310757_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qua

7
Type of Visit: EMompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: — / Arrival Time: ' D Departure Time: County: rL.
Farm Name: Owner Email:
Owner Name: ���� �Q, L� t��5 Gam_ Phone:
Mailing Address:
Physical Address:
Facility Contact: (-Xi y Jam" f �/ n� Title:
w.
Onsite Representative: r�
Certified Operator: C:::r2"24%e,
Back-up Operator:
Region:
Phone: /
Integrator:
Certification Number: /v-P
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design
Cattle Capacity
DairyCow
C*urrent
Pop.
Wean to Feeder
Feeder to Finish
Non -La er
Design
Current
DairyEEI Calf
DairyHeifer
D Cow
Farrow to Wean
Farrow to Feeder
D . P,oult ,
Ca aci
to ,
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Boars
Non -Layers
Beef Feeder
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?
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 JE3-No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
,®.No
❑ NA
❑ NE
❑ Yes
EQ-No
❑ NA
❑ NE
Page I of 3 21412015 Continued

' Facility Number: ,3 j - 1 Date of Inspection:
"
Waste Collection & Treatment
�4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
EANo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ,
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[:]Yes
2—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
Q( No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]Yes
® No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[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?
❑ Yes
Jallo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
21 Yes
o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Cj�,No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Q No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[q No
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
0 No
❑ 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
[E No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
;2 No
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

Facili Number: M- Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E[ No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes RNo ❑ 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
UE�No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
gg-No
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
®. No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
M No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[0 No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EK No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[&No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
® No
❑ NA
❑ NE
Comments. refer to .. uestion : E 1 ' ( q €�• gP ain any YES.answers andlor�any addrtEonalai:ecommendations or any other comments
Use drawings of facility to better explain -situations. (use�addit onal`pages'as uecessary):�"
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Phone: %/1t3y D'/SJ
Date:
2141201 S
Page 3 of 3

Type of Visit: Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: Qifoutine 0 Complaint 0 Follow-up Q Referral O Emergency O Other O Denied Access
Date of Visit: 2 Arrival Time: eparture Time: County: U,(�i� Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: Certified Operator:
Operator:
Back-up Operator:
Location of Farm:
Phone:
Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Design
Swine Capacity
Wean to Finish
Current
Pop.
Wet Poultry
Layer
Design Current
Capacity Pop.
I
Design
Cat#le Capacity
Dairy Cow
Current
Pop,
Wean to Feeder
Nan -La er
I
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D , $oultr
Layers
mWeMgn Current
C*_a aci P,o
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turke Poults
Other
Dischar es and Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes ff No ❑ NA ❑ NE
❑ Yes
,fNo
❑ NA
❑ NE
❑ Yes
[EI'No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ,ff No
❑ Yes "No
ElYes n
No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412014 Continued

[Facility Number: jDate of Inspection: Z-
Waste Collection & Treatment
4. Is sfofage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes RfNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes �o ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ,❑' 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 ETNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes Z No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes EjNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes [--'I.No
❑ NA
❑ NE
maintenance or improvement?
T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes _E No
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes P Ko
❑ 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 ,[�TNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes `ff No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes allo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? - ❑ Yes _2-No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes EJ-No ❑ NA ❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes 12'No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ,[�!r_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 4�fNo ❑ 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 gNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [::j No ❑ NA ❑ NE
I
Page 2 of 3 21412015 Continued

Facility Number: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 1' No
35. Is the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes PNo
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:
❑ NA ❑ NE
❑ NA ❑ NE
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes _0 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes P No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes p No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes ;2 No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes Z No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 0 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 01No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes �No ❑ NA ❑ NE
Comments (refer to question #) Explain any YES answers and/or any'additional'rec©mmendations or any other comments. .
Use drawings -of facility to better explain situations (use additional pages as necessary). -
3 F-7//f- I.q'151
1.2- All V /' , Tr
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ?1��'9 32-.3
Date:
21412014

type of visit: jet_:omptiance inspection V operation xeview V structure r.vamanon V i ecnmcai assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ® Arrival Time: Departure Time: JJ+� 1V1 County: //Lc
Farm Name: &.4a okmJ+ Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone:
Onsite Representative:
Certified Operator: '�Oy`z sr.
40
Back-up Operator:
Location of Farm:
Latitude:
Region: Wl
Integrator: ((�� Certification Number: "lg� l L4 0
Certification Number:
Longitude:
Design
Swine Capacity
Wean to Finish
Current
Pop.
Design Current
Wet Poultry Capacity Pop.
Layer
Design Current
Cattle Capacity Pop.
iry Cow
Wean to Feeder
I INon-Layer
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D . $oul Ca aci_ P,o
ILavers
Non -La ers
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes KNo ❑'NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No . ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 0No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes Vo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑Yes a" ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yeses❑No ❑ NA D NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: i.1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes PeNo ❑ 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 gNo ❑ 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 J?f No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes VfNo ❑ 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 yj No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes VNo ❑ 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?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
pfNo
❑ NA
❑ NE
❑ Yes
ZNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
�No
I No
/f/
❑ NA
❑ NE
❑ Yes kTNo ❑ NA ❑ NE
❑ Yes PI —No ❑ NA ❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes j'No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 6No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [2,f4o
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: - r7 syl Date of Inspection: -
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes En -No
25. is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes Z No
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 ZrNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �o
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 file drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWW?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ZfNo ❑ NA ❑ NE
❑ Yes P No ❑ NA [] NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
[j!rNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑Yes
No
❑NA
❑NE
❑ Yes
C,3No
❑ NA
❑ NE
Reviewer/Inspector Signature: _ L Date: ` _15J _&_
Page 3 of 3 21412014

Date of Visit: 4=1
Arrival Time:L! Departure Time: County: Region:
Farm Name: Ake.,14i.!15ein &Cnn Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Title:
Phone:
Integrator:
Phone:
Certified Operator: l T�� pQi►^ �`� !� f �il'• Certification Number:�
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
DCurrent
Swine Cpac aity Pop.
Wean to Finish
Design Curre
ntesign
Wet Poultry Capacity Pop.
I iLayer
EEI
Design
Cattle Capacity
Dairy Cow
Current
Pop.
Wean to Feeder
I INon-Layer
I
Dairy Calf
Feeder to Finish
LEiaDairy
Heifer
D Cow
Farrow to Wean
Design C«urgent
Farrow to Feeder
Farrow to Finish
D , P,oultr. Ca act PZo ,
Layers
Non -Layers
Non -Dairy
Beef Stocker
Gilts
Beef Feeder
Boars
Pullets
Cow
Other
Other
I IOther
Turke s
Turke Poults
LLL"Beefod
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes V] No ❑ NA ❑ NE
❑ Yes II_J No
[:]Yes 4No
❑ Yes No
❑ Yes No
[]Yes e No
❑ NA [] NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facili Number: - Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ;�rNa ❑ 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): IC15
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? [:]Yes VfNo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes VfNo ❑ 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 ZrNo ❑ 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 P�r-No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes f6'No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ;Z"INo ❑ 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 X No ❑ NA 0 NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yesr�o
o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? [—]Yes P�fNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA
❑ NERequired
Records & Documents;2rNo
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes ;fT No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes JfrNo
❑ 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 ;2rNo
❑ 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 ZNo
❑ NA
0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes ZNo
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

r
Faciti Number: 051 - r7 JDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes XNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes [KNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes H'No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ,fNo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?.
❑ Yes ZNo ❑ 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 ,EfNo ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes �No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes P No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes v, No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes P No ❑ NA ❑ NE
Comments (refer, to question, #):, Explain., any YES answers and/or any :additional recommendations or any. other comments..,
Use drawings of facility to better explain situations (use additional pages as necessary).
P Vora -1-S 1�0y*10:
&A�Salv
Reviewer/Inspector Name: �M�n�
r. 1 \ _ — %_
Reviewer/Inspector Signature:
Page 3 of 3
Phone: -,.&
r ,
Date: a
21412011

