310585_INSPECTIONS_20171231

NORTH CAHOLINA
Department of Environmental Qual

Type of Visit: (De-ompliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance n�
Reason for Visit: C<outine 0 Complaint O Follow-up 0 Referral O Emergency O Other O Denied Access
Date of Visit: lVjrA;M Arrival Time: Departure Time: County: c�'l Region:
Farm Name:( � F,s},(A-s L.F{j Owner Email:
r--
Owner Name: v6ks Phone: RECEIVEN/NMENR/M
Mailing Address: S e "o.—t f� ` �aJ wt APR 9112017
Physical Address:
Facility Contact: *h'I-c &�w ezrft Title: Phodffilmineonone Re onnail Office
Onsite Representative: ai Integrator: 1
Certified Operator: GllK Al wets Certification Number: a•7 4(4(G
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design
Current
Design
Current
Design Current
Swine Capacity
Pop.
Wet Poultry
Capacity
Pop:
Cattle Capacity
Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I
INon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
@O
p
Design
C*urrent
Dry Cow
Farrow to Feeder
D , P,oultr,
Ca tacit
P,o ,
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Qther
Turkey Pouets
Other I
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Eq-No
0 NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[5NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
[:]Yes
❑ No
a9A
❑ 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
�A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑14o
❑ 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 1 of 3 21412015 Continued

Facility Number: jDate of Inspection: 1j
t
'Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfatl) less than adequate? ❑ Yes CD-hLa_ ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No []��K ❑ NE
Structure 1 Structure 2 Structure 3' Structure 4 Structure 5 Structure 6
Identifier.
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _ �j31
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
U o
❑ 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
ETNo
❑ 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" o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ENo
❑ 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 of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 4 '�C -A 5 G V
13. Soil Type(s): /V 0 It k
❑ NE
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
2<o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
EfrNo
❑ 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
[�J-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E2,I5lo
❑ NA
❑ NE
Reauired 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
'KNo
❑ 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 I " Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
�No
❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Ef No
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

t)
Ficiliqi Number: 31 - Date of Inspection:
�4. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E'No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes E5-N ❑ 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 E;jKo ❑ NA ❑ NE
2T Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 10 ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑-No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes D<o ❑ NA ❑ NE
[:]Yes 0'-No [] NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[ 11Clo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[ No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑"NVo
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or.any;additional;recommendations or any other comineuts �-'
Use drawings of facility to better explain situations (use additional pages as necessary).;"
_ "*
Ca
S C'0'� szc"7 C-) -
Reviewer/Inspector Name: -4L Phone: Ww 33 3 f
Reviewer/Inspector Signature: eUA4A Date: 2ju4od L
Page 3 of 3 21412015

Type of Visit: ompliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: QfRoutine O Complaint O Follow-up O Referral O Emergency O Other 0 Denied Access
Date of Visit: Arrival Time: v Departure Time: !t !j ounty: icti( Region:
G
Farm Name: cv k v Owner Email:
1;
Owner Name: r7 j - 5 W, ILt r-i--fow- S' Phone:
Mailing Address:
Physical Address:
MAY 18 2016
Water Qua
ron
_r Wilmington Regional Office
Facility Contact: arl i �/`f,L1 + Title: Phone:
Onsite Representative: i Integrator: W Jr
Certified Operator: �L+sd�t. ��Ir<<� Certification Number: 7 r�
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design
SwineMIL.,apacity
Finish
Current Design Current
Pop. �'et Poul'try Capacity Pop.
Layer
Design Current
Cattle Capacity Pop.
DairyCow
Feeder
Non -La er
DairyEll Calf
o Finish
3 Design Current
Dr, P�oWt , Ca act Pia ,
La ers
DairyHeifer
o Wean
UFarrowo Feeder
o Finish
D Cow
Non -Dairy
Beef Stocker
Non -La ers
Beef Feeder
Pullets
Turke s
urkey Poults
Other
Beef Brood Cow
Othe
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 Q,No ❑ NA ❑ NE
[:]Yes ❑ No
[:]Yes [:]No
❑ Yes VNo
[:]Yes
[:]Yes j(No
0NA ❑ NE
[] NA ❑ NE
[] NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page I of 3 21412011 Continued

Facility Number: I r - Date of Ins ection:
-'Waste Collection & Treatment Jr
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 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):^
[?To ❑ NA ❑ NE
❑ No [&KA ❑ NE
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �o ❑ 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 [oNo ❑ 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 [EI-No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 214o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes MIN- o ❑ 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): ev— &o
13. Soil Type(s): _ 1 V o t!k
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes &1�o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [BNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [qNo ❑ NA ❑ NE
acres . determination?
17. Does the facility lack adequate acreage for land application? []Yes 02"No [DNA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes [ 44o ❑ NA ❑ NE
Renuired Records & Documents
19. Did the facility fail to have the 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 E3 N" o ❑ 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 eN. ❑ 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 [F(No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [fNo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: - Date of Inspection:
24:bid the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Ra"NO ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [-]Yes [3No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes fNo ❑ NA ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes �To ❑ 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 dNo ❑ 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 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
[a'No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
�No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
ZNo
❑ 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).
CWC6XJ1%3A - Cj- {S -t`
4q - .'F- 5_77
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 33` M3
Date:
21412011

hype of Visit: *Mompliance Inspection V Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: Grfoutine O Complaint O Follow-up O Referral Q Emergency O Other O Denied Access
Date of Visit: Arrival Time: /e p Departure Time: --� County: Region: wd _
Farm Name: Ale-I1 kiltR navvn Owner Email: RIECEIHFIIINCMENRIUWR
�
/ �- l
Owner Name: _ E l+�1 eC�jj .S" r rtL t70-2-3 Phone:
ANN U 1013
Mailing Address:
Water Quality Regional
Physical Address: operations Section
wilmingEon
Facility Contact: C ,it`6 &1'f k Title: Phone:
Onsite Representative: Integrator: ef
Certified Operator: �e+� � b vJ` l� Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design C*urrent
Capacity Pop.
Cattle
airy Cow
Design
Capacity
Current
Pop.
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
Dr, P,oult ,
Layers
Design Current
Ga aci P,o
Da' Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
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:
❑ Yes ©-No ❑ NA ❑ NE
a. 'Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No Q'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 [3*"NA [] NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [ o ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes [J No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Conti
i
`\

Facility Number: - Date of Ins ection: 1,5>r'{r
y
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [g-NU ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No �A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a2
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[�]- o
❑ 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
Q-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
[3-1Go
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Ej.Xo
❑ 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
[g'1Qb
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[ o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): L]er � S 6.0 I
13. Soil Type(s): - A 1 o
14. Do the receiving crops differ from those designated in the CAWMP? [—]Yes Q 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 [3-No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
GNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[ o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[ o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[g-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
[R 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ['No ❑ NA ❑ NE
❑ Yes [R'�o ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

a
Facility Number: - S Date of Inspection: a5
T
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M Ko ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [3-lgo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
[:]Yes
Cq-�Ko
❑ NA
❑ NE
[:]Yes
Q o
❑ NA
❑ NE
[:]Yes
['r'No
❑ NA
❑ NE
❑ Yes 20l4o ❑ NA ❑ NE
[:]Yes L2-No ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes Q No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [-}-No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [allo
34. Does the facility require a follow-up visit by the same agency? ❑ Yes EINo
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any°oth.er°comments: a :..
Use drawings of facility to better explain situations (use additional pages as necessary).
-o a•9 � _ b
.i4. '2 6 = 0. T P__� T /. 9
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: L3 3 -3,33 T
Date: 5&4 1J
21412014

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up O Referral O Emergency 0 Other 0 Denied Access
Date of Visit: I Arrival Time: Departure Time: County:ybQ Region:
Farm Name: �r�']>!i f _ �i�1 �,•yf� !V�Y'� Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Title:
Certified Operator: G ey, A l �i, /Vorim _
Phone:
Integrator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Wean to Finish
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Design Current
Cattle CapacORM Pop.
Dairy Cow
Wean to Feeder
Non -La er I
Layers
Dairy Calf
YI
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turke Poults
Other
Discharizes and 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 0No ❑ 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)
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 ZNo
❑ Yes 7 No
[:]Yes eNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes 00No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ff No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: �a
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _11 L4_ OL
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes VfNo ❑ 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? 7iiii�"'''
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 P No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes F/rNo ❑ 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 lino . ❑ NA ❑ NE
maintenance or improvement? I
Waste Apolication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ff No ❑ 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, etcFNo
❑ 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 Z'No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 7fNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes �o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes VrNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes UNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes V:jJNo ❑ NA [D 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 [3Design ❑ 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 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ZI No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0 No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 10 ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ONo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
Nan -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? [:]Yes ;no ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes P'No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
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)
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 CAWW?
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
�o
❑ NA
❑ NE
❑ Yes
ZrNo
❑ NA
❑ NE
❑ Yes ZNo ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes [XNo
❑ Yes P No
❑ Yes �XNo
❑ NA ❑ NE
❑NA ❑NE
❑ 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 exolain situations (use additional oases as necessary).
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 3 of 3
__7S,1A41t_1 lJ,1.4z
�f _ ei16W+/
Phone:
Date:
21412014

