310765_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

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Division of Water Resources
Facility N, umber ®- O pivision. afSoil and V1'ater Conservation
®Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: tp xoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ¢ Arrival Time: :phi Departure Time: pa County: Region: t
ft
Farm Name: F txw E.2 ii j
Owner Name: /q r1e, ELL-t-f
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: :3� ' Title: Phone:
Onsite Representative: t Integrator: 2rt4%-7K-- 6�7
Certified Operator: C� Certification Number: 3 2-p
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
DairyCow
Wean to Feeder
+
Non -Layer
Dai Calf
Feeder to Finish
6
d
DairyHeifer
Farrow to Wean
Design
C*urgent
D Cow
Farrow to Feeder
Dr. P,o_ultry
C+_a aci
P,o ,
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
©then
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes []No ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No [7NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No [] NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes [3'No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [—]Yes �] No ❑ NA ❑ NE
of the State other than from a discharge?
- Page I of 3 21412015 Continued

Facili Number: - S Date of Inspection: o2suw.c
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in): 97 ; ZK
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Q-Ntf ❑ NA ❑ NE
❑ No LAC ❑ NE
Structure 6
❑ Yes [a' 1�0 ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[ o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or enviro
mental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
Yes
o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�I
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
Q-NTo-
❑ 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 D-go_ ❑ 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): u-)f-5 C o, ce,
13. Soil Type(s): "T `) _h-g- Lypt
1
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[E 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
[ o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[�r_No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[ o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
EfNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
ETNo
❑ 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 [:a -No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [] Yes 0-No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ErNo
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Inspection: 2+
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0-790 ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0,N-5 ❑ 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 ❑i No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [211io ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes L - " o ❑ 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 the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes [3'-No ❑ NA ❑ NE
❑ Yes lVo ❑ NA ❑ NE
❑ Yes �do ❑ NA ❑ NE
❑ Yes E 'No
❑ Yes ETNo
❑ Yes [�No
❑ NA ❑ NE
❑NA ❑NE
❑ 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).
cal
Cr
l* 634-7 � s
F J«Ot S h1 Co v ems`
Reviewer/Inspector Name:
Reviewer/Inspector Signatw
Page 3 of 3
Phonec 11U - a3 3
Date: f "t,
21412015

N".
11Fa cifi�yNtnite�= i
Conservation
n,
O�DivDi
visiono, 0 iljan d Wat—e1r11L
tpAgencyja11t,i,o
Type of Visit: (PItompliance Inspection 0
Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit. 0 Routine 0 Complaint
0 Follow-up 0 Referral 0�ergency 0 Other 0 Denied Access
ar
blte-' Arrival Time: Departure Time: County: Region: Date of Visit: n lit 11";
4
F.
Farm Name:
Owner Email:
Owner Name'
Phone:
Mailing Addreis:
Physical'Address:
Facility Contact:
Title: Phone:
Odsite-Ripresentative:
Integrator:
Certified Operator:
Certification Number:
Back-up Pperator:
Certification Number:
Location of Farm:
Latitude: Longitude:
Design
Design
Current
ign Current
estyMMlPa
Swine Capacity Pop.Wet
Pop.
Capacity c!
Wean to Finish,
La er
DaiyCow
Wean to Feeder
IE'
Non -Layer
DaiyCalf
Feeder to Finish
-
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow.to Feeder
P041t
p_
Non -Dairy
Farrow- to Finish
r[
11-ayers,
7Non-Layers—
Beef Stocker
Gilts
0
Beef Feeder
Boars
Pullets
Pullets
Beef Brood Cow
Turke s
Other
Turkey Poults
Other
Other
Discharges and Stream impacts
I -a "- e bs�­
Is any, 8isc Aiarg b_ rved from any part "of' the operation?,'
Dis charge originated at: ❑ Structure E] Application Field E] Other:
Dyes El No .DNA E] NE
a. Was the conveyance man-made? E:] Yes E] No E] NA. E] NE
.
b. bid th6 discharge7rcach waters of the State? (If yes, notify DWR) [—] Yes ❑ No ❑ NA E] NE
c: '.What is the'estimated volume,that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR) E] Yes E]NE
NA
2. Is there evidence of a past discharge from any part of the operation? [], Yes E] No�- E] NA E] NE
'3. Were there.any observable adverse impacts or potential adverse impacts to the waters 0 Yes E] No Ej NA E] NE
of tlie'Stafe' other than from a discharge?'
Page 1 of 3
21412015 Continued

Facility Number: jDate of Ins 'ection: I a I ,(,
_1yaste 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? O'Yes ❑ No ❑ NA ❑ NE
A.
' Structure 1 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 R'
Identifier:+sn� rr St Srt''^� E•� _ ���ri i.7
Spillway?:
Designed Freeboard (in):
r Observed Freeboard (in): 7 7
5. Are there any immediate threats to the integrity of any of the structures observed?
LL(i.e., large trees, severe erosion, seepage,'etc.) .
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
],Yes ❑ .No ❑ NA ❑ NE
❑ Yes ' [3' No [] NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or en;;Oonmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? Q/Yes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes �No ❑ NA 0 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 V.
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 6; No ❑ NA NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA Q 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):
i
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA Q 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 f0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all.components of the CAWMP readily. available? If yes, check
the appropriate box.
❑ Yes
❑ No
❑ NA Q NE
❑ Yes
❑ No
❑ NA Q NE
❑ Yes
[] No
❑ NA QNE
❑ Yes
❑ No.
❑ NA KI NE
❑ WUP ❑Checklists [:]Design [:]Maps ❑ Lease Agreements ❑Other:
,r
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [—]No [:]NA /❑ NE `
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall 0 Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and'maintain a rain gauge? ❑Yes ❑ No ❑ NA 0 NE
23, If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued
,. _,, I -. -f -. .� •.1...,. r. ".i i..sx''a. ^e,.�;•....�;. :: tbs,-. ._ ..a.t {i3 �.r t,a.l �. srt'•,.n.+.�3 r.-....... i..•rin �t.h-.. ... ,1t=.-:.. --.__ 7'�... .uc. •

[Facility Number: jDate of Inspection: 1 f?
b
24rDid the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA Qi E
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
i
❑ NA ❑ NE r
27, Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[:]No
DNA ❑ 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?
Ej Yes. ❑ No ❑ NA © NE
f
❑ Yes e� No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA�❑ NE
❑ Yes ,Q No ❑ NA ❑ NE
❑ Yes © No ❑ NA ❑ NE
❑ Yes Q'No ❑ NA ❑ NE
Comments (refer to question ft Explain, any ,YES.answers and/or any. additional recommendations or any other comments.'
Use drawings of facility'to`better explain situations (use additional pages as necessary).
�- / '
e r 1 Q" "� ,L4 Co i-..✓F � r -� r P r4. tti f- (7 E a p ry 6 W�- l(n) w,•. �
GR 4 rD S (A/L 04) %N f -fT-G Jr R`e Wo 5,
kc 1Vt its c/a; 1T
raN4-co P
con- f^ 1A^4 e K I V_ Q w c 0l�
�
Reviewer/lnspectorName: U V /I (1 Phone: `r o
Reviewer/Inspector Signature:
Page 3 of 3
Date: <�(i}
/ /
21412015
. _ ,,. -.� �„ .. ,tom.:." �.�,:•.,. ..

Type of Visit: QMompliance Inspection O Operation Review p Structure Evaluation O Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral Q-Cmergency 0 Other 0 Denied Access
Date of Visit: {d {, Arrival Time: �� I I� Departure Time: ' 1 County:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Title: Phone:
Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Region:
Design
Current
Design Current
©esign Current
Swine C+apacity
Pop.
Wet Poultry Capacity Pap.
Cattle Capacity Pop.
Finish
La er
Dai Cow
Feeder
Non -La er
Dai Calf
o Finish
F
Dai Heifer
o Wean
Design Current
D Cow
o Feeder
Dry P.ouitr C*_a aci_ P,o ,
Non-Dai
Farrow to Finish
ILayers
I 113eef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turkey Pouits
Otherini
lother,
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes LrNo
❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facili Number: 31 jDate of Inspection: ao
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
Z11yes
❑ No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
;3�yes
❑ No ❑ NA
❑ NE
Structure 1! Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: i (9,4 fk-3T Ttt�"� +Liri1-.2
t
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 7
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
grNo ❑ 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 env' nmental�threat, notify DWR
7. Do any of the structures need maintenance or improvement? Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [no ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes � No ❑ NA ❑ NE
maintenance or improvement?
Waste Application i?Q
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) !!!"���"'
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12, Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 0 No ❑ NA EfNE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA '01NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA �OfNE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes [—]No ❑ NA�NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ❑ No ❑ NA NE
XjZ
Re wired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA] N
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA NE
the appropriate box.
❑ W UP ❑ Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA 4"NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA g
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA [NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of his ection: D
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 gNE
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 ❑ N NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ❑ No ❑ NA NE
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes ❑ No ❑ NA/[:fNE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes EfNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes E]"No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes:0� 0 ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility toy better explain situations (use additional pages as necessary).
eo L,c/e « Cr P CArG Q r R O w 6 W ZAO) A' , -I
(MC_ 0k)
-- e-c_ It _ kV;- I ( S �61 ; l
FC9S;yn Cor.,+ro [ ji cf C (- 4n Ar t<z I.,
C_ 0 w 11,4G 04-
Ck,,� I -I WOLr�s
Reviewer/Inspector Name: 1./& VV ff
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412015