Type of Visit: J& Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: � Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I LiI--1�--iF�'r —' Arrrriival Time: Departure Time:© County: Region:
Farm Name: (23L5&A/ Owner Email:
qb_'r)85-&QL00 w
Owner Name: ����-�� �. VC-S G%V Phone:
Mailing Address: C l& J 1, l_4wy"I '+ CH/:YJQA P I N z Nc o` a 3.1
Physical Address:
Facility Contact: Title:
Onsite Representative: 6,C5 lb�
Certified Operator: GrcQq_CS'G_ /Q )V I C_C_ V L56N. Sq—.
Back-up Operator:
Location of Farm:
Latitude:
Phone:
[nte rotor:
1 Q 12J
Certification Number:
Certification Number:
Longitude:
Design C>urrent Design C►urr—en t
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle
11
Wean to Finish Layer Dai Cow
Design LCurrent
C►opacity P.
Wean to Feeder
Non -Layer
Dai Calf
Feeder to Finish aG
Dai Heifer
Farrow to Wean
Design Current Dry Cow
Farrow to Feeder
Farrow to Finish
D, P,oultr, Ca aci P,o Non -Dairy
Layers Beef Stocker
Gilts
Non -Layers
Pullets
keys
urkey Poults
Other
Beef Feeder
Boars
Beef Brood Cow
Othe
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? [:]Yes O�No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes [—]No ❑ NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes 1� No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes PLNo ❑ NA ❑ NE
of the State other than from a discharge?
Page l of 3 21412011 Continued

Facility Number: j - Date of Inspection: t<
j
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: GAS
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
TT
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
jNo
ll
❑ NA
❑ NE
waste management or closure plan?��""��'''
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 06 No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes �No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �x�
13. Soil Type(s): i—p(1L� OTC (
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes]
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
® No
❑ NA
❑ NE
acres determination?
T�
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
tNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists Q Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
Waste Application Q Weekly Freeboard El Waste Analysis [3 Soil Analysis ❑ Waste Trans ers 0 Weather Code
Q Rainfall ❑ Stocking 0 Crop Yield 0120 Minute Inspections Q Monthly and 1" Rainfall Inspections Q Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes y No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 ✓✓✓���� 21412011 Continued

Facili Number: - Date of Inspection: y
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes ' No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
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
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes
❑ Yes
❑ Yes
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Comments (refer to question ft Explain any YES answers andfor any additional recommendations or any other comments:.: e yM
Use drawings of facility to better explain situations (use additional pages as necessary). as
a.sco
�1�g11� l.y
s1j31�� a.d
Reviewer/Inspector Name: / lq 4 w csS Phone: q 16 —_4 9 to 3 d�
Reviewer/Inspector Signature: - - Date:
Page 3 of 3 21412011

Type of Visit: Acompliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: �&Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: j y // Arrival Time: I Departure Time: County: Region:
Farm Name: %c �� Owner Email: �—
Owner Name: I qp _� g5rg QUo CG
�FQ���{�N EL L_JC�SEi� Phone:
Mailing Address: AP S -1 s /Yc HwA Ll ! L—ti16g(.4og(P1x, &C DRSQ )
Physical Address:
Facility Contact: Title:
Onsite Representative: -Te CLA, j'\OCAS + LVL,( Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
r
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dai Cow
01
Wean to Feeder
lot
Layer
Dairy Calf
ENIFeeder
to Finish
D , P.
ILayers
Design
C_a acity
Current
P.o .
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D Cow
Non-Dai
113eef Stocker
Gilts
Non -Layers
Pullets
I Beef Feeder
Boars
I
I Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes �No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facoity Nutpber: - Date of Inspection: S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LQ QCW
Spillway?: n
Designed Freeboard (in):�
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 1;4 No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA [:3NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �q 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 Cro(p� Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): SG
13. Soil Type(s): 1�U t2 CS 1 Cy
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes lNo
No ❑ NA ❑ NE
❑ YesNo ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes No
D Yes gNo
❑ Yes No
❑ Yes No
QWUP ❑Checklists ❑ Design Q Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes X No
Q Waste Application [] Weekly Freeboard ❑ Waste Analysis Q Soil Analysis ❑ Waste Transfers
Q Rainfall ❑ Stocking ❑ Crop Yield Q 120 Minute Inspections [] Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes tNo
o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[3 NA ❑ NE
❑NA ❑NE
[] Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facoity Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ 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?
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 Reviewerlinspector 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
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
Na
❑ NA
❑ NE
lComments{refer to question #f): Explain any YES answers and/or any additionalrecommendations or any other comM
Us,e drawings of facility to better explain situations (use additional pages as necessary).' w N.
QATIOIV 1�>c/lc— o`.O1 QC
a�
G GAS QI- -T L43Y
Gy_p ;) to w- 01C_ A�r� v�
5 j p�Q i IA( GgGDj/ 6 5-Vo7-S ?ggou4jy0 o4600A/
Reviewer/inspector Name: m,4%y oA L'7P uvC S Phone: 91 V ---i! (J - 330
Reviewer/Inspector Signature: Date: C;fV`'7
hl
Page 3 of 3 21412011

Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: q Arrival Time: r� Departure Time: County: LI /V Region:
Farm Name: L]l(� .tCl� ncse S/ t� , �-_in Owner Email:
Owner Name: Geca'6E Irr_C d(� �/ Phone: 9 G a& -0V3 Cc)
Mailing Address: 0�,Si S AC G 1-4 `/ / CMIA�'' 4A �l_N Ne
Physical Address:
Facility Contact:
Title: Phone No:
Onsite Representative: �dZ C� �Ac y xs ice/
Certified Operator: CTC—CZG%C— �\i4NIC—L OLSE V , . R.
Back-up Operator:
Location of Farm:
Integrat'�orr:
Operator cercation Number: 9 11, 5.yn
Back-up Certification Number:
Latitude: = 0 0 Longitude: = o =' =
Design Current
Design
Curren#
Design
Current
Swine C►opacity Population Wet Poultry
Capacity
Population
Cattle Capacity
Population
❑ Wean to Finish][:]Layer
❑ DairyCow
❑ Wean to Feeder ❑ Non -Layer
❑ DairyCalf
Feeder to Finish Oa
❑ DairyHeifer
LJ Farrow to Wean Dry Ponitry
❑ Dry Cow
❑ Farrow to Feeder
ElNon-Dairy
❑ Farrow to Finish ❑ ers
El Beef Stocker
N
❑ Gilts ❑Non -La ers
El Beef Feeder
❑ Boars El Pullets
❑ Beef Brood Co
❑ Turkeys
Other ❑ Turke Poults
❑ Other I
dumber of Structures:
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes )XNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
_J�No
❑ NA
❑ NE
12128104 Continued

` Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: 4_460o'%j
Spillway?:
Designed Freeboard (in): 9. 5
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes ANO
❑ Yes ❑lNo
Structure 5
El NA El NE
❑ NA ❑ NE
Structure 6
❑ Yes �No
ElNA ❑ NE
ElYes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes Z No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? []Yes 4No ❑ NA ❑ NE
(Not applicable to roofed pits, drystacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ,] No ❑ NA ❑ NE
maintenance or improvement? \
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No El NA El NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below.
ElYe
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 El Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) C,
:
13. Soil type(s) (=C�-q'esTaN _ C1UL-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?
ElYes
No [I NA El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No ❑ NA El NE
17. Does the facility lack adequate acreage for land application?
El
No El NA [I NE
18. Is there a lack of properly operating waste application equipment?
El Yes
No ❑ NA ❑ NE
`.%: µ . ::'... - a"'m..."z�ea `R'QLe"k .M+s:2.a p"i "?Y W 1£ p Ni. ^' k ^".=i@ M. R+ S..W�.yWP` _
Comments (refer tb question.#): Explain any YES answers and/or any recommendations or any other comments;
Vse•drawtngs-of facility to,better, explain situations (use addrtional pages as necessary):
w
• ; o �cae. OAr C—� j0,A/ o� D I 1 wA L�
��c.�11� 1• �
09 ). s
Reviewer/Inspector Name I- f-1mAyinA Phone:
Reviewer/Inspector Signature:Date:
Page 2 of 3 12128104 Continued

