310589_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

Type of Visit: Nompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for VisitRoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access j� 7�
Date of Visit: {} J Arrival Time: +L �lLJ Departure Time: County: T Region: r V l VVV
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: �� J Title:
Onsite Representative: cu� YV {"-2M Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number: 14 a o 3
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
We Poultry
I Layer
Design
Capacity
Current
Pap.
Design Current
Cat#le Capacity Pop,
Dairy Cow
Wean to Feeder
[Non -Layer
Dairy Calf
Feeder to Finish
=23
D
—'Layers
D . P,ouItr
Design
Ca aci
Current
P,o .
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
t7ther
Other
Turke s
Turke Pouets
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes
kNo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ONE
Page I of 3 21412015 Continued

Facili Number: 5 1 jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes AKNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:`
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): :3�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
K 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
[KNo
❑ 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
tkNo
❑ 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
[ANo
❑ 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): Wf V\. WY LR4 R I g&b
� I
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[ No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
[] NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
XNo
❑ 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 t No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 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 21412015 Continued

Facility Number: -J]Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes KNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes a No ❑ NA ❑ NE
the appropriate box(eO 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 W 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?
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 CWNo ❑ NA ❑ NE
❑ Yes VNo
kA
[:]Yes [ ]+Io
31. Do subsurface the drains exist at the facility? if yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
❑NA ❑NE
❑ NA ❑ NE
[lo
❑ NA
❑ NE
�No
❑ NA
❑ NE
No
❑ NA
❑ NE
No
❑ NA
❑ NE
Comments (refer to gneshon t3)s g0layn a®y YES, answers and/or,any ad€diti nill re66fnmeudgations or any'other;comments
l)se drasvtngs, of fseiiity to better.ezplae©'situ,ateotis,(use addiitional'pages�as_ ueeessary)'s
A F�a'm - wov-k_ Do, �a4-t <Sr� a/bIj -h)p
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
W
Phone: 9 L 0 —'I`i {L `i 3?1
Date: 'I?/ U
21412015

Type of Visit: o ance Inspection Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral C) Emergency O Other Q Denied Access
Date of Visit: EY44
Arrival Time: 3p Departure Time: 3 i County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title: Phone:
Onsite Representative: �e u 1 ' ' ,� �� Integrator:
Certified Operator: Certification Number: �9
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design
Swine Capacity
Wean to Finish
Current
Pap.
Design C►urrent
Wet Poultry Capacity Pop.
Layer I
Design
Cattle Capacity
Dairy Cow
Current
Pop.
can to Feeder
I jNon-Layer I EEJ
Dairy Calf
Feeder to Finish 4 zj
Ab
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Mlre7silln Current
D , P,oult , Ca aci. P,o
Layers
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other Turke Poults
Other Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? [:]Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify 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 ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
[:]Yes No ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: - Date of Inspection: Q
.4
Waste Collection & Treatment
4' is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes LS1P° ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3
Identifier: 10
Spillway?:
Structure 4 Structure 5 Structure 6
Designed Freeboard (in):
Observed Freeboard (in): !L3
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 vo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [] Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below, ❑ Yes �`No[:j 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 ff No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes �o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [�No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? [—]Yes rj"No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes Cal�o ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? Yes [] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: jDate of inspection: Zv
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E] I"o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No []' ]�❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
ETNo
❑ NA ❑ NE ,
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[21No
❑ 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
[;yf�o
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[D-No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�o
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additionalrecommendations or°any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).. .
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
D OL, + j. P-0 '_1 Al
Phone: < (J 7 r e 7_7-aX
Date:
2/4/2015

r
Type of visit: V U pliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: y[ Routine Q Complaint 1) Follow-up O Referral O Emergency 0 Other 0 Denied Access 1
Date of Visit: Arrival Time: ® Departure Time: o County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: j Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone:
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine C+apacity Pop.
Wet Poultry
Design
Capacity
Current
Pop.
Design Current
Capacity Pop.
Cattle Moll
Wean to Finish
Layer
I
airy Cow
)OVean to Feeder
I JNon-Layer
I
airy Calf
Feeder to Finish '04 oD
Farrow to Wean
Farrow to Feeder
Dr P,ouIt .
Layers
Design
Ca aci_
Current
P,o ,
Dairy Heifer
Dry Cow
Non -Dairy
Farrow to Finish
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Beef Brood Cow
Boars
Pullets
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:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes 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
21412015 Confinued

Facili Number: `y - Date of Inspection: It sn
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ZfNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [:]No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: A— 0
Spillway?:
Designed Freeboard (in): 1 C C
Observed Freeboard (in): 3 3 _ Y —
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [3No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑-5—o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes EJ�No 0 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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
0'50
❑ NA
❑ NE
❑ Yes
❑i `fio
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
es
[:]No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
2 L Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
E3<o
❑ 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
Ea'go
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
Page 2 of 3 214120I5 Continued

Facili Number: - Date of Inspection: t( q /
❑ � ❑ ❑
24. J
Did the facility fail to calibrate waste application equipment as required by the permit? Yes No NA NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes EJNo 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 E<o C ] NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No 6f NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes r No [] NA ❑ NE
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern? Yes EfNo ❑ 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 u 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? 0 Yes Vf"No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes rNo
N- [] NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ NA ❑ NE
Comments,(referjo.question.#):,Explain any YES answers and/or any additional recommendations or any other comments.
Use;drawings of facilityto liette'r egpla n'situations (use additional pages as necessary).
FL� �c rQ r z S ro o 3
�1 Ri97 41 73� j
Reviewer/Inspector Name: �/ u ez Phone:
Reviewer/Inspector Signature: ?% Date:
Page 3 of 3 21412015

Type of Visit: Compliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: 40l'outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: 1 1 eparture Time: County: Region:
Farm Name:JE
Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:�p
Certified Operator:
Back-up Operator:
Location of Farm:
I
Phone:
Phone:
Integrator: "Jpld
Certification Number: /
Certification Number:
Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
La er
Design
Capacity
Current
Pop.
Cattle
DairyCow
Design Current
C►apacity Pop.
Wean to Feeder
Non -Layer
Da Calf
eeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D PIoult ,
Layers
Non -Layers
Pullets
Design
C►_a aci_
Current
P,o P.
Cow
Non -Dairy
I 113cef Stocker
Beef Feeder
Beef Brood Cow
Gilts
Boars
Other
Other
Turkeys
Turkey Poults
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
[:]Yes VNo ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
V1 No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3 21412014 Continued

Facili Number: Date of inspection: Z
Waste Collection & Treatment
4. Is stofage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
A No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
[] NA
❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: j�J^
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ---f— 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
04No
❑ 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
,3No
❑ 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 Z] No
❑ NA
[] NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes �fNo
❑ 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 VfNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes 6No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes
�No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure
to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? [—]Yes CZ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes TZNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ENo ❑ NA ❑ NE
acres determination?
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
[�rNo
❑ NA
❑ NE
Renuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
-Ej No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[3"'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 Lno ❑ 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 o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: - Date of inspection: z3
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Vi4o ❑ NA ❑ NE
25' Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes VNo ❑ 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 6 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes C?(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?
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 VNo ❑ NA ❑ NE
❑ Yes PNo
❑ Yes VrNo
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
❑NA ❑NE
❑ NA ❑ NE
ZNo
❑ NA
❑ NE
VNo
❑ NA
❑ NE
O No
❑ NA
❑ NE
E� No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.'
Use drawings of facili to better explain situations (use additional pages as necessary).
!, 6 3
/. 3 r
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
///////3
16. jk oa�
r
Phone:
Date:
21412014