< ,� Division of Water Quality
Fait} y ggmber 3 O. Division of Soil and Water Conservations c
0 Other Agency "' ¢•
Type of Visit Q Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine 0 Complaint O Follow up O Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit:
Farm Name:
Owner Name:
Mailing Address:
V A'rival Time: I! Departure Time: County:
C_!', .0 h1 A52 Owner Email:
Phone:
Physical Address:
Facility Contact: Title: ,�y� Phone No:
/ Onsite Representative: Integrator: � `
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = o Longitude:
Design Current Design; Current r.
Swine Capacity Population Wet Poultry Capacity Population Caul
m �._ ..� .
a ❑ Wean to Finish ElLayer E
Dai
ElWean to Feeder ❑Non -La erEDai
Feeder to Finishwoof ' " " ❑ Dai
w ❑Farrow to Wean Dry Poultry ` ❑ D
r
" ❑ Farrow to Feeder - .E ❑ Non -Doi
ry
El Farrow to Finish ❑ Beef Stocker
El Gilts ❑ Beef Feeder
❑ Boars ❑ Beef Brood—(
==IU 0ther I
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?
Cy ow
Cy alf
Hy eifer
Cow
Region: %�/�"
9
❑ Yes O No ❑ NA ❑ NE
❑ Yes 1 No
❑ NA
❑ NE
❑ Yes
�lo
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
-6No
❑ Yes
o
El NA
❑ NE
❑ Yes
WNo
❑ NA
❑ NE
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Pou its
❑ Other
Page 1 of 3 12128104 Continued

Facility Number: — Date of Inspection
WAstE"Ciilection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a.. If yes, is waste Ievel into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in).
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
VYes 'pw ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
10 No
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu., Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack,of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any otlier comments ".
Use drawings of facilityto better explain situations (use additional pages as necessary):x
hlfh ��rt��4K1f
r
Reviewer/Inspector Name '. Phone•3
1.
Reviewer/]nspector Signature: Date: l
Page 2 of 3 72128104 Continued

16
Type of visit: Ucompliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: 011outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: ` c Arrival Time: Departure Time: County:'1 Qt /I
Farm Name_ �S'!'l 1 _ Owner Email: ��"""��"PP
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Region: (�✓/%J
Integrator:
Certification Number:
22Cro"� 92��
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
inish
Wet Poultry
La er
Design
Capacity
Current
Pop.
Cattle
Dai Cow
Design
Capacity
Current
Pop.
eeder
Non -La er
Dai Calf
Finish
Wean
Feeder
Finish
M,Boars
D , Paul
La ers
Design
Ca aci
Current
P,o
Dai Heifer
D Cow
Non -Dairy
Beef Stocker
Non -La ers
Beef Feeder
Pullets
Beef Brood Cow
IMFFMIther=MM__"
Turkeys
Turke Poults
Other
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
❑ Yes P] No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
fj No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
Ef No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
E1 No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
E' No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[2!rNo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3
21412014 Continued

Facilily Number: - Date of Inspection. r
/
ate CoVection & Treatment
4. Ys storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes Z No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes )21`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 1?71'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 �Alo ❑ 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) T
9. Does any part of the waste management system other than the waste structures require ❑ Yes r_LN0 ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes )ZI No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes J -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 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ETNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes f TNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes JE3'-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑"TTo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes '''fo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes f!j'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 Yam, 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 o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes f No
❑ NA ❑ NE
❑ Weather Code _
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412014 Continued

Facility Number: jDate of Inspection:
24. rJ.0 the €ability fail to calibrate waste application equipment as required by the perm' ? ❑ Yes )�TNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check []Yes Ea -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 Ili' No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes t No
Other Issues
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ONo
❑ NA ❑ NE
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
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
�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
2TNo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWW?
❑ Yes
2rNo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
VNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
P�`No
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments. .
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
r-e 4- d �oZ_P
W,
Phone:
Date: %
�941AII4

Type of Visit: Q ompliance Inspection 0 Operation Review Q Structure Evaluation p Technical Assistance
Reason for Visit: Q,toutine Q Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: ! Arrival Time: r ' eparture Time: County: `/,[fie 44 � Region:L
Farm Name: �%U Owner Email:
Owner Name: Phone:
Mailing Address: %I.
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current Design Current Design Current
Swine Capacity P.op. Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
ILayer
11
Dairy Cow
Wean to Feeder
INon-Layer I a' Calf
Dairy Heifer
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current Dry Cow
Dr. $oulti. C•_a aci P,o , Non -Da'
Layers Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I jBeef Brood Cow
Othe
Other
I
Turkeys
ITurkeyPoults
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)?
❑ Yes ZfNo ❑ NA ❑ NE
❑ Yes
J!TNo
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ZfNo ❑ NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? [:]Yes EfNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ENo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Faciqty Number: - Date of Ins ection:. , ,
Waste Collection & Treatment
4. Is�storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes DNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ONo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: :311— _.�q�
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 property addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes 6No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes VNo
❑ 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 No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, e c.)
❑ 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 A No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes �No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
'0
❑ Yes ff No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fait 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 E2 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 P�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 dNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes VNo ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

F,4ciHty Number: 3 1 Date of inspection:
id the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes
025-s the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
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 structurc(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
❑ Yes R No ❑ NA ❑ NE
[:]Yes KNo ❑ NA ❑ NE
❑ Yes RNo
❑ Yes dNo
❑ Yes 2!fNo
❑ Yes KNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [:]Yes VNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes YNo ❑ NA ❑ NE
34, Does the facility require a follow-up visit by the same agency?
❑ Yes (7 No ❑ NA ❑ NE
(Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
- F�-a- o,7 dL- keke-3- 1,00le 900c"(-
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: K;K Leto
Date: // Aq
14120 if

FactSty Number:
r
7
yl�.:
Now, of Wrater_ ua . ty;
-_
1er:Agency='-
Type of Visit _.��Compliance Inspection 0 Operation Review 0 Structure Evaluation, 0 Technical Assistance
Reason for Visitek)OIR'outine O Complaint 0 Follow up O Referral O Emergency 0 Other ❑ Denied Access {
Date of Visit: rrival Time: eparture Time: County: Region: '
Farm Name: f 1��� _ __ Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: Z
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No.•
Integrator•
r'Klc�,l q i' r
Operator Certification Number:
Back-up Certification Number:
Latitude: = o ='
= Longitude:' ❑ o =' ❑ 11
DesignCurrent
" Swine; Capacity ;Population
Wet Poultry
Y--.
❑Wean to Finish
❑ Layer
❑ Wean to Feeder
❑ Non -Layer
.�
❑ Feeder to Finish
1
Drv.l?oultiy
❑ Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
s ❑
Gilts
❑ Boars
LL_lOther �
Current -
y Population; ��Cattle '� --"
@10 DairyCow
❑ Dairy Calf
ElLayers
ElNon-Layers
ElPullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood
'lumberrof„
Discharges & Stream Impacts
1. Is any dischargerobserved from any part of the operation?
Discharge originated at: ElStructure ElApplication Field ElOther
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 ONo ❑ NA ❑ NE
❑ Yes ))No
❑ NA ❑ NE
❑ Yes P No
❑ NA ❑ NE
❑ Yes ONo
❑ NA ❑ NE
❑ Yes
ElNA ❑ NE
❑ Yes No
f
❑ NA ❑ NE
Page 1 of 3 12128104 Continued

Facility Number: jDate of Inspection:/2-4
Waste Colitction W Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2
Identifier:
Spillway?:
Structure 3 Structure 4 Structure 5
Vr No ❑ NA ❑ NE
No ❑ NA ❑ NE
Structure 6
Designed Freeboard (in):
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
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 2No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes C'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes L2'No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes jo"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_)2]'No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes � 2 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes PkNo
❑ NA
❑ NE
acres determination?
T
17. Does the facility lack adequate acreage for land application?
❑ Yes /140
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes/No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes �o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes jZr—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 '12-No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 'EffNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes &No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection: 117
24. Did theofacility fail to calibrate waste application equipment as required by the permit? ❑ Yes SzNo ❑ 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. id the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes ❑ No ❑ NA ❑ NE
. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes '12 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes Jallo ❑ 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 1/� No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
/'-
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
T
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes 71 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments."
Use drawings of facility to better explain situations (use additional pages as necessary).
�chzz I 4,-Al- llf C1S
1
� r ,� f i% al' s ✓2�
Reviewer/Inspector Name:
Phone: 7 ,e?e
Reviewer/Inspector Signature:
Date: z_
Page 3 of 3
4/20 I

[Facifity Number
Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine A Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: � Arrival Time: Departure Time: Q County: yC/+���✓ Region: wl`
Farm Name: n Owner Email:
Owner Name: _ _ I�JIJ�irJ%/%�/ /&22'S __�G% _ _ _ __ _ Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: D �S
Certified Operator:. 6,17
Back-up Operator:
Location of Farm:
Phone No:
Integrator:l��iSG��
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 c 0 6 0 « Longitude: = ° = d = ,A
Design Current Design Current
Swine Capacity- Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouits
❑ Other
Discharges & Stream ImRacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current:
"Capacity Populati :;
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures.
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes t" No ❑ NA ❑ NE
❑Yes ❑No El NA ❑NE
❑Yes ❑No El NA [:3 NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ,❑�,/No ❑ NA [I NE
❑ Yes LLI No ❑ NA ❑ NE
12128104 Continued