Facility Number: ( Date of Inspection �d
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 AN. ❑ NA ❑ NE
the appropriate box. 0 WUp ❑ Checklists
0 Design 0 Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes X No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis [] Soil Analysis ❑ /aste Transfers ❑ tYnual Certification
0 Rainfall ❑ Stocking ❑ Crop Yield El 120 Minute Inspections El Monthly and I" Rain Inspections 0 Weather Cade
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 14No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P(No ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes $No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes Im No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes ANo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes ❑ No
NNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes JXNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes ANo
❑ 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 ANo
❑ 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 6o
❑ NA
❑ NE
General Permit? (ief discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑Yes kNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes _-Z.Lo
❑ NA
❑ NE
12128104

Type of Visit A Compliance inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit (Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ® Arrival Time: 15Departure Time: � County: L-I N Region:
Farm Name: _ ��� O-s L_/V r--A a-m Owner Email:
910- S- atzoC�u}
Owner Name: C� r GSZC� AN I rc �C_ ISE.i1! Phone:
Mailing Address: 9 S N �'- ��`�`'� �, r C W EiAl C_ 1
Physical Address:
Facility Contact: Title:
Onsite Representative: G 1�1V
Certified Operator:
Bach -up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: [= o = I = [I Longitude: = ° = 6 = ,,
Swine
Design
@apacity
Current Design Current
PopLlation Wet PoultrJ C•apacityr Population
Design
Cattle Capacity
Current
Population
ean to Finish
❑ Layer
❑Dai Cow
Wean to Feeder
Rw
Feeder to Finish
❑ Farrow to Wean
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
❑Dai Calf
❑Dai Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Beef Stocker
Gilts
8 Boars
❑ Beef Feeder
❑ Beef Brood Co
Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
Is any discharge observed from any part of the operation? ❑ Yes XNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
❑ Yes ❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes ❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes ❑ No
❑ NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
❑ Yes ANo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes )�No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

.. L
Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes *No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA
❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: L"C cw
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes gNo
ElNA
ClNE
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 XNo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes �No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
\
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes kNo
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes K'No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable (Crop Wind/ow ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) '
13. Soil type(s) _63ef—g� OTi C��C. iJSgC3�
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. floes 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 ElNA [INE
17, Does the facility lack adequate acreage for land application? [IYesi
No El NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑Yes [INA [INE
�Com� nts�{refer touest<o`nZ#) �E�platna y`YES�an e�a �o any�recommendatious'orfany outer comments... -
a .� -ti.,:.:,,
Use drawings'of4factltty to better explamsttuatEons (use additEonalpages as`necessary) ;
AL
goo)
IIIGHICZ
5/131oq
ReviewertInspector Name MANg /1f _ S Phone: 216- _73
Reviewerfinspector Signature: Date: `7
Page 2 of 3 12.128104 Continued

Facility Number: Date of Inspectiong1
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes >�o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes XNo ❑ NA ❑ NE
the appropirate box. 0 WUP ❑ Checklists
0 Design 0 Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes JNo ❑ NA ❑ NE
[] Waste Application 0 Weekly Freeboard ❑ Waste Analysis [] Soil Analysis ❑ I/aste Transfers ❑ YGual Certification
0 Rainfall El Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections El Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
O�No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
>No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
N(No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
XNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
KNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
V NA
❑ NE
Other lssues
29.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
9No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
ElNA
ElNE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
-<No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
VNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
JKNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
A -A 4(- SI s TAKEN SSTwe�v 5)OR �1 tiros �
a � 'da �s o IC A�7,u,E
_W E 6X E ems/W) ON C aGA( DI K'IL wP U- --
X�C�I frXED Sl hC;+E LA5r _ �"L► V„
Page 3 of 3 12128104

i
f - Division of Water Quality iF h
Facility Number S O Division of Soil and Water Conservation F
--- -
_0 Other'Agency'
Type of Visit R Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit ARoutine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: a Arrival Time: !d Departure Time: County: C-1 AlRegion:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: I Title:
Onsite Representative: i LL e)�xS I
Certified Operator: (LQ ram- f I& L S Owl R
Back-up Operator:
Location of Farm:
Phone:
Phone No:
Integrator:
Operator Certification Number: �1 S► `� O
Back-up Certification Number:
Latitude: =o =d Longitude: 00=,
Design. e DesiCurrent Design Current Dsign Currents
Swine ..- Capacity Population Wet Poultry - Capacity. Population Cattle Capacity, Population
Wean to Finish
❑ Layer
Wean to Feeder
❑ Non -Layer
Feeder to Finish
Farrow to Wean
Dry Poultry
LJ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
z., ❑ Boars
Other
_ ❑Other
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number; of Structures: 'z
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes XNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
*o
•• 11XNo
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
12128104 Continued

Faellity 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: LL4C'Z ?j
Spillway?:
Designed Freeboard (in): 11.5
Observed Freeboard (in): 3
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 kNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes X No ❑ NA ❑ NE
❑ Yes [5�No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ht' No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes EfNo ❑ 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 {CI No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes „o No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes KNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 1 O lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Z 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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes jNo ❑NA ❑NE
❑Yeso ❑NA El NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other- comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
6e-r copc�S O F V,LA T -- ?I-xl w j 4u-ccN"5
i. A-l-CH 4 �_ I TT`+E- r_tjz�,s t (SA/ ON / AcSl De Q F
/Ifsliter -roc ; i- A C� �> f C-AR_•A_ r_.fL wl u- GuCi w l4 N P R J
Reviewer/Inspector Name m NC)C C S Phone: 9)(f) D-�3�
Reviewer/Inspector Signature: Date: 15/ 1%'R_
Page 2 of 3 12128104 Continued

Facility Number: 3 1 — Date of Inspection
Required Records_& Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [�No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes KNo ❑ NA ❑ NE
the appropriate box. ❑ W­Up ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes gNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes k No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 19 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E<No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes of No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes KNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No ❑ NA INE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
ElNE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
4 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
�No
[I NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
11
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
I�No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
fiTNo
❑ NA
❑ NE
Additionai Comments and/or Drawings:
Page 3 of 3 12128104

Facility Numi er-.
j
Division of Water Quality g
Division of Soil and Water Conservation
O Other Agency
Type of Visit (9Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine Q Complaint O Follow up O Referral Q Emergency Q Other ❑ Denied Access
X-/�i�GZ >�
Date of Visit: Z Arrival Time: �e: /�� Departure Time: Z�� Co nty: / Region:
Farm Name: ,/ Owner Email:
Owner Name: �f�0.��3(�/� e"/GSF�� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:LG L/S
Certified Operator: 6Z22�G,�—
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
�_ ❑ Wean to Feeder
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Other.
❑ Other
No:
Integrator: / ' L—
Operator Certification Number:
Back-up Certification Number:
Latitude: [—] o =] Longitude: E� ° = =
;n- Current Design Current; Des'igni Current:
i tyPo ulation Wet Poultry Capacity tyPopulation Cattle Capacity opulati on.
P
La er Non -La er
-
Dry Poultry
❑ La ers
❑ Non -Layers
j
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharaes & 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?
❑
Daia Cow
❑
Daia Calf
❑
Daia Heifer
❑
Dry Cow
❑
Non-Dai
❑
Beef Stocker
❑
Beef Feeder
❑Bee
fBrood C
0
Number of Structures::
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes 1No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ No
❑ Yes
)9No
El NA
❑ NE
El Yes
VNo
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: .0—/
Spillway?: o
Designed Freeboard (in):
Observed Freeboard (in): t3
5. Are there any immediate threats to the integrity of any of the structures observed?
(iel 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 ZNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes
No
❑ NA
❑ NE
❑ Yes
10
XNo
❑ 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? El Yes P N" o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes V(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 P
No ElNA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes 9No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes & El NA El NE
El Excessive Ponding El Hydraulic Overload ❑ Frozen Ground El 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 ofxkrea
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those"designated in the CAWMP?
❑ Yes 0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ONo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes 9 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes9No
El NA
[I NE
18. Is there a lack of properly operating waste application equipment?
El Yes" dNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name �;� Phone: lj `1v
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes #No ❑ NA ❑ NE
the appropriate box.
El El Checklists El Design El Maps El Other XNo
❑ El21. Does record keeping need improvement? If yes, check the appropriate box below. ElYes NA NE
ElWaste Application ElWeekly Freeboard ElWaste Analysis ElSoil Analysis ElWaste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
9No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
VNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ONo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P(No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
ONE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
ElYes
ld No
ElNA
ElNE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
PNo
❑ 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
,_,/
LdNo
El NA
El 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
El NA
El NE
General Permit? (ie/ discharge, freeboard problems, over application)
/
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
JZ(No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
JZ(No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104
Page 3 of 3 12128104

