310670_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

dlAs I('zyvlyf_�
Type of Visit: (:)-Compliance Inspection U Operation Review U Structure Evaluation Q Technical Assistance
Reason for Visit: Q-1routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:){ Arrival Time: •uv Departure Time: County: j�rt� Region&,jt
Farm Name: du-cA& V'l i L(�/ Owner Email:
Owner Name: UC t I rLu rl I °�J►t x Phone:
Mailing Address:
Physical Address: I
Facility Contact: &C_ S'$ (� / Title: Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
tI
Latitude:
Integrator: C _eVI
Certification Number: q [ q 32-3
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current
Wet Poultry Capacity Pop.
La er
Non -Layer
Design Current
C►attle Capacity Pop.
Dairy Cow
Dairy Calf
Wean to Feeder
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Non -Dairy
Farrow to Feeder
Drr P,oultr, C•_a aci Plo
Farrow to Finish
La ers
Beef Stocker
Beef Feeder
Beef Brood Cow
Gilts
Non -Layers
Boars
Pullets
Other
Other
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes Qom❑ NA ❑ NE
❑ Yes ❑ No [DIVA ❑ NE
❑ Yes ❑ No [:YNA ❑ NE
❑ Yes ❑ No
❑ Yes [3-No
❑ Yes ENo
D NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page I of 3 21412015 Continued

Facili Number: - 47&Date of Inspection: S4q-c-
zVaste 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 I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in): r _
Observed Freeboard (in): � [
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
D-Ne—❑ NA ❑ NE
[:]No E3rN7� ❑ NE
Structure 6
❑ Yes []•Ko- ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
L�Ko
❑ 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 l o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
M-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
[fNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ff'No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): CL W
13. Soil Type(s):0C U
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes FET'&o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes [DlNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes [TNo ❑ NA ❑ NE
❑ Yes [-No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes DNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [allo ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other.
2 t. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Ea'O-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 allo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EJ'No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: ta! - Date of Inspection:
a4. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[D No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
Cg--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
q4o
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[2 o
❑ 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 the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes )o ❑ NA ❑ NE
❑ Yes [ ,<o ❑ NA ❑ NE
❑ Yes [lNo [] NA ❑ NE
❑ Yes ['�No ❑ NA ❑ NE
[:]Yes
No
❑ Yes
[allo
❑ Yes
[3'No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
'4 (-- I . N-/:77 0- 57z
'�c( - r 0-.�C C 4 � 51
Reviewer/Inspector Name: ,� Phone: %y -.33
e 7 I
Reviewer/Inspector Signature: � {/u Date:
C
Page 3 of 3 21412015

Date of Visit: Arrivallime: (>i S Departure Time: A p Q County: Region: i
Farm Name:' k Owner Email:
Owner Name: Phone:
r
Mailing Address:'
Physical Address: A, p
In acuity Cantact:? Y Title: Phone:
`,Ons'ite Representative: Integrator:
Certified Operator: Certification Number: -
!-,- Back-up Operator:
Location.of Farm: Latitude:
Kt -
Certification Number:
Longitude:
Design Current
JEDcsign
Current
Design Current
Swine Capacity Pop.
Wet Poultry
acity
P.op.
Cattle Capacity' Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder'.
HNon-Layer
Dairy Calf
Feeder to Finish.
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dr. Poultry
C•.a .acit
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts-"
Non -Layers
Beef Feeder
Boars
Pullets
INI
jBeef Brood Cow
Turkeys
Other
Turkey Poults
Qther
Other
` Dischart<es and Stream Impacts
r:
1'. Is an dischar a observed from. an art of o eration? • .. y` $ y P P
Discharge originated at: ❑ -Structure ❑ Application Field ❑ Other:
R'
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
" c. What is the estimated volume;that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
.:
of the State other than from a discharge?
4
❑ Yes ©.No. ❑. NA ❑ NE.
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
/ .
❑ Yes' E] No ❑ NA ❑ NE
",. Page I of..3,' ; 21412015 Continued

Facility Number: "2 1 - (L �� (} Date of Inspection:
Waste Qollection & Treatment
4js storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑i -Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
�Q Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: lA 20 q 2 0
Spillway?:
'N
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
0 No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
,
Y 6. Are there structures on -site which are not properly addressed and/or managed through a
❑Yes
Q No
❑ NA
❑ NE `
•" waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify 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 /Q No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA P]'NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA E] 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 0 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
0 NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
D<E
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
❑ NA
i
Q NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑f 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
Z 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.
r
❑WUP ❑Checklists ❑Design ❑ Maps [:]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No. ❑ NA �❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield , ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections • ❑ Sludge Survey
22. Did the facility fail to install and'maintain a rain gauge? ❑ Yes ❑ No 6kNA ,❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA f0 NE
Page 2 of 3
21412015 Continued ,
..� .. - .. t _... � .. e._ - ..r.j .. t. .. ... .�... .. �1. .. ., ."4 �� :1 ¢,. .... .a.. .�. .. -..-. ,.. r. •!._ �!` Y-�I ..�.. r ... .� �.J�

Facility Number: { j _ %Cf Date of Inspection: G f 0 /
C
24. Did-gie facility fail to calibrate waste application equipment as required by the permit? ! ❑ Yes ❑ No ❑ NA ❑/ NE
A Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes ❑ No ❑ NA �Q 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 fQ N
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No 0"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:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
Comments°(refer to question ff): Explain any YES` answers and/or' any, additional recominei
❑ Yes ❑ No ❑ NAj2"NE .
❑ Yes [ No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA []`NE
❑ Yes E] o ❑ NA, ❑ NE
❑ Yes ,❑ No ❑ NA ❑ NE
❑ Yes �Q No ❑ NA ❑ NE
ions or any other. comments.
Use. araw kngs of factury-to.better explarn situations (use aadMon al -pages as necessary}. -. F w
�i'tn glnc �� 0av�c� JVCQJ�G 01t/R W7ejl) u1111 .Sum Fd4�sil�S
J
onn C�J' h C j,✓ sl % S.
CL'C It �" II
I k D W A /AID jD h
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 7/0 7Tj"2,0y
Date:
� f
21412015

(Type of Visit: @Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance I
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: n3 S Departure Time: 71 D0 County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design C*urrent
Swine C►apacity Pop.
Wean to Finish
Design C+urrent
Wet Poultry Capacity Pop.
Layer
Design Current
Cattle Capacity Pap.
Dairy Cow
Wean to Feeder
I
INon-Layer
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design C►►urrent
Dry Cow
Non-Dai
Beef Stocker
Farrow to Feeder
Farrow to Finish
D . P,oult . Ca ac►_ty P,o
I Layers
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Turke s
Turke Poults
Other
Beef Brood Cow
Qther
Other
Discharaes and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑Yes ❑No ❑NA ❑NE
[] Yes F5No ❑ NA ❑ NE
❑ Yes 21"No ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: 2.- Date of In ection: 'Z n
�r
Waaw Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 2 1es ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3
Identifier: 2._17°I i{z0
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 4 Structure 5 Structure 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?
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? Ycs ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste ADDGCation
l0. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA VE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA [Ey�
❑ 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 Ej'NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA � NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements
❑ Yes ❑ No [DNA / NE
❑ Yes ❑ No ❑ NA FZNE
[:]Yes ❑ No ❑ NA NE
❑ Yes ❑ No ❑ NA NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA Z NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 ° Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA ,ENE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA X[fNE
Page 2 of 3 21412015 Continued

