310630_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

Type of Visit: aCom nee inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other Q Denied Access
Date of Visit: Arrival Time:j Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: Longitude:
Swine
Wean to Finish
Design
Capacity
Current
Pop.
RNn-Layer
Design Current Design C►urrent
Wet Poultry Capacity Pop. Cattle Capacity Pop.
La er Dairy Cow
Wean to Feeder
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design C*urrent Dry Cow
Dr. P,o_ultr Ca .aci P,o , Non -Dairy
Lavers Beef Stocker
Gilts
Non-i a ers
Beef Feeder
Boars
Pullets
Turkeys
Turkey Poults
Other
Beef Brood Cow
Other
F—TO—ther
Discharees and Stream Impacts
I. is any discharge observed from any part of the operation? [—]Yes �o ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes [—]No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
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 E�o NA ❑ NE
❑ Yes No NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: 3t- Date of Inspection: o
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ej10�❑ 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): ID-7
5. Are there any immediate threats to the integrity of any of the structures observed? Yes MQo ❑ 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 e-1Vo ❑ 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 Ergo— ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA 2rNE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ONE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA ❑INE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA E31NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA D<E
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes ❑ No ❑ NA NE
7
18. Is there a lack of properly operating waste application equipment? ❑ Yes ❑ No ❑ NA FrNE
Required Records & Documents ,--,��
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [:]No ❑ NA Ld'vE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [:]No ❑ NA E
the appropriate box.
❑ WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ 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 �
❑ Weather Code
❑ Sludge Survey
❑ NA B>NE
❑ NA ENE
Page 2 of 3 21412015 Continued

llacili Number: - 0 Date of Inspection: p
24' Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA �NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [] Yes [:]No ❑ NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA ��-�NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes ;No
No NA NE
Yes ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA NE
[—]Yes ❑ No ❑ NA O<E
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Ye ❑ No ❑ NA NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? Yes ❑ N NA ❑ NE
34. Does the facility require afollow-up visit by the same agency? ❑Yes No ❑ NA ❑ NE
;p sii; : l a _A� _J ' 1 ' '` , : l Yit
wings of.facil�tyIto betier explahi`sWiatrans.E(use addipoual pages as necessary) Ia ,;
c-��..e �� G--� �'r-i s¢,., r►!�r.-`L san s� � • /�� << �� �f o� 6a.- dn•w-�, E
u 51 erc us / n �cC
ec✓S ,�
Reviewer/Inspector Name: I,✓/ c ('%'_q wfi� 1" v
Reviewer/Inspector Signature:
Page 3 of 3
Phone: % 77 Tab U
Date: it
21412015

Powell, David C
From:
Powell, David C
Sent:
Tuesday, July 11, 2017 8:54 AM
To:
Lawson, Christine; Joshi, J.R.
Cc:
Miguez, Kristin; Gregson, Jim; King, Morella s
Subject:
31-630 Abandoned
Hey just wanted to make sure you were aware of another facility that's has been abandoned for years, as it says in
previous inspections. It does have a few trees on lagoon. DWR will continue to inspect it yearly and attempt to contact
owner, as discussed before, but out of our abilities to contact at this point.
Thanks
David Powell, Environmental Specialist
North Carolina Department of Environmental Quality
Division of Water Resources
Water Quality Regional Operations Section
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
A - -0
IVC;ICr Reje2JrCe3.
0re'44rl h i n{!Jp, :r
Tel. [phone]
Fax [phone]
For any emergency which requires immediate reporting after normal business hours, contact 1-800-858-0368.
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
may be disclosed to third parties.

Type of Visit ,Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit J:)-<outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: C5 epariure Time: County: Region:
Farm Name: r Owner Email:
Owner Name:
Mailing Address:
Physical Address: Facility Contact: I h
n riz eA'6 [_� Title:
Onsite Representative:_
Certified Operator:
Back-up Operator:
Phone:
y Phone No:
Integrator: _V1f
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = e [= , = « Longitude: [= ° = ; = «
Design Current:
Swine Capacity Pop lation
❑ Wean to Finish
Design Current
V4'et l?�ltry Caall
paci�,ty Population
❑ La er
Design , Current
C Capacity Pop lation
❑ DairyCow
Wean to Feeder
F
❑Non -La er
❑ Dai Calf
Feeder to Finish
Dry Poultry
❑ Layers
❑Non -La ers❑ Pullets
❑ Turkeys
❑ TurkeyPoults
❑ Other
❑ DairyHeifej
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures:
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Gilts
PEJBoars
Other _
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
XNo
❑ NA
❑ NE
Discharge originated at; ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
ZNo
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
ZNo
❑ 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
�(1
.C..J�+No
El NA
El NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
ZNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
ZNo
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Vii,t�yNumber: — d
Date of inspection
Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
11No ❑ 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?
El
No ElNA ElNE
P
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No ElNA ElNE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
� No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
E6 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
❑/No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No ❑ NA NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
❑ No ❑ NA NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
I
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
0 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', El Yes
❑ No
❑ NA
NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
NE
l8. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
1� NE
Q U�rj- colili aC7, In .
Reviewer/Inspector Name �z'�•� Phone:
Reviewer/Inspector Signature: Date: zvzz
1212 810 4 Continued

Type of Visit: O Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: _T
Farm Name: 5/� j�4L '� S Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Region: / 1 LA
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
La er
Design Current
Capacity Pop.
Cattle
DairyCow
Design Current
Capacity Pop.
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
IF to Feeder
Farrow to Finish
I
D , P■oulti,
ILayers
Design6,nt
Ca aci
I
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
TurkeyPoults
ther
Discharses and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field
a. Was the conveyance man-made?
❑ Other:
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 jo No ❑ NA ❑ NE
❑ Yes P No
❑ Yes C2,No
❑ Yes J2 No
❑ Yes [�f No
❑ Yes 12)No
❑ NA ❑ NE
[DNA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA D NE
Page I of 3 21412014 Continued