Divi"sio' of Wat� e'Quality
Frcil] fiillNumber ® Division of^Soil and Water Conservation
© Other Agency
Type of Visit: 6Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: orkoutine O Complaint 0 Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: �'r�� Arrival Time: Departure Tire: 3��g County: I�
11ff' F*rrn_,
Farm Name: f t('t/1�✓1 5Yh � �d �W1rS Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: ct'w)�'�
Certified Operator: --AL
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Region:
Certification Number: Z�"74 6
Certification Number:
Longitude:
Design Current Design Cnrrept
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish La er
Cattle
DairyCow
Design C►urren#
C►apacity Pap.
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Design Current
D . P,oultr. C•_a aci R.
D Cow
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other TurkeX Poults
Other Other
Discharees and Stream impacts
1. is any discharge observed from any part of the operation? []Yes NNo ❑ 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)
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 ❑ No
❑ Yes E0 No
❑ Yes -P No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes eNo
[DNA
❑ 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 ,Zf 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 PfNo
❑ 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 KNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes PTNo
❑ 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 J�J'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes/En-No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes 4EJ�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
�o
❑ 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
❑ Yes
�No
❑ NA
❑ NE
acres determination?
TT
17. Does the facility lack adequate acreage for land application?
❑ Yes
WNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
VTNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
WfNo
❑ 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 El Checklists ❑Design ❑ Maps [:]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 4 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes K 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

r
r
Facility Number: - Date of Ins ectlon:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes CZ'No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes KNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
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 �To
❑ Yes 6No
[—]Yes 2(No
❑ Yes ZfNo
❑ Yes �No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ENo ❑ NA ❑ NE
❑ Yes ZNo
[:]Yes o
[:]Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (rerer 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).
pey�lvf b'A' —,\r, %_Ov� '�"
Reviewer/Inspector Name:
Reviewer/Inspector Signature
Page 3 of 3
Phone: 2 — v t7 PA
Date: �� ��f J3 21412011

Type of Visit: 'ICo pliance Inspection U Operation Review U Structure Evaluation U Technical Assistance I
Reason for Visit: (Routine O Complaint O Follow-up O Referral () Emergency _0 Other O Denied Access
Date of Visit: -- �-' Arrival Time: L DepartureTime: County: Region:
Farm Name: J T/`I P M 5 1JYC ./ r �� l t�wneerr E a:
Owner Name: _ C - � 13M 1 % %) _ Phone:
Mailing Address: �. V �� `7 ! i2( f� , AC C D - `? J- - - - - - - - - -
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: C"u1I S �R�+�1C Integrator: C�'O LLwjt1 ' Ee, ems
Certified Operator: ) S Certification Number: DIyM(O
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish Layer
Design Current
Cattle Capacity Pop.
Dai Cow
Wean to Feeder
Non -Layer
Dai Calf
Feeder to Finish
CQ Design C►urrent
I 1171P,ou1. , Ca aci_ P,o ,
Layers
iry Heifer
Farrow to Wean
arrow to Feeder
Farrow to Finish
) (jQ
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other Turkey Poults.
Other Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412011 Continued

Faeili Nhmber: - SAS Date of inspection: 1 /
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? 777❑��� Yes
Structure I Structure 2
Identifier: (o�L
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _5
Structure 3 Structure 4 Structure 5
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?
❑ No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 6
❑ NA ❑ NE.
❑ Yes Wo
❑ 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 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? 1A
Waste Application
M. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? ox.
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes kNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):-_
13. Soil Type(s):
U-Cf
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
Q WUP ?❑ Checklists r❑ Design v❑ Maps [:]Lease Agreements
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes �No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes '9�No
0 Waste Application [] Weekly Freeboard [] Waste Analysis Q Soil Analysis ❑ Waste Transfers
0 Rainfall [] Stocking Q Crop Yield Q 120 Minute Inspections Q 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 X No
❑ NA ❑ NE
Q Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 173, ] - S I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes T' j� 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. 74
❑ 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 IQ 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
XNA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes 0— No ❑ NA ❑ NE
❑ Yes No
❑ Yes No
❑ Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other :comnients.-
Use drawings of facility to better explain situations (use additional pages `as"necessary)::
C F Pam
69
�A-T / 0 DOI �
C� fir WI Tc4 (M9L-�1G%1o1v�D 14_F?iv5 C R j/U
4 1 S I cJ _ A F �aA�� s
Q CACCOAl
xF� °k t.�uEC,)N Gor�G �wAl
CX
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 916
Date: ^ : p )/ ol^
21412011

Type of Visit: V Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ! Arrival Time: Departure Time: County: Region:
Farm Name: W I �.� �f� (� MS 'AC . Owner Email:
OwnerName: •/Y �L-1Q �- Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
�(AS__> /I F WIC-Lq-K
Title: Phone:
Certified Operator: G6—" t- L4--'3 . / V — l L kc—
Inte rator:
Llo\1 y Certification Number: q '�
Back-up Operator: Certifcation Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Swih.
ne Capacity Pop.
Wean to Finish
Design Current
W.et®Poultry Capacity Pop.
La er
Design Current
Cattle Capacity Pap.
Dai Cow
Wean to Feeder
Non-ia er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Design Current
1) , $oulte. C•_a aci P■o
Cow
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
lBeefFeeder
Boars
Pullets
Turkeys
Turkey Poults
Other
Beef Brood Cow
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes J No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes ❑ No
❑ Yes x
o
❑Yeso
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facili Number: - Ds ection: J
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [:]No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes "''�77i� 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 fi No ❑ NA ❑ NE
waste management or closure plan? 7'
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 I No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) ZA
9. Does any part of the waste management system other than the waste structures require ❑ Yes 1A No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �Q No ❑ NA ❑ NE
maintenance or improvement? 77��
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 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): ZOO- SG
13. Soil Type(s): �1C3
❑ NE
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
tNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ 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.
QWUP ❑Checklists Q Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes X No
❑ Waste Application 0 Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
0 Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: I - 5 Date —of—Inspection: I I I I f I
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No X` NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No 0 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
�k
❑ 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
lk
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
��++�����```"`
❑ NA
❑ NE
El Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
41 No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ YestNo
No
❑ 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:
Use drawings of facility to better explain situations (use additional pages as necessary).(yj
14X A,-4 SO) L 54 Mf LC) ca Lr I t3 R,4 I-10.pj
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: -!%U `�rj' -13�
Date:
21412011

+Division of Water Quality
ility Number —�5 �' S Division of Soil and Water Conservation
(Fac
Q 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: x 110 Arrival Time: %b Departure Time: County: (JN Region:
Farm Name: CINC Owner Email:
Owner Name: E04� C �� • / Y EIA]Iz (2,L Phone: Rb-ggI-G-4Sy(_w)
Mailing Address: 199 G«-o `o j D 2d 1 1 t ig6/jop -q 4Wc_ 00g 4s3
Physical Address:
Facility Contact: x Title:
Onsite Representative:���
Certified Operator: ` e� �� • r �«
Back-up Operator:
Location of Farm:
Phone No:
Integrator:
r' 1c) l�i'34C�
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ c ❑ S Longitude: = o = d =
Swine
Design Current
Capacity Population
Wet Poultry
esig
Dn
Capacity
Current
Population
Dgn Current
esi
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑Dai Cow
❑ Wean to Feeder
❑ Non -La er
❑ Dairy Calf
❑ Feeder to Finish I
Farrow to Wean
Farrow to Feeder
El Farrow to Finish
❑Gilts
❑ Boars
Dry Poultry
El Layers
❑Non -La Non -Layers
❑ Pullets
❑ Dairy Heifer
❑ Dry Cow
ElNon-Dairy
❑ Beef Stocker
❑ Beef Feeder
El Brood Co
El Turkeys
El
❑ Turkey Poults
❑ Other
Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �,No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
ElNA
El NE
❑ Yes
❑ NA
❑ NE
12128104 Continued

C
Facility Number: 3 f -AsI Date of Inspection /O
Waste Collection & Treatment KNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑NA ElNE
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: j 9-
Spillway?: Q
Designed Freeboard (in): 143.6
Observed Freeboard (in): to o 3
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 ElNE
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 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) NoS AL &
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 9 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 t
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ❑ NA ❑ NE
ComQients (refer to'quesfton;#) Explain:'any YE$ answers and/or any recommendations or::any other comments ,z
Use drawings of facility to better explain situations(use addrhona! pages as necessary):
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date: Q b
Page 2 of 3 12128104 Continued

Facility Number:' SR'>— 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 U Checklists 0 Design 0 Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Ko ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard Q Waste Analysis O Soil Analysis El ]baste Transfersllll//// ❑��11 �Aual Certification
Rainfall ❑ Stocking ❑ 5xop Yield 0 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
❑NA [I NE
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes �No
❑ Yes � No
❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
�I No
❑ NA
❑ NE
❑ Yes 1 d No ❑ NA ❑ NE
❑ Yes �(No ❑ NA ❑ NE
❑ Yes ❑No XNA ❑ NE
❑ Yes No
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
❑ Yes j' No
\\b3:�
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
Additional Comments and/or Drawings: '
C2 -
Ja��v
Qc)
Les
i CALL) AMANDA �ATC," W� �� 5�n OFF
w j 5LL'LoG E_ Sa0 E
Fes-
e oss t 6LE �)t F
Page 3 of 3 12/2VO4

Type of Visit Alcompliance 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: �� I Arrival Time: Departure Time: County: Region:
Farm Name: 1VELxyQR,% E-49-M INC. E-02AA-# Owner Email:
Owner Name:^C CcAZGG W. �eu__-,MeK Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: Gt�12-� Integrator:
Certified Operator: G,,F_CcLr.r W �F��� �`� Operator Certification Number: 19 3(
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = o = ' ❑ « Longitude: ❑ ° ❑ ` = "
Design Current
Fapacity
Design Current Design Current
Swine Population Wet Poultry
Capacity Population C•attfe Capacity Population
❑ Wean to Finish ❑ La er
❑ Dai Cow
❑ Wean to Feeder
JEJ Non -Layer I
Dairy Calf
❑ Feeder to Finish
❑ DaiEy Heifer
Farrow to Wean Dry Poultry
❑ D Cow
❑ Farrow to Feeder
ElNon-Dairy
❑ Farrow to Finish ❑ Layers
El Beef Stocker
❑ Gilts El Non-Laers
❑ Beef Feeder
❑ Boars ❑ Pullets
❑ Beef Brood Co
❑ Turkeys
Other ❑ Turkey Poults
INumber
of Structures:
❑ Other
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
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 ANo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El Yes
El No
El NA
❑NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes �No ❑ NA ❑ NE
12128104 Continued