Facili Number: - (% Date of Inspection:
24. Bid 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
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ A ❑ 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?
❑ Yes ❑ No ❑ NA [3'FiE
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes P No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes No
—
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
f
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes ❑ No
❑ NA
— /
i � <E
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
'c
jjj""
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ VJ Yes
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes Z i10
❑ NA
❑ NE
' 34. Does the facility require a follow-up visit by the same agency?
❑ Yes jrNo
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility:to better explain situations (use additional pages as necessary).
h [( (} a PpWt !r IV( o 1~ a OWR w7/3,9) ou-i d Su —
iAI_k 0 cc Wit
CL,C. Ik a ; �e_ r_t l! � " , I `
1ec, k, - .
2.1 (o �
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
r/o 7,r6,72Dy.
Date: Z /
21412015

Type of Visit: Compliance Inspection 0 Operation Review p Structure Evaluation O Technical Assistance
Reason for Visit: r(�I'routine O Complaint O Follow-up O Referral O Emergency O Other i. Denied Access
Date of Visit: Arrival Time: Departure Time: O County: Region:
Farm Name: 4�GLrr j 9L, y, Owner Email: 1.
e
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:
Design Current
Swine Capacity Pop.
Wean to Finish I
Design Current
Wet Poultry Capacity Pap.
JLayer
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder I
iNon-Layer I
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Design Current
D . Ploultr,Y C•_a acit Plo ,
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Farrow to Finish
Layers
Gilts
Non -Layers
Beef Feeder
Beef Brood Cow
Boars
Pullets
Other
Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2: Is there evidence of a past discharge; from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of 3
❑ Yes �No ❑ NA ❑ NE
❑ Yes ETNo
[:]Yes L2'No
❑ Yes JZ No
❑ Yes 2�No
❑ Yes ' '�o
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
21412015 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 1 Structure 2 Structure 3 Structure 4
Identifier: _
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): __02
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 -ETlqo ❑ NA ❑ NE
❑ Yes P-No []NA ❑ NE
Structure 5 Structure 6
❑ Yes ONo ❑ NA ❑ NE
❑ Yes . ONo ❑ 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 )2*lqo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes FKo
❑ 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 ENo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes J-No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes,,allo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > t0% 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?
❑ Yesr�No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes —ONo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation,design or wettable acre determination ?
❑ Yes E�-No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes J:�No
❑ NA ❑ NE
18, is there a lack of properly operating waste application equipment?
❑ Yes [,No
❑ NA :❑ NE
Conments,(refer toqueshon'# Exp am any answers and/or any, iecommendationsor;any otherjcomme" nts
Use drawrngs.of faciltytobetter,ex lain situations., use addtttonal pages as neceryz� "
qPF
Reviewer/Inspector Name
%
Phone:
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12128104 Continued

'vi"sion of Water Resources
Facility Number - l50 .�_`-J Division of SaMind ater Conservation
Other AV
y
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: �outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Time: Departure Time:County:D Region:C_Farm Name:JtAkrval
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: 'Title:
Onsite Representative:
Certified Operator:
Phone:
Integrator: 1- /eg
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Wean Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Wet Poultry
Layer
jNqn-La er
Design
Capacity
Current
Pop.
Design
C+attle Capacity
Dairy Cow
Dairy Calf
Dairy Heifer
it
Pop.
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D , P,onitr.
Layers
Design
Ca aci
C►arrant
P,o
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layer
Beef Feeder
Beef Brood Cow
Boars
Qther
Other
Pullets
Turke s
Turkey Poults
Other
Discharges and Stream Imnacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Er No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
E'No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
EErNo
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
12TNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
allo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[ No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facility Number: - Date of Ins ection: Q
G
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes M No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes [ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): - if
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes Jallo
❑ 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]'No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes ,Eno
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes ,ENo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes {�>o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes 25-No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes ETNo
❑ 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.,f'No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes -El-No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes ,[a -No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes _ErVo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes 4�!I'^'o
❑ NA
❑ NE
Reouired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes _4�o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [:]Yes 12-No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes _Ero ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ,ETNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes '13'No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: - Date -of inspection: 3
24. Did.the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes in No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Vj^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 to provide documentation of an actively certified operator in charge? ❑ Yes ZNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ZNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes VrNo ❑ 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:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[:)Yes VVNo ❑ NA ❑ NE
❑ Yes E� No ❑ NA ❑ NE
❑ Yes 21 No ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
No
[%9 No
F2No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #f): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
�- real
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: (/
4/ l4

Type of Visit: _CKompliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: [i', arture Time: County: Region:G��
Owner Email:
Farm Name:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator: / / 7
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current
Wet Poultry Capacity Pap.
La er
Design Current
Cattle Capacity Pop.
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
Design Current
D , P,oul Ca aci P,o P.
Layers
Dai Heifer
Dry Cow
Non -Dairy
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes ff No
❑ NA
❑ NE
Discharge originated at: ❑ Structure " ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes J'No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes ;3No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
[:]Yes E3'No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes 4�fNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters .
[]Yes [EIINo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facili Number: I - 7 Z11 IDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes No
❑ NA
❑ NE
.L—
a. If yes, is waste level into the structural freeboard?
❑ Yes ,0 No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):��^
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes fTNo
❑ 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 fj No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes ;2-No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes L'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 eNo
❑ NA
❑ NE
maintenance or improvement?
Waste ApBlication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes 121'No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes ZrNo
❑ 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 allo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ErNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes 12 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes Er No
❑ NA
❑ NE
18. Is there a tack of properly operating waste application equipment?
❑ Yes 21 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes Z] No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes [2 No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ;2'No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [—]Yes Q,�o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

rIsthe
mber: - Date of inspection:
acility fail to calibrate waste application equipment as required by the permit.YesNo
ility out of compliance with permit conditions related to sludge? If yes, checkes ❑ No
priate box(es) below.
❑ Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32, Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes P No
❑ Yes [;�No
❑ Yes 'P No
❑ Yes ZNO
❑ Yes WfNo
❑ Yes `Fr No
❑NA ONE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
10—
❑ NA__ [Y]NE
O
❑ Yes Ej No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes 9No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as ne ssary).
k5ff !O cd G d
�J
Reviewer/Inspector Name: p go (� . 1 Phone:
Reviewer/Inspector Signature: Z
C� Date: /
Page 3 of 3 /4/2 I

Facthty Numbers
-.4@P'Vivision of Water Quality �F .
Q. Division of;Soil, and Water Conservation,.. > 6 •
'0 Other Agency
IType of Visit JQP1(5o`mpIiance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visi�-�outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Hate of Visit: l rrival Time: 1,4 4-3944wparture Time: County: v Region: LI
Farm Name:/G3 i r.n Owner Email:
Owner Name: _
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Phone:
Title: Phone No:
Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = ° Longitude: °
Design Current Design Current Design Current -
Swine Capacity Population Wet Poultry Capacity Population Cattle , r°CapacityPbpulaf�on
r= ❑ Wean to Finish La er s ❑ Dai Cow ❑
❑ Wean to Feeder ❑Non -La er ' El Dairy Calf
❑ Feeder to Finish A ❑ Da Heifer
❑ Farrow to Wean ❑ Dry Cow
Dry Poultry .: , ❑
❑Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Other
❑ Layers
-.4@P'Vivision of Water Quality �F .
Q. Division of;Soil, and Water Conservation,.. > 6 •
'0 Other Agency
IType of Visit JQP1(5o`mpIiance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visi�-�outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Hate of Visit: l rrival Time: 1,4 4-3944wparture Time: County: v Region: LI
Farm Name:/G3 i r.n Owner Email:
Owner Name: _
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Phone:
Title: Phone No:
Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = ° Longitude: °
Design Current Design Current Design Current -
Swine Capacity Population Wet Poultry Capacity Population Cattle , r°CapacityPbpulaf�on
r= ❑ Wean to Finish La er s ❑ Dai Cow ❑
❑ Wean to Feeder ❑Non -La er ' El Dairy Calf
❑ Feeder to Finish A ❑ Da Heifer
❑ Farrow to Wean ❑ Dry Cow
Dry Poultry .: , ❑
❑Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Other
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Non-Dat
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
�Number:of Stru�
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 1 of 3 12128104 , Continued