Facility Number: - Date of inspection: o
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes JC3 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes �' o ❑ 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 L;]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 E�rNo ❑ 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 'D No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes J2'1Vo D. 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 '[2,No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes PNo ❑ 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 101bs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[�-No
❑ NA
❑ NE A
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1;3"'N0
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
J�jNo
❑ 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
,C,No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the 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
1A Yes
[:)No
❑ NA
❑ NE
the appropriate ox.
WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑�io
❑ NA
ONE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
F-;M0
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
1:2,No
❑ NA
❑ NE
Page 2 of 3
21412014 Continued

G ,3a
Facility Number: - Date of Inspection: ..
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes J?"No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ,ETNo ❑ 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 allo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes PNo ❑ NA [] NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes [;�No
❑ lYes [;�No
❑ NA ❑ NE
❑NA ❑NE
❑ Yes C2iNo ❑ NA ❑ NE
[:]Yes e"No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 2TNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes Z' o ❑ NA ❑ NE
34, Does the facility require a follow-up visit by the same agency? ❑ Yes WNo ❑ 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 exp iin'sklations.([use additional pages. as necessary).
l6pj ChgnD 14 PrdyPSS -�( �c J G C� 5 , YU`"
`! S
r rr
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
U�tdr J I.� Saa 1) d
Phone: ?V 7q6 7,32-3
Date: 6/30
2/4/201

Type of Visit: Q) Cop�pliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: i.Z } Arrival Time:® Departure Time: County: 00(k( Tq) Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ,�� II Title:
Onsite Representative: W
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Wean to Finish
01
ILayer
Wean to Feeder
Non-L
Feeder to Finish
Farrow to Wean
Farrow to Feeder
rffN
Farrow to Finish
�ayers
Gilts
Boars
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?
Phone:
Integrator:
Certification Number:
Certification Number:
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?
Longitude:
y Cow
Cy alf
y Heifer
Cow
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[:]No
❑ NA
❑ NE
❑ Yes o
❑ Yes o
❑ Yes No
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Page 1 of 3 21412011 Continued

Facility Number: 1 -7071 Date of Inspection: la -
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Identifier: LAGV(, )
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _j 6 _
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
% No ❑ NA ❑ NE
[:]No ❑ NA ❑ NE
Structure 6
EYes 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 envi mental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes �o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes -C�No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ONo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ffiNo ❑ 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
0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[7NNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
6/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
ONE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA
YNE
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 eNE
❑ 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 LJ�XE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [[] NA
Page 2 of 3 21412011 Continued

Facili Number: 3 - C7 Date of in ection: ,71!' t
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [] No ❑ NA � E
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes [:]No ❑ NA [NNE
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
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
[:]Yes E] No ❑ NA ❑ NE
❑ Yes
❑ Yes
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑rYe
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
CZ/No
❑ NA
❑ NE
WNco
❑ NA
❑ NE
No
❑ NA
❑ NE
❑NA
❑NE
2/N""'
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or:any other comments
Use drawinLys of facility to better exnlain situations (use additional na2es as necessarv). .; .
t7) if c�r41 � 0 -%/ Mf- MnUS 1J COJ P 6C CCU=/?i JCP or,
�to gecoADl .
A16 o� S-'M— J��
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
a
Phone: L f a 1 `v gip
Date: ML
21412011

Fadti Nutnber
w.�
1
.
aDtvtsion of Water Quahtq
OgDivtsion of Soil and Water-. Conservation,
fD Clth r°Aeencv
Type of Visit_�Ytompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Techni¢f Assistance
Reason for Visit outine 0 Complaint 0 Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Z X> Arrival Time: � Departure Time: County: Region: �'✓
Farm Name: T7GGffir Lt,�r _ Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone
No:
Onsite Representative: I Integrator: %h /iO
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = c = ' = Longitude: = c 0 ,
71
_'--Design""'Current :Design Current DesignEurrent
Swine Capacity Po"pulation Wet Poultry `Caiiacity Population Cattle Capacityl'opu[ahpii
�-
❑ Wean to Finish ❑ Layer
❑ Wean to Feeder ❑ Non -Layer
❑ Feeder to Finish -
❑ Farrow to Wean
,,;Dry Poultry
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
' ❑ Boars
Other
❑ Other
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
❑
Dairy Cow
❑
Daia Calf
❑
Daia Heifer
❑
D Cow
❑
Non-Dai
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
ter.
Number�of Structu
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure.l Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes PNo
❑ Yes jZNo
Structure 5
❑ NA ❑ NE
El NA El NE
Structure 6
❑ Yes 2rNo ❑ NA ❑ NE
❑ Yes (a 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 ONo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ETNo ❑ 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 ONo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes j2 No ❑ NA El NE
maintenance/improvement? �f
It. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes VJ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[--]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ 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
❑ No ❑ NA ZI NE
❑ No ❑ NA ETNE
❑ No ❑ NA e(NE
❑ No ❑ NA 2"NE
❑No ❑NA 9 E
Comments refer to° uestron # .' Eft lain an YES an ( qe0 ' )� p � y' severs and/or any recommendations or other comments -
he.
Use drawings of.facility _to;better explain situations: (use additional Pages as -necessary) `
Reviewer/Inspector Name ^.- �l•2
Phone:
Reviewer/Inspector Signature:
Date: p
Page 2 of 3 I2128/d4 continued