Tu4stlay, April 24, 2007 7:51 PM Biily Houston 910-298-4629 p.01
Attention: Mr. Cheater Cobb
Company: DWQ-AP5
Fax Number: 1-910-350-2004
Voice Number: 1-910-796-7264
From: Billy Houston
Company: HYGRO Inc.
Fax Number: 910-298-4629
Voice Number:
Subject: Reel Calibrations
Comments:
Date: 4/24/2007
Number of Pages: 5
Hi Chester:
I found the reel calibrations for Buck and Mike in my truck. They
were in my farm map book.
If you need anything else let me know.
Thanks
Billy Houston

"`Tuesday, April 24, 2007 7:51 PM
Billy Houston 910-298-4629
p.02
HYGRO INC.
441 CABIN STREET
PINK HILL, NC 28g72
IRRIGATION EQUIPMENT FIELD CALIBRATION FORM
LOCATION: Buck Olsen Farm Fac 31-757
DATE of FIELD CALIBRATION: 9/23106
(mmlddryr)
FLOW METER SERIAL NUMBER: _McC:rometer 03-0830806-6
EQITFPNMNT NUMBER: ABi 751 MI-5,
MEASURED RING SIZE: 0.795 inches
Is ring size within 0.01" of original manufactured size's —X yes no
IF NOT REPLACE RING.
PRESSURE GA{IC:E READINGS At Pump: 110 psi
At Traveler: 65 pai(if applicable)
At Sprinkler/Gun: 37 psi
EXPECTED FLOW RATE(from manufacture chart): 107
MEASURE FLOW RATE(from flow meter): 110
Flow rate variance greater than 10n/e yes no
X
GPM
GPM
EXPECTED WETTED DIAMETER( from wetted acres determination): 240
MEASURED WETTED DIAMETER: 246 &
Wetted diameter variance greater than 15% yes no _X
IF YES IS ANSWERED TO EITHER FLOW RATE OR WETTED DIAMETER
VARIANCE, CONTACT AN IRRIGATION SPECIALIST FOR ASSISTAN(:E.
Comments:
Calibrator,__ H,{ Q,.n Tome- /3X4/ �,, /A" R11- l0 6

'1�LiLesdsy, April 24, 2007 7:51 PM Billy Houston 910-298-4629 p.03
HYGRO INC.
441 CABIN STREET
PAN HILL, NC 28572
IRRIGATION EQUIPMENT FIELD CALTBRA11ON FORM
LOCATION: Back Olsen Form Fac 31-757,
DATE of FIELD CALIBRA ION: 9/23/06
(mlm/ddtyy)
1+'LOW METER SERIAi, NUMBER: _McCrometer03-08308%
EQUIPMENT NUMBER: Cadman 3250WB—
MEASURED RING SIZE: _1.076 inches
Is ring size within 0.411" of original manufactured size? X^ yes _ no
IF NOT REPLACE RING.
PRESSURE GAUGE READINGS At Pump:
At Traveler: 65
At Sprinkler/Gun:
110
Psi
psi{if applicable)
49 1 psi
EXPECTED FLOW RATE( from manufacture chart): 160 GPM
MEASiTRE FLOW 1 NEK(from flow meter): 145 GPM
Flown rate variance greater than 10% yes _ _ no !X
EXPECTED Wf;-rFmD DLAMETEK( from wetted acres determinatlon):
Z82 ft.
MEASI7RED WL'I"na) DIAMETER: 296 fL
Wetted diameter variance greater than 150/9 yes no X
IF YES IS ANSWERED TO EITHER FLOW RATE OR WETTED DIAMETER
VARIANCE, CONTACT AN IRRIGATION SPECIALIST FOR ASSISTANCE.
Comments:
Calibrator: .,�wQ�_,ac�6.��.1 IV�� lr1�

'r
1//
JU Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation LZ
-- - - - Other Agency
Type of Visit m Compliance Inspection Q Operation Review Q Structure Evaluation () Technical Assistance
Reason for Visit A Routine 0 Complaint Q Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Arrival Time: ; Departure Time:
k OL 6P_rQ Fx2rn Owner Email:
Phone:
Region:
Facility Contact: Q Title: 'sPhone No: (��}
Onsite Representative: �`I /"� r 1"" Integrator:
Certified Operator: LE-129CLF— _ DLL I Operator Certification Number:
Back-up Operator:
Location of Farm:
o
Latitude: =
Back-up Certification Number:
0 Longitude: ❑ o ❑ ' ❑ ,
Design Current Design Current: Design tCurrent, ,-
"Swine. � Capacity � Population Wet Poultry Capacity Population Cattle Capacity �Populahon
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
0
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
-Other
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turke Poults
❑ Other
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures:;-:,
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes ,ICJ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes ;dNo ❑ NA ❑ NE
❑ Yes ANo ❑ NA ❑ NE
12128104 Continued

y
Facility Number: 31-750Date 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?
El NA El NE
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: O
Designed Freeboard (in): q
Observed Freeboard (in):
❑ Yes /No
❑ Yes ❑ No
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? [-]Yes [�No El NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) /
4. Does any part of the waste management system other than the waste structures require ❑ Yes /No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) raa/5
S
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes [.7No ❑ 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 VNo
El NA ❑ NE
17. Does the facility lack adequate acreage for land application? El / No ❑ NA ElNE
1 S. Is there a lack of properly operating waste application equipment? El Yes No ❑ NA ❑ NE
Comments (refer to question # ): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
75
Reviewer/Inspector Name i Phone: 9910 Z<o
Reviewer/Inspector Signature: Date: el-hzlo&
Page 2 of 3 I2/2 /04 Continued

Facility Number: Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ElNA ❑ NE
the appropriate box.
ElWUP ❑Checklists El Design El Maps ❑Other 10
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
PfNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
Rain Inspections ❑
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
,�(
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
X
[I NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
❑ Yes
[ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
4No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

*`
IType of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit VRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: // Arrival Time: Departure Time: ; County:
Farm Name: U ! _ LS�H� Owner Email:
Owner Name: DG-Sf..t AQ/YY� Phone: _..,
Mailing Address:
Physical Address:
Region: . , 67
Facility Contact: Title:Phone No:
Onsite Representative:&4�!5,50fd_ Integrator: �19
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: = O =' = « Longitude: = o [= d = 4f
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish 1,12
OV
❑ Farrow to Wean
1 &00
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Discharp,es & Stream Impacts
f ❑ Layer
❑ Non -La et
G
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: n
Is any discharge observed from any part of the operation? ❑ Yes ;a No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
/No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

t
Facility Number: — 5 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes V No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Spillway?: U
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes (� No
ElNA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes A No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No
ElNA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) to
9. Does any part of the waste management system other than the waste structures require ❑ Yes No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ;� No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
f
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
RrNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
XNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`
❑ Yes
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
/9No
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
VNo
❑ NA
❑ NE
.It qne�E>iplain,ariy}YES`fa
'lietter,explain sitiiat
��V_Co
Reviewer/Inspector Name I ` t Phone: 2/4 P-j-4Y 27.E
Reviewer/Inspector Signature: Date:
I2128104 Continued

Facility Number: —`f�j Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �TNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VNo ❑ NA ❑ NE
the appropiiate 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 ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
VNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
VNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
zNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
9No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ZNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA�NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ONo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
�No
El 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
XNo
❑ 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
;rNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
XNo
❑ NA
❑ NE
12128104

I
V
Type of Visit prCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit q'Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time:
O Not Operational O Below Threshold
© Permitted 0 Certified © Conditionally Certified © Registered Date Last Operated or Above Threshold: .........................
FarmName: _......_ .' .. G...... 0C.%j...._._...................................................._ County:..... ��. .. »......»......... .._.__ ._......
OwnerName:.... ....--....... ............... _................. ............ _ ....... ...... Phone No: -....................._
MailingAddress: • —, .__ .......... .......--�....� .W W _ __...........�....-------..._._--
Facility Contact: Title:.. ....... Phone No:
- n i
Onsite Representative:.. s �,� _ �v . Integrator: ._. !.� ...
Certified Operator :...................__ ..... ...... ...._...._.. ........_....... _ .._....... Operator Certification Nucmber:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 " Longitude �• �9 44
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes o
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 ❑— No2. Is there evidence of past discharge from any part of the operation? ❑ Yes LdNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? [:]Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identffl^r- 9 1 5C
Freeboard (inches)—
12112103 Continued