Facility Number: j - Date of inspection: Z
Waste Collection& Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �" o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ETNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: „4
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3- -2
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ,;R-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:fNo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes 2. o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes r L;ThTo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures
require ❑ Yes ��o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes �o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes,,E]"'No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure
to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ YesjjNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes 6No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes ,EfrNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes Q'Ro
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ICJ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes EfNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes ,ENo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes E2�No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
0 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 6No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes _ErNo
❑ NA
❑ NE
f
Page 2 of 3 21412011 Continued

Facili Number; L - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ,ETNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes J�TNo ❑ 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
PDid
List structure(s) and date of first survey indicating non-compliance:
d the facility fail to provide documentation of an actively certified operator in charge?
the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Yes
❑ No
❑ NA
❑ NE
ayes
[:]No
❑ NA
❑ NE
'Yes ❑ No ❑ NA ❑ NE
g Yes ❑ No ❑ NA ❑ NE
to Yes
❑ No
❑ NA
❑ NE
Yes
[:]No
❑ NA
❑ NE
Yes
[:]No
❑ NA
❑ NE
Yes
❑ No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use,drawin s of facility to better explain situations use,additional pages as necessa
lr C'/j It C Ako- ks .
' Cd a CerAk l �alob
look's jkoo
Reviewer/Inspector Name:
Reviewer/Inspector Signature: �L t
Page 3 of 3
Phone:
Date: y Z
14120

Type of Visit X Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time:
�ounty: GZiJ Region: D
Farm Name: ., �G f�L� /)'1 C G Owner Email:
Owner Name: A,�/A�.f�
Mailing Address:
Physical Address:
Facility Contact: 4140
Title:
WOnsite Representative: AA
Certified Operator:
Back-up Operator:
- Phone No:
Integrator• Z _1�A _
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = c [ = =dg Longitude: = ° = I 0
Design Current
Swine C•apaclty Population
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Current
Wetfflgultjff,�,Oap�acitPopulation
_❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ TurkeyPoults
❑ 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
❑ DairyHeifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl i
Number of Structures:I ZZ
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes �No ❑ NA ❑ NE
El Yes El No
❑NA
❑NE
El Yes ❑No
❑NA
[I NE
❑ NA
❑ NE
❑ Yes ❑ No
❑ YesZ, o
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
12128104
Continued

�VacilityNumber. % 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?
❑ NA ❑ NE
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: � R" 1/
Spillway?: D A1O
Designed Freeboard (in): 61 I f
Observed Freeboard (in): 26 440
❑ Yes XNO
❑ Yes ❑ No
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes XNo [I NA [I NE
(iel 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 EfNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes �gNo ❑ 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 /eNo []NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ElNA ElNE
maintenance/improvement? !!!
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ZNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 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? ❑ YesZO 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 o ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes [;rNo ❑ NA ❑ NE
Comments (refer to question : Explain any YES answers and/or any recommendations or any other codiments '
Use drawings of facility to better explain situations. (use additional pages as necessary):
�c L�� k �� Co�N.ECTzoti'S Ar z-iave_ eo�r"Ic-�`r�o,�.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone:
Date:
Page 2 of 3 I2128104 Continued

t
Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes XNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes PNo ElNA ElNE
the appropriate box. ❑ WUP ElChecklists ElDesign ElMaps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. VYes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis JZ 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 9No
❑ 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
XNo
❑ 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
[I NA
�NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
X
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
�No
❑ NA
El 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
0 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
V] No
❑ NA
❑ NE
Additional Comments and/or Drawings:
z�) ZA6 �i�9� �15�S .eAJ19 &G 77'14 �s its �•�
Z p pc z[r 46X %VOST W" C'Eo'J7
o) 3,50- ZOO
AL
,01./yi6�dcjr,­z,.► C L
47l
Page 3 of 3 12128104

31 H
Type of Visit t3 Compliance Inspection Operation Review Structure Evaluation Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: WPUZA Region:
Farm Name:
Owner Name: —
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: ,_.i3R_AD ► QLA4 _ integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: = e =' = Longitude: = ° ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
[]Layer
❑ Non -La ei
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
III q
9666
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turke Poults
❑ Other
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cowt
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes LI No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes ENo ❑ NA ❑ NE
❑ Yes ErNo ❑ NA ❑ NE
12128104 Continued

Facility Number: Date of Inspection o�
Y Waste Collection & Treatment �
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ I Yes t" 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: co -" UC Q Z
Spillway?:
Designed Freeboard (in): 19.)
Observed Freeboard (in): 39 y
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ✓j 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 IX0 ❑ 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
2No
❑ 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 El Yes
,�,/
l�No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
{QNo"
❑ 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) CWS
-
13. Soil type(s) I V b A Gd A
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[f "No
❑ NA
❑ NE
15, Does the receiving crop and/or land application site need improvement?
❑ Yes
[2N' o
El NA
El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,❑ Yes
L� No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
Flo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
V No
❑ NA
❑ NE
Comments (refer to question #) Explattt any YES answerstandlor anyrecommendattons,or yother;comments r #��,
Use draK�ngs ©t facility to better explato sifuattons .'(use addtttonal�pages,as necessary}
mot? T_4V7-6Gn ATdL-
U� CfUP J ELL0
r TaNPt E12 TO
rAgam
P&eC.0203,
(S a.Ot C-rt_ rs
sw =te-14 TZ
r�(t,.) CAFo 5s
2er-ati.b
5ys'' .eyr,
Reviewer/Inspector Name ( -5_0IZ0 0_,Phone:tg10) — S
Reviewer/Inspector Signature: Date: L
12128104 Continued

Faci13ty Number:31 — 00 Date of Inspection 05`
'Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes O'No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes EJ No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard El Waste Analysis ❑ Soil Analysis El Waste Transfers El Annual Certification
!r
❑ 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
o
El NA
❑ NE
23,
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
,ON'
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
El NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
ElB Yes
,No
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
t�No
El NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
� No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Cl Yes
LJ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[31 o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[Xo
❑ 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
2No
❑ 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
dNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
0No
❑ NA
❑ NE
12128104

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for ViVisit,..,dRoutine O Complaint Q Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: WEONot
Tune:
O erational O Below Threshold
xP e m ttedC erdfied © Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: ...... .._. .ih`1 ...................... ..._...... •............ ---............... County:........
OwnerName: .... .... ............................. . .... .............. . . . . ................................ . ....... . ........ Phone No: ... ............... _..........................
MailingAddress: .. .... .... ..... . . .. ....................................... . ....... ....... . . .......... . . ....... . ...... .............
Facility, Contact: ............ .......... .................................... ...._............ Title: ... ...................... .......... ...._ .. Phone No:
OnsiteyRepresentative: SiLIntegrator:
Certified Operator: ............... .................... . ............ _ .................. - - Operator Certification.�......-
Location of Farm:
a
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �� �" Longitude �• �' �«
-0 Wean to Feeder
Feeder to Finish
12—
C1 72 zJ .
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Discharges & Stream Impact,
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 than -made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes To
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes o
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ................... Z ....__........................ ............ ... ..... ...................
Freeboard (inches): 1-0 S3
12112103 Continued