C
Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo El NA El NE
a. If yes, is waste level into the structural freeboard? El Yes ❑l No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: i CQ
Spillway?:
Designed Freeboard (in): 19. 5 C).
Observed Freeboard (in): '�> S
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)
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
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below
❑ Yes 0 No
❑ Yes ONO
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
El NA El NE
❑NA ❑NE
❑ PAN ❑ PAN > 10% or t0 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)�� S G-1
13. Soil type(s) ]�� Q A u
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 '0 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes `X No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? El Yes [ No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA ❑ NE
Comments (refer to question #) Explain any YES answers and/or any recommendatibns o any oth comm nis r.
Use drawings of -facility to -better explain situations (use additional pages as necessary.)N iowl
LReviewer/inspector Name Phone: y�(J ___My
Reviewer/Inspector Signature:. Date:
12128104 Continued

r
Facility Number: , —j Date of Inspection 11 09
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes kNo ❑ NA ❑ NE
the appropriate box. ❑ WUP Q Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �6 No ❑ NA ❑ NE
0 Waste Application ❑ Weekly Freeboard E] Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Onual Certification
❑ Rainfall 0 Stocking ❑ Crop Yield ❑ 120 Minute Inspections 0 Monthly and 1" Rain Inspections [] Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
XfNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
(``$ No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
PNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
O�NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
V 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
A
ElNA
❑ 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
W No
El NA
El NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
N No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
*o
❑ NA
❑ NE
Additional Comments;and/tor Drawings ;; . » . , - fi
�z _ . Eft
Tv A MINI ►17UMk 0 F C),�VcE. �u�1
�. () - a
6qu o.lq
i
CAI, c2'ep j 1nN pub r ri �C)l
q-69Z 64-3-3
12128104

Type of Visit M Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0,Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: uN Region:
Farm Name: N e IA._�JC I V-%f- fli S . N Owner Email:
at 10-989-" ns- e-h
Owner Name: a E_w • /,Y Ely\p�l�� Phoned:
/�aRy-��SrlN�Cw�
Mailing Address: 7 �6Cb ! �I ,�y� r9 ab I�-� ! / 1 o(3A y D& L/S J
Physical Address:
Facility Contact: (�` J� f v Title:
Onsite Representative: `LJ�.�-V ! U E LA-)h i e-K
Certified Operator: S6 Eb" r_ L4_) /V I LJY—L
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number: -123 'T Vo
Back-up Certification Number:
Location of Farm: Latitude: [= 0 [= 4 =41 Longitude: = °
Design Current Design
Current Design
Current
Swine Capacity Population i�Vet Poultry Capacity
Population Cattle Capacity
Population
❑ Wean to Finish ❑ Layer
❑Dai Cow
❑ Wean to Feeder ❑ Non -Layer
❑Dai Calf
❑ Feeder to Finish
❑ Dairy Heifer
Farrow to Wean
j ('iii Dry Poultry
❑ Dry Cow
ElNon-Dairy
El Farrow to Feeder
❑ Layers
El Farrow to Finish
❑Non -La Non -Layers
El Beef Stocker
❑ Gilts
❑Beef Feeder
❑ Boars
El Pullets
❑ Turkeys
❑ Beef Brood Co
Other
❑ Turkey Poults
Number of Structures
❑ Other
1 10 Other
Discharges & Stream Im2acts
1. Is any discharge observed from any part of the operation? ❑ Yes KNo ❑ 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
KNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
�ZNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

ltiacility*umber: 31 -SAS 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: 1 f1}RQ
Spillway?:
Designed Freeboard (in): 9.5
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
No
0
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
iR No
ElNA ❑ 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
El NA [I 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
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
4,No
❑ NA ❑ NE
maintenance/improvement?
t I. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
ANo
❑ 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
'ANo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
KNo
❑ NA
❑ NE
t6. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
ZNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
O�No
❑ NA
❑ NE
'€q t wm y 4 9c. w� --.: •-, �, ;,y - .x' u .q. "- Yin t -•. t.....
Commen 's;(reier to question #) Explain any YESranswers and/orany ecom�mendatto s or'a y ath_ a corn_ ents''
Usedrawtngs of facthty to betteryexplatn s�Euattons: (use addrtrodalapages as necessary}"
C14AX6e ?ANTS di..sg ��41. 1 f1AcT Co10 JrcLn y �)ypR�4�vTS5t/ ..
SCE St-LCLc_ i C> lnri i SZA IN FR t�
(x)eg.A - (7 Aa.*A- C-,�b n
Reviewer/Inspector Name Phone:
Reviewer/inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: 31 — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes XNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 9No ❑ NA ❑ NE
the appropirate box. 0 WUP El Checklists +❑ Design [D Maps
p ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
lNo
❑ NA
❑ NE
❑ Waste Application 0 Weekly Freeboard 0 Waste Analysis ❑ Soil Analysis
❑xaste Transfers
❑ *nual Certification
❑ Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Mont�nd
1" Rain Inspections ❑
Weather Cade
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
L'OLNo
❑ 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
QQNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[fiNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
�kNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
[)iNA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes KNo ❑ NA ❑ NE
29. Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
1
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
14 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
MNo
❑ 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
KNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
U�No
❑ NA
❑ NE
AaationalComments�audlor�Drari�n s,: - - -
f
Page 3 of 3 12128104

41 Division of Water Quality
Facility Number O Division of Soil and Water Conservation
- O Other Agency
Type of Visit fieCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit toRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
�
Date of Visit: Q Arrival Time: Departure Time: County:Region: /4�D
i!/�tclf
Farm Name: � ZR/��l/% �NG Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone No:
Onsite Representative: �7/tf. � Integrator: �r
Certified Operator: tJ f ��'� /' "F ���c Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = e =' = " Longitude: 0 ° = ` =
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean 1200 j 2
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
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 Cgt'6Cnt
Capacity Populatioi
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes J9No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes [:]No
❑ Yes No
❑ NA
❑ NE
'0
❑ Yes ONo
❑ NA
❑ NE
r
12128104
Continued

- - - - I �
f ";..
Facility Number: 3175IR 1 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
Identifier:
Structure 5
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):g �S
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/�INo
❑ 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 A"fication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes '7(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 Drifl ❑ Application Outside of Area
12. Crop type(s) 'yf_g1 11/Q4 C
13. Soil type(s)
M10 M
r
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Vf No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
XNo
❑ 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
�dNo
❑ 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):
T � SOm E
Nf'e4C-12 V-V G.✓s zp � �q zs ��
Reviewer/Inspector Name . Phone:
Reviewer/Inspector Signature: Date:
12,128104 Continued

Facility Number: 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 appropirate box. ❑ W1JP ❑ Checklists ❑ Design El Maps ❑Other
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes r No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections ❑
Weather
Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes A No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ❑ No
FfNA
❑ 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 P(No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes ❑ No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes ❑ No
0NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
� No
❑ NA
[I NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El 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
J(J No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
!
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
ElNE
General Permit? (ie/ discharge, freeboard problems, over application)
!((!
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o
tN
❑ NA
ElNE
33. Does facility require a follow-up visit by same agency?
❑ Yes
El NA
❑ NE
Additional Comments and/or Drawings:
`1
20 A;rr-T 7"14 �: %n7 E /�}ni Gs 1/i/ 4
/ _ Q
�0
f�M _
611
�
7) i��9f�
nlppu
0
12128104

Division of Water Quality
Facility Number sly 0 Division of Soil and Water Conservation /
- - — 0 Other Agency
V
Type of Visit
C-0 pliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
V Koutine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: 1 g 6% 1 Arrival Time: 1 2:4 S I Departure Time: County: 3k4k2AJ Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: GE6R,Cx'1 0 t W L1A 14_
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: E__1 o E__1 " Longitude: = o = S = it
:Design . Current Design Current;', >, Design " Current .
a Swine Capacity tyPopulation Wet Poultry Capacity hPopulation Cattle Capacity Po _ulation
❑ Wean to Finish ❑ Layer
❑ Wean to Feeder ❑ Non -La er
❑ Feeder to Finish
® Farrow to Wean 17oft 1 2,5 Dry Poultry
❑ Farrow to Feeder
❑ Farrow to Finish I
❑ Gilts
ElBoars
Other.
❑ Other
❑ La ers
❑ Non -La ers
❑ 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?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
-Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes [ oo ❑ NA ❑ NE
❑ Yes L� o ❑ NA ❑ NE
12128104 Continued

Facility Number: 3Date of Inspection o�
Wpste Collection & Treatment
/No
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure i Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: LA&oh) L++1 g ^[A6m&) Sy+ ALk.
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 ZL
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
WNo
❑ 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
ental threat, notify DWQ
envi26yes
7. Do any of the structures need maintenance or improvement?
❑ 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
❑ Yes
E�`No
❑ 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 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) 3 C&) SGO
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ONO ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0 o ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
eNo ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[I NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
7No❑ 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):
Ct C-W OMLL W A LLl o ( OV E c Gr n-o r.f 14 +
U?OPTS S10CjC_W&r' ze(,oa4) '. s*u NoTcb MsS�NC� W14St6 AIJAL4JXX . rAv-fLtJ
AMC TWN.G►3 Ar .X?"MrUtALJ Ndh! . VA,EAsC. Ke6P C*MSZSr9hy . t*t.L APJA6`15-rS
fAlc6N Fa a 't000� Bar 1� NUC N617 ,2E _Lev4D �.E,Sv�S , NZ'A c tJ w wH J
04LXB"TZ o A►so SEWDGG SQ"(-L) 006 8" Egrz, dF SEPT.
Reviewer/Inspector Name F�j �N Phone: T t+D 7q6 —73 1V
Reviewer/Inspector Signature: 0 Date: $
l 4 C 4 of ✓ l!y/LTV/VY ....I ... I.-

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes :No
N ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ElYes ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design [I Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 0Yes [I No ❑ NA ❑ NE
El Waste Application ❑ Weekly Freeboard ,Waste Analysis EoxSoil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall P 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
B No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ONo
❑ NSA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
Yes
ElEl�
No
N/A
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes❑
No
[? NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
L;'No
NA
[I NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
,❑,
[911NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
oo
El NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
Yes
,L.'.
L_�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
�,/
l3 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
MNo
❑ 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
9<o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

