNo
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
[] Yes ❑'No
c. II' discharge is observed, what is the estimated flow in gal/ruin?
Yt Gt
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
❑ Yes JZNo
2. is there evidence of past discharge from any part of the operation?
❑ Yes ZNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes '=No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes ❑ No
Structure I Str cture 2/Structure 3 Structure 4 Structure 5
Structure 6
Identifier: ........K......1............... ......1 ..I .......... ..I . . I..�'..L..... ................................................................................................
Freeboard (inches): 1 5g
5100
Continued on back

Facift Number: 31 — 5-/d I Date of Inspection /4 O ,
5; Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ONO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ONO
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ) 1(eS s
7. Do any of the structures need maintenance/improvement? Saolies jItNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes J'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 JZ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes L'No
12. Crop type wt u 0() Cl
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes. RrNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ONO
b) Does the facility need a wettable acre determination? ❑ Yes ONO
c) This facility is pended for a wettable acre determination? ❑ Yes XNo
15. Does the receiving crop need improvement? )dyes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ONO
Renuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes L314o
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 J2'No
21, Did the facility fail to have a actively certified operator in charge? ❑ Yes 12'No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ff No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes PYNO
24. Does facility require a follow-up visit by same agency? ❑ Yes PNo
r
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes �No
: �Q •YiA1;i(i ijs .or- ftrjc}en�i" wire 00(ed. 00669 01sAsit! - Y:00 wii1 •I ofu iye 4o g it o' . .
roriesnorideRce: abotiti this :visit: ..:..:...................:::....... .
%_oinmeniS trezer..w.gaesuon ) r xinain any z na: answers anuior any, recommenuauous or any over commenla. ',' ,d i %'jj t;d � e ;
Use�drawmgs,'Of facility to:better'explain situations ,(use additional'pl ages as necessary.}:� E. ri �, .i(° i "3?�til �r f�', ^ bE a t `f_n.
I` G
�. 'w ! lct�oo� deeds weed 6-frets e1�M�►����( so 4 A.
15. IV eea( �o �;11 r� I ew U,e AfcaS ij, F;el� and es�c. 61; s !, dG3i�h�cu Lra�v
So -� rd S�✓ r'� ?e e Wed %,,rC AAA Grvf CRH .4Gke DP - 1i v4 'i Gm
efd bci'1;.,d kW Iron �+n� t.ta�e� o� �ie(Lj deeds be�r►wVdG
be -Pe,- es4 c, W xkcel q ltd need ,s �0 be OV e r eeded wA V-10t+v et ; 4t,Cse 4 414-S
Gi r'c 4P Qee,4ek
Reviewer/Inspector Name ilet/l/ f "s !+!Ll� sz' F� �� 7 K) •k� i a„ �`
f 4
Reviewer/Inspector Signature: Date: 11132 Y o f 5/00

Facility Number: 3) —jto Date of inspection /O
Odor Is -Sues
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 f0No
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 XNo
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 O No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes VNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Adcb:Ppp#omrneots and/or D
/1fect *O rnclke .Surat 11,44 AJ/ gjppgeet)s a''e 14�-Ce 40 •
The Leer-.vdq teop rS ;+►yroted bo A 6
004 joor-bv, , of 4i e A -el i
s%•tce My las4 v>; s1'�. Ar�011 l; e a� 1 4an 146re otl herd.
��. AJCed �r Use 153 NlAcee PIN els r'4Gt,-4,r9 ✓et4e Air rgtjvcl
rci-fhe►- Jhc,4 186. weed b eq l t vl4le a, S9 a,Lre Zanz As dj'scvSSe4.
5/00