Facility Number: 3 Date of Inspection
/e
�. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes /No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or El Yes
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an ?0j"
immediate public health or environmental threat, notify DWQ)7. Do any of the structures need maintenance/improvement? Yes8. Does any part of the waste management system other than waste structures require maintenancelmprovement? ❑ Yes
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes o
elevation markings?
Waste AP-Plication
10. Are there any buffers that need maintenance/improvement?
❑ Yes
No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
o
❑ Excessive Ponding ❑'PAJJN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type C'5 W
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
b) Does the facility need a wettable acre determination?
❑ YesENoo0
c) This facility is pended for a wettable acre determination?
[:]Yes
15. Does the receiving crop need improvement?
❑ Yes
I6. Is there a lack of adequate waste application equipment?
❑ Yes
o
Odor Issues
IT Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes ffNo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there any evidence of wind drift during land application? (i.e_ residue on neighboring vegetation, asphalt, ❑ Yeso
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes No
Air Quality representative immediately.
;Comntents`�{r�'er to gnestron #}-�Expiam,�ny�YLS�answersandlrirFany recomme�atious or any odercommeai5. ,
_Use drarv�ngs of facjli'ty tobetter exgla n srtnaafioa5(useadd�tional,pages as necessary}reld Copy ❑ Fu►al Notes s
1rr AslK R rJ A%-ps is fc-l;t- PpR. 2MV3 WCAS To l56 t°CA7ED
L
tAe W gCq-T F_fU—g LS 064-P-5 W4Z.jC. bo J( u^J t_ow Agf As (AdD la rrCH
o,&c s ctxaaP4zu U Fa-L— FeoeEj Qp.AT90 AGC,
Cotu7 7�0`� EC�j �' °jn�lE G+ t'_rGgTSo r) i2ANSC2 �l� l� �rt�owl
�� �►.J
�, SHEE`t TO 0CAT.
-y,nl&aZ %XG00�
PP�NGS on/
H,
Reviewer/inspector Name
Reviewer/Inspector Signature: Date: 7 6t
12112103 1 Continued

Facility Number: — 6 Date of Inspection 17
f
Rectuired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes o
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facilitynot in compliance with an applicable setback criteria in effect at the time of design? ❑ Yes::Ov,
/No
P Y aPP �
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes wo,
26. Fail to notify regional DWQ of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) ❑ Yes
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes
28. Does facility require a follow-up visit by same agency? ❑ Yes 29_ Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) Yes ❑
31 _ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes N}�
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes [—'rl
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes
34. Did the facility fail to calibrate waste application equipment? ❑ Yes o
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes j No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
12112103

Type of Visit 10 Compliance inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit: Time:
Not O erational Below Threshold
©Permitted ©Certified © Conditionally Certified 13Register d Date Last Operat r Above Threshold:
Farm Name: u County:G�
Owner Name: _ CDT l 1 l(�R Phone No:
Mailing Address:
Facility Contact: 0 Title: Rhone No:
Onsite Representative: �r �`d _ Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
°Desigrt ` ,_Current Design Currtnt Desrgn Cnrrent
:SKme=� -
Ca»acitv:rt Pooulahon. PuiitErv_ Cnoacrty .Pooulstion Cattie = Gaoecrtr `Poiifiishon -`
LJ Wean to Feeder
Feeder to Finish
El Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of i.agoons -�
Holding Poads l Sohd.Traps
N
N
Field Area
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes V No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
trcture I �ructure 2 Structure 3 Structure 4 Structure 5 Structure 6 f
Identifier:
Freeboard (inches): 3
05103101 Continued

R1
,1�0
Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, .
❑ Yes
[� No
seepage, etc.)
/
6. Are there structures on -site which are not properly addressed andlor managed through a waste management or
closure plan?
❑ Yes
No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
VNo
9_ Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
O'No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
[X.No
11. Is there evidenc f over application? ❑ Excess '/l on mg ❑ P ❑ Hydraulic Overload
❑ Yes
XNo
7�
12. Crop type IJ
13. Do the receiving crops differ with those designated in the Certified Aniinal Waste Management Plan (CAWMP)?
❑ Yes
0.No
14. a) Does the facility lack adequate acreage for land application?
El Yes
0 No
b) Does the facility need a wettable acre determination?
❑ Yes
/,V,(No
c) This facility is pended for a wettable acre determination?
❑ Yes
I!J No
15. Does the receiving crop need improvement?
❑ Yes
0No
16. Is there a lack of adequate waste application equipment?
❑ Yes
VNo
Reguired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[�No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
/
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[INo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
Xj
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
y No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
VNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24. Does facility require a follow-up visit by same agency?
❑ Yes
VNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
OfNo
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
Corninents'(refer 1.to gtseshnii #) " Eiplsun'auv YES answers atxdlor any_reeommeridatyons or anv"ather"cmmen#s:
[ise"drawtags of_farility to better eiptaYn sitgat7tons {use addittonaLpage`s as necessary) ❑Final Notes
~Field Copy _�,•
&15:409 IS 7 rO A V, 0
Zr�
v�
Reviewer/Inspector NameAQ
Reviewer/Inspector Signature: Date: 4
05103101
�f
Continued

Facility Number: Date of Inspection 02
Oda- Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads. building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
05103101
❑ Yes ❑ No
❑ Yes X o
❑ Yes �tio
❑ Yes /No
❑ Yes �No
El Yes �\io
❑ Yes ❑ No

of Visit AP -Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit J243outine O Complaint O Follow up O Emergency Notification O Other 1 ❑ Denied Access
Facility NumberDate of Visit:
13 Permitted 0 Certified D Conditionally Certified 0 Registered
Farm Name: ` e mtiG ='ba...................................................
OwnerName:...... Sc o44 ............................................^.............................................................
I) 3D O) Time: 3 2 S
Q Not Operational Q Below Threshold
Date Last Operated or Above Threshold:
County: _Rup
Phone No: _.•... ------ -------
FacilityContact: .............................................................................. Title: ................... ................................... ........ Phone No:...............
MailingAddress: ..................................................................................................................... ..................................................................................... ..................
Onsite Representative:.... . �'t` _ ............................................................ Integrator:... �..... �� �.... ............................... ......
Certified Operator: .................................................................. Operator Certification Number:.......................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse
Design.. . Curz*
Swine- - .Capacify Po ulat
❑ Wean to Feeder
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
Gilts
:'❑Boazs
Latitude • 4 69 Longitude • 4 «
Design Current ; ,. Design Cuirreat
Poultry : Cattle
- CtipacioPo alatiaa
❑ Layer 10 Dairy
❑ Non -Layer I JE1 Non -Dairy
❑ Other -
Total Design Capacity
T©W SSL-W -_
Numhek of Lagoons 2 ❑ Subsurface Drains Present IFElEjoonArea ❑ Spray Field Area
{ " "6ldintPoi3ds1SoUd'Tkaps_.1 10 No Liquid Waste Management System
e
Discharges & Stream I_mpacks
1. Is any discharge observed from any part of the operation? ❑ Yes j2'No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min.)
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? XYes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes )FrNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 9No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ................................................ �........................................ ........... ------- ........... ........ .............................................. ............... ........... ........
Freeboard (inches): -76 �Z
5/00 Continued on back