IType of Visit 1) Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 16 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Q Arrival Time: Departure Time: � ounty:
Farm Name- 4J/r—Yz. [ fi,Q/A 5 _Ln Y_ _ _ Owner Email:
Owner Name: TF�1LC F ��j� Phone:
Mailing Address:
Physical Address:
Region: al" D
Facility Contact: �% u�Title: Phone No:
/� Q
Onsite Representative: /�] I.zkl, /t' �U)lrK Integrator3C4� Qe�{
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Operator Certification Number:
Back-up Certification Number:
Latitude: = 0 0& a« Longitude: 0° 0 A 0"
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
j❑ Non -La et _ _ _ 11
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Marrow to Wean
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
[]Boars_
Other
❑ Other - - - - - -
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ 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 Ef No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El Yes
[__1 No
[:1 NA
[:1 NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
jXNo
❑ NA
❑ NE
❑ Yes
Fe5No
❑ NA
❑ NE
12128104 Continued

f
�r
Facility Number: % —5
Date of Inspection 3 .17
a'
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?
❑NA ❑NE
❑NA ❑NE
Structure I Struc "- �e 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Lvet1E,[- d 41
Spillway?: Ilk A�o
Designed Freeboard (in): /,7, 5
Observed Freeboard (in): Y-2
❑ Yes ONO
❑ Yes ❑ No
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ONO
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
;Z 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?
A Yes
VrNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
JZ 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
LZ No
❑ NA ❑ NE
maintenance/improvement?
1. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
0 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or t0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift ❑ Applic1ation Outside of Area
12. Crophrpe(s) .blea/I mog 6�kji�J��Q✓��—f�/
13. Soil type(s) p
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
V1 No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
JZNo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'! El Yes
9No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
/0No
.?I No
❑ NA ❑ NE
T YELL #'�(<oc�,o 5ET} � 5v-'Idi LhI,C�F•
Reviewer/inspector Name r i ° p :' Phone:
Reviewer/Inspector Signature: Date: Os
12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? [:]Yes ONo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ;Z No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. JZ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis JZ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ;�"120 Minute Inspections JZ Monthly and 1 " Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes P No
❑ Yes VINo
❑ Yes VNo
❑ Yes No
❑ Yes No
❑ Yes ZNo
El NA El NE
❑NA ❑NE
❑NA El NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
VNo
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE
❑ Yes WNo ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes �No El NA ❑ NE
Additional Comments and/or Drawings:
'-7 ��FA Zoo 3001- r,
TORT Ar �/gq - ao -Zoa 4
12128104

+t3"3 WK I RK FARMS #2 FAXf N0. : 9185322651
Mar. 07 2005 10:31AM PS

N
0.
a
X`
Q
TM
Cormier Newkirk Farms ine.'
Copfec to:
Alin: George W. Newldrk
..,
199 Cold Pond Rd.
)s
O
Z l
T V SV
Magnolls, NC 28453
Report Farm
2/ 5/04
SERVING N.C. C1'1'IMN5 FOR OVER 50 YLW
Du Zia Coun
Agrouomist Coruments:
,u,•
i, ME'IIII E17
—mNarnple No. last Crop
Mo
Yr T/A
Crop or Year
Lime
N h05 1w
Mg Ca
Zb
B
Mn See Nole
1,1B No Crop
1st Crop: No Crop
2nd Crop: I
"West Results
moil Class IiAlrifi W/V
GEC
BS%
Ac pH'- P-1
K-1 CA Mg%
Mx-1 Mx -Al (t) Mn-Al (2) Ztrl
Zn-AI-
C0-1
S-1
SS-1 AU-N Ar &N . Ali
Nt1N 0.81 1.35
3.4
62.0
1.3 5.7 - 128
•6 43 .0 10.0
120 75
75
7 .
2 .
O.Q
i
C Y!''..
a
]ga.I
•i
r, : tae.
k
�t .I
-%-1X
4`i.l
•€I 1 I• i
• FrtS• I ;J"�r
€
_
Sample No. Last Crop
Mo
Yr T/A
Crop or Year
Lime
N hos AO
mg Cu
Zn
B
MN See Nole
2B NO Crop
r
1st ": No Crop
2nd Cm :
'Test Results
Soil Class lIM% W/V CGC
8S%
Ac pN ' P-1
K l CA Mg%
Afa-1 Mn-Al (1) Mn-Al (2) ZIP-1
ZA-M
Cwl
S-1
SS-1 NOtw A U-N Na
MIN 0.76 1.=A6 3.4
62.0
1.3 5.7. 127
44.0 10,0,
6 .79..
7�1 . -
6
22
Sample No. Lasl Crop
NO
Yr T/A
Crop or Ye#r
MAW
N B05 *0 .
AIg Cu
zn
B
Mn See Note
No Crop
1st Crop: N6 Crop
2nd Crop:
ts
VO
I
HM% W1V C6C
BS%
Ac pH : , P-1
K. 1 Ca% Mg%
Afr,I Mn•AI (1) Mn-AI (2) Zn-t
ZAI
Cn-t
$-I
SS-1 NIb-N NIN Na
MlN 0.76 ]_ 8 3.4
59.0
1,4 .7.. 12'
SG 42.0 0 ...
22 7.4.
74
3 .
20
0,
T
Sample No. Last Crop
Mo
Yr T/A
Crop or)
Lirt:e
N PXJS llit•0
Mg Cu
Zn
B
Ala See Note
5s1 No Crop
Ist Crop: No -Crop
Test Results -
Soil Class Imm W/V GEC
BS%
Ac. pH Al
K-1. Ca% ft%
Altr-1 Alra-Rl (1) M+vAI (2) Z -I_
Zu-M
Ca-1
--1
SS-1 NO;-N IV&N Na
MIN 0.71 1.34 33
61.0
1.3 5.7 ` 130
57 43.0 10.0
yU 74
74
32
21
0.1

M
�v
m
N
r~
m
in
W
N
M
m
m
O
z
Q.
LL
•„�{r
�17
I r
1
ir�'.y I. rI i
I .I 1`"I,.
I:I a.. :I , c F' ~'' III
fhl i I
I IH of li ,; , 1P
1.Ir!LPI
�.
! PI 'I�
uCrop
I :r
! ' I! �-' �'�.I IIn � i
li° � i� �• �
i' I +I'
I EMlr-
, .I ,r , II" .I� a
Sairrple No. Cast
Ho
Yr TIA
or Year
Lime
N A05 no
Cu
ZH
By
Am
See Note
2A No Crop
151 Crop: No Crop
2nd Cro
Test Results
Soil Class HN% WIV CEC
BS%
Ac pH: . P-1
K 1
Ca%
Mg%
Mn-1 MwAI (1) MOW (2) Zw?r
Zn-Al
CU_1
S_1.
' SS-1 N(8-N N1b-N Na
t1ilN 0-76 1.37
.5
7.0
1, 5.7. ..128
521
40.0
r .11
(} J4....
74
4 .
- 21
0.1.
.�
Sample No. Last CrnCrop
pP�Os
"oYir
or Y&r
Lime
N A�0 -�
.. � Cu
Zn
B
�Yln
See Note
lA No CropIA
Crop: Igo Crop
1
2nd Crop:
Test Results
Soil Class HM% W/V GEC
BS%
Ac pH' P-1
K-1
Ca%
ft %
Mw1 Mn-A1(T) Mn-AI (2) DW
Zn-Al
Cu-1
S 1
SS-1
NLk-N A7h-N Na
MIN 0.71 1,
61.0
1. . 10
56
4 .0
11.0
81 71
71
.22
21
0.1
- �i�:?n•:k
I
I ' ,I.
hI'I' :i.rsl l I-k���ki ��I
III I
•III
I
4 I I• I Iry
II I II. � C I{bI
Sample No. Last Crop
Ho
Yr T/A
Crop or V#ar '
One
N B05 MO
Mg Cu
Zn
B
Mnv
See Note
L1A No Crop
lsl Crop; No Crop
2nd Crop:
Test Results
Sod Class MV% W/V CEC
BS%
Ac PH, P-1
K 1
Ca%
Mg%
Mw1 A1n-A1(1) A!n-A1(2) Zu-1
Zn-Al
Cr-1
S-1
SS-1
NO-N AB-N Na
WN 0.76 1.
.4
62.0.
1.3 127
7
43.0
2.0
g 1 75
' . .75
36
22
0.1
I
'
ii
.1
'�,^
;i��' .. ;
I
4 1 r k a l i`•
I r if i Ilf'!,. .I - i:., t,GfE- e li J' r "I'1.f II'
h.�r,nlii•f�lnllli.n,E�' � f�,
I,. ' I �Iliiy �' iii
1 ��...-.
Sample#a Last Crop
Ma
Yr T/A
Crop or Year
Lime
N h05 A0
Mg Cu
Zn
B
Mn
See Note
L1C No Crap
lsl Crop: No Crop
2nd Crop:
Test Results
Soil Class HM% W/V CEC
BS%
Ac PH..'P--1
K-1
Ca%
Mg916
Mn-1 Mn-Al (1) Nx-AI (2) Zx-1
ZwAI
Cn-1
S-1
SS-1
NC9-N NIA-N NO
MIN 0.76 1.34
3.6
58.0
1.5 5.7 ' 125
57
42.0
9.0
92 75
75
33
22
0.1
i�
N
It
E
3
'I

.3
Time: Z c�
,dPermitted,Certified 13 Conditionally Certified 13 RSegistered Date Last Operated or Above Threshold -
Farm Name: ...... E!�`�d......��...a_ __'� - J'?C:................... County:.... ... ............................. ....... ..._ ._...
OwnerName: -------- ----------------------------- -----.... ................ -------............. ---..... --......... ....... Phone No:
MailingAddress:........................................................... ........................................................... ... ....... ._._..........
FacilityContact: ...... ...................................................... .......... Title:................................................................ Phone No: ................. ......... ............. _.........
Onsite Representative: s J...P%5*�.. �`c.._.... Integrator: ................................
Certified Operator: .. . ............................... . . . .... . ..... .. . ... Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ° ic Longitude • ' "
- , Ign ` rCurient Design Current = Desrgn Current
Swine r "Poui Cattle'
_ nCa as :'PQ ulafron- _. 3'o Ca LLci Po `elation , , Ca- city, Po elation
- _ _
Wean to Feeder ❑ Layer ❑ Dairy
r Feeder to Finish ❑Non -Layer
`a Non -Dairy
Farrow to Wean �a i
Farrow to Feeder ,9 ❑ Other
-
Farrow to Finish TOI Deli CapacityE�
_ gn
Gilts � �' �= -s- � � -, ter.
Boars ' TOitBi`SSLIy-F
s r Z
w _
�Y w Number of Lagoons
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ N
2. Is there evidence of past discharge from any part of the operation? ❑ Yes �Zo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes o
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
b�.. o
Identifier:.... 'Z(ToP_.............. ........................ �..._.. _._._..__.._._.....�.�__ . ........ _..._._.._...
Freeboard (inches): y 3
12112103 Continued