Type of Visit QV"C ompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ZRoutine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: % G Arrival Time: Departure Time: County:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
/ /� Owner
Title:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region:
Location of Farm: Latitude: = o = d = Longitude: 0 ° [� g = N
Design C►urrent
Swine Capacity Population
Wet Poultry
Design Current Design Current
Capacity Population Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
ElNon-Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
I I Number of Structures:
❑ Wean to Finish
10 Layer
❑ Wean to Feeder
❑ Non -Layer
❑ Feeder to Finish
Dry Poultry
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Layers
❑ Farrow to Finish
❑Non -La era
❑ Gilts �
❑ Boars
❑ Pullets
❑ Turkeys
urkey Poulin
❑ Other
Oth
FET Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
IrNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
❑ Yes
O No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
�No
❑ NA
El NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
VN
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

acility Number: — Date of Inspection fy
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
ElYes
VNo
❑ 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. l
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
C3 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
E�4o
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
PNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
W 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
[?]rNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
)�p"2'¢B: g-act .8`°v��R .. - _ SA
'rr' ..
Comments+(refer.toqueshon#Ez lainany YESi swersand/©m�recomendattonsrbrbanyoiher comments.
E
Used, gs of facility to better explwn sttuatrons ^(use,addittonalcessa _ y
�v
417
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date: 1.2 9 q
Page 2 of 3 1212AVU4 conlinuea

ivision of Water Quality`
Facility Number: O Division of Soil and Water..Conservation
0 Other Agency
IType of Visit compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit Q Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:
Farm Name: _
Owner Name:
Mailing Address:
Physical Address:
Arrival Time:: /I
J/ k � Lt a_
Departure Time: County:
Facility Contact: Title:
Onsite Representative: eP7
Certified Operator:
Back-up Operator:
Location of Farm:
Owner Email:
Phone:
Region:
Phone No
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: [= e = d =.. Longitude: = e = 6 =
i
! ,
Desii' n .
g Current Design Current Design Current.
Swine Capacity: Population Wet Poultry Capacity Population .: Cattle Capacity -Population
❑ Wean to Finish ❑ Layer
❑ Wean to Feeder, ❑ Non-Layer-
0 Feeder to Finish
❑ Farrow to Wean
� -Dry Poultry _
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:,
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
[:3 Yes
El No
❑NA
[:3 NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Date of Inspection `� G
Facility Number: 3 f—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
❑ No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify
DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments
a
Use drawings of facility to better explain situations. (use additional pages as necessary)::.
Reviewerllnspector Name r Phone: U
Reviewer/Inspector Signature: ZDate: `
Pnov 2 n£ 3 12,'28164 C antinued

•` Facility Number: 3 — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard KWaste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑.NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
�1, �►`�`� tom\ ��e✓ 1 `� fGtlYt �l �C,­,cyr, t ykS feC
Og)lm3 3
�z/`16s- . `7e
illl
/*
Page 3 of 3 12128104

IType of Visit eta<ornpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit (2rTtoutine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Arrival Time: I f- . 6)(2 1 Departure Time: County:
Facility Contact: Title:
Onsite Representative:1%/!
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Owner Email:
Phone:
Phone No:
Integrator: Y
Operator Certificate umber:
Back-up Certification Number:
Region: G`
Latitude: 0 0 = 6 = Longitude: = ° = 6 =
il
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder a t?o
❑ Farrow to Finish I
❑ Gilts
❑ Boars
Other
❑ Other
❑ La er
❑ Non -Layer
Dry Poultry
❑ Layers
❑ 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 Heife3
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
i
❑ 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 'JZ"No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
El Yes ❑No
❑NA
ONE
❑ NA
❑ NE
❑ Yes Zf No
❑ Yes fj No
❑ NA
❑ NE
❑ Yes /[!�No ❑ NA ❑ NE
12128104 Continued

Facility. Number: 31 - o Date of Inspection d
N
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes f'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): l
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 2'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 p 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 J2No
❑ 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 ZNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �o
❑ NA- ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below, ❑ Yes 2:rNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [IEvidenceof Wind Drift ElApplication Outside of Area
12. Crop type(s) C145)
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
❑'No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`
❑ Yes
0"No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
,I No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
d No
❑ NA
❑ NE
4keoav& sl rais-
Reviewer/Inspector Name Phone: /
Reviewer/Inspector Signature: Date:
1212814 Continued

Facility Number: 3 — Date of Inspection
Regu_ired Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ZrNo ❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA
❑ NE
the appropirate box.
❑ WCdP El Checklists El Design El Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below. ATYes ❑ No ❑ NA
❑ NE
Ol"Waste Analysis El Analysis El Transfers ❑Annual Certification El Waste Application j "eekly Freeboard
❑ Rainfall ❑ Stocking ❑ Crop Yield X 20 Minute Inspections ❑ Monthly and V Rain Inspections Weather Code
22.
Did the facility fail to install and maintain a rain gauge? ❑ Yes 13'No ❑ NA
❑ NE
23,
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [aNA
❑ 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 (2 NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge? ❑ Yes ONo grNA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No ❑ NA
k] NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 2rNo ❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document [:1 Yes 2 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 GNo ❑ 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 'VNo ❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency? ❑ Yes 0,No ❑ NA
❑ NE
�Aianamngs:.ddttsEo
a 2� S fecofcA�.�e � -�� 1<�e.Q.�ca r o� o ^ affroveGrI
s2 u 4i
v4hre
w[ CGrO� 1("'VCa 1V1__ C O 4 4' l llt! 7 la "l a /�� l 20
'e A P? 4-117
- C}- <�F 4-1Pcj a,=�
`,k2l✓P,2.)e- h� �l,ry rl 41., -IL tfrews
Udl/�/ �U ,�P� � l 12128104