I?
(Type of Visit: 91compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: y� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Phone:
Title: Phone:
Onsite Representative: Integrator:
AA,
Certified Operator: 5`P_�'1 Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Region:
Design Current
Design C>urrent
Design
Current
Swine Capacity Pop.
Wet Poultry Capacity Pop. Cattle
Capacity
Pop.
Wean to Finish
La er D=Stocker
Wean to Feeder
Non -La er D
Dairy
Feeder to Finish
Farrow to Wean
Design Current D
Farrow to Feeder
D , P,oult�. Ca aci l;o , Non -Dairy
Farrow to Finish
Layers BGilts
Non -La ers
BBoars
Puliets
Bow
Turkeys
Other Turke Poults
Other Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
/No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[:]Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[:]Yes
[] No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
[:]Yes
[:]No
[] NA
[] NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
XNo
❑ 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 l of 3 21412011 Continued

lFacitity Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[:]Yes
V] No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
ONo
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freehoard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
gNo
❑ 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
Z No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Ej 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? 0 Yes ZrNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 9No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes E } No ❑ NA ❑ NE
acres determination? %
17. Does the facility lack adequate acreage for land application? ❑ Yes �TNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes rNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ZNo ❑ NA ❑ NE
20. Does the facility fail to have al] components of the CAWMP readily available? If yes, check ❑ Yes VI 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 0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall 0 Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V 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

Facili Number: - q Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
;�:rNo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
VNo
❑ 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
0 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 ;ZNo
❑ 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 XNo
❑ 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 V1 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 L�rNo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes [] No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes— No
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments. -"
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: j j' Arrival Time: Departure Time: b _l County: Region:
Farm Name: �� 1 ,� Lx-% I- `'Owner Email:
Owner Name: rn Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: 9FT Ey [
Certified Operator: '3—jej f C_ M.Gk� N IT F I f L�
Phone:
Integrator:
00191
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Wean to Finish
Design
Capacity
Current
Pap.
Design Current
Wet Poultry Capacity Pop.
I 11-ayer I
Cattle
Dairy Cow
Design Current
Capacity Pop.
Wean to Feeder
I INon-Layer
I
Dairy Calf
Feeder to Finish
Farrow to Wen—
Farrow to Feeder
Farrow to Finish
1504
Design
D . P,oultr. Ca aci P,o ,
Layers
Dairy Heifer
Dry Cow
Non-Dai
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:
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
'M
�No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

Fimili ''Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: _
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(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? �y
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? Im
Waste ADnlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �4 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): V�3��
13. Soil Type(s): ALcigA lu-icC.F Rc_,4,ll 1n/Y
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 [DNA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ,Z]rNo
(_
❑ 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
r] Yes 9No
❑ NA
❑ NE
the appropriate box.
QWUP ❑Checklists ODesign Q Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �A No ❑ NA ❑ NE
❑ Waste Application 0 Weekly Freeboard Q Waste Analysis ❑ Soil Analysis Q Waste Transfers [] Weather Code
❑ Rainfall ❑ Stocking ] Crop Yield 0120 Minute Inspections [] Monthly and 1" 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 kNo ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Fe[zili Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ YesNo ❑ 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 iii❑��� No/ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes ANo
❑ 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 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 No
❑ NA ❑ NE
Comments -(refer to question #): Explain any YES answers and/or any additional. recommendations or. anyothercomments.-
Use drawings of facilityto better explain situations(use additional pages as necessary).
31� pa 1,9
C���� t90H
Old flT �U`� ► D GG��T � a(.�c-DS �DG�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 910, J—Ko*:1
Date: 5 % --
2/412011

Division of Water Quality
Facility Number � � - r(y � Division of Soi[ and Water Conservation
Other Agency
type of Visit: , Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 10outine 0 Complaint 0 Follow-up _0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ® Departure Time: / 3S County: 4 Uif Region:
Farm Name:QJUACH�MS Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: S j E VE
Certified Operator: S 1 CGVE M • W 141 `1 0E LN
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
O1 1
ertifecation Number:
Certification Number:
Longitude:
I geo3
Design C►urrent
Swine Capacity Pop.
Wean to Finish
Design Current Design Current
Wet POUR Capacity Pop. Cattle Capacity Pop.
La er Dairy Cow
Wean to feeder
on -Layer
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean Q
Farrow to Feeder
Design Current
Dr, P■oul Ca acit P,q
Dry Cow
Non-Dai
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other 11LIOther
Turke s
Turkex Poults
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 O"No
❑ NA ❑ NE
❑ Yes
❑ No
[] NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes X No ❑ NA ❑ NE
❑ Yes CR�No ❑ 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 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes o ❑ NA ❑ NE
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: C11—
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): H
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public stealth or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes }CJ 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 I}(I No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window' ] Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): l/V 56- �1] Qi�� VxQ- C/ _;6
13. Soil Type(s): �it �U 1ZC-r
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 ❑ Design ❑ Maps 0 Lease Agreements
❑ Yes No
❑ Yes No
❑ Yes jV No
❑ Yes M No
[] Yes '4 No
❑ Yes No
❑ Yes No
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
Q Waste Application [] Weekly Freeboard [] Waste Analysis Q Soil Analysis p �ste TP
fers
❑ Rainfall ❑ Stocking 0 Crop Yield ❑ 120 Minute Inspections [] Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
0 NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA []NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ONE
❑ NA ❑ NE
Weather Code
0 Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3
21412011 Continued

Facility Number: -5 F9 Date of Inspection: e
w'
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
[] Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No XNA ❑ 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? f
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes �No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ONo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes W o ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or,any other cominents.z
Use drawings of facility to better explain situations (use additional pages as necessary).
w V_�:'
('19-1/o 2 D. d
CAC tea-R i,av CJ�c �al a
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
G AIxl S
Phone: a+6
Date: a L
21412011

Type of Visit A Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ARoutine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 6 (j Q Arrival Time: Departure Time:
Farm Name:
Owner Name:
Mailing Address
Physical Address:
County:
Region:
UU 1 4J'tl.�fNL P IF HVJ r r— n r Owner Email: I
Phone:
3Y-) %EAQ ANCA s 4LJ f1)QC .,V r 01-106 / c .083b5-5oa5
Facility Contact: Title:
Onsite Representative:
Certified Operator: �T r V r r" ti �i�l-3lTr1Et-�
Back-up Operator:
Location of Farm:
Phone No:
Integrator:
Operator Number: %'Oe-N
Back-up Certification Number:
Latitude: [ c = Longitude: = ° = 1 = «
Design Current
Swine C►►opacity Population WnRoultry
Design
CaP c i A
Current
Population
Cattle
Design
Capacity
Current
Population
❑ Wean to Finish ❑ Layer
❑ Dairy Cow
❑ Wean to Feeder ❑ Non -Layer I
I
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
Farrow to Wean
❑ Farrow to Feeder
) Dry Poultry
❑ Dry Cow
ElNon-Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
El Pullets
❑ Turkeys
❑ Beef Brood Cowl
a# Structures:
I
Other ❑ Turkey Poults
❑ Other 10 Other INumbe€
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 X No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El NA
❑NE
El Yes
❑No
❑ Yes No ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
12128104 Continued

r
Facility Number:
Date of Inspection O /d
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?
S cture 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?: Q
Designed Freeboard (in): I • 19.
Observed Freeboard (in): L W
5. Are there any immediate threats to the integrity of any of the structures observed?
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes No
❑ Yes //❑ No
Structure 5
❑ NA ❑ NE
El NA El NE
Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes W
No ❑ NA ElNE
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? P
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ElNA ElNE
maintenance/improvement? p
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes K 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 [I Application Outside of Area
12. Crop type(s) �� 14C—A! S � 'L n e�� o &Vt6
13. Soil type(s) Ak4j Ei.caU I t<i
Ij
14. Do the receiving crops differ from those designated in the GAWMP?
El Yes
No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
El NE
Comments"
(refer.to question #): Explain auy:YES answers and/or any, recommendations or any other comments
Use drawings;offacility, to -better explain situations. (use'additional°pages as necessary)
Reviewer/Inspector Name D '` Phone:
Reviewer/Inspector Signature: `�1_ Date:
Page 2 of 3 1 Y28/04 Continued