1 ;
- .-r;
Facility Number: Date of Inspection
E044-
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: ' �7
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):, 0-
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 No
❑ Yes /❑ No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes YNo ❑ 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 ANo ❑ NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA El 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 needoy`es Vf No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. Yes ❑ No ElNA ElNE
Excessive Ponding ZHydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes )ZfNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? Yes ElNo ❑ NA ElNE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. .
Use drawings of facility to better explain situations. (use additional pages.as.necessary):,'
%!'�GF�v.�'.� �/rliOG,¢f�,/T� Ci�cG �� G�/i5',� �nlDa�G- /�',,.tp lrc,�✓�F� /viy.P„�
Reviewer/Inspector Name (�c1 Phone:
Reviewer/Inspector Signature: Date: 1go /n2
Page 2 of 3 12128104 Continued

Fxcilit� Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA NE
ElWaste Application [IWeekly Freeboard ElWaste Analysis ElSoil Analysis ElWaste Transfers El Annual Cer Zrication
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
V-NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
0 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?
PYes
❑ No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
�No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o
y0j]
[-INA
ElNE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
W4,1 �5'K5r2�1�1
,� S�f!%� ! fi�G� S �i✓ /���G/� �iJ� ��/ guc.c /,g-z� /�� IVF,E Q !� Zc-cr
tea, �v� �.��� �r�,,i/J G. J G✓E � �� f>�-S�,
/?7�,o��,� 41V
Page 3 of 3 2 Q ,Q : j f119-5: lk,- p! , /I% I) -p /-04&0,J,12128104

e
1
Type of Visit 10 Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit / Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other ❑Denied Access
I
Date of Visit: /� '! a?6 Arrival Time: rr� Departure Time: r ntj : 4 Region: s �Q
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: i��W_577
Title:
/�Onsite Representative: yC. ' 4%J
Certified Operator:
Back-up Operator:
Phone No:
Integrator: ��!7 ^�
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = 0 0 i =As Longitude: 0 0 = i = u
Design Current
Design
Current
Design Current
Swine
Capacity Population
Wet Poultry C►apaeity
Population
Cattle Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
❑ DairyHeifer
Feeder to Finish
%
El Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
El Beef Stocker
❑ Gilts
❑Non -La ers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl
❑ Turke s
Other
❑ TurkeyPoults
Number of Structures:
❑ Other ❑ Other
❑ Layer Dairy Cow
❑ Non -Layer ❑Dai Calf
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?
Page 1 of 3
❑ Yes VNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
)IJNo
El NA
[I NE
❑ Yes
XNo
❑ NA
❑ NE
I2/28104
Continued

t
Facility Numher: —an 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 D NE
Structure 1
Identifier: ':�2 Z
Structure 2
/ 21
Structure 3 Structure 4 Structure 5 Structure6
;5
Spillway?: No
A
NO
Designed Freeboard (in):
! /. ,T
Observed Freeboard (in): ,3 rP
33
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes XNo ❑ 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 D WQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
V No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
VNo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes]
No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
j[d No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
/
❑ PAN ❑ PAN > 10% or l0 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)
Z­�,�7rs4>63yiP�_�OZ�
f
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes 9 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
to Yes ANo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes Y(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):
15)
1kr
A,
414 il,EX7'�
Reviewer/inspector Name
Phone: O
Reviewer/Inspector Signature:
Date: O
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection O�
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El maps [I Other
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
9No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. [Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis 9Soil 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to property dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes No
❑ NA
El NE
El Yes //No
❑ NA
❑ NE
❑ Yes No
X
ElNA
[INE
ElYes ONo
❑ NA
❑ NE
❑ Yes X No ❑ NA ❑ NE
❑ Yes YNo ❑ NA ❑ NE
❑ Yes XNo
ElNA
ElNE
ElYes 0 No
❑ NA
❑ NE
❑ Yes 'VNo
❑ NA
❑ NE
❑ Yes 121 No
❑ NA
❑ NE
❑ Yes Ld No
❑ NA
❑ NE
OYes�❑ NA
❑ NE
Additional Comments and/or Drawings:
n
�4r,G� r cJ�4�l.-2 AQ f 7 �P � D f0 /j%Fft<'� �T n :5�,.Px,9 -In
2� Rep Va � �2 6C.7�;Ml 3/
33� Fol
Page 3 of 3 12128104

Type of Visit &Co fiance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: I al Uj Arrival Time: 60 Departure Time: County: I O Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: (3f'-Rb PALks I Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ 0 = ❑ Longitude: ❑ ° ❑ & ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
❑ Wean to Finish
❑ Wean to Feeder
® Feeder to Finish
a
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ urkey Poults
❑ Other
Discharp,es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Co
Number of Structures: ❑
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes Z No ❑ NA ❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
❑ NN ❑ NA
❑ NE
❑ Yes
❑Yes
L/JN DNA
El NE
❑ Yes
No ❑ NA
❑ NE
12128104 Continued

Facility Number: 31 6
Date of Inspection �j� l 11 1oS I
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: I f S a �rs 3
Spillway?:
Designed Freeboard (in): r f �, S_
Observed Freeboard (in): Ll 7 14 2-
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 2/No ❑ NA ❑ NF
❑ Yes []No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes Id No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes Q No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 9No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) /
9. Does any part of the waste management system other than the waste structures require El Yes L�l No El NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ElVo ❑ 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 ] 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑l Application Outside of Area
12. Croptype(s)S f3C+►11C(�� J ��
13. Soil type(s)�V2(sjJy LIiL
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[] Yes ❑ No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes [--]No []NA. ❑ NE
�Coroments (refer to question Explain any YES answers, and/or any, recommendations or any o#herscomments , 4.
Ilse drawings''>of facility to better explain s[tuaho i Ause additional pages `as necessary}
Reviewer/Inspector Name I Jo 4 )-j ra Q_� 16C L . Phone: T b29 & ' 7a t; S
Reviewer/Inspector Signature: Date: l a+ a
72128104 Continued

Facilfty Number: — %(p Date of Inspection o
Required Records & Documents /
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes B No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 04 ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
LXNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ t20 Minute Inspections ❑ Monthly and 1"
Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
<0
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[�/No
El NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
❑ NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
[I Yes
�C]]/No
L�l 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
❑ ❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P K'
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Pxo
❑ 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
EJX�o
ElNA
ElNE
If yes, contact a regional Air Quality representative immediately
No
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
O
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
�,,�
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes
Ufgo El NA
El NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Cornments'and/or Drawings: - _F
12128104

(Type of Visit jO Compliance Inspection O Operation Review O Lagoon Evaluation
for Visit oRoutine Q Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of visit:
13 Permitted © Certified 0 Conditionally Certified © Registered
Farm Name:. <11
Owner Name:
Mailing Address:
�Tiarne• �
Not Operational O Below
Date Last Op ted or A ve Threshold: _.
County: Lie M
Phone No:
Facilitv Contact: _____ .. __ .Title:. Phone No: ...
Onsite Representative:_ .HQ, l f' Integr'ator•. %!' l u l ,_,,,
Certified Operator: _ , .... _ . W. _ .... „.� _ _ , _ Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 " Longitude • 4
Discharges & Stream Imp cts
1. Is any discharge observed from any part of the operation?
❑ Yes 0'1Go
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a_ If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
•c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes eNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes El'Ro
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: __ ;L
Freeboard (inches): 3 to 3 Q r
12112/03
❑ Yes M-No
Structure 5 Structure 6
Continued

Facility Number: Date of Inspection 716
5, Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ yes ONO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑yeso
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of,the structures need maintenance/improvement? ❑ Yes Rf4o
8. Does any part of the waste management system other than waste structures require maintenanmprovement? El Yes ,E!rNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes •dNo
elevation markings?
Waste Application
10. Are there any buffers that need mainteaancelimprovement? ❑ Yes'2NO
11. is there evidence of over application? If yes, check the appropriate box below. ❑ Yes 'Ergo
❑ Excessive Ponding ❑ PAN ❑tH draulic Overload ❑ Frozen �G�round ❑ Copper and/or Zinc
12. Crop type f f'1'UIJQ �11.1 •,f..<��✓�_a-���c+.l�..1 �� _ _ - —
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes Ea"No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes jNo
b) Does the facility need a wettable acre determination? ❑ Yes ONO
c) This facility is pended for a wettable acre determination? ❑ Yes eINo
15. Does the receiving crop need improvement? ❑ Yes eNo
16. Is there a lack of adequate waste application equipment? ❑ Yes ETRO
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ❑ Yes ETNo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes .eNo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes eNo
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 j2No
Air Quality representative immediately.
vV t vs !VN o U2�
to e i A3, CyQ s
eG
Ms s ry) 0 Field Copy ❑ Final Notes
Y
on V'\ 'B5 aoa. c vc j
S �' T8 A i e- v..
V leq.�e-' con -a rvuLjz-
1`-zt� o 04 sklzkfe- ,eXGzp&i-t
Reviewer/iaspector Name
Reviewer/Inspector Signature:
Date: /%�

Facility Lumber.,:? — Date of Inspection G
Hired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes R-jNo
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
No
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
23. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes ;2140
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes �No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes Z No
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/lnspector fail to discuss review/inspection with on -site representative?
❑ Yes Pfio
28. Does facility require a follow-up visit by same agency?
❑ Yes j2<0
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
NPDES Permitted Facilities
30. Is the facility covered under a NPDF.S Permit? (If no, skip questions 31-35)
.^Yes ❑ No
3I. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
0 Yes ff No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes �Fo
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes .0No
35. Does record keeping for NPDFS required forms need improvement? If yes, check the appropriate box below.
[I Yes Zr-No
❑ Stocking Farm ❑ Crop Yield Form ❑ Rainfall ❑ inspection After I" Rain
❑ I20 Minute Inspections ❑ Annual Certification Form
l2112f03

Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification f6 Other ❑ Denied Access
Facility Number Date of Visit: Time: ED=
Nat O erational Below Threshold
Permitted [3 Certified [3 Conditionally Certified 13 Registered Date Last Operat or Above Threshold:
Farm Name: „ Su}�irP L © x, F cc\ V3 County: Q-PLZ I-1
Owner Name:
Mailing Address:
Phone No:
Facility Contact: Title: C Phone No:
OnsiteRepresentative: �eF?�P.ROS uRRo�VVON& Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
In Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ' " Longitude ' 4
Design
C+urrent
Design Current
Design Current
Swine Ca acity
P,o ula'on Poultry
Ca aci .,. P,o ulation Cattle
Ca aci Eo ulation
❑ Wean to Feeder
Layer
❑ Dairy
❑ Feeder to Finish
❑ Non -Layer
❑ Non-Dai
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
rotas Design Capacity
El GiltsM-M
❑ Boars
Total SSLW
Number of Lagoons � ❑ Subsurface Drains Present ❑ La oon Area
❑ 5 ra Fie1d Area
Helding Ponds 1 Solid Traps
❑ No
Li uid Waste Mana ement S stem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection && Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Continued

Facility- Number: — Date of Inspection D 3
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes []No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes ❑ No
(1f am 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 pan of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do anv stuctures lack adequate. gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
W'aste 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 ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CANk MP)? ❑ Yes ❑ No
14. a) Does the facility lacy: adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This faciliy is pended for a wettable acre determination? ❑ Yes ❑ No
IS. Does the receiving crop need improvement? ❑ Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
:. 18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps. etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soiI 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 DNt'Q of emergency situations as required by General Permit?
Oe.f discharge. freeboard problems. over application)
El Yes
❑ No
23. Did Re-, iewerrinspector fail to discuss review/inspection with on -site representative? �
❑ Yes
❑ No
24. Does facility require a follow-up visit by same agency.
Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
(© No violations or deficiencies were noted during this visit You will receive no further correspondence about tfiis visit.
.�, �.�1,.— -• .s raYi�"�"•_, •..,.: - ��`a.-.��-'�"�'�4if�w �'=_. ..._�- r., _ -•T :;6ta` y�-i'° ;�`"A-c '_.._•-� f-ic?r •- in
WgnRfwn #) `F.iplsm:any I 'answers-snd/ar any i�ccin:meudst<oas or am! i liet.comaients`: ; M
Use drawings of facility to better explain situations. (nse addstxonal pages as necessary) 0 Field Copy ❑ Final Notes
dd- w-s .-- Ts..-i^qr 'G.,., _. �_.%.�.ei.��.�:.X`n'r"�r. v-.�sr.:.-i � r-.,_'s,..s «:.1,.�_��..Y`3 �-7�-`�•ra�v-`e.�w�..�+-err-.^rY-_,—a�.r.� T '�.:.Y�•%:fe
ee '' `� -�
tSREC_'�"sfl CvNS3'ACITEp kr�TN ZcSCEa-r L Cu.rr5 Svc- `JCs'Etrr�ST
Tk 't�
erry V-z:V.:_s-z-o+J 0r- S0z'- Wr'\-76fe Co�as>`c� a�zan! FOR WE'rLAPD
ZZ-v(A An1G�F2 An�o �RuL M Rs--�,, ��o�n S�ANC�L F�2 �� V�►garvrn�r�r�
SZ�rC
c�1C. Gg C Uri waea e O.
. •a .«pS Y N
ti
Reviewer/Inspector Name .' 't` `.�
Reviewer/Inspector Signature: Date: d
05103101 Condnaed

Facility Number: 1 — Date of Inspection
Odor issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Additional Commeats and/or..Drswin
OF a�-�.� COO cF-R t� LOP,5p F � F
UkXE-y �kOuSE5 PVT P 1
AAA ZF_FJJ CLP-P2Z- Q L 90r,) RCv4 F t ' ,• - '�r l -
RN ,7-(-z-rt-( rS F:�:Le- A 5 Z c-s0ID 0 rDRE0 �pC { ( ids
AREP�- L�A S `i.J E �i�N A FQ �S 1r �f [ r>' �F r s' /� �p,5 8y
1' ELT C R F L.L
" ANoAR� I Oi aqS�.
- 14 Wp'S,f\C�-a-F-C-Q POn7 rNX
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rOU5E5 1-�F4 ti iJ!a0 6EF��+1�ous
Y .DFL�2T�
" SP�� GLF� �Nt)zROcJN�F tJTAL tJG R( Z-Eo �O -C E maRk i '
fA�E"���t��� 1�PC��O C�►t� �i�E �R'F�12ac..►s �FL7rJ�1"�"�On),
15: pm Dr -- `moo u3p,, Ee \D©i3 "
rgP'K5y N® Es
05103101

i
Type of Visit 4mompliance Inspection. 0 Operation Review A Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification
{Facility Number Date of Visit:
Permitted U Certified D Conditionally Certified [3Registered
Farm Name: - i�--X�,1 � 3 .
' `,y
Owner Name: rJ f �/�ZIY 1 6
Mailing Address:
0 Other ❑ Denied Access
Time:
Date Last Operated Above Threshold: _
County: � A/ — — „--
Phone No:
Facility Contact: TitI : R Phone No:
Onsite Representative: '0 Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
swine ❑ Poultry ❑ Cattle ❑ Horse Latitude &6 " Longitude ' 9 �u
Wean to Feeder
Feeder to Finish
Farrow to Feeder U Other
Farrow to Finish
Boars
Subsurface Drains Present
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?
Area lu Spray Field Area J
❑ Yes tVNo
❑ Yes ❑ No
❑ Yes ❑ No
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
Identifier:
cture 2 Structure
Structure 1 Structurecture 3 Structure 4
# ��
Freeboard (inches):
OY0310I
Structure 5
❑ Yes
❑ No
❑ Yes
1pf No
❑ Yes
0 No
ZYes ❑ No
Structure 6
Continued

r
f
Facility Number: —Date of Inspection
5. Are there anv immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑Yes
❑ No
seepage, etc.)
b. Are there structures on -site which are not properly addressed and/or mananed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
❑ No
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 maintenancelimprovement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
'*'*�aste ARRfication
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11_ Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
El Yes
❑ No
12- Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAR'MP)?
❑ Yes
❑ No
14_ a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Reuuired Records & Documents
17. Fail to have Certificate of Coverage 8 General Permit or other Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP. checklists, design, maps. etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
El Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the faciliry 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?
(iel discharge. freeboard problems. over application)
❑ Yes
O'No
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
ONo
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
L© No violations or deficiencies were noted during this visit. You will receive no further correspondence about tliis visit.
Commenis�{refer to question �.:Eitplatti-any Y!E'S ans>leers°andlw- atly re�nime�t#attons'flr atrv:otiier comments: .�:._ � �. `tl
_
Use drawings of facility to better explain situations. (use additional -pages as aecessaryj
w ... _ ain x � - Field Copy - 0 Final Notes x
�^�_M'Tac!`.r
i -_,., �.._.. ._^ .L�.-..+'3i_� Lv`..:.�'+'.���--.....r._x._tis_.Y.-.R._elM�.: Y.:". ::'S..='.;�,:.as �.fi.. �,..5 S"......Ci•..e"' L
AL
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LA_- J-J W 2/iJC� VA� 6E L—,O GC),6jZ
r� / •�Y7✓ r f 3V Y./� r jJ/ l
r
Reviewer/Inspector Name "gym« yLL
Reviewer/Inspector Signature: Date: f
0510310I 1 Condnued

Facility ,lumber: Date of inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
28- Is there an,,- evidence of wind drift during land application? (i.e. residue on neighboring vegetation. asphalt. ❑ Yes ElNo
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 anv 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 permanentitemporary cover? ❑ Yes ❑ No
05103101