Facility Number: Date of Inspection O
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes ZN
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ yes No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? dyes FNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level El Yes
elevation markings?
Waste Applieation
10. Are there any buffers that need maintenancelimprovement? ❑ Yes
11. Is there evidence of over application? if yes, check the appropriate box below. ❑ Yes ❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type &`WVV06 U . l 5"40u (-9&AX4J NC96ER-1'} _
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes o
14. a) Does the facility lack adequate acreage for land application? ❑ Yes
b) Does the facility need a wettable acre determination? ❑ Yes ��Np
c) This facility is pended for a wettable acre determination? ❑ Yes
15. Does the receiving crop need improvement? ❑ Yes �Zq
16. is there a lack of adequate waste application equipment? ❑ Yes YJ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below []Yes to
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 04
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 7No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes No
Air Quality representative immediately.
'Comments (refer to question #) F.xpla� any YFS answers and/or any recamrne�dat�oas or aayaoth_ei_commeats. _ Mom=
.Use drawings of facrty to b tter explain sfmat<oas. (aSe addit:onai pages as necessary): ❑ geld COPY ❑Final No� tes
r S p^
3� I"' RAZ4-a jSP(-CTzotJ N tC— ")S 1�o E3 F u'PA"6f )
a 3 td o6TE Rq P LMCR TI . 12 EC.o R.W M1. S'c TtJ(5t ro sL PA OZt OF 2.6 a 3
t'ZEcs�n5 nn L5S �G i�U{L La-rE G� �i��--F o� 7��3
swe( nu eAus aF oc o Ay c,ocaTEo ro DTrrctz.Pgr �Acf-S
K.ECP Cap,? of STocicm)G G(z&n wV it 4UCoQ_0s,
Reviewer/Inspector Name cx
Reviewer/inspector Signature:
Date:
1L/lL/VJ a.Vrssusr�ca.

.;
Facility Number: Date of Inspection
Ree uired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes [ Fo
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 o
23. Drwoeecord keeping need ' provement? If yes, check the appropriate box below. �s ❑ No
aste Application Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes C3140
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 Q•iQ
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 ZNo
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? M"Ves ❑ No
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 L.l
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes KNo
34. Did the facility fail to calibrate waste application equipment? ❑ Yes
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall dnspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

Type of Visit ACompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification Other ❑ Denied Access
Date of Visit: Jr �Z Time: S,4Q
Facility Number 3J 5
Q Not Operational Q Below Threshold
© Permitted [3 Certified 13 Conditionally Certified E3 Registered Date Last Operated or Above Threshold:
FarmName: ..... G ...0/se', ..................................... ........... County:.- j n_----•-----•-----•--------• -------•---------
Owner Name• .----- -- C-= - !Se ----------------------- Phone No: ----------------------------._._._ -------
Mailing Address: . . .................................................
Facility Contact: ........................................................... Title: Phone No:
Onsite Representative: 1_t���� _ D ttC� _____________ Integrator: _ BfoE✓/J f _4'%�r� /+'�-.�___
Certified Operator: ........................ ........... : ............. .. . ......... . ..... I ......................................... Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • + ++ Longitude ` �'
:.- Destgn
Current D esign Current. -
Design Current
Swine _ Ca aci
-
Po alatioa PouIt►y_ : Ca aci -Po elation -=Cattfe ' Caps Population
❑ Wean -to Feeder
I JE1Layer ❑Dairy
❑ Feeder to Finish
❑Non -Layer ❑Non -Dairy
❑ Farrow to Wean
--
❑ Farrow to Feeder
" ❑ Other
-
❑ Farrow to Finish
- Total Des1 n Ca aci
g P
❑Gilts
❑ Soars
- = Total SSLW
4 Number of Lagoons
❑ Subsurface Drains Present ❑ Lagoon Area
10 Spray Field Area
Holdtog Ponds / Sohd Traps; T
-
❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
. ❑Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ 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 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier:--•--•--•--------•--•-----............................ --•-----------•-----------
Freeboard (inches):

UNUNU!
FacilityNuinber:.31 — 57
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? EfExcessive Ponding ❑ PAN ,Mydraulic Overload
12. Crop type
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
'PlIffes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15, Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (iel 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?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
(3 Yes ❑ No
❑ Yes ❑ No
❑ YesdNo
❑ Yes ❑ No
_Q'Yes ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
C mments (refe to gnestion;#� ExptaNp�`�a y YES answers-and%r aby-reeon endations�or-any�ofhercomments: L �
Used"rawYngs:of facility to better expla�n�situat�ans.�(use add�tionat a es as necessa
��
:::
�_' �-�� _�, � ❑Field Cop ❑Final Note '
3-, '1;9et-A 04q a-' an;. 01 l vvceswgl 0GG0eetV1 �po'1 /21 y 'q�f;��, .
i;.� abseri/�d y��`�I Waste �o�zd,'n� `i�d a� ��ll Lv�-r-fe 1,vaS
y'rin�, �..g �6�ti�Q �� � of �';t�ld • �- D/ser �e� r^ y ,�ts�r✓�'�►'��
�5.� dg,"med 8,1
G v aft` )-o'Y, I ; CA, e:'q and Df
�s��,✓Gaed
t�✓Rsar3 6h �';��AC, Pv.ti� wAr4e -��a co11eG�s
114
nd 4),e dim b q,( en'�d 4he �': e1d • W4 4e 9 va
�G�v�e1_ lriefe �-aken.
• p :4 Ti"":- t 6�' 1"''A..�,i.. r�cT ..-. n F
Revrewer/Ins ector Name_ .n�.�, :i° �� �.__ ..er ,
Reviewer/Inspector Signature: Date: d
6

Facility Number- J1 —17S cl Date of Inspection S 4�
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
29.
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
Additional Comments and/or Drawings:
Z S. Ql1O� I'yf,�. Ols�� ,r G►l�lol : wQse Gnn�'A'�J �O
�13�r %✓'/' r'' R'�t`0tj des h �IQ6 e RG eS G1)?Q WAX -le hPl
y J 9 t It I �
h ; s �e I bee vse k, s „- f �a h svPrp1 >`e.,r /�s-�f v fed �,'.►�t
1,f do r-1nGe -fie 1vo ih hfkr
pv*- T 4,01d P41?.
05103101

Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason far Visit oRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facifitv Number 3I �1SrJ bate of visit: 4Z Time: J Z ' a p
10 Not Operational 0 Below Threshold
©Permitted E3 Certified O Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: 13 C} !sin County:
Owner Name: �`-1 i r "`� S ePhone No:
Mailing Address:
Facility Contact: J Title: Phone No:
War%iG= t�t ��SP�'1 -Integrator:
$rowrtlD�GC�fo(�.�A
Onsite Representative: egrator Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a �• Du Longitude '
Design
;Swine Ca acih
Current _'Design Curren!': _Destgn '.CurMt
_.
-Population `; )'oaltrF = -Ca achy_ Pa uliition Esttle . `_ : Ca achy Po utatiron
,'=
❑ Wean to Feeder
`
❑ Layer
❑ Dairy
❑ Feeder to Finish:
t:_
❑ Non -Laver
Non -Dairy
❑ Farrow to Wean
v.:... -.
- Other
,-. - -
T(ltal Desi t Ca acll
`- w_ _T€rtaI:SSLW
❑ Farrow to Feeder
0 Farrow to Finish
❑ Gilts,'
❑ Boars
Number of Lagoons
I aldIng'Ponds ! Soitd Traps
❑ subsurface Drains Present La oon Area ❑ 5 rav Field Area
❑ No Lici uid Waste Management System
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
❑ Yes 2 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 'P'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 O'No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 2 .1
Freeboard (inches): 3& 4 3
05103101 Continued