k
Facility Number: 3 1 — 0 Date of Inspection !1 3p p
5. Are there any immediate threats to the integrity of any of the structures observed? Oe/ trees, severe erosion, ❑ Yes Mo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes �'No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes JdNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes JZNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes JYNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ,!(No
11. Is there evidence of over application? ❑ Excessive Ponding OPAN ❑ Hydraulic Overloads �[ 9Yes ❑ No
12. Crop type , Ger n I (/J So y hr.)eS G ve' geaZc l C� r7a�•
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes `Rf NO
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records &_Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems. noted which cause noncompliance of the Certified AWMP?
�'Vo �iolaiigris:o dgfciepc{ps •wire nq '0 ¢fig this'visit; - Yost wili•;e0iye O i i'ui
correspondence' aloof: this 'visit: - • - • - • - • • - • - . - .
,01Yes ❑ No
❑ Yes ❑ No
❑ Yes ,ENo
❑ Yes.XNo
❑ Yes 'ONO
❑ Yes j2fNo
)ZrYes ❑ No
❑ Yes] No
❑ Yes PrNo
❑ Yes PrNo
❑ Yes ONO
❑ Yes ❑ No
jp"Yes ❑ No
Comments (refer_to question #):-Eapiain any_YE5 answers apdfor any recotninendatians or;any atb�tr eo
_ -
ibse`dra�iims of fa61ity to bettereziilain situations. [rn3e addrhonal owes as necess>3rvl. . e _ _ . �._. - _
Q . W CAS �� �`S Gt,F. rc�G f f ► <• r `�7 ri E' S �'[Gtw !/1 V ,,L,+ 3 Wee
AL
I.v:se W eLr G4efAvr ;; Ire
1''/'��-1 Cle qq ed ant , `mil, e �s-k a+ ;►tiro
q I eswc,� rcq ri cx A o , d r 4 c% sq s� J %'!'? r. W r fC 4 h e d ,`s rV ;4 yr
Z•j, arrccjr-r -/1.�,,4 4-� e -tve cic, %off ;Ipe 4,11r 1niot-�6rgvad +
saV-1rCd'f 4q'''yC}p1c+ure,r ►were -a key,.Z' 4kg4- escue,E AQ
�ie � t � Yl �crf ► yr -� �,e d +' sc Ali q ✓' eo,� ►� dl ���e d r'-} c� a► tom+ d ci �va rt_dtd �7 /��,
rn 1.r rieI�{ qrP 4� be p�rr,feR th4e �'�,e 1�®Ph+ and 0r46 -the VC1d d
s i .r b,—_, d e7,z e b b 7]ee e vnbCr- 3, Z a ?.
Reviewer/Inspector Name r S-re7YIG{,ve �t' r�,r r - 44
_.
Reviewer/Inspector Signature: Date: 1 3 O 01 5/00

ii acility Number: 3 j— 6 �A Date of I uspection3.{l�f�j J
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes XNO
28. Is there any evidence of wind drift during land application'? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes JZNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes �No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ZNO
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes J:2,No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? El Yes ❑ No
Additional -Comments an or; rawtngs:, . y
Ovar,tPr1(,?A TAnJ btJ Z.$ lk/cq re oP� -fru64 1ZZI F7ele(y
a" -}ke zeo ) C,6�oxi Gfe
1qr 7.1e lac; h nee4l a �weAq b le ar feS �e- c✓,�.�.�t- �o . Mende t
�is- dve by DeGem.ba-, 10)Zoo1. A cbL -A.s
-pendedrr'' n o� rece1'Vd,4) lac: j;47 W;11 h^v'e 4e, c,,o,"'p 14C, A
v11 W�2tlAblc �iG o�e�t!✓►-�Iptt-fro'' 1'�G
be based on w e- Bible
q. Need �v 11AVe 2a 01 .Se i 1 4CS 1-4-r-F t
4e hoa 4 } b 0+ i-( iS vlo�- qv�t� la b Ia IV Bed �a
t `s w fn,�-10 U74A �-j� GIYw t7 S's d rt}eA w14k1h 6,6 Ael s or
a kcti-�iart everlIs e-&, Jbe ' ��2�-Z's Zoe' eat cv1,*4;,04ke nu4r)e►s�
ay��ppl ; -,q I o vleed be sv /,e 4a -/, tlee -<o, /es a4 q jeeq ✓ebc'�
I I eve✓'//y',� 1
40 Govdr all apP 1t•G�Ti'��.�VG��►�'S� �t^2Gos r1d�fL�G0e2 ��r4c� I^D&t�
'�� e �C �4 ✓ e q -:mac w ��b oct✓� O�� � 9
the VCIV--1e, sure 4P re Gord, leVets eve „Je i ed G
Z5-.7he wtxee4 ire �' � do
sce� ,"► . �� e waste J a „ Vee G✓ a10 . n7T.
-rra� .�Gtt t�✓�P�� �a be vsed as q green m4-s
S P - r�� R/ j tnlct "
�re Sit y�-,G�>'� r ems,' et I ►'r+ aid ��. A► ehdv"cn�
Ned 4O hoL OVI✓-1CG�2thi cr.c �� VSEd qS /`eGh
e [�,-. WhytG�► ct11 ow_f -ra✓' Lvhca �a be
aV
a,.►.t c ,ram m .Skol,I I d show .P a t Lot, a �C )
C- v fJ a".01 4ke Flap ,SZtoct .au -�o
raG)' Jrf -T re CPrK^ C114 4e 1e+ " 1hP G! a �S 9 PI 1 FBA
^+a- v 14 a'x61
hafvesl^i' You also neeo�4o dedt,cf
C &S-1 ^Avt%J le -r^(7 w-,. {e 1 d�^!'''�`j G!`df •
a pt„rv%er e7VId KVVQt-,A e✓ )Ieed 40 -eiC,n
fig)-��Gfe P WA s e IQn,t� [l

Facility Number 7 rl Date of Visit: l2 3 01 Time: 1 d to
Q Not Operational Q Below Threshold
13 Permitted U Certified
r 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: . -
Farm Name: .........2d t l b l�.... m c c- ..T .t ............ County: .... D U41w%...................................
Owner Name: ............L fl.i... j'''�, Z. q......_................................. .................. Phone No: ..................... ...... »............ ..... ....... ....
__
FacilityContact: ........................ ...................................................... Title:................................................................ Phone No:................................
MailingAddress: ...........................................................................
Onsite Representative:..5.1 . • • l G L�rvt �j.... Integrator: - v'r ..---T...
Certified Operator: ...................... . ........................... ............................................................. Operator Certification Number:............... _ ...
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ' 46 Longitude . 0
_Design , Current_ Design Cuirrent. Design Car
Ciil aci Pa illation Poultry--'-' ,::Ca aci ..,:Po ulation - ,Cattle
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
❑ Boars
❑ Layer I I ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity .=
= - Totw: SLW..
-:Number of_Lagaons =:' ❑ Subsurface Drains Present 110 Lagoon Area . ❑ Spray Field Area
Holding Ponds 1 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. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑-No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I I Structure 2 Structure 3" Structure 4 Structure 5 Structure 6
Identifier: ............................. : ...... .................................... .
Freeboard (inches):
5100 Continued on back

Facility Number: 31 — Tim Date of Inspection ► 2 3 p
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes [:]No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste ADDlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes [INo
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
N•yiQlfi-*'reh0f4rgth;;is; • Yo� will •reitO no furthrR�nr c. ;
corres�o deiice: about: this visit.
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
Coinrnents'(rder to quesfidh #)- Explain: any -YES answers and/or any reeommertdations or any other com ae . - ,
Use dra of faeility,to Ibetter,explai situations (use additional: s n ter;
wing. per._ . _ B)
1'+'tsPeG i o� 1,VA5 dbhe A3 A Irvilo.t4l o 4-0 Il^o 11 11/01
2 - w�s�e 1�as � ee►-, vrn p ed -Arom d f4d, a-,,f / po►lde-d -+k- a"A i-t .'etof
has beer worked'6•--►. fAS Wellarea 4ka� So1ids wPee
beers 4
diyced ve r1 ore.' 4 f6 XdG� d-" 64. IV�d 4,o scoop
N0. t-1Te r^'Lq'8r2ro✓`1 4�� wJ a back roe an4 spread 4 Bn ., zL4
erar Ir>'e Id re" 0f 4o -}: -�� tnea . Need -io plans- -��s�e v►'k d: scee
o% rec, w. �.h,'� 4wo Wge.ksI b� Dec.. I? r Loot.
s
Reviewer/Inspector Name
Reviewer/Inspector Signature: %A.,e� Date: �'�- O i S/pp