Facility Number
Date of Visit: 3 2rj O Time: 1 ,
3
Not Operational 0 Below Threshold
O Permitted O Certified [3Conditionally Certified [3Registered Date Last Operatt d or Above Threshold:
Farm Name: Sty .A >"Lle F'o k Fa, ""1 County: V Old
Owner Name: , � H L_ /`"'t sA L L G _ Phone No:
Mailing Address:
Facility Contact: Title:
Onsite Representative: 13 '' 0. iq
Certified Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ° " Longitude 0 6 �u
Destgn
Current Design
Current
Design Current
Swine Ga acity
P,o In 'on Poultry Ca paci
P,o ulation Cattle
Ca aci Eo ulatiap
❑ Wean to Feeder
❑ Layer
❑ Dairy
❑ Feeder to Finish
❑ Non -Layer
1E1 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSLW
Number of Lagoons
❑ Subsurface Drains
Present ❑ La oon Area
❑ SeraSeray Field Area
Holding Ponds 1 Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
2. is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: I z 3
Freeboard (inches): ? 2 r- Z O.7
05103101
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [--]No
❑ Yes ❑ No
Ye
s ElNo
Yes ❑ No
0Yes ❑ No
Structure 6
Continued

e
I
Facititti Number:
Date of Inspection 3 2
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 ves, 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 anv stucrures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
«`ante Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? -,Excessive Ponding ❑ PAN ;Hydraulic Overload
12- Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA)INP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
37. 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/ VVliP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation. freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional D«'Q of emergency situations as required by General Permit?
(ie! discharge. freeboard problems. over application)
23. Did Reviewerllnspector 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
Oyes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Yes ❑ No
❑ Yes
❑ Yes
❑ Yes
❑ Yes
,ayes
❑ Yes
❑ No
❑ No
❑ No
❑ No
❑ No
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
El Yes ❑No
❑ Yes ZNo
❑ Yes ❑ No
❑ Yes ❑ No
13 No violations or deficiencies were noted during this visit. You will receive no farther correspondence about tliis visit..
•,9, _ r ;
Coinenients'{refer to gnestioa ''Ez iian :a YES snsweFs sndlarany ri coixumendaaous-or.W- atlier eomm�
_�
Use drawin of factiftty to better esplaut sihtattons: use additional pages�as necessary) y Copy ❑ F' '. -_.
q© Fie d in Notes
��_
T-.%spec4:ok, do,..e in 1'eyanre 4o ot co­f/air,f ,
1 1
2 . (_.�J a-f4e r' v Le Ff dE SGk_Ae0c � In 4D kJal4cl-s W 44 e .�,q4e e-s- ;,A A 44- be
,,1a je4S+ -15-eO gallmhS, J44e,- Qv,1114y _<vto files end f;Z-4i110$ were•
4-t kerl
3� q.-rytr�e i ,s pe-�ded wo,-s-4 c 2n d waS4e rh q et,4 ck nPq-
1,o�sCs arrAre•%J(%j resvjfah[ re6r►% A ]&AL,'n� I relic-f" Vat).�.��
�� 9 w> - : tires �.s .t'
Reviewer/InspectorName — " xe�'
-ate-„ �' .°b°�" �Y.'.' rii-Y r. ir+' Su +hr��%sw..�r
Reviewer/Inspector Signature: Date: 3 Zr% �3
O5103101 1 f Continued

M
{
Facility Number: 31 -7i(51 Date of Inspection 3 2
Odor Issues
26. Does the discharne pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there anv evidence of wind drift during land application? (i.e. residue on nci+hboring 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 probiems with the ventilation fan(s) noted? (i.e. broken fan belts. missing or
or broken fan blade(s). inoperable shutters_ etc.)
1. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary covcr?
Ge M-4 I n t. a C<) 4,9 pee. ven4 laa k T
i-Y eN S 4-e
i t .—rker-c rertd;n j a,r' U'jAx ie %� -✓hv and rt.ncr'4r
z4 arp,4rs m4tY nett int�revcMeit�7.
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
❑ l'es ❑ No
El Yes ❑No
❑ Yes ❑ No
O5103101

R
Type of Visit A Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 56 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit:
Permitted [3 Certified 0 Conditionally Certified 0 Registered
Farm Name: _ . J4- .4 / U_Y A /— .�3 —.—
Owner Name:
Mailing Address:
Time:
Date Last Operated or Above Threshold: _
County: L!>oG�i✓
Phone No:
Facility Contact: f Title: Phone No::
Onsite Representative: — it - Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
.[swine ❑ Poultry ❑ Cattle ❑ Horse Latitude I .1 4 1 " Longitude I * L__J` 1 66
Wean to Feeder
MILJ Layer
Feeder to Finish /
Farrow to Wean
L=Eiooth
Farrow to Feeder
Farrow to Finish
Gilts
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)
e. 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?
❑ Yes VNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes VNo
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 S Structure 6/
Identifier: 2
Freeboard (inches): UIIIE
05103101 Continued

�l
Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed 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 maintenance/improvement? ❑ Yes /VNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes PNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ko
11. Is there evidence of over applicatign? ❑ Excessive Ponding , ❑ PAN ❑ Hydraulic Overload , [I Yes PrNo
EIL
i� i cj . I:� % " IA 1 1!/l•; lll�?_-?�1,�f�.Tl �1E&M,
13. Do the receiving crops differ with those designated in the Certified AnimarWaste Management Plan (CAWMP)?
Jf ❑ YesXNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
V�No
b) Does the facility need a wettable acre determination?
❑ Yes
A No
c) This facility is pended for a wettable acre determination?
❑ Yes
)2� No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
Y(No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
JNO
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
/VYes
❑ Yes
9No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
PfNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
'0
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
`Comments ('refer to question #) Explain any YES answers and/or a recpmmendabons ©? any other comment§.:
.� - : .„ _: t • o Field COPY El Final Notes
Use drawings of facdrty to better eaplam srtuatrons (use a_ ddtttonal"pages at necessary)
$ r
�1 v�/1tE GUGc� ,7'iP�� ��/✓ �?./�G,O #� 1���Q � � �t.G�'Qr
J
Reviewer/Inspector Name �' F
di 0
Reviewer/Inspector Signature: Date:
05103101
Continued

Facility Number: EM Date of Inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ 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?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i-e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
aona -omments'an or _.rawrnp::
41YO 4a-7'--'r
rT�'''rJ �i�? f�-LG- �`R�.�^/ ��G�G'r�� � onl5 �,✓r0 ���
y
❑ Yes No
❑ Yes o
❑ Yes Y110
❑ Yes10 No
❑ Yes�No
❑ Yes ❑ No
5/00
A

I
Type of Vlalt ACompliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit Routine O Complaint. O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: ® Time:
Q Not Operational Q Below Threshold
Permitted [3 Certified 0 Conditionally Certified © Registered Date Last Operated or Above Threshold: ........W _w
s cam, P PDX �c a..nc..�..r�..
Farm Name:.�.�.—.�.7......1..�.).r:�...�.l�:�i.................. 1..-.,�............. .............. County:. .............. ..... .....
W.........»W.
Owner Name:.. .1� ..{... t...rl.............................................................................. Phone No:.
Facility Contact: .i IA ALAD....... tti. � ............ Title:. 1nl11t.1'1 e s ......... Phone No:.��
Mailing Address:...! .❑.�....QOX...... E............ H..L.L-L.......... --"C ................. ....... ........ .....
Onsite Representative:.U3.Lj�.. J�?......tt&L_5C_.5........ .......... Integrator:...-n,.^,,,.AU.rj .. •
Certified Operator:..jD.t;?.-ATi..........k �`\.t...�............................................... Operator Certification Number:......
Location of Farm:
PTxpnAn T- ei u_ t n- E m,-5 ,57-Tt Q n O F 5 r-a- l % O Z S M_ l l Z� , CrQ 0. 2- ­Vn t , +
D t`l S t t t 'Z A t=A M C.< S O tZ T l-t L— 1=T S t b C. 5_11, S t to Cj
19�Swlne ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �` �" Longitude �• �� �u
Ilesigm.. Current`_:
Capacity -P' nnlation
Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Gilts
❑ Boars
Design Current:, -
Poultry -= .Ca- aiaiPo ulation ,Cal.ttle -
❑ Layer ❑ Dairy
❑ Non -Layer I 1 ❑ Non -Dairy
❑ Other
Total Design Capacity
6tal sSLW- I
rr:..a... , ..
N tber.of.Lk66ns ❑Subsurface Drains Present LagoonAres ❑Spray Field Area
_Holduig Pnd/ SoldTWaste Management System ;
r -
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
f `No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
/
a. If discharge is observed, was the conveyance man-made?
❑ Yes
qNo
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
❑ Yes
"rlo
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? [I Yes
o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
*0
Structure 1 Structure 2 Structure 3 Structure A Structure 5
Structure 5
Identifier: .......�.' ........................... 1............... ...........�r.............. .................................... ................... .................
...........................
I.......
Freeboard (inches):
5/00
Continued on back

acility Number: -� j —rl F, Date of .Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes *o
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes gNo
(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 XNo
8. Does any part of the waste management system other than waste structures require maintenance improvement? ❑ Yes ANo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes XNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ONo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ONo
c oSTf�t�
12. Crop type 'hn�Tt l4 / 17;), `-sr L , I ) r► T1-44. O`lS:ta�� f
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 'KNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes XNo
b) Does the facility need a wettable acre determination? ❑ Yes gNo
c) This facility is pended for a wettable acre determination? ❑ Yes 'E�(No
15. Does the receiving crop need improvement? ❑ Yes E�No
16. Is there a lack of adequate waste application equipment? ❑ Yes T(No
Reauired Records & Documents
17. 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
A No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
ligNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
IR No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
gNo
\
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
JXNo
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
)E(No
24. Does facility require a follow-up visit by same agency?
❑ Yes
I"No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
t�No
-viola�iQris:o�r d�fc�e�ci�s -vt�re p4ted• atlt'�g �Lis:v�s�tt • Yoh wi�1-�ee�iye Rio fu4-th�r
• . .
corres oridence. aboui this visit. .. ...
(refer i)question #}: F.upiaui-any_YES answers and/or any. recommeniiations orany other cnmmeata T =
�.
Use drawings of facihty„ta Better"eaGpi" ' situiitions. (use additional pages as necessary) a - 7
NZ
`iv H
'M �t_J C? C-0-V \ <_ la.._ t71 fi S -It,�A b '1-- 'IA.,_ ,6, SO ra-- l
i-1 T S TD T N t 5 i=f ra_� V_= t3 O^ tom- p C_U.t 5
4 X—
t�i�C r-L C L_n s
CrOO o
LG t-r-D S c-c' t �- t t1 � . �C �.�t_ -�5✓ rr T
S rl P
� .
Reviewer/Inspector Name`t SZ{�
Reviewer/Inspector Signature:' 1/ - J{ f 1 1 on Date: t 1 5100