r
Facility Number: —s Date of Inspection O d
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes A No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ]LI No ❑ NA ❑ NE
the appropriate box. El WUP ❑ Checklists ✓
0 design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes )kNo ❑ NA ElNE
0 Waste Application ElWeekly Freeboard ❑ Waste Analysis 0 Soil Analysis ElWaste Transfers ❑_ / ual Certification
❑ Rainfall 0 Stocking ❑ Crop Yield ❑ 120 Minute Inspections 3 Monthly and 1 ° Rain Inspections [3 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
No
El NA
❑ NE
El Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
El Yes
El NA
El NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes ❑ No �NA ❑ NE
❑ Yes 'PfNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
Vf No
❑ NA
❑ NE
Additional'Comments and/or Drawings:
_4/100 0. 9
415/10 0.0
1/11116 I.60
{�LcB9A IW bur �Ol o,
Page 3 of 3 12128104

Type of Visit 'vim. Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 3kRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: n Arrival Time: 1��~Departure Time: � County: u IV Region:
Farm Name: 1C_C_ TLk Z-0-ANCH+ CIO"
w -P- LM A't' Owner Email:
Owner Name: ST6 U (: a 1 1 �V+�I TF 1 �-� _ Phone: 9 /9 — (0SR` 0 5L1L/
Mailing Address: 3 U� A (J� u S ' —a T Quci . Ally COP 3toS —5Q() s
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:. i ' + ' �`-�' TF1€L�
Back-up Operator:
Location of Farm:
Phone No:
Integrator•
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0= f Longitude: 0° 0' 0 "
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
❑ Wean to Finish
❑ Layer I
I ❑ Dairy Cow
❑ Wean to Feeder
I 10-Non-Layer I
I ❑ Dairy Calf
❑ Feeder to Finish ❑ Dairy Heifer
Farrow to Wean 6 Dray Poultry ❑ Dry Cow
Farrow to Feeder ElNon-Dairy
❑ Layers
❑ Farrow to Finish El Stocker
❑ Gilts ❑ Non-ts ers ElBeef Feeder
El
Pulle
❑ Boars ❑❑Beef Brood Cow
❑ Turkeys
Other ❑ Turkey Poults
❑ 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
x No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104
Continued

FAcility-Number:.S —
Date of Inspection
Waste Collection & Treatment ),�
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [I Yes J�1 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
S A
ture 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: Q
Designed freeboard (in): S ! .
Observed Freeboard (in): 9 Is y
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No [3NA ElNE
(iel large trees, severe erosion, seepage, etc.) A
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? P
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 El NE
maintenance/improvement?
IL Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 1�No ElNA [3NE
ElExcessive Ponding ElHydraulic 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 (❑l Evidence of Wind Drift El Application Outside of Area
12. Crop types) � �1 _ S9 � �1�f - - ifL(t ) --
13. Soil type(s)
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?
Cl Yes No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes o
❑ NA
❑ NE
101
11
Comments�(refer torquestton:#) Eyx,,���plaut ady YES answers and/or�any recommendations or any other comments:
Use draw,ivngs!ot faciiRty�ta eAb.�e�tte...��.r�yle�'�xplatn,yy s ttuaLhvons (use addtiianal pageS. necessary).. p
�V 14 -
9
j�91�? 1.9 � •o�
rrj3)o�s �•S l•y
Reviewer/Inspector Name F—IY1 S Phone:
ReviewerlInspector Signature: Date: OC
Page 2 of 3 12128104 Continued

Cy acuity Number: — Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Ill No ❑ NA ❑ NE
the appropirate box. El WUP El Checklists T�
Design 0 Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard 0 Waste Analysis ❑ Soil Analysis []aste Transfers!!!!''" �l�l❑nnual Certification
O Rainfall ElStocking O Crop Yield 3 t20 Minute Inspections El Monthly and V Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional_ Comments and/or Drawings:
❑ Yes )9 No ❑ NA ❑ NE
❑ Yes
No
❑ NA
[INE
❑ YesjNo
❑NA
ElNE
ElYesNo
❑ NA
❑ NE
❑ Yes
X No
❑ NA
❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes]
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
*No
❑ NA
❑ NE
Page 3 of 3 12128104

Division of Water Quality
Facility Number 5 Division of Soil and Water Conservationq
--- -- — O Other Agency
�= y
Type of Visit X Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 4 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: � on) Arrival Time: Departure Time: h.� County: h&QUALRegion:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title: Phone No:
Onsite Representative: S 16 V MCA- � N' 11 F I �L� Integrator: �S ►` ti E
Certified Operator: �M 7EVL • Lk3r-1 i t F 1 CLk�A Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =1 o = I = ff Longitude: = ° = 4
Swine
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
® Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
Design Current. Design Current Design +
Capacity Population Wet Poultry ; Capacity. Population Cattle -Capacity 1?i
.
Non -
Dry Poultry'
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouits
❑ 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?
Pont
❑ 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 1 of 3
❑ Yes KNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
�(No
❑ NA
❑ NE
12128104 Continued

PacilityNumber: I Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
A No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3ptr Li
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA ❑ NE
(ic/ 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
D(No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
KNo
❑ 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 No
❑ NA ❑ NE
maintenance or improvement?
' \
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
jo No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
10 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
KNo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ZNo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
[9 No ❑ NA ❑ NE
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
DtNo
❑ 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):
K��� N E�C oN >�(t4SlON !N Go(ZNE4LQF ��}Gaan� N��� DiiilM P1
C t:T CO 0 p 6 LA COON
�4((M LOoS �Q� A i
k
Reviewer/Inspector Name IA M I Phone:9(o 391
Reviewer/Inspector Signature: Date: d
Page 2 of 3 12128/04 Continued

f
Facility Number: 31 Date of Inspection �4
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 PdNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps
p ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22,
Did the facility fail to install and maintain a rain gauge?
❑ Yes
KNo
❑ NA
❑ NE
23.
1f selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
KNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
XNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
XNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P�No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[RNo
❑ 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 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
CR�4o
❑ 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
KNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
D 'No
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12128104

Facility Number 3 S
Q Division of Water Quality
Q Division of Soil and Water Conservation
O Other Agency
Type of Visit 7Routine
pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of visit: Arrival Time: ® Departure Time: County: hUfft- AJ Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: r Title: Phone No:
Onsite Representative: Sfi�� kdxr z6, Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = ' = Longitude: [= o = i
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer I I H]
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
urkey 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
ODry 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?
❑ Yes Vo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
2 N
❑ NA
❑ NE
❑ Yes
YNo
❑ NA
ElNE
12128104 Continued

Fpcility Number: 3 —
Date of Inspection /o t77
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural Freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: - (.A G.sy 5IT
❑ Yes E" No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) /
6. Are there structures on -site which are not properly addressed and/or managed ElYes o ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 940 ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ yes [do ❑ 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 U<O ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes L�JNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 2 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifi ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
[TNq/ ❑ NA
❑ NE
[</ ❑ NA
El NE
�Nl❑ NA
❑ NE
o ❑NA
❑NE
Ld No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name 6 - (/ Phone:
Reviewer/Inspector Signature: Date: �G v
I 12128104 Continued