i
Facility Number: r — Sq Date of Inspection 8 f S D
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 2fNc,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes 7No
(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 _ZNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes . P No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes O'No
Waste Aunlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes j2rNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ONO
12. Crop type -bre —. - o[ ei N ^
B. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes �TNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes /�Vo
b) Does the facility need a wettable acre determination? ❑ Yes,
c) This facility is pended for a wettable acre determination? ❑ Yes J2"No
15. Does the receiving crop need improvement? Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes �TNo
Reguired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ONO
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 ONO
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ,Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ONo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes E3"No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ,O'No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes 01No
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? Oyes ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments'(refer t�question.t#)Eaplam�any XEStanswers•and/or any recommettdattons or any�other,�omments.. r -
Use drawrngs of facility to better explain situations: (use asecessary)
addrtional�pages
' ," � .. � : s y - �. � �. , - " .�- � ., r.Y: - . ,.""� . ❑Field Copv ❑Final Notes
iP Ice, se 6e svI-e 4a case i wf,s4e gnct lr sLf dct;ed w1'4ti;-, 60 day s
o-� 4Ae "C, evc; r 44 Y314"j'ryi lit r/1'*Sd okn
411'e TtC/z- Z) s . Ye't" 11"Ve - 4e
o� -r<he eve,4.s' 6 v. you hA✓e vstoc eu4da cd g-wI ys .r -Fo- .sere �'
41te a ✓2rt45 on -/4e --TA2- Z's. P) ease -the 2ocZ je"'.16d4
4Ae Cep/e64 LV'AS4'z antrl sPS. ��en���,ieG��
Reviewer/Inspector Name '
Reviewer/Inspector Signature: Date: [i /S OZ.
05103101 Continued

°r
Facility lumber: —12SQ Date of Inspection (S oZ
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
2& 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 permanentitemporary cover?
❑ Yes 10'No
❑ Yes '�o
❑ Yes '10�No
❑ Yes 'O�No
❑ Yes-'ET'No
❑ Yes ,3 =No
❑ Yes 'KNo
.-Additional Comments and/or Drawings-m
z 5. r✓! �. G l s e r.�. Gl ,n a f p r��� Sr-z 1! g� A ro Lie •
ZOO l 2-Z>0 Z (,tl>'1�-� SC�ciso�.. �v. OjseA,'s t-,o l-fie L14)'I t
�� Gt h rr�� v;'�s h�l sya•►� 1 ] �.-�ri 6 e o ✓ve: 's ee'd ed in
S'or"e povr+2•ons of ��)e -or,e1ebr ReL- PrCd0--„'►A I/
Sore 04lic, q✓4-55 (Wot-e� grgs� or 'J605e -`ass, 13v- D44el-).
Please w o rktl 4o be#e,. Ps �a bl ; sL, 1 e✓'►-' vo' JYt 44c2S2 Gq req s .
41. ��g vE jute [ 6v jeoi, ;,) ! a�t 7- rt5&�.
05103101

-Division of Water ah . Qn h'
,
T Q Division of Soil and Water Conservation
0
Other Ageincy '
of Visit �0-Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit-(Yhoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 3 rf S'J Date of Visit:
0 Permitted ©Certified ❑ Conditionally Certified 0 Registered
Farm Name: (S 1' G 0/.Se —
..........................................................................................
Owner Name: b\l '., ! q wF C.. �� St;." t
�.................. ............................................................
Facility Contact:.............................................................................. Title:...
MailingAddress: .........................................................................................
Onsite Representative:... G !1/ ; 5.....0 / se.►-,
.........................................
CertifiedOperator:...............................................................
Location 'of Farm:
Time: I lgg5- Printed on: 7/21/2000
Not Operational O Below Threshold
Date Last Operated or Above Threshold: ..
Countv:.V.V,0/
Phone No:
Phone No:
......................................................................... ..........................
Integrator: 9tl , A, r O..C�.�t.'a.�.i.!al...................
Operator Certification Number:
16wine ❑ Poultry ❑ Cattle []Horse Latitude • C 66 Longitude 6 «
DesigQ , Current
Varmi!ity Pennhitinn
Wean to Feeder
eder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
tW Boars
--
Poultry
❑ Layer
Design Current
Capacity population Catde
❑ Dairy
❑ Non -Layer
❑ Non -Dairy
❑ Other
Total Design Capadty
Total: SSL W . I
Design Current
aci Population
Npnjbe .of Lagoons ID Subsurface Drains Present JrO ^oa Area 10 Spray Field Area
H , Pods / So id Tre ] - � ol�g. � ps � ❑ No Liquid Waste Management System '
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ................................................ L..........
Freeboard (inches): 3 q M
5/00
❑ Yes,)2]�No
❑ Yes XNo
❑ Yes No
A l,I
❑ Yes FeNo
❑ Yes No
ElYes5x
❑ Ycs�No
Structure 6
Continued on back

Facility Number: — Date of Inspection bt S Printed on: 7/21/2000
V5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes QNo
seepage, etc.) J
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes,/ffNo
(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�,ffNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ YeNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes 10-No
Waste „r ?piication
10. Are there any buffers that need maintenance/improvement? ❑ Yes /�No
It. Is there evidence of over application?'I ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload El Yes �No
12. Crop type 1� e ►^1 vG� t[S ��+ ,a �� / p ; h -
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes IEZRO
14. a) Does the facility lack adequate acreage for land application? ❑ Yes )2r-No
b) Does the facility need a wettable acre determination? ❑ Yes�o
, f
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? 0 Yes ❑ No
16. is there a lack of adequate waste application equipment? ❑ Yes_JTNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes Ej'N0
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 zfNo
19, Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes4TNO
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes �No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes _0"No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yesja�o
24. Does facility require a follow-up visit by same agency? ❑ YeSXNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Ye�No
�'�10 viijlaiitjtis:or i}ef cieucies were pofed d4tititi this'visit'. - Y;oit will receive dd further - : - : -
�orrespozidence: about: this visit.. :: : : :
to question #) `Explain any YES answers and/or any recominendati
efi--►=�ts,�e han�er•,vd� Vey �� ►an. 0- 6e S v rc �a use of wa.L�z ^"I 'r d0Lfed L,,;q4;h 40 dig s Of
za f t i ca l + o � c V c rt�1 art �e —�. Fo � g . src ca ^-t +mac �� 10 Or, kc
tti a 5 e a h.c► I ,� yrP`s eve y (00 delyV .s6 04C." W t2 t'I,ave G( Val 16 .tW.t��s��
TO
leas j6 6eq:n �spo�slbjc p�,,.,p;.,� off' ta.000i-t Z -r�o keep a r�� s� re� . I+I
Reviewer/Inspector Name - .S _
Reviewer/Inspector Signature: Date: 0 5 M 1 5/00

Facility Number: —r]`j� Date of Inspection Q Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ YesNa
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes PNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes'gNo
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')2rNo
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�ONa
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes-,131Qo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
5100

>r `�
XDivision of Water Quality
O Division of Soil and Water Conservation
O Other Agency = -
Type of Visit Compliance inspection O Operation Review O Lagoon Evaluation
Reason for Visit -0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of visit: 12 i J9U Time: ZS Printed on: 7/21/2000
10 Not Operational O Below Threshold
'Permitted © Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ...........•..
Farm Name: B 4........O 1 �� ................................................ ................ County:..... Ir 1 t.. . .............................. ......................
....................... ...........
OwnerName:............'.�.f t4►�1...........:..®�5..�1................................................. Phone No:..............................................................................-........
FacilityContact:..............................................................................Title:................................................................ Phone No:....................... ......................
MailingAddress:.......................................................................................................................................................................................................... ..........................
Onsite Representative; .... ..........^..5......QIS.. h...................................................... Integrator:... �`�'1s1.t►.�.r..... L...... .�`'O i.i±!45.....
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location'of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 6 0« Longitude • 4 96
'Design Current
Design Current Design : C orreut
Capacity Population
Poultry
CapacityC!pacity Population Cattle Ca acr :" Fo uation '.
Wean to Feeder
❑ Layer
10 Dairy
Feeder to Finish
p p
❑Non -Layer
❑Non -Dairy
Farrow to Wean
_
Farrow to Feeder
❑Other
Farrow to Finish
Total Deli Ca ad
P
Gilts
- �
Boars
TotW.SKW
Number of Lagoons ❑ Subsurface Drains Present I.ag�w.n Ares ❑ Spray Field Area
_
Holel:ing Ponds /5olid:Traps ❑ No Liquid Waste Management System
z
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes ONo
Discharge originated at: ❑ Lagoon (3 Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes )4No
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 (low in gal/min? h 1g
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ONo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes RNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes J9 No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4
Identifier: .............. 1.....
............ ........... z'.................... .....
q
Freeboard (inches): 75 Z I
s/00
❑ Yes A No
Structure 5 Structure 6
Continued on back