Type of Visit 4 Compliance Inspection O Operation Review O lagoon Evaluation I
Reason for Visit JZFRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: / I , ?une:
0 Not Operational Q Below Threshold
�ermittedAfCjeerrtified © Condi naily Certified © Registered Date Last Opera Above old:
[ l Q '�`` fir.
Farm Name: ___ Y/Y7 -. County: �h
Owner Name:
Phone No:
Mailing Address:
Facility Contact: ____ . __ ------ .. -Title: Phone No: M
Onsite Representative: Integrator. ,� /%.V
Certified Operator: , _ .. _ , Operator Certification Number: ,
Location of Farm:
Swine )2foultry ❑ Cattle ❑ Horse Latitude Longitude �• �< �«
Desgn C1IrFCLtt Design Cnrreat rt r DeskCu�at
Swine-Pti"ulattoa pY �Po turn: Cattle No han
Wean to Feeder Layer Dairy
Feeder to Finish Non -Layer Non -Dairy
Farrow to Wean'
arrow to Feeder
Farrow to Finish
Total Design CaParttY
Gilts
Boars` a _Total SSLW' .'4
Number of A 3otts
eb Y
Discharges & StreamIMPR
1. Is any discharge observed from any part of the operation? ❑ yes
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a- If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes � "o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes , ❑,pio
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier_
Freeboard (incites): a
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,
.=
❑ YesA!TNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes PVo
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes L2'fqo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes 'PNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes R"So
elevation markings?
Waste application
10. Are there any buffers that need maintenancefunprovement?
❑ Yes .014o
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes ONO
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Prozen Ground ❑ Copper and/or Zi
12. Crop type tl '
13. Do the receiving crops differ with those desi ted in the Certified Animal Waste Management Plan (CAWTAP)?
❑ Yes ONO
14. a) Does the facility lack adequate acreage for land application?
❑ Yes ❑ No
b) Does the facility need a wettable acre determination?
❑ Yes ❑ No
c) Ibis facility is pended for a wettable acre determination?
❑ Yes ❑ No
15. Does the receiving crop need improvement?
❑ Yes P No
16. Is there a lack of adequate waste application equipment?
❑ Yes ,ONO
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ yes j2fNo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes ZNo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes pllo
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 UrNo
Air Qualityrepresentative immediately.
xUse dravc+mgs � facdLLp to better�cxglatn �tnahom�: (tee adi�iti;P� ems]')- R ❑ Wield Copy ❑Final Notes ��=;
OL i'`_ -t yl 300 6�eE ;
T
Reviewer/hupector Name = "�
Reviewer/Inspector Signature: Date: u
12112103 Confinued

rt
Facility Number: 3 ? z.626 Date of Inspection
Reauired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? J2'S'es ❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
�o
23. Does record keeping need improvement? If yes, check the appro 'ate box below.
Q'Yes
❑ No
Waste Application Freeboard XWaste 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
ONo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
27. Did ReviewerAnspector fail to discuss reviewFmspection with on -site representative?
❑ Yes
,3'No
28. Does facility require a follow-up visit by same agency?
❑ Yes
ONO
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
OONo
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
J2rNo
3I. 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
113 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
42J Prim se.., Veep Cer41-6 (ak Q-F COUCCa�C' �-
Ge.nera ) Perm� wig on 5 � fe co -dS
a 3) T lease, use -P-9-e loca r fe COOS 0 0 6fP f 0 ved
s he��s k� ,-e C.O rds r r y es
C'n1 o a o a 3 FT-pe.L4ar0� (-LGd rrd S
106 j4R)
dui- -� �nd�r) - r J rve,
S � fump a� ew le as a
ID NO
-uVe rr reno�XGat
�a1
I2/I2/03

4
Facility Number Q Date of visit: 2 i q,� Time: ' 3
Not O erational 0 Below Threshold
O Permitted orcertifled. 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
,! P�
Farm Name: I"t a wa,�a7j , U.Sf,c,r �� rr*, � � County:
Owner Name: Fl o L.j a r'd U.S! to f Phone No:
Mailing Address:
Facility Contact: Title: _ _ Phone No:
Onsite Representative: A o w 5 ,41-d USL,C Integrator: m �'
Certified Operator: Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ' " Longitude ' C ` 0"
Design Current Design Current Design Current
Swine :. Capacity Po ulation Poultry , Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish Non -Layer ❑ Non -Dairy
El Farrow to Wean --
--
Farrow to Feeder 0 ❑Other 3
Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars ' Total SSLW
Number of Lagoons
❑Subsurface Drains Present J1E1 Lagoon Area JEJ Spray Field Area
Holding Ponds 1. Solid Traps ❑ No Li uid Waste Management System `
Discharges & Siream tnipacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collgetion $i Trea-tment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: I
Freeboard (inches):
05103101
❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
XNo
❑ Yes
ONo
[:]Yes ,RfNo
Structure 6
Continued

•s
Facility Number: 31 — 6 3o Date of Inspection 2 I aZ
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
❑ Yes eNo
❑ Yes &No
XYes ❑ No
❑ Yes ZNo
❑ Yes ZNo
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
12`No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
allo
12.
Crop type 6er-Vn vef C" Pr-' S-f " -e S-e -VA t Ge)e:, i r+
13.
to
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
XNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
JffNo
b) Does the facility need a wettable acre determination?
❑ Yes
ff No
c) This facility is pended for a wettable acre determination?
❑ Yes
ZNo
15.
Does the receiving crop need improvement?
❑ Yes
21'No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
.fNo
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
1'No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
ENo
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
,Yes
❑ No
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
ONo
21_
Did the facility fail to have a actively certified operator in charge?
❑ Yes
[ErNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
;2rNo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
, 3 No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
,ONo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
la'No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #):_ Explain any YEs answeis and/or any recommendationss or aiw6ther coimnents ;
ioaa
Use drawings of.facility to better 'egplam ons: situati(use additl"pages as necessary) [� Field Copy " ❑Final Notes "
r7 Rer,,.Q..e 4maces �,��,r.,. iac� oo o(; ke wallso� keolo 6r,'�►.s
r"owcd, 4o exI1ow -fof i.r\syceC-1I"IV, b,r;, ;. � , e r.-i1 O-oW&'-
q ,/ 1 n S 'off G 1
-,,,141 S is S
1 Nc we,54fy-S r ok4ce,' S✓-Pr► c'.—C 4 t In J'A j ►"' 60 GL4y Q�
Yert �Vl1,i; AVcJt�S�,
at�y)�( ')1'pr. e S iN AAd�� e„'t6crlet24O�I
Pye Sv -,e 4o 6Ave a 4� Anq[ s.r w►��+, � l� day s rr aloe lic44 tam evv�s
i, ear
Reviewerllnspector Name �,��0 t w4r, G /yIC14k -r
Reviewer/Inspector Signature: Date: 2 © Z.
05103101 Continued