• Facility Number: — Date of Inspectionb pJ
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes D N ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ NA ❑ NE
the appropiate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
9<.
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
[]Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspectionss [j
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
ENo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
VrNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
3, NNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
L�No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Bl�o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
E30<A
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
allo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E(No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[ /No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31, Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
2 No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
2No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Type of Visit A Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit xRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency Q Other ❑ Denied Access
Date of Visit: O Arrival Time: ' eparture Time: t O County: 0 Region:
Farm Name: O``D V / , Owner Email:
Owner Name: _ --5i F_ Y GL�1��G�f�,o _ Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:7,�IJf_ C�F�ELD
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: [= o = 0 « Longitude: [—_1 o = ' =
Design
Current
Design Current
IN ...
Design
Current
Swine
Capacity
Population
VVet Poultry Capacity" Population
Cattle Capacity
Population
❑ Wean to Finish
❑ La er
❑ Daia Cow
❑ Wean to Feeder
❑Non -La et
❑ Dairy Calf
❑ Feeder to Finish
❑ Daia Heifer
Farrow to Wean
Dry Poultry
❑ Dry Cow
Farrow to Feeder
[INon-Dairy
❑ Layers
El Farrow to Finish
❑ Beef Stocker
❑ Gilts
Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood CoYJ
❑ Turkeys
Other
❑ Turkey Poults
❑ Other
❑Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
1VNo
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
V
❑ 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
o
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number g Date of Inspection ! O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes A No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: T 5,qA t f ff&
Spillway?: D A/0
Designed Freeboard (in): ,Z2
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes /No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes 0 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 ZNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Z 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 ElNA ElNE
maintenancehmprovement?
11. Is there evidence of incorrect application? 1f yes, check the appropriate box below. ❑ Yes /0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop W',, JJdow ❑ Evidence of Wind Drift� ❑ Pplication Outside of Area
%
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes '0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes 9'No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[:]
Yes [21 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Z! Meo 11,e, IVEw v v/Z"►5 t2 /join,,,►_
Reviewer/Inspector Name Ti g . Phone��Z(p
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: Date of Inspection 8 ! O
Required Records_& Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ko ❑ NA El NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes 0N❑ NA ❑ NE
the appropirate box.
❑ WUF ❑ Checklists El Design ❑Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
W1 Yes
Cl No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ElAnnual Certification
El Rainfall ❑ Stocking El Crop Yield A 120 Minute Inspections 0Monthly and 1"
Rain Inspections Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
VNo
❑ NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ANo
❑ 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?
El Yes
YNo
ElNA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
ElYes
❑ No
;?(NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes '0 No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes allo ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes XNo ❑ NA ❑ NE
12128104

Type of Visit aCompliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility N ber 3 C Date of Visit: Time:
Q Not Operational Q Below Threshold
Permitted ID/Certified 13 Conditionally Certified © Registered Date Last Operated or Above Threshold:
Farm Name: R a'` i s `� Cp^-O" J 0 w f _p a ry. - A :B County:
Owner Name:
Mailing Address:
.._ . _ _ .. ..... _ .. _.. Phone No:
Facility Contact: . _ _._ » __ _. Title:._ . __ _ _. _._ _ . ___ . _ _ Phone No:
Oesite Representative: srevE wux-LEIEO Integrator. Pr_E 5'rP1G E _
Certified Operator.
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 499 Longitude • C l�u
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0<0
Discharge originated at: ❑ Lagoon ❑ Spray Feld ❑ 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)
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 S
Identifier:
Freeboard (inches): 3to two
❑Yes
El No
El Yes
0No
❑ Yes
[ io
❑ Yes
040
Structure 6
12112103 Continued

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 0'-No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes No
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? 2N/es ❑ No
8. Does any part of the waste management system other than waste structures require maintenancerimprovement? ❑ Yes eN9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes
elevation markings?
Waste Anulication
10. Are there any buffers that need maintenancelimprovement? ❑ Yes [3No
I I. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
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 R</
b) Does the facility need a wettable acre determination? ❑ Yes ❑' 0
c) This facility is pended for a wettable acre determination? ❑ Yes ; o
15. Does the receiving crop need improvement? ❑ Yes (/No
16. Is there a lack of adequate waste application equipment? ❑ Yes 0440
Odor issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attar below [:]Yes
io
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 7No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes No
Air Quality representative immediately.
� Conmts Erefer to man #) Expla� atay.�YFS answers aad/otE any- �r aety�otitercamnmmts,� �� � �-
�
Use drawrngs of�c�ty3to`b�etterxa�asn s�baai�oas.��use addrtio>� pagesas rY),"Field Copy ❑Final Notes
UrD�$iE LCRS� �C--42CE4f1 5 ��"� I�o�® �uJ woe.
GIM.fl
Reviewer/Inspector Name,j
Reviewerffitor Signature: Date:
12112103 Cowed

Facility Number; 5jc Date of Inspection 2 a
Renuired Records & Docnments /
2 L 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 'V
23_ Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes
❑ 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 ONo
25_ Did the facility fail to have a actively certified operator in charge? ❑ Yes 10
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes No
27. Did Reviewer/Impector fail to discuss review/mspection with on -site representative? ❑ Yes 7No
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 0
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

Type of Visit __-E�rCompiiance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notfication O Other ❑ Denied Access
v_ Date of visit: Z D2 Time:
Facility Number
Not O erational BelovrThreshold
C1 Permitted O Certifiedr © Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name o a� $ r`3 'SIG L- So_ t�i i<Gi v -i County: D i
Owner Name: s4 e l./Lo ► �7 a Id Phone No:
Mailing Address:
Facility Contact: j Title:
Onsite Representative: f IJV e Ve 4,, . fe_
Certified Operator:
Location of Farm:
Phone No:
Integrator: PrC,S14 'r
Operator Certification Number:
Swine ❑ Poultry ❑ cattle ❑ Horse Latitude �� �• �K
- :Design: Current - W Design,_ .Current
=:SWtne _. Ea acitv.. Po tslatton W Pdultri_.... Ca acrtv: Pa Mateo
❑ Wean to Feeder _ ❑ Layer
❑ Feeder to Finish 'P ❑ Non -La er
❑ Farrow to Wean 'A
Farrow to Feeder 2 ❑ Other
❑ Farrow to Finish Total"De5
❑ Gilts
❑ Boars
w e
'IViimber ❑Subsurface Drains Presei
mHoIdtag Ponds 1 SoltdrTraps °'-�` .� ❑ No Liquid Waste Mana�i
Longitude �� �• ��
n_ ; 'Cattle
❑ Da'
❑ Non -
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ YesONo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed. was the conveyance man-made? El 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 gat/min?
d_ Does discharge bypass a lagoon system? Of yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ZNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes J No
Waste Collection & Treatment
4, Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes j2rNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: A 3
Freeboard (inches): 34 4d
05103101 Continued