ivislon oFiSoil and Water Conservation
ush
3 ; Q Other Agency ii
,
,
tag
Type of Visit 3kcompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit NRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number t)ate of Visit: me: � Printed on: 7/21/2000
0 Not Operational Q Below Threshold
Alp'ermitted 0 Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name:A�.... i........ 14C.M.n..... V-LjJ.:Z......................................... County:,.L7i~.?..L?(..,l...t1. ..... .............................
Owner Name:... %....................V— 1....................... Phone No:.�..�.Q......... .c.. Z. ...................
Facility Contact: i:I?-l�,.f? ....... .iZ.C).t.-G„STitic: ..Qi:. .L .. Phone No: Z,:l....
Mailing Address:.. �-I.. ...... C.0-D.-1..:.3.C..t. AL..L-L..S....... 1'-Q........ ....... ... �c.............
�
Onsite Representative:..{,,.Lla-� r ......................... Integrator:.. ail L71?-[.. F`.`......................................
Certified Operator-...L eA,..D-1-;>-...e..... , ; L,/ „1 1 (, S, ........ Operator Certification Number:..t.�,�,{� . L
........ .... .............
Location'of Farm:
t7 C1 S W S t b,T-, Cp r~ S tom- I I O (l A P h t- i C) r s 't.ti l I� S-5--
`Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �' �� ��� Longitude '
Design Current
Design Current Dim Current ...
Svt�ine Caaci . . Population
Poultry
Capacity Population Cattle Ca' d 1Po 'elation'
Wean to Feeder
❑Layer
❑Dairy
k3
We eder to Finish
❑Non -Layer
I 1 10Non-Dairy
9 ,i
Farrow to Wean
[3Farrow to Feeder
❑Other
�
Farrow to Finish
� Total Design Capacity,
❑ Gilts
$�=G
Boars
Total SSLW..:
Number of Lagoons �❑ Subsurface Drains Pres!nJ10 Lagoon Area I❑ Spray Field Area
Holding Ponds ISolidcrags ❑ No Liquid Waste Management System
�..,;.
Discharees & Stream Im act5
1. Is any discharge observed from any part of the operation? ❑ Yes MIo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 'E(No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes PNo
c. ll' discharge is observed. what is the estimated flow in gal/min`?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes JB�No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes KNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? []Yes 12rNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: .........................................................L5.............................................................................................
❑ Yes Z�_No
Structure 6
Freeboard (inches):
5100
Continued on back

Facility Number: — tDate of Inspection Printed on: 7/21/2000
- 5. ,Arz4herc any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, Xyes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes )<No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes 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
elevation markings? ❑ Yes XNo
Waste Application
10. Are there any buffers that need maintenancclimprovement? ❑ Yes KNo
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes (RVo
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
'Ryes
❑ 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?
0Yes
❑ No
15. Does the receiving crop need improvement?
WIYes
❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes �o
Required Records & Documents
17,
Fail to have Certificate of Coverage & General Permit readily available?
; Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes
(ie/ WUP, checklists, design, maps, etc.)
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
NrYes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
ONO
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
5(No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) --'
❑ Yes
151No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
KNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
'�To
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
1\Va
yiQlati0s;off• d0denries Were n. . 0. O(Wi ft �hjs'visit; • ;Y60 Will-teceiye iio futthO - .
icorrespimdence. about this .visit. • . . . . .
ii`
U drawings of facility to better explain situations. (use additton� P ge as necessary) or any other comments' f" `� j iE ,t'
'j , t,,0 (3 O C) U G-'�_ T"Pc`C" CC n n b S T O 0'C_ l�-��I�-� O�� b �- ta-�•� �
eft S T L.,J A- -k--
b crc--H rDt->-_O�c
rlpry`r-t1 t�tri✓� Cot.TC-H LS TOO) C_c—OSIC
-�A� NTU'4r V3 try t­1 T":L- D
A4 UT b t—A n C_Fk c_t_S �o ta- S'�-v`tt.(_ G-h-�t tl
Reviewer/Inspector Name W, ti
Reviewer/Inspector Signature:
it vwir:/
'„
Date: 5/00

Facility Number: -3 — Date of inspection �DC] Printed on: 7/21/2000
O&WWssues
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 `Jj�No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes KNo
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 gN0
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 permanent/temporary cover? Yes ❑ No
Additional Comments an or Drawings: !
t S, anx�v D/\ D S '���b s -+-'I-"h 6-C) h1T,
Twt--I D . b--l>-O C'J 5 b
G-
c�
S fE-A,\n V> �.. L �t�c _ V (�� t�t D rz S Q n
`vCCD tC--y D S T
r'cr1 Le S l S GcD rD -t5 � tt-rH Pcc� ���tC�T-tUr,
/V I_ C L f� t 1
ht7� : c�- l�-QL� � ['�.-_. �r� c� I-, ►� � � , tr ��oC�) �-�_ S T ,
J
5/00