Facility *Number: ,7l — 30 Date of Inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below XYes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ONo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? [:]Yes ONo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ONo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ZNo
32. Do the flush tanks lack a submerged it'll pipe or a permanent/temporary cover? ❑ Yes XNo
Additional Comments an or rawings: u
&)eed 4a se�4�"tc4e crops- a,-t -7Rk- 2.1%-4 be;j'n U/14L�`5/0
For ,;r►al( �`�;� $ ZoZ t'nr be.rr%Vdr,-fAS4vr-f45 r1eirk-
M We#a61e ACr�3 fin$ �e Aor.e bJ S-fer -6 wc-,14e yoletvx
aC60-Id ;#5O1 � ee0i 4O 6L� )evtg3,Cctlrvl�-F�a,
,co, --r-r0c4pe aCIPs Also 1 grat„�r is vs��'S rlstl r-x o+� �XiL- 2 J.
Lie4)mtle ae-res sa�s 02 510r-.. Nord 4o have vtole, fro-,.%
r,-orQ"r loersnn s. � tie'1 sue, 7 �+-.y %""41 411 rJ c.affe0 a�^d v se co��ee
Flew ✓'a4C' 0t, TR11Z--2's,
/11e44abcSe ci.c,,�s �oE�r,i-i aff + be,r- 2 o a
a ,,A nev2r- neeAs 40 9 e t 1ver ►^t; .
5100

_ Division of Water Quality
Q Division of Soil and Water Conservation '
M D Other Agency
Type of Visit xCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit IgRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: —77TGO 'Vilne: 3 d Printed on: 7/21/2000
30
0 Not Operational Q Below Threshold
E3 Permitted 'LCertified© Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ...................
Farm Name: .... WG.......... [� .� ° �"' Count .... !�! Ip11!................................ ............ I..........
OwnerName: ............................................................................................. ....................... Phone No:.......................................................................................
.
FacilityContact:...............'ritle:................................................................ Phone No:...................................................
MailingAddress: ...................................................................................................................................................................................................... ..........................
Onsite Representative: .0trL-4Z. ................................................................ Integrator:.......6 . ....................................................
.....
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 6 .4 Longitude • 1 46
Design Current
Swine CaDacity PODulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I JE1 Dairy
❑ Non -Layer 1 10 Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lag -on Area JE1 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste :Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
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. Il'dischage 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? El Spillway
Strucaurc I Structure 2 Structure ; Structure 4 Structure 5
Identifier: ........................ ........................... ................................................................................................................................
Freeboard (inches): 3�
5100
❑ Yes 9No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes WNO
❑ Yes bdNo
Structure 6
Confinued on back

-lFacifi�t`y�Number: �� — �3� Date of Inspection Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes KNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure'plan? ❑ Yes XNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes [No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes P No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes VNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes )ZNo
11. Is there evidence of over application? ❑ Excessive Ponding El PAN ❑ Hydraulic Overload El Yes NrNo
12_ Crop type �V 11� 2t -s g _
13. Do the receiving crops�differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
IT 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 reviewlinspection 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?
�: Nd,• iglatioris bi, def ciencies •mere• noted- during (his'visit' - You Vi I. -eeeive 4io #wither
...............................
cor'respondeii&aboutithisvisit.•.-_-.•.•.•.•.•.•.•...-.-.•.•.•........-.-.•.•.•.
❑ Yes bdNo
❑ Yes JK No
❑ Yes ❑ No
YYes ❑ No
❑ Yes 11No
❑ Yes k No
❑ Yes NNo
❑ Yes X No
0Yes kNoW
❑ Yes ff No
❑ Yes [)SNo
❑ Yes 0 No
❑ Yes XNo
❑ Yes [NrNo
Cl Yes k No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): t
F, Ag-e—r 1—*A
Reviewer/Inspector Name lloQ 9 0 -3y Z-3 g G 0. X-Dac
Reviewer/Inspector Signature: Date: I - _-"G 5/00

Facility Number: 3 t —6 Date of Inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor below KYes ❑ No -
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �(No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes O(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 0 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 kNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes D�No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes XNo
Additional Comments and/orDrawings:
�`� C��. +ter+-��-5 'Q�l� �- �•�s� G�e�ee�.-- ��- �, S� ��
��S 23c
S !0
A'SrJ \�
Aee_\�
ac\-_ A f"
'3 Z s�,,� Pis A�. P4'�f � ►� rc - �
J
5100