Facility Plumber: Date of InspectionI IVY
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ❑ No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ❑ No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
thona omments an or raw'
mgs: -
iR. r4e. me,1,A-%6 hmd 411l,e zaO 1 so; f �es4 feF61" OrvA, 1Ot 61e dv�:-,e,
4A,s - i,,,r�oecA' O " .
Nate: Me'l.a-,D -Acts s; f)ple-A �,"d dajed 4Lle we,Oe plgk,
w

Type of Visit O Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit O Routine Q Complaint O Follow up Q Emergency Notification O Other 0 Denied Access
Facility Number 31 670 Date of Visit: g-13-Z000 Time: 12:00
Q Not Operational O Below Threshold
® Permitted 13 Certified N Conditionally Certified © Registered Date Last Operated or Above Threshold: - -- .. -- .. -- _.
Farm Name: .......---.---........................................ County: A tot._.................................. W190......
Owner Name: Ret21<t.............................. McLu,b.-----.--.---..._..--.......__.-_.--.-- Phone No: 91 -16-M6-........-.._.--.--........_.__...---.-----.
Facility Contact- - -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Title: - -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- - Phone No -- -- -- -- -- -- -- -- -- -- -- -- --
Mailing Address: j364.,rcnny.j.ewjWlj.did................................•
Onsite Representative: Gales Wlje................ ...... ...... Integrator: llZ] =Jjy.Fvmjjy.Fzxm&............................
Certified Operator: GxWoTX B,- -- -- ._ - .. -- hlo;rt$ -- -- -- -- -- -- -- -- -- -- -- -- Operator Certification Number: J AU9 -- -- -- -- -- -- --
Location of Farm:
West of Wallace. On South side of Hwy 41 approx. 0.5 mile West of SR 1100. +
7
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 45 1Z u Longitude 78 0b 42 µ
-Number
`of Lagoons 2 ®Subsurface Drains Present ®Lagoon Area ®Spray Field Area °-
:s
Holding Ponds / So1id4raps ❑ No Liquid Waste Management System _
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation? ❑ Yes N No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) 0 Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes N No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes N No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes N No
Structure 1 Structure-2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .............................................................................................................................
Freeboard (inches): 37 41

5/00
' Facility Number: 31-670 Date of Inspection 9-I3-2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement9
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
Continued on back
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
N No
❑ Yes
N No
11. Is there evidence of over application? ❑ Excessive Pondmg ❑ PAN ❑ Hydraulic Overload ❑ Yes N No
ii
12. Cr6p type Cotton '' Fescue (Graze) Corn, Soybeans, Wheat
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes N No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes N No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ VAR, 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. Di`d 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?
No violations or deficiencies were noted during this visit. You will receive no further
correspondence about this visit.
9. Please put current soil sample report in with records.
Have irrigation system mapped better. Please show effective wetted acres by pulls.
❑ Yes ® No
❑ Yes ® No
❑ Yes N No
❑ Yes N No
® Yes ❑ No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
Outflow pipes on both sites have been repaired due to flow problems. Pits cleaned out. Old carcasses were in pits. Grower
on clean up of lagoons.
Reviewer/Inspector Name ,poi College _ _ - : <.. Entered':byBette Rose
I

IRevizwer/Inspector Signature: Date: 5100 I
Facility Number: 31-55 Date of Inspection 9-13-2000
Odor Issues
26. Do.s the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ® No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
A itional: , omments an or rawm s• - m
mro
NOTE: Please submit OIC designation sheet to DWQ. +
This can be obtained from Murphy or Duplin County Soil & Water.
Please fill out with Scott McLamb as OIC.
r

•
7P,� �" � i _ jV151oII Of Water Qllallty i, �_�� � i �� Yr I5� r. g�.
�` � Q_Dlvlslon of Soil and Water Conservation �. uNK� -' -
s� ' 7 �,Q Utter Agency .-
Type of Visit 9XCompliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit �ZRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit:
0 Permitted 0 Certified 0 Conditionally Certified E3 Registered
Farm Name: ........A�!s.61................ CL...... ........... .,<=.......
................
Owner Name: ..............
ame:.............................................................................
Facility Contact: ..•.4 D............flr..itle
j�HTine: l. ,o U Printed on: 7/21/2000
1 Not Operational O Below Threshold
Date Last Operated or Above Threshold: .........................
Count•:............LP4yJJ.1'1—...—.......
Phone No:
Phone No:
MailingAddress: I-- ................................ ....... ................. I..................... ..........................
Onsite Representative:......-.. �................... ......... Integrator:................. r....................................................
.... .. .
Certified Operator: ................................................... Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude a
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer I 1 10 Dairy
eeder to Finish -7 Z ❑ Non -Layer I JCI Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 1111 Lag -on Area ID Spray Field Area
Holding Ponds / Solid Traps 10 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes PNo
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'' (Il' yes, no fy DWQ) ❑ Yes ❑ No
c. If discharge is observed- what is the estimaled flow in gal/min? W —
d. Dees 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 Wo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes WNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1
Structure 2 Structure 3
Identifier: ................ 34... ......... ..............
Freeboard (inches):
�
rar�L
5100 �(1�
❑ Spillway ❑ Yes (Xio
Structure 4 Structure 5 Structure 6
Continued on back

. Facility Number: Date of Inspection Printed on• 7/21/2000
• 5. Are there any immediate threats to the integrity of any of the structures obse ed. (ie/ trees, severe erosion, ❑ Yes A No
seepage, etc.) \
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ]E�No
7
(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?
Oyes
❑I No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
I No
9. Do any stuctures Iack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes0
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
No
11. Is there evidence of over a plication? ❑ Excessive Po ing ❑ PAN ❑ Hydraulic Overload
El Yes
o
C S
12. Crop type69i I
13, Do the receiving crops differ wih those designated id the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
WNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
�TI0
b) Does the facility need a wettable acre determination?
❑ Yes
o
c) This facility is pended for a wettable acre determination?
❑ Yes
o
15. Does the receiving crop need improvement?
❑ Yes
o
16. Is there a lack of adequate waste application equipment?
❑ Yes
ETN\ o
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
$No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
�TIo
19. Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
I<0
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
�Ilz0
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
Nz�o
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application) ❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes o
24. Does facility require a follow-up visit by same agency? ❑ Yes k�qo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes Wo
:: �'�10 yiglaiigris:o� defcier�cies werr? notes during this:visit. - Yoi} will-t& -ive Y.W.tui-ther
:: cories�anc ence. about this visit . ::::........... I ...... . - .. . :
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):
6 P y ffPO4- S- y wLuA44A— a-A\w6 1\66-- PX`i'('X S
J
k'
S J
back_ o'V ho5
-0�rknam__
' L
a�avx 1 e v rfs havt:t1�. ee N M IA r I_) A &4L Bt4i- lri m,. no _P + R," 4 p, r. yms(.
Reviewer/Inspector Name E� . ((- 4 r/
Reviewer/Inspector Signature: /-, _ „/•jam- a A f d „ Date: 111 a y h-pp'a- 5/00

FaOlity Nutnber. — Date of I11spection 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 aft blow ❑ Yes 1!��
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes CEFRIO
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes A5-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? ❑ YesA5Ah
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 CWNV
31. Do the animals feed storage bins fail to have appropriate cover? ❑ YesA!5M'
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Oyes ❑ No
t_ona -oniments and/or. Drawings:
J
5100