i
Longitude �• �' �"
Design w Current::
Poultry Capacity Population 'C
Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
10 Routine 0 Complaint 0 Follow-up of DW2 ins ection 0 Follow-uE of DSWC review 0 Other
Date of Inspection Z
Facility Number
Time of Inspection 1� 24 hr. (hh:mm)
Registered [3 Certified [3 Applied for Permit © Permitted 10 Not Operational Date Last Operated:..
Farm Name: ............. ........ }'....�rW.Z.........{........ county :........ �w1 Li.h..........................
Owner Name................[�k�Qki.�e `�... i G m�......Vf xC................................................ Phone No:...1 .f R��. �.-.?r' f Z!...........................................
Facility Contact:.....................�.—..�..{.+(.� .�L $. ... 'Title:................ ..... Phone No: .......
Mailing Address:
Onsite Representative ................ a-1 ...... lcrgRS................................................ Integrator:.............
Certified Operator. .................................................. ............................................................. Operator Certification Number ..........................................
Location of Farm:
Fir,...... . s.i .g...... ....:SaL ........ 0.7...... sp,1133.....................................................
......
.... .......... .... ..... ...... .....
Latitude �•�'���
D- ign, Cui
i in • ` CapaettV Pouf
........... ...... .
❑ Wean to Feeder
x
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Al
❑ Gilts
❑ Boars
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
b. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes 04 No
❑ Yes IN No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
Yes ❑ No
❑ Yes No
❑ Yes No

Fri ility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed?
"t ctures (Lagoons,1121din Ponds Flush fits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: &W1.
Freeboard(1t): ................. 1A.............. ................fit. 2...................................................................................................................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste_ Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ......................hmti7.l..................................................................................................................................................................
.
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0, No.violations-or. deficiencies.were.noted.during this'. visit'. YodWill i6cei:veno.ftirther::
:. correspOidehO shout this;visit:
(refer to questio&#)Explairi fany YESanswers ani/a�ir any,resounendations or
Qs of facioty to bettei< kvlain: situations. fuse.additfi) i napes as neccssarv}..
❑ Yes
P No
❑ Yes
Ep No
Structure 6
❑ Yes
RNo
(Yes
❑ No
(A Yes
❑ No
❑ Yes
[yNo
❑ Yes
0 No
❑ Yes
91 No
❑ Yes
E@ No
1�bYes ❑ No
❑ Yes ClNo
CRYes ❑ No
❑ Yes & No
❑ Yes [2( No
❑ Yes [M No
❑ Yes 0 No
❑ Yes fo No
IV,, 4.4, rocel s a�- "K",Wlin� dm%,,. 4AL i v. S"
k(1j;
a
It.� OS,iO} GV bit 1h�uY� 0 l-e. kia
O [ItL01 I(i- OUv. 5 0U O
(tSeeC�__t"""C�, r1PG+S v�-u b� ��iar Qr.
C1�1[c
t„x-l1� Of
(61�oori� V_WI `F kfaiZ S�ou(t� iAe
j�Q,tu�.8v`�o. Eos%K Cut -As DYE IlM-ir' di 4,
, W,�i
0� KW
lavoY, 0*J10 W2 A-Ictj to+a-
G 41 r4seeJtJ , ,� o oc�,S o� fkkW
�a�aa�
s1 �{c�
f tveye 'W .
-0 5e e� seta k l � : h ry v►} �G �-
�`er>J c�3t� S .
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: 1`Sn,!_ / /„? _r- Date:

� '.:.j•f , :.�''; �E.11
{;;Division of Soil and`�Water., - onservatlon �-`Operation Resew
c [] Division of Soil and Water Conservation Compliance14s ctlon f lei i
)DlV Ion of Water �u t ' ` �
is Q ah y Gam�liance Inspect<oii�
Other Agency - Ope>rataon Revtew l s a .
o.
Routine 0 Complaint 0 Follcnv-u of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number I J( .� Date 01' Inspection
Time of Inspection 24 hr. (hh:mm)
Permitted A Cer ified ©Conditionally Certified [] Registered r] Not O erational Date Last Operated:
Farm Naame:............1..........ii'i�.Z.............�C..................................................County:..........!..............................................
t�
Owner Name:......�r�..%�...V
............................. eCfdk�l.0.................................... Phone No: ��1%lJ ����17.Z.7.............................
Facility Contact: 4 .,...................4,f.?,G..WA6............ Title:Phone No:....................................................
Mailing Address ./
....................................................................................................
........................ .A. ...........................
.............. .... ...........................
Onsite Representative:...........................Integrator:......11.=........................... ......................... CertifiedOperator: Operator Certification Number:
Location of Farm:
f
..................................... ................ I ....... . ................... .................................I..... ......................
Latitude 0 �° Longitude 0 ° "
"' Design CUrrellt �" De31gnLUTrent ' Design CUCCetlt Z
Swine,'
Capacity Population PoItrY PopulationCattley Capacity Population
i ❑ Wean to Feeder 10 Layer ❑ Dairy
Feeder to Finish Non -Layer ❑ Non -Dairy '
❑ Farrow to Wean _
❑ ❑ Farrow to Feeder Other
,,.
❑ Farrow to Finish " i
Total Design Capacity
❑ Gilts
❑Boars Total'SSLWa,
�Number of'Lagoons 3 ❑ Subsurface Drains Present ❑ Lagoon Area
�.`.
,. Holding' Ponds. / Solid Traps „ ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1, Is any discharge observed from any part of the operation?
Discharge originated at: [ILagoon ❑ 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. II' discharge is observed, what is the estimated flow in gal/min'?
d. Dins discharge bypass a lagoon system? (If yes, notify DWQ)
] Spray Field Area
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 kNo
❑ Yes 0 No
❑ Yes {1No
❑ YA KNo
❑ Yes No
❑ Yes No
❑ Yes 0 No
Structurc 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 2+`�'Je )"
r 2 ^
Freeboard (inches): ........ ............................... .
5. Are there any immediate threats to the in t tty of any of the s uctures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
3/23/99 Continued on back