I
` r' 'Division of Soiland :Water Conservation-- Operation Review
Division of Soil and Water. E✓onservahon--'Compliance Inspection x }
]IDivision of Water QuAity 'Compliance )(iispeetiion
- j __.•. -
-W �] Other Agency' Operation Review
116 Routine 0 Complaint 0 Follow -tie of DW2 inspection 0 Follow-up of DSWC review 0 Other
Facility Number r p Date of Inspection y
Time of Inspection 24 hr. (hh:mm)
© Permitted XCertirted 0 Conditionally Certified [3 RegisteredJE3 Not Operational] Date Last Operated:
Farm Name: ....................................... County ....... l P!_ 1/✓....................... U1/.....
..... .
Owner Name:........... �✓ ....... Phone No:....../0...-..L8f...`.2 .6&
1........................................:.........................
Facility Contact:.......4v10 ......�.......... Title: .......... P- ......................... Phone No:.........
Mailing Address: .......lfssQ........ ls ' vi..dam . ... a ........................ . ..........................I...........-
Onsite Representative:......... . .....�P�Itegrator:......". .- �..................................... n....A;n�...............
Certified Operator:......../(!1(Q ............................................. Operator Certification Number: .... .7.g2!/
Location of rarm:
..............?...................mlf............I................:....Q.........., ... .% I.
ram .✓.. :., Q.... -�n�co A, Q1 1�.:. ...4 .. p3...-. Fes, ...:..may... +!i..... ... .- K.. . �YzC7.Q........:..
Latitude ' •= Longitude EM:1 • ®' 64 e. 7 /A/ . 91V
g ;•
Deli n Current 'Design ..- - - � - Design
gn _ . - nrrent -�, �- = -•. � Current._ .�
Swine Point" _ .._;
Capacity Population _ !�y _ Capacity,. Po ulation Cattle - - ,_ Capacity Population s,
❑ Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish; ❑ Non -Layer 1 ❑ Non -Dairy
❑ Farrow to Wean -
Farrow to Feeder ❑ Other
❑Farrow to Finish 'Total Design Capacity
❑ Gilts,
❑ Boars -r Total SLW �}�4
y. Number of.Lagoons ❑ Subsurface Drains Present 110 Lagoon Area ILI Spray Field Area
Holding Ponds /Solid Traps ;. ❑ No Liquid Waste Management System = -
Discharges & Stream ImRacts
1. Is any discharge observed from any part of the operation? ❑ Yes XNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ 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 ] Structure 2
Identifier: I
Freeboard (inches): ....Z ..`.r *1... I. ...................................
Structure 3 Structure 4 Structure 5
❑ Yes ❑ No
❑ Yes 1z No
❑ Yes AfNo
❑ Yes A No
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
3/23/919 ST,41z- 4PP&A es 7O N66-t) ,R&-sowv� seepage, etc.)
b/&E wAa- *e16A Tr&W-eb
❑ Yes ANo
Continued on back

Facility Number: S% — 630 Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
•Closure plan? ❑Yes XNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ;eNo
8. Does any part of the waste management system other than waste structures require maintenatice/improvement? ❑ Yes 'm No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes XNo
Waste e\nulication
10. Are there any buffers that need maintenance/improvement?
❑ Yes $ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes $ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes PdNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes K No
b) Does the facility need a wettable acre determination?
❑ Yes 19 No
c) This facility is pended for a wettable acre determination?
❑ Yes IKNo
15. Does the receiving crop need improvement?
❑ Yes ANo
16_ Is there a lack of adequate waste application equipment?
❑ Yes )VNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
M 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?
�: Rio yiolatidiis:or• deficie'ndte� were hated d(W ig �his:visit: • Yoir will•i-eeeiye ii6 further •' -
... .. .... ...... .......
correspondence. about this .visit.. .
Comtments.(refer to,quest o i #) .Explain any YES answers and/or any recottt�nendations or any oilier i
0 < ( - pages
g i*
Use;drawin of facilt to -better explarn situations use addttiopai a es as:necessa ") -
❑ Yes A No
❑ Yes No
Yes ❑ No
❑ Yes ANo
❑ Yes KNo
❑ Yes Im No
❑ Yes � No
❑ Yes PQNo
❑ Yes No
P91 lhlPeove R&eaE_b X�i�� /J� s����- ✓-1
T2o1,ji 41A-PS Sole- ee,P4PXr5 el-" Lxi e -y
SA-W L t g Afgtr tW6aC-;rt I� 9' f 20 Ale) SA-,-nPG LS
Sli►/G� Z��9 Lln/rIC- %l����99
Reviewer/Inspector Name F4'
Reviewer/Inspector Signature:
Date:
aE
n
3123199

Facility Number: a / — �3d Date of Inspection
Odor Ssucs
26.�Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below XYes ❑ No
liquid level of lagoon or storage pond with no agitation?
2T Are there any dead animals not disposed of properly within 24 hours? ❑ Yes X No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes X 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 X No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32, Do the flush tanks lack a submerged fill pipe or a permanenthemporary cover? XYes ❑ No
rtion:a - omments an or rawings .. = -
PJPS �,2ari► Z L�. hfa�Se1' To J��-LJ Cr�tl�� L flrr�
32, L'�v�,�S • S�dayc,o J3G Jit/SrwL�� �4-To� �c,�r ,�� �Y���
r
��- �•�.� 5 �2©t/�� SiNG 1 ?J�i,S in%P�cr�rd� —
�,��
2)/A /iV tl&t6e-r1t-7iV oN1
l AlOtJ oA/ bl ee-.
3/23/99