Facility Number: 31 — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes N
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes o
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 maintenancetimprovement? ❑ Yes
/NNcj
8. Does any part of the waste management system other than waste structures require maintenanceJimprovement? ❑ Yes Id
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes
l l . Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes!NNZ
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type &gmj/ rin CP ) 5 *vfY a_ /
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
b) Does the facility need a wettable acre determination? ❑ Yes
c) This facility is pended for a wettable acre determination? ❑ Yes �i
I5. Does the receiving crop need improvement? ❑ Yes [�' TIC O
16. Is there a lack of adequate waste application equipment? ❑ Yes 1Vo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes VNo
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 o
Air Quality representative immediately.
❑ Field Copy ❑ Final Notes
t,jC>�z CovL0 NBC =N0 wE1'TA {�c S
RcuR-w 4 FAK'm
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
11/1L/UJ l.onunuea

a
Facility Number: — Jr 5 Date of Inspection
Required Records & Document.~
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?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ 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 6 No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes o
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes 7Ne
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 9No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103 ■

13 Permitted © Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
/Ue w I�� ,�
Farm Name: j,� J /�'"" s ►1 r County:'
Owner Name: ,6 e vV Ne wk r� Phone No:
Mailing Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Location of Farm:
Phone No:
Integrator: _9 V O tnlh S
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' �• �" Longitude 0 -
_..Design„ Current =Design Current _Design rv: Carrent
_ -
❑ _ _.tronSKtne oa acy =Pu�hi
Wean to Feeder ❑Da ❑ Feeder to Finish JEJ Non -Layer _ ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder-10 Other m
❑ Farrow to Finish Total Design C�paetty .w
❑ Gilts
❑Boars T4#aISSLW
-s
Nnenlie of iC agoons �k T ❑Subsurface Drains Present ❑ L oon Area ❑ spray Field Area
r � .
Notdtrt Pondsl Svhd g" ?raps w° ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a_ If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structu 2 Structure 3 Structure 4 Structure 3
Identifier: !f �tduti� Z 7T6
❑ Yes j2rNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes .2rNo
❑ Yes _.EfNo
❑ Yes XJ No
Structure 6
Freeboard (inches): t71 7
05103101 Continued

E
Facility Number: 3 % S 5
Date of Inspection ZO D
5. Are there any immediate threats to the integrity of any of the structures observed? Oe/ 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 anv of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Q �. r� v!.?�®► �>'q z �; �1^'la ?I
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
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?
(ic/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22 Fail to notify re ional DWQ f emer en situations as re uired b Gene al P rmit?
❑ Yes eNo
❑ Yes ONo
❑ Yes Z] No
PYes ❑ No
-ZYes ❑ No
El Yes �No
❑ Yes 2 No
❑ Yes 01No
El Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �No
El Yes _'�io
El Yes ❑ No
❑ Yes �No
,&Yes El No
El Yes �No
El Yes ,�No
g o g -.7q .7r e
(ie/ discharge, freeboard problems, over application) ❑ Yes gNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes -,ErNo
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 WNo
10 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
Comments (refer to question #): Esplain ang'k'ES aac;rers andlor any recommendations or ativ aiher:eomments.
Uie d�rawii�s of:facility ia-better explain; srtuatiob!i, (vse�additional pages as ne es�ry) E
_. _ 3... .. Field Cony ❑Final Notes 'y
1 R. -T),r.E are no F'reelb of pre coraC 5 �or ]rjvo�-. 7— , NI✓ - Ajew,�,'.
S�s -��. �-F �� l ,� s �'� d •�. �11e sere , cc [ 6 � � � y �'e a t/e d ��tG ,�
lc,� do•-• 9 ci vole cna� _S el -' of 4. l,./".r llo-- r i2eoled . —7_1'1 e ] goo•
gauge rs ,?C&Ae-v( a✓lcf r'-l-eeboa,-d-e64--dS
be�c, 1 ayao*,s . T
g , P 1 pare ; .1 f4,q 1I P�oToc r..t a r, .� ,".,, %g riot-, Z .
Reviewer/Inspector Name ,�
Reviewer/Inspector Signature: Date: ZO Z
05103101
Continued

Facility umber: 3 � - S S
Date of inspeetinn S ZL
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation? V
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, andlor public property)
A 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?
nl',
m
❑ Yes to
❑ Yes 10
❑ Yes 10 No
❑ Yes �vo
❑ Yes P1110
❑ Yes yf No
❑ Yes ❑ No
_Additional`Comrnents and/or -Drawings..
1q . Wa G l q G / e t G�e�� •-. ; r7 a -,'a
�o,r Gt'l �'��/d.� • �{ js LLY?G[e�,✓ !�'��e Go��ec� »i����
oP aG✓'PS �f� 6ei� q.ccv��r-��d i�,. ih F�>G;Id � �� ��
44 SKt_ Z,fJI
rend I Y►�iat7 1/t�rvc A IvS4 o1 /ol d vB 4a Ae
kjewe..'' �a�ao�-1 Go�s��vr ivn
Seven a��I i cg ► n "? e Uev1 S 44.o.,4 ®GG v.-eend o,? a l'y'!
ApA,I sa s 41-taf he S� /44e
Su r►�� �P , �7U� A" 'gY2A%�,J t.tJ `tOT ,27r,.�ne4Q Dim is
nv J q ve� 1 14(6 e - /0 � . Ne, w 16 /,� 's 4o v IT dc nl e w1
Sovx'tt
where �J er'OVc,e�lt„ `Th;J
- - heeds bE J fior d -t -tee �'cr .}� ! y 4 n!4 M
Sa�S 0 WIT 6e . 7� AVOP,,✓•s 4JR7
aJn �; X )� naW • i
-b ee14 t4Ie a�' Gp✓c+-�r5� #o✓ iZbQ ,�G.�.�vL✓��
� ,J
y, l.f I S��'� GEC )�►"5 WO r kelp o Y
4 L,cy 4AAP? noted e3bn ter, -the -lac )d e,­ ►-td G,-o os Afe n e V74'
05103101

Division of Water Quality'
Q,Dtvision.of Soil and'_Water-Conservatron :.
a _ Other Agency
of Visit A3 Compliance Inspection O Operation Review Q Lagoon Evaluation
Beason for Vislit__,�Routine O Complaint Q Follow up Q Emergency Notification O Other ❑ Denied Access
Date of visit:
Facility Number f S�tS
© Permitted © Certified Q Conditionally Certified © Registered
Farm Name: ^Ne`^ kJ! r k ..
Owner Name: ..........
� 'Qf C �1 • , V�W
..............................� ...............
Facility Contact: .............................................................................. Title:
(1 l Z C�! 'lime: 3 7 Printed on: 7/21/2000
NNot O erational Q Below Threshold
Date Last Operated or Above Threshold: .........................
County: py o-n..........................
Phone No: .....................
Phone No:
MailingAddress: ................................................................................. ............... /+
Onsite Representative:.. -Sue( A)e_LjK►rk Integrator: ........ ..... L%�.......�►.!'%:
u �Q(,unlf �p
Certified Operator: ...................................................
Location 'of Farm:
Operator Certification Number:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �' �� ��� Longitude
Destgo Current ' Design Current' Desrga Current .
H ...5� CapacityJPo elation - Poultry Capacity Population Cattle .Ciiiiarati :Population .
`= EF
eeder FON
Layer ❑Dairy
;`.
= Finish on -Layer ❑Non -Dairy
Wean Feeder ❑ Other
r Farrow to Finish Total Design Capacity
rro Gilts
'=` soars Total.
AilikiiiePonds soda Trap4 C
Subsurface Drains Present 110 Lagwmn Area
❑ No Liquid Waste
Dischar¢es &Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: [ILagoon ElSpray 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)
Spray Field Area
❑ Yes j—;!"No
❑ Yes,0No
❑ Yes ONO
'hfa
❑ Yes XNo
2. Is there evidence of past discharge from any part of the operation? - ❑ Yes )21110
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes eNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure. 3 Structure 4
Identifier:.......�.gp...................1�5e- a► -...... .......................... ......... .............................
Freeboard (inches):
5100
Structure 5
❑ Yes XNo
Structure 6
Continued on back

Facility Number: —v S Date of Inspection
FA jzLol I Printed on: 7/21/2000
5.' Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes o
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes1,2'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 maintenancelimprovement?
❑ Yes eNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes [�`No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes A?JINo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes �No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes ,Q•No
12. Crop type T e r"^ iV 0( ei w-,r S eQA
11 Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes eNo
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 R-!rNo
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?
WUP, design,
❑ YestfNo
(ie/ checklists, maps, etc.)
19. Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes ONO
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes P1Vo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes �O'No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes',El"No
23_ Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
❑ Yes 21.40
24. Does facility require a follow-up visit by same agency?
ElYes ,No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes XNo
: 10 vigl ticj[is:oi deficiencies ever notes] ititring this:visit; Yoh will-t eetiye till futther •;
. - corres ndence: abcr it this visit.
-..
Comments (refer to nestion #) Explain any YE5 answers and/or any, r"mmendattons or any outer nits
Use i3rawtngs of fac>11�ty to ballet explain situations (ttse addtttunal pages as necessary) w _... a. . ,...«
e
-T-he. -(AGtf rr4`� qvA rcGD1'Y.[S Are well 16,r�-
f t7are itf qrl ekte1tle'1l •
S`M� � k-r lvA. Menke .wee, 4h%4-4W,,e� e on 7�tr �►e%L-Z,f
end 5 is r,,rre *4 . 5
-ewer/Inspector Name �IQIiGrL✓
al; a Y � Rern.�
� .,sy�s��ti
Reviewer/Inspector Signature: _ Date: &117-191
_ 5MO