r
Facility Number: 3 —, Date of Inspection 1 L a
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes '®`No
liquid level of lagoon or storage pond with no agitation? �� \\
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ONo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes `KNo
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 K No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ONo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Yes ❑ No
_! p o ments andfor rawings: W - .. .._.
5/00

t . XlDivision of Water Quality
fQ Division,. of Soil and Water Conservation . " -
Q Other Agency
e
Type of Visit Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit )� Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: It mfj e: Printed on: 7/21f2000
0 Not Operational Q Below Threshold
Permitted ❑ Certified Q Conditionally Certified [] Registered Date Last Operated or Above Threshold: ..........••.
Farm Name: T ..... !�t6n/4�a ..... ..�....' . ........ Countv:..... .a. I .( ... h ...................... .............
Owner Name:. .{? -`'' ....V-4. ......... Phone No: q1Q.. .....
Facility Contact: 2-:.Y..... .....iI[ir�.Title:..Q.L.i,J..t.�..r .................. Phone No:..�... Z
1:.
Mailing Address:..4 � t. l?- I C. I; ?/'cot...1...�........ �..... ...:.f?- 7.5 . ...... L.i_...... �11. ..... 1....ts ..�
Onsite Representative:......... FL t_7L.1~............ Integrator:...�/1��(.%tj.t i:..`7................................
Certified Operator:, l-� i`-[�-'Z' 1-n,Q,�C� Operator Certification Number:,' 1,.,['
............ ................ .......... ...
Location 'of Farm:
W S�S T- CD 1! S V_- 5 i ID c0 P S M__ l 1 'Zq ' A J
O z its,`• t t_j'_S 5 C,j op S r>- t 1 0-2_
10wine ❑ Poultry ❑ Cattle
❑ Horse Latitude ®•�
��� Longitude ®• ��«
Deli "
gn
Design
Current Desi
Current Desi'
p _ Current
-Si
Capacity
Population Poultry Cavadtv
Po ulation Cattle Ca d _ Po ulatfoA .
Wean to Feeder
❑ Layer
❑ Dairy
=_
-Feeder to Finish
❑ Non -Layer 1
10 Non -Dairy
Farrow to Wean
Farrow to Feeder
❑ Other
Farrow to Finish
Total D&ign Capacity_
Gilts.
Boars
Total SSLW`>Y
- Numbeii•.of Lagoons . ❑Subsurface Drains Present ❑ Lag^�►n Area ❑ Spray Field Area
W -
Holdmg ]ands / Solid Traps ❑ No Liquid Waste Management System ^,
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes )ZNo
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) El Yes ` To
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 'O'No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes �LZNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yeso
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier .l1.. 2.....51
� 2
........„�. ................................................................... ..........................
Frechoard (inches):
5100
❑ Yes'`4No
Structure 6 �--
Continued on back

Facility Number: — Date of Inspection Prinked on 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes "No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes `<No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
XNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
No
X
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
ANo
12. Crop type A3�-�V rpn^ D � , rl•� - n74TL/A, A, k-Z D Cs-f°l -UA- ^-A
r•
P yP t i-7 tMtj 6 c At _t � ,_r�R'f r, n4' S f D
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
KNo
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?
`KYes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
D'No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
oyes
❑ 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.)
XYes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
5kyes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
XNo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
Wo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
CjrNo
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
❑ Yes
J"No
24. Does facility require a follow-up visit by same agency?
❑ Yes
TIC)
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
JKNo
�i6.*R Wiis:or• deficiencies -Wi�re ngted diWifid this:visIC • Y:oh will teeeive lio fufth�r
corgis' oridei ' ' about: this visit:
Com%nents (refer to question" #): Explain any YES answers and/or any recommendations or any. other comments v
Use drawings of facility_to better explain situations Juse_additionaipages(as aec essas"9),
-
Q� Crt_-'-OUt ���a S r'Q C O I-�i-C�-O t-- �-r�TS r t t A l a [a-� Ab
�-3 v r--ta=0 W t r-% G -1-A T` T-0 (v L c— p c n G.- Pou n D
crn-� C C) v r-) r(a
L 5� Crta ©c �t�- `vL CCU S i 0
(� t` C i_ t7 C i 1_-:- r) r, n 4C LD
Reviewer/Inspector Name
Reviewer/Inspector Signature:
5/00

Facility Number: —,� Date of Inspection l Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below '(Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �KNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes �'No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes 1�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 gNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes Tx(No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Yes ❑ No
Additional Comments and/orDrawings:
AL
t5'. CCJc�T{D try-, LOS}. vn,/�
s d D
•'2n� f�-�CJ A t f� j O sv`�� to—[_74 F l ha-U[ cJC. fa_
T-o n h l-- Y i- e -�-L ALCO h-D [ t� G T
S o t t. T` S-T- h- C G D A--r- L-O n S L t-X ^-j-
C D hTt v� ��V Ci_� G F t C i_tJ S
c_-U
�- O w e� "� 4 �p S
L -- L L A O-OC) C �' r
(�-GCp c3-tJ S r
IL &1->_C)C j C[�SOS
i3 U t-a_
Za40 "1 So inn v t0�Artpt,S .Y
t t -� 'tom OT AS -
L� � �
f3 Ct Le p f
5/00

of Visit OO Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification OO Other ® Denied Access
Date of Visit: 8-18-2UOD Time: 1530 Printed on: 9/152000
Facility Number 31 765
O Not Operational O Below Threshold
Permitted M Certified 13 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: UAcBAIeEarin............................................................................................ County: D.upft .................................... 3MU......
Owner Name:..... ....................................... KRRWImF'=1LJXw� --------•-----•----- Phone No: 9l.R2$1:24.24_.--•--•--•--•--•--•-
Facility Contact- - -- - -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Title:. -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- - Phone No: - -- -- -- -- -- -- -- -- -- -- -- --
Mailing Address: .1.2.4&.l jxmw.*1is.RwAd....................................................................... Rasr.tlJill..XC......................................................... .28458..............
Onsite Representative: _____________________ Integrator: Grp]r�X.��naj�y,k', ts..__.__.__.__._
Certified Operator: ,Iam�s A.Kna�les ._ .. _. ._ Operator Certification Number: JL724JL __ .......... _.
Location of Farm:
West of Wallace- On Southeast side of SR 1129 approx. 0.2 mile Southwest of SR 1102. +
® Swine ❑Poultry ❑Cattle ❑Horse Latitude 34 •
45 i�
55 :K Longitude
! 78 • 08 20 u
-Deargn Current
Design
Curren#
Design Current
. ..
5wme......... .....::.:........Ca a :: Po uIa#ron :.Poultry
Capacii#y
.:-:
Population Cattle ..
Gapacify: '.Popiilahon
❑ Wean to Feeder
® Feeder to Finish
11016
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
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 6
Identifier: ..... ............ ...... .... ... ... ... ... ... ... .............. ... ... ............ ... - - - - _ - --........... _.. _.. _..... _.. . _.. _.. _.. _.. _.. _.........
Freeboard (inches): -- -- -- --14.- -- -- - - -- -- 1$ -- - -- - -- -- -- --21-- -- -- -- - -- -- -- -- -- -- - - - -- - - -- - --

J/UU Conlrnuea on back
Facil;■ty Number. 31-765__j Date of Inspection 1 8-18-2000 1 printed on: 9/15/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes © No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes © No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? [:]Yes ❑ No
Waste 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 ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ©No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
© No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
© No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
© No
19. Does record keeping need improvement? (iel 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
Cl No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
® Yes
❑ No
23. Did Reviewer/Inspector fail to discuss review/mspection with on -site representative?
CK Yes
❑ No
24. Does facility require a follow-up visit by same agency?
9 Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
No violations or deficiencies were noted during this visit. You will receive no further
correspondence about this visit.
urpose of visit was to assess potential problem at site observed during a fly -over on 8-15-00. Waste was observed being a►
rigated very heavily on the field behind the poultry operation. Waste was ponding and had potential to run-off field based on
erial observation. Gate was open when I arrived and a vehicle was observed at the end of the path near the houses. I
roceeded to enter the site to make contact with a farm representative. I met Mr. Knowles' daughter at the end of farm path
ear houses in the same vehicle I had observed. I asked if the farm manager was available and she asked me to state my
usiness for being there. I told here what was observed and that I wished to check on things.
Cont. ---�
Reviewer/Inspector Name Deat;Hunkeie :.