Facility N, umber: 3•�. [ Date of Inspections
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan'?
❑Yes
XNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
XNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
D<No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
XNo
Waste a\pplication
10• Are there any buffers that need maintenance/improvement?
❑ Yes
XNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
rNo
12. Crop type ✓O1 /7
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes
D?rNo
14. a) Does the facility lack adequate acreage for land application?
❑Yes
9)No
b) Does the facility need a wettable acre determination?
❑ Yes
KNo
c) This facility is pended for a wettable acre determination?
❑ Yes
KNo
*15. Does the receiving crop need improvement?
❑ Yes
ZNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
DONo
Renuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes gNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily availabl
(ie/ WUP, checklists, design, maps, etc.) 1�2�es `0No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
t 9Yes
&No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
XNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
�No
��
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
/
(ie/ discharge, freeboard problems, over application)
❑ Yes
RfVo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
5;jNo
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 _RNo
v�ol'a00ris:or• &flciendi $ **re noted• during this'visit:• Y;ori'will•receive iio fu>�-tri�r; . ;
.. ,corresponcleizce. aN ' f this * I It. . . . . .. ... . .
1� fie44 art S�i�l sk /x G/vC 6rIk X 4or Ad- keeAr a4v 4 w,^kG.
�fti+cth vl ik►� Is u-r i y2 G�►� G: aroL svwl� -Cal. r �]� se-ecLS
wam,_ Acv,Sis 6-6 1 E&" Sep-{— / y -; w14419 .,ad) J S
Gr� wee IS 11p,.• .G �Lc rt �'JVt,S
frrPar►,,j diaw,,�fe 4. �b
RevieWer�nspeCtOr Name t Y n , a¢ l � .�t ,� n f r 'a (E 4 o' 1 il
= Ni l ._i
Reviewer/Inspector 5ignatur Date: -
3/23199

r •:. ... .,94„ x ,x a iw'..,: . • •�:.. i.s ... .. .. F.,rY. •�sHM..: �:."kr.�4', • .•r• � r:, �• Y x .:r .� � n h.,, s Wz.
❑ DS WC Animal Feedlot Operation Review
® DWQ Animal Feedlot Operation Site Inspection
0 Routine O Complaint O Follow-up of 1V1' inspection O Follow-up of DSWC review O Other
Date of Inspection 151 zo 1911
Facility Number -
Time.of Inspection onn 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ®.Registered ❑ Applied for Permit (ex:l?5 for I hr 15 min)) Spent on Review 0
❑ Certified ❑ Permitted or Inspection (includes travel and processing)
10 Not Operational I Date Last Operated: ....... ..................................................................................................................................
Farm Name:...l v.x.- .... !^ d. ..... ...1......�... k�...1 �........:...... Co��nty:....p i..rr�....................................U�.s.. .
Owner Name:..... �y.Aa. ..... Y`.^....................... ........................ Phone No: ...... .Z....... ....................
.....
Facility Cozitact:...L�:,�......�t.1....................Title:................................................................ Phone No:.�,..l.A. 2..&.`i...�{.
r ?... ..
Mailing, Address: ... i., .! �. ...... .......titd............................ Az__a.L.2.....� t..i.�.f.....f)..0............. ........
..... .� �..�i .B....
Onsite Representative:. { 4� a. ...S.�a,� r. .'.. rx t'....�t�n,�x lls ntegrator:... h t�.........................................................
Certified Operator: .................................................. ........................................................ Operator Certification Number:....... 1-74 .............
Location of Farm:
LYN.... S.4Ai........ .E..j..... .s..t.a$......Q. ...... .. .i. Q..�.. .....0.: kl�.i..�.�d.....Lj*..Y............. ....... a`
t....s.n. ...,,....... W.A.k.... � ..�. �.1.�.�..................................................................................................................................................... �
Latitude • ' 0" Longitude ` t «
Type of Operatiou ma`s $a r ":L S a w f a
esign Current Ds Design Currents Design :Current
�xSwinet 5 } Ca actt `Pa ulation ry Poultry;CapaCityPopulatton
s2'CattleCapacity Population °'.
«:•,a... ,a r ... ?. iC:: P„ .... y,.:...., ,.—..9.T. .-.-..:e nu'..N ....-- - A�: `a,. a... ,.f.+ .3 •. .r'�;�
er ❑ Wean to Feeder ❑Layer € ❑Dairy
Feeder to Finish ❑ Non -Layer ❑ Non Dairy
a
❑ Farrow to Wean x H F
❑ Farrow to Feeder fi� `. t TotalDestgn CapaClty 1 �(�� a k s
�
� ❑ Farrow to Finish � � TotUVSSLW
❑ Otiler itl A�� of n
y.#.x,<o �,•> ,.::�--.... ... ... .. C .,'+ 'a' Y?'z e.?s:s�Z`.x- k __v;"�r,<c �w e, 3
Number of Lagoons / Holding Ponds 3 ❑Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
.� �Z-. w . ­11--111--i
-
1. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
2. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharw^e 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/nun?
d. Does discharge bypass a iagoon system? (if yes, notify DWQ) ❑Yes ®No
3. is there evidence of past discharge from any part of the operation? ❑ Yes RNo
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 Iagoons/holdinb ponds) require ❑ Yes KNo
maintenance/improvement?
4130/97 Continued on back