FacilityrNurnber: 3r -s j Date of Inspection / pf 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 'ONo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ YesX 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'ONo
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 -eNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes,,eNo
32_ Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
5100

JUL-13-99 TUE 04:51 PM BROWN'S OF CAROLINA! FAX NO. 2961333
P. 02/03
$ROW N $1
OF CAROLINA
July 13, 1999
Rick Schriver
Department of Water Quality
127 Cardinal Drive Extension
Wilmington, N:.28405-2845
Fax. [phone]
Dear Rick,
In mid -April, Brown's of Carolina, Inc. acquired the swine inventory of all company farms
known as AK Farms, and assumed a contractual production agreement with all of the contract
producers formerly affiliated with J&K Farms. Before the completion of the acquisition, it was
ensured that each farm had a General Permit to operate and that each Waste Management Plan
had adequate land base to agronomically utilize the nutrients produced on each farm.
Furthermore, Brown's of Carolina. Inc. staff began a farm -by -farm audit of the environmental
status of each of the former J&K Farms, and it was determined that the facility owned by Newkirk
Farms, Inc. had a discrepancy between the facility capacity fisted in the General Permit and the
actual capacit/ of the farm. After further investigation of the discrepancy, it was determined from
a representative of Newkirk Farms, Inc. that the farm had been expanded and stocked prior to
August 1, 1996. Newkirk Farms, Inc. and Brown's of Carolina, Inc. then thoroughly investigated
the status of the permits and waste management plan for this facility and found no further
modification cf the permitted capacity of the facility. At present, the permitted capacity of the
facility is 650 i"arrow-to-Feeder, and the current operational capacity is 1,200 Farrow -to -Wean.
The need to expediently resolve this discrepancy is recognized by all parties_ Newkirk
Farms, Inc. and Brown's of Carolina, Inc. would like to work cooperatively with the Division of
Water Quality to quickly and efficiently bring this facility in compliance with a revised General
Permit reflecting the operational capacity. Newkirk Farms, Inc. is committed, with the assistance
of the Division of Water Quality and Brown's of Carolina, Inc., to diligently seek a waste
management system that will effectively treat and store the waste generated by this facility.
Newkirk Farms is also committed, if necessary, to submit an Individual Permit for Innovative
Animal Waste Operation within 30 days of the date of this notification.
Altematives to solving this issue are as follows:
a) A possible up -sizing of existing lagoon capacity to meet current lagoon standards for
tre 1200 sows. This solution, if allowed, could be employed in no more than 30 days
fr.)m approval.
b) Conversion of existing lagoon to aerobic treatment This would require Individual
permit and may extend the time required to accomplish compliance. However, this
equipment and monitoring wells could be installed in 30 — 60 days from approval.
c) Other Division approved animal waste management systems.
Immediate action to revise the Waste Management plans to apply effluent on acreage
required to support 1,200 sows is taking place.
BROWN'S OF CAROLINA. INC.
M MY 24 EAST - P.O. 4OX 487 - WARSAW, N.C. 28338 • PHONE [phone]

JUL-13-99 TUE 04 : 51 PM BROWN'S OF CAROL I NA! FAX NO. 2961333
P. 03/03
Rick, I appreciate your time discussing this issue on the phone with me and realizing the
urgency in resolving this issue. If there is any way in resolving this problem without having to
remove the 560 pregnant sows, the cost to Brown's of Carolina, Inc. and Newkirk Farms would be
dramatically induced, In addition to the reduction In the amount of time required to farrow out the
pregnant sows_
In addition to the added expense and increased time, depopulation of the excess sow
inventory after weaning these pigs would increase the time required to meet compliance to nearly
5 months; therefore leaving the farm operating at % capacity, likely forcing Newkirk Farms into
bankruptcy.
Newk rk Farms, Inc. and Brown's of Carolina, Inc. would like to arrange a meeting with
the appropriate representatives of the Division of Water Quality to further develop the {plan of
action needed for resolving this permit discrepancy, We appreciate your cooperation with this
matter and are committed to an expedient resolve.
Regards,
Ronald G. Brcwn
Brown's of Carolina, Inc.

]Division oi, Water Quality
0 Division of Soil,and Water Conservation
0 Other Agenc _
(Type of Visit *0 Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit ORoutine O Complaint O Foilow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: 2l 6� Time: e ® Printed on: 7/21/2000
5'
0 Not Operational 0 Below Threshold
A Permitted 0 Certified [] Con
d
itionally Certified 0 Registered Date Last Operated or Above Threshold: .............
Farm Name: jUeL kj.. .m$� C , County: DY - ...................
.........................,,....jj........... JJ ....1..t.. .............................
Owner Name: GGoY °�L L+i- !mac F Phone No:
........... w ....`f ......I ................ I.....................
FacilityContact:..............................................................................Title:................................................................ Phone No:...................................................
MailingAddress:.......................................�......................................................................................................................................................................... ..........................
tru
Onsite Representative:... u.. l u s~ W k:.F.................................................... Integrator: ,. o.wY.../f ..�... ro 1, ` .........
Certified Operator: ................................................... ............................................................. Operator Certification Number:
Location of Farm:
M
Swine ❑ Poultry ❑ Cattle ❑ horse Latitude • 4 �4 Longitude • 6 «
.... Design Current
Swine.- Capacity Population
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
SO
Farrow to Finish
Gilts
Boars
Design Current Desiign Ciirrent
Poultry Capacity Population Cattle Capacity'Population
❑ Layer 10 Dairy
❑ Non -Layer 1 10 Non -Dairy
❑ Other
Total Design Capacity
Total. SLW
1uatibti.of Lagoons 2 ❑ Subsurface Drains Present
x ':Haling Ponds! Solid Traps ❑ No Liquid Waste Managers
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?
Area I❑ Spray Field Area
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/ruin?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
❑ Yes ;6No
❑ Yes No
❑ Yes 'No
h �q
❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes VNo
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 ONO
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Ta
Freeboard (inches): Z
5/00 Continued on back

Facility Number. 31 -585 Date of Inspection 21 AO Printed on: 7/21/2000
7
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, El 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 —0 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 NfNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
RTNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
ZrNo.
Waste Application
10. Are there any buffers that need maintenance/improvement? 971-1
❑ Yes
DdNo
11. Is there evidence of over application? ❑Excessive Ponding�*AN ❑Hydraulic Overload
AMYes
>f N ��jD:�
A
12. Crop type _ ge rM VolcL G rgZC� S�,,tgCl 6 ^R,',1
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
WrNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
RrYes
❑ 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
15rNo
Required Records & _Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
JKNo
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
gNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
X'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
IJ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes 0 No
23, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? [:]Yes fM 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
�'S10 yiola�igtis:or def cienc{es were noted dirritng �his:visit= Ya t will i e. . .Rio fui thgr : :
'COrrespondene' e. ab' t i this visit.:
Comments (refer to question #): Explain.any-YES ansyvers and/or any rec6nunendatious.or any other comments: ,
Use drawings of facility to`better explain situations. (use=adtioaal pages as necessary" } -
P ---7,A l l --c i QA A _ 7 A . A.
I G V4 =;,.a " & rely c
L_ . r r—. 1 1 —7 w Al f
- - . — - T--rT--� - — — • e ' 7-- - _ _ - r , , a — r _ — _ — [ -. -- '' JJ
14' FaG J �l4 `? Y1codS A WeRAble G(Gl�I de-fGr m%r►q� f0y. Wo. � plot+, 40 v)1�7�t/
Ar� 4,o LeP mr—ordi based a1-, we#,q�b je acres-
!&ked 4o vie L lo,-she Avtglvs-;� dated tvr- 4 &144ys ar 4i e a[ele, off`
a�� �iUOl�l`oh oYt f qc ZI�%t Zis, Keelo free bagrQ records -F r. buff t /0000PS —
Reviewer/Inspector NameG ►'�� �J°1 i Ll' �i _ ,
Reviewer/Inspector Signature: Date: ii ��l !� l� 5100

Facility Number: �` — �js Date of Inspection 2 QO Printed on: 7/21/2000
. f
Odor ISSUES
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor below J?ryes ❑ 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 P�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 *o
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes �dNo
Additional Comments an or Drawings:
i
I , C'",O)L-0 &)I a week 17 b� S �s.
`
Mo4e + —T1,C Cer-Tj %+ i GA46 Ole C-Iwc. "'Rge Ge.•�; r' ia�1 TO✓ �"►t
i'� a s a ��D a.-ro t,- -fir)eG��''
Gra we r Arid I.ti/1'iSfe rC1 �e ellAe)
► s 2-00
5100

XPDivision of Water Quality
Q Division of Soil and Water Conservation
O Other Agency
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification [other
❑ Denied Access
Facility Number bate of Visit: Time: 2= Printed on: 7/21/2000
Q Not Operational Q Below Threshold
®Permitted Certified 13 Conditionally Certified [j Registered Date Last Operated or Above Threshold: .............
Farm Name: �,r�.....r rms m:... .. County:......I n
.............................................................
Owner Name:..... !`)- ..................... e w er. Phone No:....` `1 n.47. X............................................
Facility Contact: ........ JS!gw!�+Y ......................... Title:................................................................ Phone No:...................................................
MailingAddress: �r 1 n � �5"3 �`� ..............lQ_...._ahl.......i�0!fv...................................................... .....!' 1cltl� �.......................-----................. . . .........
Onsite Representative: ....... 3.q... kKt. . Integrator: ... &GO.S ..............................................................
Certified Operator:........! a6.f I.......,6....... ........UN Vu�,' ............. Operator Certification tiumber:............................
Location of Farm:
r■
I Imo:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �� ��� Longitude �• �� �«
Design Current
Swine CaDacitV Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
arrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I ❑ Dairy
❑ Non -Layer I I I ❑ Non -Dairy
❑ Other
Total Design Capacity G St
Total SSLW I 33 4,300
Number of Lagoons Z ❑ Subsurface Drains Present 110 Lag-nn Area JE1 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed; was the conveyance man-made:' ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. if discharge is observed. what is the estimated flow in gal/min"
d_ 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'? FO Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Spillway ❑ Yes ❑ No
�Strueture I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ......"............. ................. •.................. ................... ..........I... ...............................................
Freeboard (inches): 3
5100 Continued on back