v
Facility Number: 3�_
Date of Inspection 2 OZ
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?
❑ Yes ONO
❑ Yes Te5No
❑ Yes ONO
❑ Yes ONO
❑ Yes j[2rNo
Waste AvOication
10. Are there any buffers that need maintenance/improvement? ❑ Yes /ErNo
11. Is there evidence of over application? ❑ Excessive Ponding , ❑ PAN ❑ Hydraulic Overload ❑ Yes ['No
12. Crop type �e r r►� �dk �f n $e r �'�9 v�� �y rCt 2P W n-i¢ r v�i �% t r�
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? El Yes �No
b) Does the facility need a wettable acre determination? ❑ Yes 0-No
c) This facility is pended for a wettable acre determination? ❑ Yes �No
15. Does the receiving crop need improvement? ❑ Yes A No
16. Is there a lack of adequate waste application equipment? ElYes �No
Required Records & Documents,�
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available. ❑ Yes IJ 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 ANo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) El Yes No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ONO
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes /FZINo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ONO
23. Did Reviewer/inspector fail to discuss reviewhaspection with on -site representative? ❑ Yes "�IINo
24. Does facility require a follow-up visit by same agency? ❑ Yes '�Rio
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes '12No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Gbtnments (refer to:.question'#) .Eicplain.any YES ansvrers andiQr_--any rwmmendatrons +nr anY other comments:
.Use drawings of ficr'ttty-to better explain situations: (use addit,oiral pages ss netessarv)
_. _ _ ❑ Field Covv ❑Final Notes
-
i_ a g o ' l �l � U r r P► t 1 Y P� v a / �S-���-ryalZ'�r: — ✓ G( CCal g �
fy
3c� 5 O�-(✓eeDe'ai'✓�IG� to r+i!a_;-1..4U)rtea -7 --T e e "i �a d e of
.�ech�l,'r.2j Sj0eGlal,'S) Glenkt G1,`I�oh air PY'esigof. r
�c ��✓�SY ►�yR-�� iP�2S� yli•'! 4,> {,, - —41,e 4t jelve ;ne-1, plr.s Zsr¢ctr
A ; ✓ ✓,'•^ e4 /�ee �,o'r r d
2 h o S-�a r ,•�P� v> Al e sM , rt ,� ,i'l%j .
U��11 ��j s i s do,� P � � , W �,: � .� � P ld ,'J �o �►-��,'•��,,'�, � � leq.s� 3�} �� o���
,
Reviewer/Inspector Name T.,
Reviewer/Inspector Signature: Date: �� Z
05103101 Continued

Facilih' N umber: .7 / —�j5jl Date of inspcct inn
oZ
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?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes 'ZNo
❑ Yes �'4o
❑ Yes _ONO
❑ Yes 'FerNo
El Yes 4—No
El Yes No
❑ Yes ZNo
Additional Comments .andlor:;Dra► ings
(� on-}� �.rRG1iPS o� Free �atir� ;y, 1_acfooy� � , So ilea se rise
Ae *-1 ►-e» Ct;y71'►'y Ovada,ble n;4V'OAeq allerer4;oh1 a,17 6eP, v�n
1►.l G� G LO�dDrrLG� w 4 , wAs4e pl a L► 44 j�c_✓ C�+r 7� P
,�vrd level i--I PiVeO"' A- The GUrreq, s4e Fu'p )evil
S 5B ; ric.he-C of iti 14?6 a w) A .
2�. please L Pd z4e 44e lease Ay,'ee"1#en1s qs nece-uovy .
ma)"t41"'Pled r•'1 an ekcellP.;7I
Gond,'�)'6i. -he /eca.ds are UeY Lvee e14-1
q l�Gt an i h r1t.AE^e is
#-V6 �7nor5 e- 'r
eKc-ere'l� .Sqld of ber vda and e a'--,r R 1 read
(/ in pieldS, 7� e 14 ooii -y eI n� qr'Pa�
y reo no( 41e Swine
I
k7aczses a -e Gve�� mail '� urea(.
0
05103101

r RfIJrvesion of Water Quality ,• "_
- Q Division of Soil and -Water Conservation
Other Agency "
4 _
Type of Visit ercompliance inspection Q Operation Review 0 Lagoon Evaluation
Reason for Visit ZlRoutine O Complaint 0 Follow up O Emergency Notification Q Other ❑ Denied Access
Date. uF Visit: ri 6I Time: � 3 S Printed on: 7/21/2000
Facility Number 1
Q Not Operational Q Below Threshold
(] Permitted 13 Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .............
Farm Name: ..,IG 40 ..7.. .r�1! � `rot-J Fel ''t J rJ ' .................. County: �or� ••--• Q-.....................--.......-.- .-.-................
f
OwnerName:.......... S- c 112 i.J.....!..!....................................................... Phone No:.....................................--......-..-.-...............................-.
Facility Contact:
Mailing Address:
Title:
•,.• Phone No -
Onsite Representative: ....... 4eye- w.-4T..'-.�.�..I.............................................. Integrator:...101>°'44clC
Certified Operator: ........................................ .......... ............................................................ Operator Certification Number:..........................................
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �� �" Longitude ��• �� ����
Design Current Design Current
S Ca paci Po ulation Poultry Capacity Population Cattle`
Wean to Feeder ❑ Layer ❑ Dairy
Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
Farrow to Wean
Farrow to Feeder g ❑Other
Farrow to Finish Total Design Capacity
Gilts
Boars Total SSLW .
Design Current
:pa.do�
P� Area
L �.� Ntiiiubrtr oiLagooas Z ❑Subsurface Drains Present ❑ LagLagoon❑Spray
Field Area
r Hokitag Ponds/Solitd'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: [ILagoon [ISpray Field [IOther
a- If discharge is observed, was the conveyance man-made?
❑ Yes 10N0
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
❑ Yes 'No
c. It discharge is observed. what is the estimated flow in gal/min?
✓1 C'�L
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
❑ YesNo
2. Is there evidence of past discharge from any part of the operation?
❑ Yes�zNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
/
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes /EfNo
SuL.,'ture 1 Icture 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:...-.....-.'..`.......................111-.........- .............
Freeboard (inches): 36 3 Z
5100
Continued on back

Facility Number: 31 15 late of Juspection � G J/ U([ Printed on • 7/21 /2000
51 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 ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an T
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10- Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type 1K e- e .w ✓q I,\
s,;iG 1L 4/-,-, , Bt'y-^.;/A /�-,
❑ YesNo
❑ Yes ,21N
❑ Yes 13'1io
❑ Yes ❑ No
❑ Yes.,,�o
461►' 1V2114/
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes)231No
14. a) Does the facility lack adequate acreage for land application?
❑ Ye S;No
b) Does the facility need a wettable acre determination?
❑ Yes � No
c) This facility is pended for a wettable acre determination?
[I Yes /� No
15. Does the receiving crop need improvement?
❑ Yes tC1 No
16. Is there a lack of adequate waste application equipment?
❑ Yes 0
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ YesdN0
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
dNo
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes 40
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes/01110
21. Did the facility fail to have a actively certified operator in charge?
ElYes�lo
/
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 ENO
/s
24. Does facility require a follow-up visit by same agency?
❑ Ye �o
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ONO
:: �'�10 yiolai}Q�is:or deficiencies -were noted- dirrttig #his:visit: • Y:ou wijl-teeeiye do further • : :
corres inidenke: about this visit. : '
CommentsT(er touestEon #) Explain`any'.YES answers and/or any recommendations of any other comments
—x -.. .i _.'�.z.tMKA:4v :aT'
r✓d /'fie S v rQ v c, ZO D - 4 • di s4ct h c e fro rQ
0 ,✓n.Qd 6� Ot4 , l
vcc[
,vat iiVj,�ICG� �d 7 �e Lv, qd✓ AOn ura/ Sl1D"Ial
bed vc d �ra� �� c, ll�w�,ce -{o k .9 c o
ol/,eroll, -44e �L►'�tt-�y a�� tece a_f a,e wet/kY1_ -
Reviewer/Inspector Name
d.hC✓&
Reviewer/Inspector Signature: Date: g/pp

Facility Number: Date of inspection 57/2r? }Tinted 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? f
2T Are there any dead animals not disposed of properly within 24 hours? ❑ Yes dNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes z] 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,,E:(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 PVo
31_ Do the animals feed storage bins fail to have appropriate cover? ❑ Yes /�Vo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes [I No
5100