„- sM
r _ i
Cj Division of Soil and WaterConservabon -.Operation Review
•_1-Division of Soil and Water Conservation ;Compliance Inspection Y
_j;Division of Watea r QuaUty Complince Inspection 7
A
D Other Agency.- Operation Review
Routine Q Complaint O Follow-up of DWQ inspection Q Follow -tip of DSWC review () Other
Facility Number 7
Date of Inspection 7 9
Time of Inspection $:SD 24 hr. (hh:mm)
Permitted © Certified © Conditionally Certified 13 Registered [3 Not O erational Date Last Operated .
FarmName: ......... D•O.UI L..... G................................... I......................... County:....-- t ititt...............................................
Owner Name:.......................d.....................5. [.rL? 11�1.......... •.................. Phone No:...�..,?�4. .......... ................................
Facility Contact: .............................................................................. Title:.............. . Phone No:
Mailing Address: ..... L ][a't.........PC�r,� f.t4T... i�.L....................................... ........ }..�1��t-.`....L,.. ... �.. , ......:.
Onsite Representative:................SC 1......�`!.t.s..Lid............................................. Integrator:......' ” (..�N1 ............................................................
Certified Operator:................................................................................................................ Operator Certification rNumber: ..........................................
Location of Farm:
................................................................................................................................................................................................................ _
Latitude �� �� ��� Longitude �• �� ���
Design Current. „--Design. Current. Design Current
Swine . _Ca aci Po ulairon_ �Y:_ _ c.a acit Po elation.... Cattle _ W
ty Poult y ., Capacity Po elation
❑ Wean to Feeder ❑Layer ❑ Dairy
Feeder to Finish Q% ❑ Non -Layer ' ElNon-Dairy
Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity 7qz _
❑ Gilts
❑ Boars :: Total SSLW -
Number of Lagoons- �_. Subsurface Drains Present ❑Lagoon Area Spray Field Area
HoldrngPoirds /Solid Traps ❑ No Liquid Waste Management System
r.�
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: [:]Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min'.
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ( Z
Freeboard(inches): ............ Z-.............. .............. 7e..3............. ............... ........ ......------- ... ................................ ............................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes rwNo
❑ Yes No
❑ Yes No
❑ Yes 1p No
❑ Yes [�No
❑ Yes 'P No
❑ Yes 2 No
Structure 6
❑ Yes ® No
Continued on back
3/23/99

. Facility [camber: 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
CjPNo
(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
5allo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
J No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
j� No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
P No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
Mo
f_
12. Crop type c4t6n ► WInx0.T Pft'cQe_ wazt '_ [OYr/h1 I :s246ja, =
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes
RNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
V3 Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
JS No
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
U No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
*es
09 No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
JU Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
19 No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
P No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
Ayes
No
0; o yi, 'a i6fis or• di fciencies *ere noted• during this;visit: Y;oit wiii-reeeiye iio further ;
... - .......
orrespoiridence. abo' U' f this.visit_ ; ; ;
Comments (refer':to question #): _Explain any. YES answers andi6f-any recoFrimenahon ds or_any r co oiliemments:
_ - _ _
Use drawings.oU&cility to-&tter ex lain`situati©ns use:additional a es as;n,ecessa Ws=
rr i�a�i Uh 5L165�- tp f 6104 Iftcc � i yYiGaT1�0f1 1YA' C ieS S vw�JJ�U toe. i r! �ftt r-w- IYC
lq . K MT SGJJYmt
L 0 f.A bns JJ kod 1� i r, gwl" Vt Cova� . �O ; { - 5 H,W
6 dr 5i�... Ricar�� Lj re.. ytn� �'`E'� 61- �urrsei a�� �tic&K#- FfoYd-
7.5. iAO) La-ams 5kwt� be- krr- bD'R— in Oom a� Oi%PC 4 0�
L
Reviewer/Inspector Name -—
Reviewer/Inspector Signature: Date: f 7 7
3/23/99

Facility�'�lumber: — G%O Date of Inspection �T"
Odor .Issues 7�"
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
itiona , Comments an orDrawings.
3/23199

❑ Division of Soil and Water Conservation ❑ Other Agency
01 Division of Water Quality
ID Routine 0 Complaint 0 Follow-up of Dw2 inspection 0 Fo"ow-up of DSWC review 0 Other
Date of Inspection $ —7 MY
Facility Number
Time of Inspection : D p 24 hr. (hh:mm)
U Registered 1A Certified`` 13 Applied for Permit P1 Permitted E3 Not Operational Date Last Operated:
Farm Name: S(Wh4i`X!f��Z County..bupl!........................................ .......................
Owner Name : ...................... cjalt.................Ar'..",.L ........................................ Phone No:....I.5�.... ...................
Facility Contact:
Title:
Mailing Address:......... Z.11.1........ 5:.....N L...l .,ly....`i.l................
c I
Onsite Representative: ..............:? c W: ► lla...............,.
Certified Operator;
Location of Farm:
............................................... Phone No:......................................
�lli �kCtC...........N................................. ..�a.�P......
Integrator:.......: vif.........................................................
... Operator Certification Number: .........................................
.......Q1........ 5W_1 I........ �. .....�.......1tat ...! .t........ Q ..................
............ ............................................................................
Latitude 0 ` �_ 46 Longitude & 0"
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes No
2. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes U) No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes to No
c. If discharge is observed, what is the estimated flow in gaUmin? N)
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes Qg No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes EB No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes 19 No
l maintenance/improvement?
S. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
1 Did the facility fail to have a certified operator in responsible charge? ❑ Yes ([ No
125/97
i

Facility Number: 3 —6-70
8'
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
® No
Structures (Lagoonsjlolding-Ponds, Flush„ 'its, etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
K3 No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: L...............................Z..........................................................................................................................
..............
......................
.........
Freeboard (ft): ........., ............... 3. L
10.
Is seepage observed from any of the structures?
❑ Yes
0 No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
jg No
12.
Do any of the structures need maintenancelimprovement?
53 Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ............ .....� r.n..............h1LAkA- ........... sajb-, t� ..............................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
[� No
18.
Does the receiving crop need improvement?
❑ Yes
No
19.
Is there a lack of available waste application equipment?
❑ Yes
No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
22.
Does record keeping need improvement?
Yes
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
FNo
24.
Were any additional problems,noted which cause noncompliance of the Certified AWMP?
❑ Yes
0 No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
,® No
0, No.violations-or' dWicieiacies.were noted-diuci_ng this:visit:� You.witl ireceive,iro-further
correspondence about -this; visit::
It. a m4iov, Sr.m, e f l TC, AZ, fO eKsui-- no ;P K4,- A+ -a s e-
pCC 1X3 . (1 i Jjjj
2 �. Ce�r Fi CA or• "�� ^ - S U� sLv t!f J �e ti1 i - •,, r�CoYtk . 111110D},_ co gl� ; r.tt�.
t dwY i p fin.- 4w 6e off �L �uvr� records. 0i4.1 +Tn� �fJ wl. a+ �(
uvet 49 s" be- v5e� to c4owlafr. t1j 61-611ce onZ-
7125/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: �n,_� /_ - A J Date:

.........
7.777777
®Division of Soil and Water Conservation, ❑ Other Agency
.❑Division of Water Quality
Longitude 78 '.F 06 42 u
Routine 0 Com taint 0 Follow-u of DWQ inspection 0 Follow-u of DSWC review 0 Other
E:
Date of Inspection 11/17/97
y Number 31 670Time of Inspection 100024 hr. (hh:mm)E:,el
[3 Registered E Certified ® Applied for Permit 0 Permitted JE3 Not Opera Date Last Operated:
Farm Name: Sty xe12 � r . ,tx� ]�t.#I..s% E ................................................................... . ..... County: Ruplin................................................IRQ.........
Owner Name:.. ..............................._................. B,.B .&.�..Ir . .......................................... Phone No: 9.10.-.285r2129 ................................................
Facility Contact: &t$xpI.Hrj:11ax............................................... Title: DivJlRl:.......
Phone No:
MailingAddress: P .Box.5SQ............................................................................................ W.allarc.BC .......................................................... 184.66 .............
Onsite Representative:. GggNords..................... g wT y... y.. . ............................................................... Integrator: M 11 anvil I'ar=...........................
Certified Operator: Grtgon.L........................... No[rigs....................................... ......... Operator Certification Number: .18.1Z0 .............................
Location of Farm:
Latitude F 34 " F 45 12
❑ Wean to Feeder
® Feeder to Finish
9792
7000
[]Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
2. Is any discharge observed from any part of the operation? ❑ Yes Cg No
Discharge originated at: ❑ Lagoon [I 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 d No
c. If discharge is observed, what is the estimated flow in gaUrnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) © Yes © No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes 0 No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes H No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes 0 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 0 No
7/25/97

Facility Number: 31-670
8. Are thereslagoons or storage ponds on site which need to be properly closed?
Structures (Lap-oans Holdine Ponds, Flush Pits, etch
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4
[ate►:��
❑ Yes N No
Structure 5 Structure 6
Identifier:
Freeboard (fl):...............................................t6.............
10. Is seepage observed from any of the structures? ❑ Yes N 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 iii excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ........................ N=Q........................ ......................................................................... ... ....... ....................................
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?
rl'-No.violatibas:or'deitciegdes-Waetioted'duri>ng 4is-Visit.'Wd Will'reecfve-upfarther•' -
::corresnonde... about this:visit:: -
❑ Yes
N No
❑ Yes
® No
[:]Yes
® No
N Yes
❑ No
❑ Yes No
❑ Yes ® No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
N Yes ❑ No
1011®Dnlm
❑ Yes N No
❑ Yes N No
DR done with Mr. Norris.
14 & 24) Need to use WIN recommendations on records to be sure not to over apply N on fields. Has over applied by about 251bs on
Few fields. Was using soil recommendations instead of WUP. Need to also use the ERR- I for the pulls and an IRR-2 for the field or an
[RR-2 for each pull to show what is being wetted on the fields.
to have Murphy of Duplin S WCD fill out odor, insect, and mortality checklists.
7/25/97
Reviewer/Inspector Name `vhri tzg�Eald YeFilEon t q
Reviewer/Inspector Signature: Date:

Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection
Facility Number E
Time of Inspection Q 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm:Status- ❑ Registered ❑ Applied for Permit (ex:1.25 for I. hr 15 min)) Spent on Review 0
JRCertified ❑ Permitted or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated:.... _.... _ .... _..
Farm Name: 5..sGr ti. -� �..��......_ County:....t"a,. �t ... �...........1c.11..i..�i..a .
Land Owner Name- �.._. ... .... �i , .... � K] L.._ ....._....._. ....... Phone No: t a L.Q.. 5 � ....
Facility Conctact:.... .,c+l�t. Title: Phone No:
Mailing Address: �.....p .Q ... 9�L ... S.5-Q...... ......... ...... ......... .._..... ...-......
. .�....��. � f. [�.��..._ ....__......... -�. i�.l?�....
t
Onsite Representative:. , _ a Y: .� ..,�_ s :.."� �[.�a, I. Integrator: i,i.sc _........_.. _ .
�J
Certified Operator:. (�.Xi ., l. ,, ......1 �xuL..................................... Operator Certification Number:. .
Location of Farm:
... p.. F•f-....t► ��p..l�.i�l
w�. �z.: .! x.. tu.xt ...� R:!.1 .2 .:....... 1..... .... _.... ....__..... _.... ..................... �
Latitude Longitude ®• ©° «
Type of Operation and Design Capacity
Swide R
�Des�gn Current" ,Design `Current Des gn C P eat
r
sci `'Po ul`a"tion ; Poultry avaelt Po s lateon� Cattle �Ca aci ` Po lahan
❑Wean to Feeder❑ I❑ Da'
® Feeder to Finish S147, ❑ Non -Layer ❑Non Da
Farrow to WeanZ _—MRS, aq
r.
Farrow to Feeder k Total RDe ign Capacityr IT,FIMM "� x
Farrow to Finish
w_ . , w.w � a SLW l ZO
To S °l
❑ Other`: ' .' sue- �, � � s
�Numlieaf Lagoons 1 Holdu►g Ponds= (Subsurface Drains Present
Lag Area Are -
Y goon ❑Spray Field a
e a al
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gailmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
❑ Yes ® No
❑ Yes ® No
❑ Yes No
❑ Yes No
❑ Yes
® No
❑ Yes
No
❑ Yes
No
® Yes
❑ No
Continued
on back

6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes RNo
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 (1,agoons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): 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 942 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 Anulication
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
❑ Yes B No
❑ Yes [R No
❑ Yes 19 No
Structure 5 Structure 6
15. Crop type ..... ......... ........... ... _r....... ................. ............. ...... .......... ....... _.... ........ ............ .................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
For -Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes ®, No
❑ Yes No
❑ Yes No
❑ Yes 0 No
❑ Yes MNo
❑ Yes 0 No
® Yes ❑ No
❑ Yes 19 No
❑ Yes ®.No
❑ Yes ® No
❑ Yes 19 No
❑ Yes KNo
® Yes ❑ No
F9 Yes ❑ No
Comments `(iefer to`giresttou # Ezplam any YES"answers andlor any rec`ommendarions'or any other comments:
Use:drarv2ngs of facihty to better expiaan situations:. use additional as necessary) ;E
z pages y
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bf v1- a IT
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d-� �4.�,.✓�.u.r
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Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
cc: Division of Water Oualitu Water Oualkv Section. Facility Asses ent Unit 4/30197

Facility Number:, .. — Date of Inspection:
>Addiuonal Coinu ents and/ "Drawings
�1
L a T T h t> L U..-�„ � �j V l U v -4N O-+ti ( a 6 Le- f-p V— ,� Q� 1 � S •0 v L-,CL
v" l tv�- a{, P gym-,., s >4 v d i l.e - `4-0
i ri 1 & P, r caw• a v a. e N n.�.. {=,ro v- -e: c v-c
q P .
V �
w ¢
,(�"��'�]
T'�- I p
,4/30/97

Cj
Site Requires immediate Attenn n: —
Facility No_
DiVVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD 31-4o 70
DATE: , 1995
Time:
Farm Name/Owner:
Mailing Address: A.
County: -
Integrator: Phone. —
On Site Representative: Phone�C�
Physical Address/Location:
Type of Operation: Swine Poultry , Cattle
Design Capacity: `-#t_), GJ l_ Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude 3 4 Longitude: T'E� ° Ob %M & Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon hav Sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Ye or No Actual Freeboard: (9+ Ft_ Inches
Was any seepage observed from the lagoon(s)? Yes or V)Was any erosion observed? Yes or §
Is adequate land available for spray? es or No Is the cover crop adequate? Yes or No
n
Crop(s) being utilized:
Does the facility meet SCS mini
setback criteria? 200 Feet from Dwellinas? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated. within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state -by man-made ditch, flushing system, or other
similar man -arcade devices? Yes o No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments:
Inspector Name Signatur
cc: Facility Assessment Unit Use Attachments if Needed.