Facility Number: 11 — S' Date of Inspection Printed on: 7/21/2000
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 Application
10. Are there any buffers that need maintenance/improvement?
Is there evidence of over application? Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP,'checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge'?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0: N6—*i61'atioris;or deficiencies mere noted duffing �his:visit: You will t eceive Rio further; ;
. - . , cori-esporidehce' abotit this visit. ::'' : ' : ' : ' : ' : ' : ' : '
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
® Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ .Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
-Ikt 1vsr_on WKh C"11CeSrs[. Ao nr ttA c, JJQ F[y-ales- }filec rr A.
?.�1rit � 6 0. uS� d(SLI,' t�2 D 9�tti1t (h Petb -"o- � 3 "w p►tf1 `itsa
aqe cce-< ) Xsc6)4 a,,'
0—�� �Mb a��crw a.+ 400 wow,-! . tic �+s. W,kr aw,(41 sot�,�s rerc QUA- �I�P H4 Om
[1_4t ,ter 6_ t, 31�_ ��ZA, %�r �{�a a���. rya s4i, „_�,l�
CY- V/L lV Iti.q� d�"'ri1'LvL.." �C11'fl�
1 (
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i
Ll !Lxte on SeC4. Z&V lar. -f t­ - E 11+�x4nA Wa %
Reviewer/Inspector Name Y.�
wetwetp 77 rI —P
Reviewer/Inspector Signature: [�,`�. / Date: %I- (QX466 5/00

ti 0 Division of Soil andyWater- I
13-Division of Soil and Water l
�Division-of Water Quality =
_ [3.Other Agency Operaon l
Routine Q Complaint Q Follow-up of DWQ inspt
Facility Number
ation Operation Review
' oP r
anon m lin�P
ace ectroiit
_
►pliance Inspection w
r Q Follow-up of DSWC review Other
e —
Date of Inspection OD
Time of Inspection : 3 24 hr. (hh:mm)
Permitted [Certified 13Conditionally Certified Q Registered JE3Not O erational Date Last Operated:
Farm Name �W /+' ....--...-- ✓h*5...... .-�+�. -.... -. ...... County:.............0-�[�1 /t..........-..------.... ......-....-....
............ ..- -.•-•......... ........ ......
�? _J ti
Owner Name: ......(✓ Kw ...................... ................ .....-..- Phone No:...................................... .........................
........................
Facility Contact: K. ............ ........... Title: ..... G:{ ........................I Phone No: .............................................
Mailing Address:
Onsite Representative:.;r�✓�-......... f,Lti h(Y. l�G�ntegratar:............ ..N,, ,°. L,�.............................................-..-......
Certified Operator;,,,,,,,,,,,, ............... Operator Certification Number:,,,,,,,,.,,,..,,,.,. „
.................................................,... ....,.-.......-.....
Location of Farm:
r................................................................. .............................----------- .................................. ......................... .......................................................................... ................
.........i _
Latitude �' �� �•� Longitude
Design Current Design' Current. Design 'Current -
Swine Capacity Po Population Poultry = .Capacity -Population . Cattle Capacity Population' _
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts.
❑ Boars
Number of Lagoons _ . ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Fieid Area -
W _
H6Idrng-Pon& / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts .
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made.'? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes *0
c. if discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: p ri 5L trie w)
s
Freeboard(inches): ....................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
3/23/99 Continued on back

❑ No
❑ No
❑ No
❑ No
❑ No
❑ No
Facility Number: 3 — ! Date of Inspection -7 ;3
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes
(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
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes
12. Crop type S
13. Do the receiving crops differ h those designated in the Certi ed
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?
21
15. Does the receiving crop need improvement?
Animal Waste Management Plan (CAWMP)? yes
El No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
[-]Yes ❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists,, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ 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
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
0: NOMolatioris or• defciehdL-s *&i8 noted 04ing this. visit. Yoit wiil•i-eedW iio furthO
.. correspondence. abatif this visit' . ... .. ... ........... . . ..... . . .... .
Comments (r eferFto question #) Explai i any YES answers ati'd/or any recommendations or any -other comments:- _
Use.draw '-..Offacility to_tiettef explain situations (use adrlii6onal=pages as necessary)
G4uf'z%.& Pt4 Cd &-rk off lYj i . � A 3�
. y
{ � � Sr��{�'� Cart SI.v� �C�. f r � S %ern' . oarl /tad
�h a� ) ) ,,/ /
7v /✓�� ��� Gf�"r� las�7�lty
ivr•K . T`U 5 67", fke-- Pr-,lymo d. Cax�incc,t w was
�
/"_4DA loci/ _ f
Reviewer/Inspector Name
Reviewer/Inspector Signature: t Date: 3 �jpjj
3/23/99

Facility Number:Date of Inspection: 7
t
d►dditional CommeriTts andlor'Dmwings N
It�Yi Q
arr-i✓�taL 6n.sij4e- 1�%r. /yewk-1 1.
u��S v�rt� �iL S'L- latch � /°L , �t%as was 11
P I
Coh�,,/ in SL , hr�-c. was ,0vldeoe� Some ww sAe
A�DI � e K +64US l-- 6,de- obwv- i " Tri "mot • Tire-Y
-P Wa44-e- 6K A OP v-f- pt i ILL wa! t CCc vac r� j A _, o�
5 6it (d- b t b rr,%�hA- i n 4i�' li -'s tti or P" 4,k iwIL t n v j r i r�
A-, � is--3- rIon ci n . (`Pe role. w � 1� s)
Q17J i> % Cwrt• �i+��(y a�ota,r o h,l As
r
iiImo- u��(�s- �� wyv ( �'7 `j
C e n e-e r rl js p re C Ca r-c- a r► �tva1 ,17�d� v,c �Cs� �- � '� `.. Wl k
1117
IkSDsy. 1Gr� �yy���r �akr /prr 616ss
Cr ( 1
kh-k;l kn e
S c cG-fu+ r Arm c �
-
�� - � �yt,A l9 0 jYeeAo. r ,j
o-F �ks�• -�-�- sG � pL sue[ 1 s
ova S L . . YVi r . N��i�+r,�'s Fi e�.�s .r�. ��'!! ra �Q-�t
5 G �O� C°"�� Ca �, � � L �' rarer
P L �� o
bG 7awco{row - S'�Ye�/jl .
L
�l ( D 14) Q, C ke-G iW - �a.0 L k I %9 (. " - 3 [ � d o�
j h S L ��. d-ro p f csC -� `4P1, " "-"- "'-
tntkc � . C C �Lra S )t,,.V) w s-�-, � [ a V• s� 1-c a wL b tv k-�- ; ►1
P vLMF- m"k Also s-4-oar-I 1` 4b s ►rph-t . S -- -f v e e 6vxyot J e Ve. j
6 4v ae n I a ' - 12 " a + +; �-c v,( s etob d I•.; e:-4 , (a) PMAJ-1 6 h Sift nP',
r ► w ' +� jo <,^ - ZObv Ar4-
II ,w, sr I cG�
4/30/97

k•2
Division of Soil and Water Conservation Operation Review
`Q_Division of Soil and Water Conservation ComIn
pliance specti on -
- = ® Division of Water Quality Coinplianee-Inspection
EI Other Agency Operation Review =ry _
_.- -
14D Routine O Complaint O Follow-up of DWQ inspection Q Follow-up of DS►%'C review Q Other
Facility Number Date of Inspection
„ Time of Inspection 4 04 24 hr. (hh:mm)
® Permitted © Certified © Conditionally Certified [3 Registered 113 Not O erational Date Last Operated:
Farm Name: Ne W k 1" k F-�r �Vi G • County: �
---.... �.............................ms...-- ................
Owner Name :...... G -f,�C �' 'v .� l�.i r f� Phone No:
...............................................................................
Facility Contact: ....................................................
Mailing Address: ....................................................
Onsite Representative: ........................................
Certified Operator: .................................................
Location of Farm:
..... Title: ................................................................ Phone No: ....................
...............................
.......................................................................... ............................................ .... .................. 1........ :. ...
.............. I.............................. Integrator: ..• Rr o t'v'� S
...............................
............................................................... Operator Certification Number:...................
r--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------�
Latitude Longitude
Swine -
Design Current
Canacitv Population . Pc
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
j Z a Q Jon
® Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design . Current " Design Current -
V .:-,,Capacity Population--'-,'' Cattle Capacity ,Population°
Number of `Lagoons �' ❑ Subsurface Drains Present ❑ Lagoon Area ❑eaSpray Field Ar_
HoldmgPonds/ Solid Traps ❑ No Liquid Waste Management System
Discharees & 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. 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
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: f�
Freeboard(inches): 2 "................. ................................... .................................... ......................... ......... ...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes X No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes R No
❑ Yes 91 No
❑ Yes RNo
Structure 6
❑ Yes J9 No
Continued on back
3123/99