Division of Water Quality
Division of Soil and Water Conservation
r Agency'
V
. Q Oche- _
Type of VisitCompliance inspection O Operation Review O Lagoon Evaluation
Reason for Visit to Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number EaZBate of Visit: 'rime: Tjy-:�--T Printed on: 7/21/2000
Q Not Operational 0 Below Threshold
Permitted Certified 13 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: .. ... ....�!Lay.[ �.... It�......"T...�.:Y±—� County: ............�1�*�i�t.................. ....S�L��......
.
_ia
OwnerName:.. ......... T.,-V. '................ .......... ............... Phone No:.......................................................................................
FacilityContact:.............................................................................. Title:................................................................ Phone No:
Mailing Address: ..................................................................................... .-......... ............... .............................................. ........................ ......... ..........................
.
Onsite Representative :............. � `�......... ....-..........� ........ ............ Integrator:...................... :..... ........
Certified Operator:.............................................................................................................. Operator Certification Number:..........................................
Location of Farm: .
I�
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• �' �«
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish JE1 Non -Layer I I❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons 7, Subsurface Drains Present ❑ Cage-- Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
I. 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'?
h. If discharge is observed, did it reach Water of the State' (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon systent? (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
5trt fXtl _ r► Structure- t' . ucture 3 Structure 4 Structure 5
-f'Ft- 1�-1t 1"rt�rm L�
Identifier: ....................................................................................................................
Freeboard (inches): rt 3 f
5100
❑ Yes MNo
❑ Yes ❑ No
❑ Yes ❑ No
=;v 14
❑ Yes ❑ No
❑ Yes
❑ Yes [T0
❑ Yes -;XNo
Structure 6
Continued on back

Facility Number: — Date of Inspection Printed on: 7/21/2000
5. -fire there any im diate threats to the integrity of any of the structures obs e . (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? [I Yes *o
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over 01pp 'cation? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
13, Do the receiving crops differ h those ignated 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
I7. 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?
violaticjris;or deficiencies mere noted• ditririg 4his:visit: • Yo>it wiII-f&6*4e iW Wirth& -
....................................
cor'resporiden& a)3outi this :visit:
❑ Yes KNo
❑ Yes 9 No
❑ Yes \9 No
❑ Yes V No
❑ Yes 5�rNo
❑ Yes qXNo
❑ Yes gZNo
❑ Yes 9jNo
❑ Yes V�No
❑ Yes No
❑ Yes �No
❑ Yes �rNo
❑ Yes KNo
❑ Yes $?(No
❑ Yes %5-lNo
❑ Yes `54�No
❑ Yes %No
❑ Yes `�rivo
❑ Yes 1' No
❑ Yes �TNo
Comments (refer to question #):.Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (upp"`�` se additional pages as necessary):
V y l n.i wvk Y Corti' ► Y �. tc,1 I k j I i !cam kmw
o-u ot4ofLk a OL u,'✓ PM � 5
()I& ow -c- C,_ Robof 00
•cCa'�-
Reviewer/Inspector Name
Reviewer/Inspector Signature: �� _ ��j�,, l� Date:

Facility Number: Date of inspection Printed on: 7/21/2000
(m6r ISSt1eti
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor below El Yes 0,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 �KNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, [:]Yes Q�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 -KNo
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 KNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes S&o
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes �No
Additional Comments and/or Drawings:
1 Q.r.v.n✓ MDYY 01u�
U Y
U
yV(� GrJ � GU
Y�
Ice
W4/I- @G�
5/00

[.Division of Soil and'Water'Conseryahon •'Operation Review
�e
i' 4.. [3,Division of Soil and_Wa#er Conseryat,o -;Compliance Inspection
® Division of Water. Quality-Eompliance inspection
[].Other. Ageney OReratton Review ,_ s
. r -
UD Routine 0 Complaint 0 Follow-up of DWQ ins ection 0 Follow.0 of DSWC review 0 Other
Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm)
® Permitted © Certified Q Conditionally Certified 13 Registered JE3 Not O erationat Date Last Operated:
(�ap�
Farm Name: ............ County:.._.vtQ1!_.....................................................
s4ev ewI '' /r� f ,,J/ T '
Owner Name:...................................[N.�:.���?.'..�...Y..l... Phone No:............_.
Facility Contact: .....:.......................
........... Title: ................................................................ Phone No:'
'failing Address: ........................................................
.......................................................................................................................... ..........................
Onsite Representative:.... e v6..,,!F �� 4 Integrator: �� e
........ ......................................... ...............................................................................
r
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
....................................................................................................................................... ..
Latitude ' ° Longitude • 6 66
Design Current._ esiCurrent -Design_ Current.
Swine ;
Capacity Population Poultry C.apaci "...Population Cattle Capacity .Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
® Farrow to Feeder
/24$
1 2&6
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Number of Lagoons Z ® Subsurface Drains Present ❑ t-agoon Area 0 Spray Fzeld Area
Holding Pofids I Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
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)
❑ Yes N No
❑ Yes ❑ No
❑ Yes [—]No
❑ 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 01 No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes JD No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: A 23
Freeboard (inches): 36 3$ ................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, []Yes Ej No
seepage, etc.)
3/23/99 Continued on back

Facility Number: 31 Dale of Inspection !D r1
1 .
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes '® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes & No
Waste Armlication
10. Are there any buffers that need maintenance/improvement? 2g Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes No
12. Crop type 13 f�'[� r r" u,4%6!n4rell
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15.
Does the receiving crop need improvement?
❑ Yes
29 No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
0 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
in No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
C4 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
IM 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?
J@ Yes
❑ No
�'4q viol'attoris or de eiencies mere noted dit;°tng this:visit: - :Y:oir will -receive Rio: fukth& -' -'
corres orideRce: about this visit:: ::::............. ' ..... I ..... ' :::::: ' : '
Comments {refer to question #); E);pIain any YES answers and/or any recomrtiendatioti or -any other comments::
Use drawings of facility .to better explain situations (use additional pages as necessary)
�'d 'P�'@V2!? Ot►'1i+� �2�/CZd4'1ijJ/1.
-2 5 . a r wt e Y' n e V c Gi'1 dG k raa ra -� e �; G>✓d �S� -fie �j
�dd�Q
�o G 6V44,e flan . 7h ,--< km s
?p1A4 AA;j5 -�6 1;_O 4. Vaorr-,er 4 s 1,1-4 a ehe I/ o» IV 4h,srW.
NDTE �ccyL]P fvmO ;nt q k e -tO&14�-
r JJ
Reviewer/Inspector Name f
Reviewer/Inspector Signature:
L �
.t =.....j, Qit. -J%A_ Date: A /Um l9
3/23/99

Facility Number: J — 3r&47 Date of Inspection• d q
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ® Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes Z1 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 I] No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 6 No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? JA Yes ❑ No
trona , omments an or swings.-
�&J
3/23/99