Facility Number: -7 i— `59 Date of Inspection 1 1 Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes gNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure'plan? ❑ Yes JX 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 A No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes W No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes gNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes %No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes P(No
12. Crop type r'1 tlef k ' e..-
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes X(No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ,No
b) Does the facility need a wettable acre determination? ❑ Yes 0No
c) This facility is pended for a wettable acre determination? ❑ Yes RNo
15. Does the receiving crop need improvement? ❑ Yes �,-No .
16- Is there a lack of adequate waste application equipment? ❑ Yes YNo
Renuired Records & Documents
IT
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
ONO
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
XNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
39rNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
0 No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
J4No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
Yes
No
Oe/ discharge, freeboard problems, over application)
❑
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
;M No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
B No
No•yioiatioris'oi- &riciettcies -were poteci-d&it ii this:visit:- Yoil'Will receive rid iiitihk -:
coriespondence:aboutithis visit. ::::':::: ; :':'::::::::::::::':::'::':: :
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):
lS, rlscare A J00d - 4L.-Ley &- Sw�1'i1 Gjr0.)[�`� /d�' W��1QIG�loyts. 'A,y1Vltq -W / i "LLe etC.e0,-d ,q To Sall ✓Aer7 ✓'�[dw�„9'L2 lD� s-
1qUse a 1,t,gsle QkTq17 rt°r dad y✓;�ri�, ba dgys s al?Pl''caa►o�,
F�GalGvlet �,,o=-ts e m -r Meg-���.
Reviewer/InspectorName �,��n@�6'1�� 1�?a7Ktf
Reviewer/Inspector Signature: Date: I G / / 142 5100

Facility Number: VP % — '7 Date of inspection 112111,401 Printed on: 7/21/2000
(kior Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ONo
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes Wo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes .2j'No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ONo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes 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 A!f No
Additional omments an orDrawings:
i
5100

Facility Number ']s'] Date of Inspection
Time of Inspection _ �r�� 24 hr. (hh:mm)
Permitted E3 Certified © Conditionally Certified © Registered 0 Not O erational Date Last Operated:
FarmName: ....... ....C........ �S H........t!V�............................................. County:......... -D ......................... .._....................
Owner Name:........C.lf./..11l.. .fl!..................... ..'.....................D. S .............. Phone No: ......... 1.h.r S'.. a D._........_.........._._..........
Facility Contact:%�-
1.�.a..c....................&i2..... Title:........ �...r......_..---..............Phone No: �...s..—..b......r
Mailing Address:
Onsite Representative:... I,�lraw,........ ',:,A Et Integrator: &,G�,,,
,.......... ........................................... .......................
Certified Operator: ................................................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
........... ............. ........ ..........................................................................................................................................................................................
Latitude �' �� �.� Longitude
Design Current `. Design Current:.
Swine _ Capacity Population Poultry Capacity _; Population Cattle
❑ Wean to Feeder
Feeder to Finish
6 op
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Current
opulation
Number of Lagoons, Subsurface Drains Present jr t agoan Area ILI Spray Field Area
-Holding V onds / JEI No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes A 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 gallmin'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes 1 V9No
2. Is there evidence of past discharge from any part df 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 Cl Yes No
Structure I Structure 2 Structure 3. Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches):.................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes 9 No
seepage, etc.)
3/23/99 Continued on back

Facility Number: Data of Inspection
6. Ard there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
El 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 maintenatice/improvement?
❑ Yes
No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
X No
Waste A 11Catlpn
10. Are there any buffers that need maintenance/improvement?
❑ Yes
No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
No
12. Croptype
13. Do the receiving crops 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
19 No
b) Does the facility need a wettable acre determination?
❑ Yes
0 No
c) This facility is pended for a wettable acre determination?
❑ Yes
00 No
15. Does the receiving crop need improvement?
❑ Yes
A No
16. Is there a lack of adequate waste application equipment?
❑ Yes
M No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
XNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes IN No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes KNo
24. Does facility require a follow-up visit by same agency? ❑ Yes No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes No
0: Rio yi9lafiQris:or deficiencies . . ..... iiirri . g . ... s .... will r e. . . . i. . f.... .
eorresporideirce. a%out. this viset_
Comments-(refet: to•gtxestion #). Explaln,any YES answers anwor-any_ recomMenda#ons gravy ether comments,:
_ z
Use;drawu gs of.facility:_to better explain situations (use additibnal pages as.necessary) w
s W..
As beei, !e_wt l 9,_kl 'b *akh Ais wehW &te- Jo "y Lc Wcr— Q _ +
f ' pr.� l�YgT�Y �n�Yt?kjovr Ali' �,Ks S4�-ls-ticR1S~�P I )avt $ 3 q W
S1>1 P
WCt�'L"QLY� rltict -
�qc, �l JOb� �� � kEc� k� �i�li�s • .
9'
,�...�<
Reviewer/Inspector Name t YCP
Reviewer/Inspector Signature: Date: jI ILI 19c,�
" 3/23/99
(kl a) 3gs-3�6� �,sc+. 2�

Facility Number: 31
Date of Inspection
Odor Sues •
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
ANo
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
19No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
QQNo
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
19 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
Additional Comments and/or rawin -
3/23/99

1�
E:] Division of Soil and Water Conservation ❑Other Agency w : ,
Division of Water Quality
r
Routine 0 Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review 0 Other
Date of Inspection 61116M,
Facility Number
Time of Inspection ! ► 24 hr. (hh:mm)
0 Registered gCertiFied [, Applied for Permit P1 Permitted 10 Not O erational Date Last Operated:
Farm Name: pp 11 .................
.............R.'.P: e... � f SC!4'.�:..............................-----.......................................... county:....... u�l�.n�..............-------.........---- ......
Owner Name: I 1
................t.�1.3(k.^....�............. Lisa . . ...................................................... Phone No: .....�i10.�..��.�.(t.�`�.f1..........................................
FacilityContact:.............................................................................. Title: ................................................................ Phone No:
Mailing Address :......... A.6fi........�v...1a,1.C....i+6,l.u...!:�1 .................................. .......... ....�t,�,�►�� •..,.....NC......................z.����:.......
i .
Onsite Representative: ............ .0.).Sek ........................................................... lntegrator:.......... JwKS..........................................................
Certified Operator: .................................................. 4 ...
Location of Farm:
Operator Certification Number, .....................
....... p.► ... � ...... i........ ......... ....1iZKy.... .....!W r , ...4. �......... cesc.....4 ',reek................................................................ �
.................................. .................... ......................
Latitude • 6 0 fL
Cai
Longitude
itA Design _,. Current....
on PoultryCapacity Population Cattle
.
❑ Wean to Feeder
® Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
I ILI Non -
Total SSLW
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes IN No
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 gai/min?
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ)
3. Is there evidence of past discharge'from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenancelimprovement?
b. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes IR No
❑ Yes ® No
❑ Yes 19 No
❑ Yes VINo
❑ Yes R No
❑ Yes P No
❑ Yes No
❑ Yes No
❑ Yes (] No