Division of Soil and Water Conservation 0 Other Agency
10 Division of Water Quality
f L Routineinr O Complaint O Follow-up
er � p of DWQ inspection O Follow-up of DSWC review O Other
.��
Date of Inspection �g
Facility Number '' �
Time of Inspection � 24 hr. (hh:mm)
Registered 03 Certified [3 Applied for Permit 13 Permitted 113 Not O eratianal Date Last Operated:
Farm Name: (?.W ........... ..i .....C."!►^............I............................. County:...... Win ....... ! .
Owner Name: ........................ IAMN.md ............ Q. i ................................................. Phone No: {. ...........
Facility Contact:
Title:
Mailing Address:...............1.3 S ....... `� {t`...... N1 ff ..... .....���a.............
Onsite Representative: ................... J��
.. ..............
Certified Operator�...............................................................................
Location of Farm:
........I ........................ Phone No: ---.......---.-- ..................
........... 90.5&...... ...........................:...�... 5....
Integrator: ........ k1(&..........................................................
Operator Certification Number, .........................................
....... r :4..�..t.R..11 i..4........0 :`�...►� m its ... is �� .....a......tE ? ....�A�_....................................................................................................................................
Latitude =' =' 44 Longitude =' =' 0 "
Deli Current Design `Gjurrent ; , Design v Current
wine ,,, a
Capacity'.'Papuiation Poufiry CapacityPopulation Cattle Gapactty Population
Wean to Feeder
❑ Layer ❑ Dairy
❑Non -Layer ❑Non -Dairy
] Feeder to Finish
f[I
Farrow to Wean;
❑ Other
Farrow to Feeder
Z Z-i?
'
❑ Farrow to Finish
t
Total Design Capac#y
❑ GiltsW.
. . TOta1 SSLW
❑Boars
'Number of Lagoons / Holding Ponds��
ID Spray Field Area
❑ Subsurface Drains Present
❑ Lagoon Area
❑ No Liquid Waste Management Systemk`
1
r
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes MNo
2. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes No
c. If discharge is observed, what is the estimated flow in galtmin?
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 M No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes [)No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes No
7/25/97

i
�acility,Number: 3I --
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes CO No
Structures (LaeoonsAoldine Ponds. Plush Pits. etc.
9. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes [3 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(ft):.............? : -................................... ..................... ; ............. .............
............................................:..........
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?
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 ... .......... ......�Q4Y.nv.&:.......---------.---..5.01U.t ....yz;kott................ .............................................................
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,itoted-during this:visit.- You:W_ill receiver 6-ft rther : -
: OfreSOhdeh6about -this; visit.:
❑ Yes 0 No
q Yes ❑ No
❑ Yes IN No
❑ Yes 0 No
❑ Yes No
❑ Yes No
10 Yes ❑ No
❑ Yes ® No
❑ Yes No
❑ Yes No
1�3 Yes ❑ No
❑ Yes IM No
❑ Yes No
❑ Yes ® No
1-2— a1q.0.s ." ro&,,A-- ko6s s6Ulj be- �- Iw Wig- 0" &A'j m&ee.M.
r' f't'4- vers 'Y Wo vw'(TP'Aioh `-skou�o b.,hLwmf�-Ow'
Sl'�Y► C�� �.t�� { � �1�p'�tr �►� y�`�t�f `"'�£. `
S4yV lGQ �W 0.SSti� 1 SS
7,Z 11�a- �AN p,lntf 1a.�,t(<t1 or
G o�ry LL 7/25/97
,re-f h , At .Soon e,;-c. i p 7 S�wil� c� �n� 1Lt. �-„ r ec�cti•-
Reviewer/Inspector Name g x� a ° r
Reviewer/Inspector Signature. ��,r� �,J Date:

.1
Facility: umber:.. Date of Inspection: q (261o,
Addi661.-C di"
tl omments an & Drain
Wi S:....
in 4e G,CAN q--
ev 4,o ky—f-e � 4�
�vf 6--% mzc�
I
4/30/97

DSWC Animal Feedlot Operation Review
`U DWQ Animal Feedlot Operation Site inspection
,_.
JQ Routine O Complaint O F ollow-up or I:}1yQ inspLction O
Eality :N4umber :E �j[ D — E i =
of DSIVC review O Other
F+owo�
2.4 hr. (hh:mm)
z .turn
Farm Status: ❑ Registered ❑ Applied for Permit i� _ pent on ReviewSi
Certified ❑ Permitted 5 7 }eI and processing)
0 Not Operational Date Last Operated:..._ J j..........,. ..........................................................
Farm \atne:......�wo.A.....uslv..t.......��iar!�....................................................... - �_ ?�iJ...................................... ..............
Owner Name: Phone No: .....................................
N�.......0................................. �g�j..e�f.......$Q.�...
Facility Coutatct: US.N ...................'hith:...........1oG4!�1+k{r......... Phone No:,�......
Mauling Address: ...... 3,3.Vo.......stlA ......Nyu..Ault.....9�� ..�.....................I...........&S...iT1.L17IN.1........................................ ... .n......
Onsite Representative: ..... N.W"A......... US.6Y........................................................ Integrator: ........ AtN.p�.........................................................
Certified Operator:......... LCA......H....._NLV.................. . Operator Certification Number: ........ t-1UZ.
Location of Farm:
....... on....�...... ... c .........ax±.......
.....3tcicy:s......sl.vtg...... tr ... .... ............% &. 4 ...
Latitude �• � ©� Longitude SRII1-O' scum tS O.7
V i S Qr` no+r+k si a r-
Type of Operation . Design . , Current Design Current Design =v Current
Swine Capacity. Population;-; Poultry Capacity Population Cattle Capacity:"_Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
2,2.o
❑ Farrow to Finish
❑ Other
Number of Lagoons / Holding Ponds ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If dischan,e is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water! (if yes, notify DWQ)
c. If discharce is observed. what is the estimated flow in calhA0
d. Does discharge bypass a lagoon system? (If ves, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
4/30/97
❑ Yes 19 No
❑ Yes Wo
❑ Yes [� No
❑ Yes EW No
❑ Yes 1� No
❑Yes PNo
❑ Yes C�LNo
❑ Yes I,No
Continued on hack