Facility Number: 3 l —5795 Date of Inspection
8:" Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes 25No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ) S
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 ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes JS No
.Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
9 No
IL
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
'® No
12.
Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
J9 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
0 No
15.
Does the receiving crop need improvement?
❑ Yes
IffNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
9 No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
A 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
IR No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
19Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
KNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
19 No
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
03 No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
JR No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
19 No
0: N6 -yi61hti6iis;or de denaes were poted� during Ibis;visit; - Yolk will -t eeeiye �no further
corresporideizce. atbau this visit. . ... . . . ... .. . . . . . . . .
Comments. {refer to question #�): Explain any YES ans "wens and/or auy recommendations or -.any other comments::
Use drawings of facility #o better explain situations (use additional pages as necessary) z
8. 4wAew stjauld -mince OL(T Ofrfck oteea *o �Oreven-1 cg4fle dcfr► A7-
vertir%�nt Je A/'e0. be --we" .F:w.jd! .-L 4 Z- S�roc�1d b� .
re ve j e+ �,+ed .
Iq • C l/relary - Sa? i 1 s'a✓+tip'2 need r -to be 1 n �alr A, r'C G ord s,
C yrrec- '[PAN.6 fceado codes 5-hot41d be S own i" irriq34iorx
YoecoO-ds-
Reviewer/Inspector Name �-1 ll 3nez .v 1 ► =.t tt ,1W,= :. T-.Y-� r. j
Reviewer/Inspector Signature: d 1%4,t� Date: ! - Z r% 4 I
3/23/99

Facility Nurnber: 3 —��" Date of Inspection
(Sdor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ® No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes Nj No
Additional Comments and/or DraWin
ae�`r"L GlopA1'1 C Ta 2O O C4voi-v4J ! q M ( 1 6
L1/ t�LO GG�t"I %�'�af e'er ►'!a'�1��'r' c 4!� ion %Jas-�� ���1:'\ i S
��„ �� des ��n�d �Q 3ncD✓�or�a�e add;-����.�� � � t'r� GIs
Dt n d r e S.
3/23/99

Sa
19
[� Division of Soil and Water Conservation Other Ageney t R`
,��Division of Water Quality ; � �_ � ,
10,Routine O Complaint O Follow-up of DW2 inspection O Follow-up of DSWC review O Other
Date of Inspection R$
Facility Number Time of Inspection ® 24 hr. (hh:mm)
D Registered Certified MApplied for Permit O Permitted IDNot Operational I Date Last Operated:
Farm Name: ..... �� County: �� ~ .................. .
I........................--...............------.......................................... 21..`--...........................,.......
Owner
....................... ............................................................-•------•--•--•.......... Phone '�10. "
Facility Contact. ........................................................... ................... Title:................................................................ Phone No:...................................................
.
Mailing Address:.......... S.:JI- ....a `*................
OnsiteRe resentative:... �^lA ..l. ti�1-� ... Into rator'--sty—_& c ......... ....
p ............................ g -- ....................
Certified Operator:............................................................................................................... Operator Certification Number:....................
Locati n of Fa
.............. ............ `' -.1-...........s!�Y! ..........\...... ```............. .......----- -. � �'�....... ...............................-...............................
t t_
.... .. �.. .. ...\�,a -.... i �. 15 �. �...7c'-�L 1� 4`^ . v� ra-..................................
Latitude ='=f " Longitude =' 1 96
f Designr Curl ent m
:Design Current :Design Current
Swine ,> Capacity :Population
Poultry
Capacity Population Cattle Capacity Poptilattott
❑ Wean to Feeder
1
10 Layer
❑ Dairy
❑ Feeder to Finish
,
❑ Non -Layer
❑ Nan -Dairy''
❑ Farrow to Wean
-:
Farrow to Feeder
(�
❑Other
n
❑ barrow to Finish
T©tal Deslgn£CapaCify `
g
❑ Gilts
N
❑ Boars
_
: T6t [SSLW
,v,...__
Number of Lagoaiis / Holding Ponds °�
❑ Subsurface Drains Present
O Lagoon Area
❑ Spray Field Area
r......
❑ No Liquid Waste Management SystemAN
^
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
KNo
2. Is any discharge observed from any part of the operation?
❑ Yes
No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made?
❑ Yes
No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
dNo
c. If discharge is observed, what is the estimated flow in gal/min?
B.
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
❑ Yes
ONo
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
04 No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
O No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
VNo
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
9No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
P No
7/25/97

.�� Facility Number: — S
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes 0 No
Structures (Lagoons.Holdine Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes 5j No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: I,
Freeboard (ft): ........... , ...
10.
Is seepage observed from any of the structures?
❑ Yes
14 No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
KNo
12.
Do any of the structures need maintenance/improvement?
❑ Yes
krNo
(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
ONO'
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
($ No
(If in excess of WIMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type :S i1. �`' �p.
-------------------
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
0 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
[XNo
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
P9 No
22.
Does record keeping need improvement?
MYes
❑ 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
XNo
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
N No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
1XNo
0- No.vio'lationsor. deficiencies.were noted,duritig this. Visit.- You:v'ill rec_ eii+e-ito,fdrttier, :
:�:�:.�::�:�.�:�:�:�:�. :.:.�;.�.:-.:.•
7/25/97

x::❑ DSWC Animal Feedlot Operation Review
3 DWQ Animal Feedlot Operation Site Inspection 4'
Routine O Complaint O Follow-up of MV0 ins action O Follow-up of DSWC review O Other
Date of Inspection
Facility Number
Time of Inspection 24 hr. (hh:mm)
D Registered 11 Certified D Applied for Permit D Permitted [] Not Operational I Date Last Operated:
Farm Name: .....�Z.ewy..._.(n1..... NCW. f
!L......�ar!�.... County:......bvt i►n....................
............................................... • /............................................
ON.Mer Name: ....... &r_Q%e.......... N.e�t".sv...................................................................... Phone N`o:..L�1 lG� p..............................................
Facility Contact: �C7i/ Title: awru.a•..................... gL.�.'........`f.7. 9............
....6.C.a%e........hW .. ...•............. I.............. Phone
illailitig Address:.....cLc.......�tQ��....aGn�....... .......................................... ............. 1 autaGi.ia 11,1G........ ....... .41-n ...........
k l..
Onsite Representative :...(,?f0�........ ,(j�l"-cy....................................................... �rator:_...A+K .
. _....... Inter.......................................................................
GG ll /
Certified Operator: .................................................. .... ................. ................ Operator Certification Number:.......l.f. j..S_................
........................
Location of Farm:
........ . . ...... . n,......1:.....r!.#....4#-....161rUfS.....�int<e..... h&' ......t��......t ... s1Z....L�I?1.�...rvrn..... ... i
....Qtn.. .......1. t ?.....90 ..:f r..... ►�....!r �i ....a��.....s. ,_1.L a<cm..iS.... .._l...mls_.O.r.....5QLA ...s�rS,w..C.'
Latitude 1 .9 Longitude 0 ° ;°
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 I I ❑ Dairy
❑ Non -Layer 10 Non -Dairy
❑ Other
Total Design Capacity �J,
Total SSLW
Number of Lagoons / Holding Ponds 10 Subsurface Drains Present 110 Lagoon Area
❑ No Liquid Waste Management System
JE3 Spray Field Area
General
1.
Are there any buffers that need maintenance/improvement?
❑ Yes
No
2.
Is any discharge observed from any part of the operation?
❑ Yes
E.NO
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑Other
a. If discharge is observed. was the conveyance man-made?
❑ Yes
No
b. If dischar-e is observed. did it reach Surface Water') (If yes, notify DWQ)
❑ Yes
No
c. If discharge is observed, what is the estimated flow in galltnin?
d. Dees discharge bypass a lagoon system`? (If yes, notify DWQ)
❑ Yes
V 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
,9No
7.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
W No
7/25/97
Continued
on back

Facility Number: 31 -
8. Are there lagoons or storage ponds on site which need to be properly closed`?
Structures (Laeoons,lloldina Ponds, Flush Pits. etc.)
9. Is storage capacity (freeboard, plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Freeboard(ft): ........... z.'"3................ .....................................................................................................
10. Is seepage observed from any of the structures?
❑ Yes IS�No
❑ Yes tO No
Structure 5 Structure 6
❑ Yes RNo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes P No
Cr
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 R) No
Waste Application
14- Is there physical evidence of over application? ❑ Yes JgNo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ........6-P.mil O.....................................5ft �O.....Va n..-............ 5(�.ti m+t�f.....A rlvx u� �...... l�1tin ..ahrtt�ct ....................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW,MP)? .Yes ❑ No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes R,No
18. Does the receiving crop need improvement? ® Yes ❑ No
19. Is there a lack of available -waste application equipment? ❑ Yes 19 No
20. Does facility require a follow-up visit by same agency? tK Yes ❑ No
21. Did Reviewerfinspector fail to discuss review/inspection with on -site representative? ❑ Yes (,No
22. Does record keeping need improvement? ER 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 5d No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? RYes ❑ No
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes IN No
0- NoNiolations or deficiencies were -noted during this'visit.:.You.will receive- no ftirftier . -
correspondence about this:vtsiC-:.' :.
rtw
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments
Use drawings of��facility to better explaiiistuations {use additional pages as necessary);,
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er
ReviewerlInspector Name
Re wer/Inspector Signature:
Date:

Site Requires Immediate Attention: /LO
Facility No. , LE�
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL. FEEDLOT OPERATIO . STIE.VISITATION RECORD
• DATE: Zd , 1995
Time: NO
Farm Name/Owner:k1� 'r �Nottlow
Mailing Address: Q lU2-Ale,--
County: / [J�I�L A/ r
Integrator: .! Phone:
On Site Representative: "I/e/71�Lit�_ Phone:
Physical Address/Location: _ �,,__
Off.
Type of Operation: Swine ' -Poultry Cattle
Design Capacity: J O SOW _ � Number of Animals on Site:
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' Ye r No Actual Freeboard:h__rFt_ Inches
• Was any seepage observed from the lagoon(s)? Yes COWas any erosion observed? Yes r No
Is adequate land available for spray_ Ye NQ Is the cover crop adequate? es : No
Crop(s) being utilized: _.t'it�(,U�1 Ark-1
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings es r No
100 Feet frorn Wells?(Yes r 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 US+sS 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 No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific)creage with cover crop)? Yes or No
Addirional Cornments: ���.LL
c/ Q.e- DS SC/,Q,e peAl b IYQV_U S S€-i S4r _ Lj
l� G.,6-JYi-r
Inspector Name
Mire
a"
cc: Facility Assessment Unit
Use Attachments if Needed.