Facility Number: ... 1..1.....—•.....1A.Q
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes ® No
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structuresa,aff
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4
10. Is seepage observed from any of the structures?
❑ Yes El No
❑ Yes ® No
❑ Yes RNo
Structure 5 Structure 6
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ........... ..» »....................._..... ........ ...... ........ _......»............. .......... ...._ ...._
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes ® No
® Yes ❑ No
IS Yes ❑ No
❑ Yes B No
❑ Yes B No
❑ Yes ® No
❑ Yes Wo
E9 Yes ❑ No
❑ Yes ®"No
❑ Yes 12 No
❑ Yes KNo
❑ Yes ® No
❑ Yes ® No
RYes ❑ No
} 1, 17. - T t a F p t'O-r EI^ t S a rv--c t'4- E-9-i w; I Y`-� L,4
w �►^ 0 o n
w a l l. P l e,-& & e. c 4 c,� 7r> I S f- r c G t
C 1s CQ
pp r d' Sir S fiW I' Y-4
1 a c1 d ti o r, A:� s�Ir I a L", t-
10�
o a K s tti av 1.d Idl-L I LE4 �V
P +-,.�,..e t
R..ry S i q �.. o a t 0--a1 w aL
V
LJ
Wv.tl•
i 9. W n r o r ce v <-a t-, 4,iv-e�-d�s i V,
1-z o
5 v-o� •�
{ + �-W s-
r e 44 VV -a-�
y, }, C41 c v t a o �e..,.
Reviewer/Inspector Name', <f,'
Reviewer/Inspector Signature: Date: ZG 4 q
cc. Division of -Water duality, Water duality Section, Facility Assessment Unit 4/30/97

Or
Site Requires Immediate Attention: �
DIVISION OF ENVIRONMENTAL MANAGEMENTiry No. I
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: —_ EJ/,L , 1995
Time:
Farm Name/Owner: K� -nuol l s .
Mailing Address: 1_r�� Z��rz-,-..��0 � c�_c� !-� in c 28 yS�
County:
Integrator. "14 A-- lacy► r Phoned r=-) ;?1o'sal �� Y
On Site Representative: J Phone-L,-> boo — a9� �� 9
Physical Address/Location:
Q . ca.
Type of Operation: Swine 1 Poultry Cattle
Design Capacity: CI Number of Animals on Site: I ��
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 1 Foot + 7 inches) f or No Actual Freeboard `� Ft. Inches
Was any seepage observed from the lagoon(s)? Yes o No Was any erosion observed? Yes r No
Is adequate land available for spray? Yes No Is the cover crop adequate? Yes o No
Crop(s) being utilized:
Does the facility meet S S minimum setback criteria?. 200 Feet from Dwelling ? Ye or No
100 Feet from Wells? by or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Ce r 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-rhade devices? Yes o 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 n v P
Additional Comments - Pi' g-p- a-U(-t_9. c /L-r ,
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