I1Aev1ewerrin3PCCLur aignaLure: Late: 5100 !
------------------ - -
1" acility Number: 31-765 Date of Inspection 8-18-2000
Printed on: 9/15/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ❑ No
She asked if I had appointment and when I stated no, she asked me to leave the farm. I did so after providing her with my
name and mobile number to relay to her father since she was going to page him. She escorted me to the gate and I
proceeded to try another site nearby.
returned approx. 30-45 minutes later after failing to make contact at the other site and found the gate closed. I pulled into
ie path and was waiting to hear from Mr. Knowles. She observed me at the entrance and drove to the gate observing me
'om inside the truck and made no attempt to contact me. Approx. 10-15 minutes later, Mr. Knowles drove past me to the
ate which she opened and he drove in, then the gate was closed once again. I waited for 5 minutes or so and drove up
ie gate to find out what was going on. Mr. Knowles finally came over and I relayed to him why I was there and showed
im the photo I had taken on 8-15 from the air.
e stated that he did not have time to deal with me since he had poultry dying at another farm and had only come over to
ck up something. I told him that she could escort me around and he said he needed her and another young girl to come
th him. He asked me to come back on Monday or Tuesday and everything would be the same. The forecast was for
;avy rain that night, thus any discharge or evidence of one would most likely be gone afterwards. I told him that I really
-eded to get on -site and he pleaded with me to 'work with him". I asked him what his lagoon levels were and he provided
e ones listed on this report. I informed him that I was considering this a Denial of Access and could get a search warrant,
it was not going to do so. I also instructed him that there could be reprecusions for denying access and promptly left to
void any possible altercation.
Levels were not observed, but given to me by the owner at the front gate.
Mr. Knowles stated to me that he had called in his high levels to DWQ. If levels are correct, then DWQ was not
ied according to our records. In addition, we most certainly would have made a site visit after such a report given the
of year. Mr. Knowles had called DWQ (Scott Vinson) on 7-27-00 to report lagoon levels of 23" and that he had lost
records in a fire at his office.
This inspection report was entered on 8-30-00 after the visit and no copy was provided during the visit. A copy will be
to Larry Knowles and faxed to Kraig Westerbeek with Murphy today.
Site definitely needs a follow-up and close monitoring over the next several months.
Note: Previous owner (James Knowles) listed as the OIC, but unclear if he is still in charge or not. Mr. Larry Knowles
needs to re -submit OIC designation form as the new owner. Larry Knowles is licensed according to latest information we
have

of Visit) Compliance Inspection O Operation Review O Lagoon Evaluation
;Reason for Visit O Routine O Complaint O Follow up O Emergency Notification ©Other ® Denied Access
[7
Facility Number 31 76S Date of Visit: 8-18-2000 Time: 1530 Printed on: 8/302000
w O Not Operational 0 Below Threshold
Permitted M Certified r3 Conditionally Certified (3 Registered Date Last Operated or Above Threshold:
Farm Name: ........... Coun • Du . ....................................'!h'. [-------
Lame.P.ine.F.arxn............................ty R�
Owner Name: ....................................... K.nR1ylgs.jFj= .In&----------------•--•-- Phone No: 91.Q 28.`I_-142.'k.-----•--•--------•--•--------•--•---------
Facility Contact- - - - -- -- -- - - - - - -- - - -- -= -- - - Title: - -- -- -- -- -- -- -- -- -- -- -- -- -- - -- - Phone No:.. --
Mailing Address:.].2.48.Cn.M$'albs.RQ,ad....................................................................... R0.$f'jWjl..KC ......................................................... 28.4aS ..............
Onsite Representative: _.__.__.__.__,__.__._ _.......- _.__._ _.__ Integrator: NCIurphy.Famj)jy.Fa=&...._.
Certified Operator: Jam &A.-_ _ Knemle9 _....... _ .. Operator Certification Number: J1241
- -- -- -- -- -- - -- -- -- -- -- -- --
Location of Farm:
West of Wallace. On Southeast side of SR 1129 approa. 0.2 mile Southwest of SR 1102.
®Swine []Poultry ❑ Cattle []Horse Latitude i 34 • 45 €' 55 ?u Longitude 78 • 68 20
n Curreiat Design Current Des n
... lg-.......- Curren#
..
Cairaeitv::Pririulatirii:::::: ,o rY.=:.::=::':::::Cariacity,Pnnnlatinn:::::=:
[ aiiae�ty : Pnrii�lahnn-::"
❑ Wean to Feeder
® Feeder to Finish
11016
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
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 6
Identifier: .. _.. _.. _.. _.. _........ _... _........ _.. _..... _.
Freeboard (inches): - -- --14-- ---- -- - -- -- -15- -- -- -- - - -- .� 1- - ._ .. .- -- -- -- -- -- -- -- - - -...._ -- -- -- -- -- -- - --

J/Ud
Conftnuea on back
Facility Number: 31— 765 Date of Inspection S-1S-2000 printed on:
8/30/2000
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
T Do any of the structures need maintenance/improvement?
❑ Yes
© No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10. Are there any buffers that need maiatenance/unprovement?
❑ Yes
© No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes []No
14. a) Does the facility lack adequate acreage for land application? [:]Yes © No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21, Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did ReviewerAnspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
No violations or deficiencies were noted during this visit. You will receive no further
correspondence about this visit.
❑ Yes © No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes []No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes ❑ No
® Yes ❑ No
t& Yes ❑ No
® Yes ❑ No
❑ Yes © No
rpose of visit was to assess potential problem at site observed during a fly -over on 8-15-00. Waste was observed being +
Sated very heavily on the field behind the poultry operation. Waste was ponding and had potential to run-off field based on
rial observation. Gate was open when I arrived and a vehicle was observed at the end of the path near the houses.
)ceeded to enter the site to make contact with a farm representative. I met Mr. Knowles' daughter at the end of farm path
ar houses in the same vehicle I had observed. 1 asked if the farm manager was available and she asked me to state my
siness for being there. I told here what was observed and that I wished to check on things.
Cont. - >
Reviewer/Inspector Name Ilea

neviewernuOspecLur aiguaeure: a►aLe: 5100
1
Facility Number: 31-765 Date of Inspection 8-18-200U Printed on: 8/30/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes © No
She asked if I had appointment and when I stated no, she asked me to leave the farm. I did so after providing her with my
name and mobile number to relay to her father since she was going to page him. She escorted me to the gate and
to try another site nearby.
returned approx. 30-45 minutes later after failing to make contact at the other site and found the gate closed. I pulled into
ie path and was waiting to hear from Mr. Knowles. She observed me at the entrance and drove to the gate observing me
-om inside the truck and made no attempt to contact me. Approx. 10-15 minutes later, Mr. Knowles drove past me to the
ate which she opened and he drove in, then the gate was closed once again. I waited for 5 minutes or so and drove up
ie gate to find out what was going on. Mr. Knowles finally came over and I relayed to him why I was there and showed
im the photo I had taken on 8-15 from the air.
le stated that he did not have time to deal with me since he had poultry dying at another farm and had only come over to
ick up something. 1 told him that she could escort me around and he said he needed her and another young girl to come
nth him. He asked me to come back on Monday or Tuesday and everything would be the same. The forecast was for
eavy rain that night, thus any discharge or evidence of one would most likely be gone afterwards. I told him that I really
eeded to get on -site and he pleaded with me to Vork with him". I asked him what his lagoon levels were and he provided
ie ones listed on this report. I informed him that I was considering this a Denial of Access and could get a search warrant,
ut was not going to do so. I also instructed him that there could be reprecusions for denying access and promptly left to
void any possible altercation.
Levels were not observed, but given to me by the owner at the front gate.
2. Mr. Knowles stated to me that he had called in his high levels to DWQ. If levels are correct, then DWQ was not
otified according to our records. In addition, we most certainly would have made a site visit after such a report given the
me of year. Mr. Knowles had called DWQ (Scott Vinson) on 7-27-00 to report lagoon levels of 23" and that he had lost
records in a fire at his office.
This inspection report was entered on 8-30-00 after the visit and no copy was provided during the visit. A copy will be
Red to Larry Knowles and faxed to Kraig Westerbeek with Murphy today.
Site definitely needs a follow-up and close monitoring over the next several months.
lote: Previous owner (.lames Knowles) listed as the OIC, but unclear if he is still in charge or not. Mr. Larry Knowles
eeds to re -submit OIC designation form as the new owner. Larry Knowles is licensed according to latest information we
ave.