--:, .y r �'� �'z`�t�� : u „_. ----• --`-- '.,:rrl --„ y.: .;..- '-.- ��' .;o: -:d, 'x. � �3� '#� +2�5T'Wp, �i
,; 13 Division of Soil and Water Conservation T ❑ Other Agency
Division of Water Quality
Routine 0 Complaint 0 Follow-ue of DW ins ection 0 Follow-up of DSWC review 0 Other
Date of Inspection
Facility Number 1
Time of Inspection 60 24 hr. (hh:mtn)
13 Registered © Certified © Applied for Permit Permitted JE3 Not Operational Date Last Operated: ..........................
FarmNamc:....Q....... .... .-- --.--. . County:....................`.�.....................................................
............................ ........ ............................................. .
Owner Name:.... i! ...:...." ... .............. ............... Phone No ,qki. �JIcL C)}.�...1............................
Facility Contact: ........ Title:
......y...�..........................................................................................................................
�.
one ...o.....................................................
..7��...`d�\ • Q�.�Maiing Address:...dSS
....
tiK Integrator:...
pp�..xOnsite Representative:. . . .
Certified Operator: .................................................. ...................................... ............ ............ Operator Certification Number;
!�"tio5 of Farm: dp
s� ............'�.. �s.. ......... ....................................................................... .....�e... ................ ............. .............
........................................................................ .. ........................ ------- .--- . .
Latitude ' " Longitude ' 1 L(
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes CgNo
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 MNo
c. If discharge is observed, what is the estimated flow in gaVmin? A 6-
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ll 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
MNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
M No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
Wo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
XNo
7/25/97

r Facility Number:
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
[l No
Structures (LagoonsHolding Ponds Flush Pits etc.
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
Yes
❑ No.
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: LN �VB
...............tt....uu...........................................................................................................................................................
...................................
Freeboard(ft): ................r.:..l..... ... r�7. ;!5r.......................... ................... ........ ..... ................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
No
11.
is erosion, or any other threats to -the integrity of any of the structures observed?
❑ Yes
No
12.
Do any of the structures need maintenance/improvement?
N,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
UNo
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
No
(If in excess of WMP, or runoff waters of the State, notify DWQ)
1entering
�� L�1►^�►ti��w�
15.
Crop type .......
......................
.............................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
gNo
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
RNo
18.
Does the receiving crop need improvement?
❑ Yes
%No
19.
Is there a lack of available waste application equipment?
❑ Yes
1XNo
20.
Does facility require a follow-up visit by same agency?
❑ Yes
Wo
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
�(No
22.
Does record keeping need improvement?
[(Yes
❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes 0 No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? VYes "O'No�
25. Were any additional problems noted which cause noncompliance of -the Permit? ❑ Yes No
[3-No.violations-or deficiencies:were inoted•duri_ng this:visit:, You:grill rec_eivem6ltirdier
: 6orresp4nd0kO about this:visit:.
C :��.CK5 GV%_' Ak-
7/25197
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: IG— 13--a -

v
z
a
�
�
1
S
�
V

\�
_........ .... ... . .. ........ ...
��t❑ DSWC Animal Feedlot Operation Review�K.
�
A DWQ Animal Feedlot Operation Site Inspection
Q Routine 0 Cum laint 0 Follow-u of I)Wti ins ection O Follow-up of DSWC review O Other
Date of inspection
Facility Number 5 Time of Inspection 24 hr. (hh:mm)
Registered ® Certified. © Applied for Permit © Permitted JE3 Not O crattonal Date Last Operated:....
Farm Name:..k. �.�. _... _.. Ann c�� S �. �J.. .crr.......:A--�._�..... County:..Au�..� a.rt.............................................................
t i�
Owner Name: ................. ... hri`:.......................................... Phone No:..,..1.4 ...............
Facility Contact: ........... Title: .. Phone No:
.....................................................................................................................................................
1-lailing Address: ... 3.3.1�t..... ��e a^!.... .. caS..... :._.......................... .}. S�.�a.,l..i .r.... ........................ ..{�.s ...
Onsite Representative:.... 't....................................... Integrator:... .r.. ._................ip........................_........
Certified Operator,................................................................. Uperator Certification Number-, }—
............................................. ............
Location of Farm:
lbLa1. .V..h. .......... .W.A:3 M I
....1,,,Aln... 1� .1 5 _ 5a.�. +<►_.. �.-�.s.� a . ,-.... •A .� ....s �-..eF......s .s.3.5.�_ ....Q . ... .�...... T
+� ri
Latitude t•�� Longitude �• ��< �«
Design . Current
FSwine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
51 Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design : Current Design _ Current.
Poultry Capacity Population Cattle Capacity Population... .
❑ Layer ❑ Dairy
❑ Non -Layer I I JE1 Non -Dairy
❑ Other
Total Design Capacity
Total SSLW - j tpS
Number of Lagoons Holding Ponds JE1 Subsurface Drains Present ❑Lagoon Area 10 Spray Field Area
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement! Yes ❑ No
2_ Is any discharge observed from any part of the operation? ElYes MNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? Ye ONO
b. If discharge is observed. did it reach Surface Water? (If yes. notify DWQ) ❑ Yes ONO
c. If discharge is observed, what is the estimated flow in gallmin? N
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑Yes ( No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes ®.No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes & No
5. Does any part of the waste management system (other than lagoons/holding ponds) require R Yes ❑ No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes CffNo
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes ELM
7/25/97 Continued on back

r
Facility Number: — r�
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons.Ilolding Ponds, Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
........................ .. .... . . .
Freeboard (ft): .......�-....��. Z .....5............ .
t0. Is seepage observed from any of the structures?
I I_ Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes ELNo
❑ Yes KNo
Structure 5 Structure 6
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
•15. Crop type .... mot .0 _.t ,4i .....................m.................................... ............................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0 No.violations or deficiencies. were no-ted-during this.visit.- Vou;will receive no further
correspondence. ahout this:visit::.
imenN (refer,t6gi uest!6i #} ';.Explain any YES answers and/or any,Mo'n
aa..n..—'-r :_
❑ Yes Q No
❑ Yes O.No
❑ Yes KNo
❑ Yes KNo
❑ Yes §4 No
❑ Yes
JR No
❑ Yes
f4 No
ElYes
❑ No
❑ Yes
5(No
❑ Yes
El No
❑ Yes
Dq No
w
jS Yes
❑ No
❑ Yes E3No
O Yes ❑ No
❑ Yes 59-No
5.
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L, l.JL la R, i
C� VT_ ,ti �;:.,Q- 1`. 17 --,- E D--^ i i S l t4 cJ s i�^ C Q.,-1 t` �i k-4
S J � Cl L$ 0 G .¢_ O �t t- t [ �j .�E( L'-Q I 1 ✓L t �U i Vv`tl- '► $""h0-�i f Q
tR e D e, u vv t L la tr e.K l �- e rt L U r. �o 1 I C uJ {,�-�
7/25/97
s
i �.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date
5

Facility Number Date of Inspection
I I Time of Inspection 24 hr. (hh:mm)
13 Registered M Certified M Applied for Permit [3 Permitted in Not Operational I Date Last Operated:
Farm Name: JRoaty.Rraurh.Sotw..ForzL:z-&,&.B ....................................................... County: Duplin WiRO
Owner Name: Steve ....................................... wMitficK .................................................. Phone No: 9.19=65S-.054.4 ..........................................................
FacilityContact: ............................................................................... Title: ............................................................... Phone No: ....................................................
Mailing Address: 3-3.1.Bcautancus.R.& ............................................................................ ML.Q1iyP_..XC ....................................................... 28a65 ..............
Onsite Representative: S.teLve..Whitfwld,...GlecL.Clifion ........................................... Integrator: Prestage lFaxim .....................................................
Certified Operator: Skve.M. ............................... Whitfield......................................... Operator Certification Number: 18803 ............................
Location of Farm:
Latitude 6
Design 7 -urrent
;SwineC I
_apacjty -Population
E] Wean to Feeder
0 reeaer to F1­n—isTT__
C] Farrow to W—ean--T2ZX—
N Farrow to Feeder
[3 Farrow to Finish
[3 Gilts
[3 Boars
NU.m4erof LagoonV, Rldi!ij; Poifils--] 2 1[3 Subsurface Drains Present I10 Lagoon Area JE3 spray tie rea I.
❑No Liquid Waste Manage ment System
General
1. Are there any buffers that need maintenance/improvement? []Yes 5g No
2. Is any discharge observed from any part of the operation? ❑ Yes 51 No
Discharge originated at: E] Lagoon [] Spray Field [3 Other
a. If discharge is observed, was the conveyance man-made? p Yes X No
b. If discharge is observed, did it reach Surface Water? (if yes, notify DWQ) El Yes og No
c. If discharge is observed, what is the estimated flow in gaUmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ij Yes H No
3. Is there evidence of past discharge from any part of the operation? [3 Yes H No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes Ig No
5. Does any part of the waste management system (other than lagoons/bolding ponds) require ❑ Yes jj No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes N No
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
[]Yes 0g; No
Continued on back