Facility Number:....3
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes I N'No
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures a,agoons and/or Bolding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (fl): Structure 1 Structure 2 Structure 3
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 Ievel markers?
❑ Yes WNo
❑ Yes No
❑ Yes JR No
Structure 5 Structure 6
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 ....... .. L C 6-.--...._........ ........ ........................ ...[.".c....... (.2�A � . ��7(.i�sln�-----•--- _
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes [9 No
W Yes ❑ No
Yes ❑ No
❑ Yes Iff No
❑ Yes §�No
❑ Yes IS No
❑ Yes No
JR Yes ❑ No
❑ Yes JW No
Yes ❑ No
❑ Yes WNo
❑ Yes Kj No
❑ Yes Oa No
® Yes ❑ No
6"slon or. 4L D,41, w(Al of 4.,,. (a560A '%kcdJ 1c VOW vjA- cleI d reSeed(d, krur
a4,) ov�cr wa[(% of #o oov� sha�Zd �e fnaucr� aRK, s ri b� l�stedcci• Trees an
o U tee w OJ< o �_ 1).S ko UP 6 c, 'a".
A. C ov.ev C- old slno�L� lae, �erovej.
14. was t u i; _e(av s 6vul 6, ctnavy) 4o ccwec' W d Auft6feS .
be_ 4- + V VL"P� A'VJ conresp'�{ �ie{� nuYribu% (}
((''� 1 �a ky�w
�s4c 0^' te' ( �4 �C "a S S ShOVO 4 Ors 5-'k.
i
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
�r
cc: Division of Water Quality, Water Qualify Section, Facility Assessment Unit 4/30/97

Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 10 3 , 1995
• Time:
Farm Name/Owner:
Mailing Address:
County: 13U NLJ N
Integrator: PyM i LM I-A?-y►'i 5 Phone:
On Site Representative: tb'LAM USA Phone:
Physical Address/Location:
Type of Operation: Swine _jZ Poultry Cattle
Design .Capacity: Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
{approximately 1 Foot + 7 inches)Pagoon(s)?
rNo Actual Freeboard: 2 Ft. Inches
Was any seepage observed from thYes 00Was any erosion observed? Yes or No
Is adequate land available for spray? Yes or No ' Is the cover crop adequate? Yes or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state -by roan -made ditch, flushing system, or other
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, Iand applied,
spray irrigated on specific acreage with cover crop)9 es or No
Additional Comments: LX-, WALL- AIM SDK M60 opoz5
56 AP02W W1AT6 Cy - 4 2 - 15 ' 416N . 1-M126- Af2E 600-E
STUT�S
. Inspector Name
cc: Facility Assessment Unit
Signature
Use Attachments if Needed.

Site Requires Immediate Attention:
Facility No. -Co 3`bR
DIVISION OF ENVIRONMENTAL MANAGEMENT
• ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: �' , 1995
Time. D /
Farm Name/owner:_GLSHI,P 9,eILIS�y I,ep GL S �� -
Mailing Address: _ 1 l 62 C' 0 N IVIVAC'i 4 CC , . &0BSE A �� _ o?,� V. ST
County:. _Vy P L,r (,J _-
Integrator: PuRavu Phone: a�S
r Gt,s�a /ar - o
On Site Representative: ,57�V6 (� � y Phone: 7 a � f i-I,-
Physical Address/Location: a 7NFu ,2z>�<­14icI- o,- 5,K11-6 J7- Te ENo LEt7- AIP/�-V-
��Jt�v
7u rz�. Qr o a s4_1 i Z, LLaw 6, 7-Rd 2T 6FOU7-6
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: a�'�' car s Number of Animals on Site: _PGy
DEM Certification Number: AC'E DEM Certification Number: ACNEW
Latitude: 3 `{ So ' 3.2 S7 " Longitude: -?L d -' d 7.o2Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes or No Actual Freeboard: Ft. r Inches
• Was any seepage observed from the lagoon s)? Yes or No Was any erosion observed? Yes or No
/4 M T 0 •�
Is adequate land available for spray? es r No Is the cover crop adequate? Ye �r No /Pc
Crop(s) being utilized: d: ieA-S-7A c IMAA, Sorg v �j
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellingse or No
100 Feet from Wells? es r No
J
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes oSO
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes orco)
Is animal waste discharged into waters of the state -by man-made ditch, flushing system, or other
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments:
�Do
Inspector Name J Signature
cc: Facility Assessment Unit Use Attachments if Needed.

l3� ti
C � '
J Site Requires Immediate Attention: _ -✓
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
. ANiMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time: P 1 U
Farm Name/Owner: r`
Mailing Address:
county: --
Integrator. k y _. _ Phone:
On Site Representative: Phone:
Physical Address/Location: _ (VC S R � 1� 0 P, ��P-aZC T ,.�„ � we,f di _ NC9 d �,
Type of Operation: Swine `� Poultry Cattle
Design Capacity: �<,� _ Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: Elevation: Feet
/1/0 P) . K U Y's Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes or No Actual Freeboard: __�_F€. Inches
• Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or N�
Crop(s) being utilized: V\A vw
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
i00 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No y
rot
Additional Comments: _ - _ � _ � =:b? -� (2 A_%1
- �i u-t t,��xt t i � U-��_ � A--f ram-• _ _ � _ _ .., , .
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

•
Site Requires Immediate Attention
Facility Number 1 (v 3 d
SITE VISITATION RECORD
DATE:- 1995
u s� e2
Owner: Farm Name:
County: D,-t6fl I r, .
Agent Visiting Site: w�o,h n I e. ! ' Phone:
Operator: Phone: -ZVI- go 8 _
On Site Representative: Phone:
Physical Address: G�n 1[M
sad, � �'�... i�3 • --—_......�
Mailing Address:
Type of Operation: Swine Poultry Cattle
Design Capacity: Z-Z�C? Number of Animals on Site: '� '�� FeqJ
Latitude: O Longitude: "
Type of Inspection: Ground Aerial_
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hoar storm event
(approximately I Foot + 7 inches) Yes or <9D Actual Freeboard: Feet Inches
For facilities with rrtvre than one lagoon, please address the other lagoons' freeboard under the
comments section.
Was any seepage observed from the lagcon(s)? Yes or No Was there erosion of the dam?: Yes or No
Is adequate land available for land application? Yes or No Is the cover crop adequate? Yes or No
Fax to [phone] Signature of