Facility Number: 3 — -
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (LaEoonss,Holding Ponds, Flu5kZjjEqga
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Freeboardft ..................z.4..................................................................................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
❑ Yes No
❑ Yes No
Structure 5 Structure 6
........ . ...................................
IS. Crop type bG!r11►!�4 .........................5.Kvj' f...... t�Q1 k�............................... .............................. .. ...............................
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 Animat 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?
[3• No.viotatio'ns•or deficieitcies:were-noted-during this.visit.- You:rill receiveno-ftirttier,:
:-:-cQrrespandenceatiou�t�is:visit.-:�:::,- ; : ...:.:,'.::�.�.:,•:.: �.:..,;.'_:.• .,'
❑ Yes No
❑ Yes No
(} Yes ❑ No
❑ Yes JA No
❑ Yes 10 No
❑ Yes 0 No
❑ Yes ® No
JM Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes R No
❑ Yes fig No
❑ Yes No
91 Yes ❑ No
W Yes ❑ No
�2.S�(j1. 4r4o S ih �1Ortn U}�'LY
O Y�PS16n on �'v
s�U[J
W� i l s off"
�Ao fir- �a tflor. [ s �v�c�
ioe- y�-cx„xd,
It �Q (MU�f1
Cep S�.ncil� rhn.�Yd�<U.
L►� �np�80� V}�o r[
j.��
i r1c rt Ir
O".ce- eve"
4wI %) � Q.�Ql� 1 l�
l�YLh,t� 4r 1 w�w � e�c., L,rr,;\ 'g1vmw �m <kelik A
z�l� ►''��,,,mr
o I\;cz,�f ar Q� ���ra�t�. czS (bS/ac, `&-s -t6u)b
�e Sub ar�ecl
IT4101k o)ra le, .
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: c��.. ,� ,�_ Date:

_❑ DSWC Animal Feedlot Operation Reviews .�
DWQ Animal Feedlot Operation Site Inspection
IG Routine 0 Complaint 0 Follow-up of DNVO inspection 0 Follow-up of DSWC review 0 Other 1
Facility Number
© Registered © Certified [3 Applied for Permit IRPermitted
FarmName: __. ... ..._C ....... S.erg.....................................-...........
Owner Name: 1!U, 11.�. .... ...�x�o.�ge ........ qu.er. � ..............
Date of Inspection
Time of Inspection i lZ :6SJ ) 24 hr. (hh:mm)
113 Not Operational I Date Last Operated
........... County-:.....A..u.>..L...-............................... . W..t...J .
............ Phone No:...�.9....4.....�. _"
Facility Contact: ........ .. Title: ...................... Phone No:-0-1 0 o
r
Mailing Address:..Z.�?.��..9.�....... W.-C......`A...k......... ........... ...G.�.�..ra...rdsJck.�.,.,n .�:............. .................�..�
Onsite Representative:....{�1.i.� t.�..► n....GL r..:. ........o.iS rr ................... Integrator:.Yin.c til..t!!..$.......... ._...........................................
Certified Operator, .................................................. .................. : .......................................... Operator Certification Number:...f .7
Location of Farm;
.....�aa........s.i.�,.�...b...,5.,1.�... a. ro..Y,.r�!`rrk......... .......�j`....,ran.i........S.n..�lT�'1...i�a'....o...:...
.57 L�.F.!_1.�4.....W..!. ...............'..Asb.._f............. ....................... ........ .......................... ....................................................................................................... F,
Latitude • 4 49 Longitude ' 1' 41
Design Current Design Current Design. • Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population,
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer I I ❑ Dairy
❑ Non -Layer I 1 ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons /Holding Ponds JE1Subsurface Drains Present IIIJ Lagoon Area 10Spray Field Area
❑ No Liquid Waste Management System
General
I. Are there any buffers that need maintenance/improvement'? [9 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 [a No
b. If discharge is observed, did it reach Surface Water? {If yes. notify DWQ)
❑ Yes
RNo
c. If discharge is observed, what is the estimated low in gal/min?
A
d. Does discharge bypass a lagoon system`? (If yes, notify DWQ)
El Yes
E[No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
RNo
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
RNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
RNo
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design`?
❑ Yes
JKNo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
K10
7/25/97
Continued on back

Facility Numbe . -
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
49 No
Structures (La oons loldin Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: Z.A
Freeboard(ft)...............................................................................................................................................................
10. Is seepage observed from any of the structures?
❑ Yes
® No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
19Yes
❑ No
12. Do any of the structures need maintenance/improvement?
CKYes
❑ 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?
NJ Yes
❑ No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ......................., .VVs-st.L..� ....�c .tirzA x..---.........................-..........
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
ENo
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
Ed No
18. Does the receiving crop need improvement?
IR 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?
0-Yes
❑ No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
RNo
22. Does record keeping need improvement?
R1 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
JRNo
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
5� No
25. Were any additional problems noted which cause noncompliance of the Permit'?
❑ Yes
Q No
-No violations or de'ficiencies.rvere noted during this visit.- You.will receive no further
correspondence about this.visit......
C©minents°(refefr to question #): F,Ekplain any YES. answers and/or an` recgmmendations'o an ;other comments
y y
Use drawjngs of facility toabetter explain situations (use additional pages as necessary}
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7/25/97
Reviewer/Inspector Name `
Reviewer/Inspector Signature: r;,,�-S� ��� �,40 Date: I

i
4
State of North Carolina
Department of Environment, Health, and Natural Resources
Wilmington Regional Office
James B. Hunt, Jr. Division of Water Quality Wayne McDevitt
Governor Secretary
October 10, 1997
William & George Olsen
B&C Farm
2659 S. NC 41
Chinquapin, North Carolina 28462
Dear Mr. Olsen:
Subject: NOTICE OF DEFICIENCY
B&C Farm
Facility Number: 31-757
Duplin County
On October 8, 1997, staff from the Wilmington Regional Office of the Division of Water Quality
inspected your - animal operation and the lagoons serving, this operation. During the inspection, it was
observed that erosion on the walls of your lagoons could eventually threaten the integrity of the structures.
This erosion should be corrected, and all bare areas on the lagoon walls should be revegetated. We suggest
that you contact your service company, local NRCS office, or Soil and Water District office for any
assistance they may be able to provide to correct this situation.
You must notify this office in writing within fourteen (14) days of the receipt of this notice, what actions
are being taken to correct this deficiency. Failure to do so may insult in the facility being required to obtain
an individual non discharge permit.
Please be aware it is a violation of North Carolina General Statutes to discharge wastewater to the
surface waters of the State without a permit. The Division of Water Quality has the authority to levy a civil
penalty of not more than $10,000 per day per violation.
127 Cardinal Drive Extension, Wilmington, N.C. ZW5-3845 a Telephone [phone] s Fax [phone]
An Equal Dppor4tnity Affirmative Action Employer

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US Postal Service
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William & George Olsen
October 10, 1997
Page 2
If you have any questions concerning this matter, please call Andy Helminger, David Holsinger, or
Brian Wrenn at 910-395-3900.
Sincerely,
Andrew G. Helminger
Environmental Specialist
cc: Harold Jones, Duplin County Soil and Water Conservation
Sandra Weitzel, NC Division of Soil and Water Conservation
Tunmy Vinson, Brown's of Carolina, Inc.
Operations Branch
Wilmington Files
S. I WQS I AAD PA L31- 75 Z DEF

Site -Requires Immediate Attention;/IJC.w
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
. DATE. ' �-3 , 1995
Time.
Farm Name/Owner:
Mailing Address:
County: _ (11CA
Integrator: ,`� s v urns Phone:
On Site Representative: �cz C� l@i•� IBLce,�Is Phone:'I.4 --2�sr.
Physical'Address/Location: _ e a. `� _ 5 t OQ0 ham;
is
Type of Operation: Swine ✓ Poultry Cattle
32 -3 d
Design Capacity: (D _, _„ Number of Animals on Site:
DEM Certification Number: ACE DELI Certification Number: ACNEW
Latitude: '_5'-° �l`'�' Longitude: 7Z&2_'_" Elevation: Feet
3 G O % Circle I7e7or No -
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches e or No Actual Freeboard: -Z— Ft. Inches
Was any seepage observed from the agoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate land available for spray? e or No Is the cover crop adequate? Yes or�
c
Crop(s) being utilized: _i %A
Does the facility meet SCS minimum setback criteria?
200 Feet from Dwellings? Vs or No
100 Feet from Wells? is or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes 00-0
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or o If Yes, Please Explain_
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated an specific acreage with cover crop)? Yes or No
Additional Comments: InD,, ) T-Z?A ✓I rQ/i J
a
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tea, e 6Z�- �
Inspect a Signature
0
cc: Facility Assessment Unit
Use Attachments if Needed_