r,
Facility Number* M _589 Date of Inspection
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons,Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1
Identifier: ....................
Freeboard (ft): 3.1
Structure 2 Structure 3
3.5
10. Is seepage observed from any of the structures?
Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
[]Yes
® No
p Yes
® No
Structure 5 Structure 6
p Yes
® No
p Yes
® No
® Yes
p No
p Yes
® No
p Yes
® No
15. Crop type ......GoastalBezpautia Grass.....................+.inter.annuals....................................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? []Yes
N No
17. Does the facility have a lack of adequate acreage for land application? p Yes
N No
18. Does the receiving crop need improvement? p Yes
H No
19. Is there a lack of available waste application equipment? p Yes
® No
20. Does facility require a follow-up visit by same agency? p Yes
® No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? p Yes
® No
22. Does record keeping need improvement? ® Yes
p No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? p Yes
®No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? p Yes
N No
25. Were any additional problems noted which cause noncompliance of the Permit? p Yes
❑ No
p NNo violations or deficiencies were noted during this visit. You will receive no further
correspondence about this visit.
Comments (refer to guest�o© #) Explain aay Y) S answers and/or any�recommendations or any other comments
'Use drawtngsaof facility to better egplam situations {use addrt�onal pages as nessa cery)
_
- .. .i-�
-.'
.. _..:i. ,.. ,. ...- ,... - ... �._.,s 1�+
12) Pipe extension needed for first lagoon.
Have a technical specialist verify if trees should be removed from the lagoon wall.
Mow inside wall regularly for ease of observation and to minimize weed competition.
2) Waste sample needed within 60 days of application. Sample needed NOW for May `98 events. Follow latest W.U.Plan
nitrogen limits for nitrogen rates unless WUP is revised. Cautioned against exceeding hydraulic loading rates for soils.
Producer contacted DWQ during wet winter weather and instructed to keep lagoon level down. Thus necessitating the over
application of nitrogen to the rye crop. Cotton followed on leased field now, but not included in the WUP. 8.9 ac. of bermuda in
e vicinity of this lagoon. Over application of N for field 1, tract 3089 w.annual allowed 100 Ib.N/ac.; applied for 4 pulls;
325 lb.N, 299 lb.N., 322 lb.N, and 352 lb.N. DWQ to be notified of excessive loading rates-
Reviewer/Inspector Name �JohneN u �~
Reviewer/Inspector Signature: Date: Continued on back

p Division of Soil and Water Conservation p Other Agency
Division of Water Quality
outine 6-Complaint p Follow-up of DWQ inspection p Follow-up of DSWZ7 review p Other
Date of Inspection
Facility Number
Time of Inspection r__TF3U__j 24 hr. (hh:mm)
p Registered 0 Certified p Applied for Permit p Permitted 113 Not OperationalDate Last Operated:
Farm Name: Roaty.Rrauch.Saar.F.airm..:..A.,&.R....................................................... County: Duplin WiRO
Owner Name: Stexe....................................... W..Ititfield ............
Phone No: 658-0544...................................................................
Facility Contact: ............................................... .Title: .... Phone No:
Mailing Address: 331Beautancus.11d............................................................................. Mt..Olixe..rjC............... ....... ...........,.... ............... ... 28.365
Onsite Representative: S:tnye.Whitfw1d......................................................................... Integrator: PjrfstageYarms .....................................................
Certified Operator: S.teve.M............................... W.hitfield......................................... Operator Certification Number: )1880............................
Location of Farm:
Latitude ©•®° ©K Longitude ©• ®� ®K
L'
Design: Curren ....
SworeT Gapatity -Population
p can to Feeder
p Feeder to Finish
p Farrow to Wean
® Farrow to Fee er
❑ Farrow to Finish
❑ Gilts
❑ Boars
esign• .urren w.:.. _ esign Current. _.
Poultry = Capacity Population Cattle __ -Capacity Population
ter
= Tata1 Design "Capacity
Total SSLW... ,
Number°of Lagoons ! Hold :Ponds ` pSubsurface Drains Present ❑ -goonArea
p o Liquid Waste Management System
❑ Spray ie
rea
General
1. Are there any buffers that need maintenance/improvement?
® Yes
❑ No
2. Is any discharge observed from any part of the operation?
❑ Yes
® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
® No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
p Yes
® No
c. If discharge is observed, what is the estimated flow in gal/min?
n/a
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
® No
3. is there evidence of past discharge from any part of the operation?
❑ Yes
® No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
® No
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?
p Yes
® No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
® No
7/25/97
Continued on back

Facility Number: 31_..589
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
® No
Structures (Lagoons,Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
p Yes
® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure
6
Identifier:..............................................................................................
................................
Freeboard (ft): 2.75 2.5
10. Is seepage observed from any of the structures?
❑ Yes
® No
11. is erosion, or any other threats to the integrity of any of the structures observed?
[]Yes
® No
12. Do any of the structures need maintenance/improvement?
❑ Yes
IN No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
® No
Waste Application
14. Is there physical evidence of over application?
[:]Yes
B No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ...... oastal.Bermuda. Gmas............................. 1:'i=_q....................... ................................................... ........................................................
I6. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
g 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?
p Yes
® No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
22. Does record keeping need improvement?
H Yes
p 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
®No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
® Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
p No
o violations or deficiencies were noted during this visit. You will receive no further
correspondence about this visit.
Comments (refer to quest�ori #)Explae© any YES answers and/or any recommendations or any other c©mments -
Use drawmgs_of faciE�ty toFbetter a plAw srtuatEons (use additional pages as necessary)
~
5. Revegetate any bare areas in bermuda fields.
.
18. Overall, Bermuda looks great; however, in some places you need to work on correcting weeds.
2. Get a current waste analysis taken.
4. Operator is pumping on fields that are not in certified plan. These fields should be incorporated into the plan. In addition,
operator grazing fields that are listed as hay in certified plan. The plan should also he officially changed to include this managemen
practice.
N.O.D. will be sent for failure to follow plan.
Reviewer/Inspector Name Andrew G' Helmioger w _ -
Reviewer/Inspector Signature: Date: Continued on back

Site Requires Immediate Attention:
Facility No. 3-
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: '9Z , 1995
Farm Na
Mailing.
County:
Integratc
On Site Representative:
Physical Address/Locadon:
Phone:
r e, Lq'nno V "'�7 I
V65 )e /oo
Type of Operation: S 'ne ./ Poultry Cattle
Design.Capacity: is Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: -72_° SA Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have ff cient freeboard of 1 Foot + 25 y 24 hour storm event
(approximately 1 Foot + 7 inches es No Actual Freeboard:Ft. Inches
Was any seepage observed front the lagoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate land available for spray?? Y s/or No Is the cover crop adequate e or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings n- or No -
100 Feet from Wells? 1T-a or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes 06
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes 06
Is animal waste discharged into waters of the state•by man-made ditch, flushing system, or other
similar man-made devices? Yes or� If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage cover cro )? Yes or No
Additional Comments. F'r "raw
f i m IJ V,
Inspector Name
Si
cc: Facility Assessment Unit
It
Use Attachments if Needed.