1 Division of Soil and Water C-onservahori - Operation Review
Doil and -Water Conservation :Compliance Lnspeettan s s
,Iivision of Soil
of Water uali Coin Dance Inspection-_-,
r
Q P�
O Otlier Agency Operation Review
�G
Lq Routine 0 Com Taint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of .Inspection
Time of Inspection ® 24 hr. (hh:mm)
[Permitted Certified © Conditionally Certified © Registered 113 Not O erational Date Last O Operated.:
- -
...
Farm Name:......t./..n�............................�........._ County:._.....JZ.,1�.%4....... ............:...... Co.........................
Owner Name..4A''✓L................................f.�fi!1.U..,Wles................. ............ Phone No:... l�l�...ao_C7- ` ..........................
Facility Contact: ........ ......... Leewles....-Title:....... #1//ti Phone No: i
�1......................................................................
MailingAddress: ......................................... .......................................... ................................ ............_........................................................................ ..........................
Onsite Representative: its �Gl #'(.......... �0. '�I............................................ Integrator:....... Yr................................I....... I.................
Certified Operator: ,�',k, p/:✓ S....., ........... Operator Certification Number:
e
Location of Farm:
Latitude Longitude
"= Design Current Design _ ` Current. Design .Current -
Swine Ca acity Po ulatio- PoulCattle'
iCapacity Population
❑ Wean to Feeder ❑Layer ❑Dairy
'IMSeeder to Finish / p/ ID Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
_` ❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish T6tal Design Capacity
❑ •
Gtlts ,
❑ Boars Total_SSM
Number71 of.Lagoons. ❑ Su t ❑Lagoon ❑ Spray Field Area ti
bsurface Drains Presen Area
,Holding°Poiids /. Solid Traps _ ❑ No Liquid Waste Management Sy stem
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 �j 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/mi0
d. Dees discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: Gi0/ LPA*Z. t)oA3
Freeboard(inches): ...... Z/...................?.��i........................-z�_............... ................................... .........................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes +� No
seepage, etc.) �L
Continued on back
3/23/99
❑ Yes j� No
❑ Yes [ No
❑ Yes No
❑ Yes 'j No
Structure 6

.' -:.,. Ad��'k `f"y`.�,,.; a,a, - �,-- ... � . ---, . ,h .. � ;�°� i ....,; „:�.3 x. - :::: a: , -,-�� . - � •.,,, � ;.,.xuo-;,,w..e3t`.%e�� - ""g y � �` � '" ..
• ❑ Division of Soil and Water Conservation ❑ Other Agency
10 Division of Water Quality
Y
r
Routine O.Complaint O Follow-up of,DW9 inspection O Follow-u of DSWC review Q Other
Date of Inspection
F- Facility Number '1G
Time of Inspection i = z.S 2.4 hr. (hh:mm)
Registered 0 Certified © Applied for Permit Of Permitted JE3 Not O erational Date Last Operated:
Farm Name n� 3 Count
T
Alt.......�.s...............YP�..........�..`............... 4±.h....................................
Owner Name:
.�aq.......1".fi�.....�1alr.. .... Phone No: ................�°�.( �i - �V�'
Facility Contact: .............................................................................. Title:.
Mailing Address :..... hoI....... ................................
Onsite Representative: ........... •• ow- 1t.......k. aw6..........................
Certified Operator-,
Location of Farm:
......................................... Phone No: ...................................................
t� .,.. h1k,.......................... ................. �fG.' :........
... Integrator: ...... Ak irt.bj...............................................
.. Operator Certification Number, .........................................
t?:n.....5a .. S......:aa......6.......�..1.1.?�t....�...Q.:.z....r�i. 5.......',xx. ...rn2cr� ......n...........1iR?:...................................................
......... ..... ............... ................. ................... ............. _....... .......
Latitude 0• =` 0" Longitude =' =' "
llesign Current Design , Current rc Design 'Carreint
Svne ff:, Capacity. Population ,; Poultry Capacityy Population Cattle Gapactty. Popu�ahon :
FE ❑ Wean to Feeder ❑ Layer ❑Dairy
EN Feeder to Finish lGl ❑ Non -Layer I' -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑Other
❑ Farrow to Finish Total Design Capacity A
❑ Gilts
❑ Boars Total SS.W 4
Numbee' of Lagoons ! Holdrng Pnnds ©, ❑ Subsurface Drains Present rea
❑ Lagoon Area ❑ Spray Field A
,ate _ ❑ No Liquid Waste Management System boo
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
ONo
2. Is any discharge observed from any part of the operation?
❑ Yes
No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
b3 No
c. If discharge is observed, what is the estimated flow in gal/min?
1�}
l k
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
` 4No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
7/25/97

Facility Number: k --1
•= 8. Arathere lagoons or storage ponds on site which need to be properly closed?
Structures (LaeoonsMolding,Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
0 Yes 0 No
❑ Yes 1A No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...............Z.........I................................................................................................................................
Freeboard (fit):........Z. .......................2-5,
.........................•---..............................................................................................---.......
L.S
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 WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ................... 0�41mt!^G........... ftr+u�............. sk a l....yaik...............................---------.-------•...................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
13-No.vitilations•or deficiencies.were-n6ted-dtiririg this' visit'. You:wvi11 rec've,noltiriher
,..:� .. �::.. .-:�:-:.: ..
❑ Yes
allo
❑ Yes
[A No
Yes
❑ No
❑ Yes
I No
❑ Yes
1p No
❑ Yes
0 No
❑ Yes
J] No
Yes
❑ No
❑ Yes
P;No
❑ Yes
N No
❑ Yes
JQ No
C,Yes
❑ No
❑ Yes
No
❑ Yes
No
❑ Yes
P No
17-• COntiAllt Z'�t bCY`e L�*tcL % oe., ail[. wo-k1s of o_Jj 1'nftG Lui6ons.
�r^or urasio�n C� ti r►n�r aticA Wall o - (o��►. t#i s l�ovO � o Ito.%r j , J
;�• Cu��inu•t. e.-(�-or� '%o in.t�YD1/E_ i lg�mr►1� �j �►"'a-�'�� �rassCS.
LZ- �}WS�'�-� Sa�L ar�.u.�y Srs1_ S�cVIV b2 U �O-'K,f1. oav�CSi d
5"5kovld be. �in gy►r
il ' `
�) w �E C.,f a •I�,,,�, �,,; ��b�,,�� .J,tn"`� _1.� c4S �r
Qr,r t tt � e�
s4.o��d be. 66%e,r�J, C6iv,, 4 f Ur o}�or. da{cs or�c.fi>o-
�oSS;bk � X !1T
d� p .
7/25/97
c�6; , 4rm. for �L skoulc bt, or,, !s {e..
r

© Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection 7 1 Y7711
Facility Number
Time of Inspection �L� 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (ex:1.25 for 1 hr 15 min)) Spent on Review
® Certified ❑ Permitted - or Inspection includes travel and processing)
❑ Not Operational Date Last Operated: ... . .... ...... .. _.. ... ... ..... _ ... ..._ ..._. _ .� .._.
Farm Name: L..�..'_ n .? ..... }� ^ # .1. Z County: • t:.� .n .» ..................... t .
Land Owner Name:.?—" Phone No: _Lft IL 14
Facility Conctact :............._._............._...... Title:
Phone No:
Mailing Address ) ! '- N ZK
Onsite Representative:.'=, ,�+, ,r z „_ Y.. '� ,,ei. ti e, i- Integrator. �� a r — .
Certified Operator:..»�.... » I
Operator Certification Number:.._.... _ .... _
Location of Farm:
s;2r►. ss. z..r%0" CL L� .I: =,1L., _�
__ ^---- t3
Latitude Longitude �•�� o
Type of Operation and Design Capacity
s ga:� Design�Cnrrenr� r� Des�gii CurrenE
Des Current
�Srv�ne,_ ¢_• Poultry- Cattle :<,T _ ar�
3 Ca ace Po ulation aY �.� Ca ac�tvPo rilation�x.@a ace x Po ulat<on
❑Wean to Feeder ❑ La er ❑ Dairy
❑ Feeder to Finish , b l 1 ❑Non La er ❑Non Da
x
Farrow to Wean
Farrow to Feeder 3671 L
Farr F' Farrow to mesh ;
w - Toni
❑ Other �
xNumberof fagoon'sk1 Holding Ponds ❑ Subsurface Drains Present _...1. MINIM
,ta
w:. ,
Lagoon Area ❑ Spray Field Area
en ral
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ® Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (if yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/rain?
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
maintenance/improvement?
4/30/97
❑ Yes [R No
® Yes ❑ No
❑ Yes ® No
❑ Yes g No
2—
® Yes
❑ No
RrYes
❑ No
❑ Yes
91 No
9j Yes
❑ No
Continued on back

fFaiifity Number: .... .�;�
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
® No
Struc-turea (Lagoons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
® No
Freeboard (ft): Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
10. Is seepage observed from any of the structures?
❑ Yes
® No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
'® Yes
❑ No
12. Do any of the structures need maintenance/improvement?
Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13_ Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
®No
Waste Application
14. Is there physical evidence of over application?
❑ Yes
KNo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
IS. Crop type �-,m is _.t ►^-�: ' 1`-. SL . ..._.__..._ .._ _ _ ...._ _ ...
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
9 Yes
❑ No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
[NNo
18. Does the receiving crop need improvement?
Yes
❑ No
19. Is there a lack of available waste application equipment?
❑ Yes
RNo
20. Does facility require a follow-up visit by same agency?
QYes
❑ No
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
E9 No
For Certified F'acilities_Qnly
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
E9 No
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
9 Yes
❑ No
24. Does record keeping need improvement?
® Yes
❑ No
2-- Wasj_tk,aatty- wr.s aiSt ti vvt t-kv- y V"vS L.-1; -Eace Lit-
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o c -1 . 1L c p_¢r- t-G.r
t/�10 3 s r is ; ��e[ Zia t Yv� �+ti s.ct ► c4
J► "+ Q W 4 S M- � 3 -. t -p L la� tom. At t--� ,.v, e t t ',� 'a' tL x
I- OF G ,� �a r- . S j' �-a-zl C'(-t ; C. S t-s t [rt L,
-it j . i ' e. I "'-t f lc� cL i n w 0- ` _e., I
J..." W " +%.R L i 1 ' � WN'% c�_ rem
/�-- IV Y- M 0_X CL i E--vie► _ t I � j � � ! f � /� �7
5 . N'i-1 .1 ...�� �f •�v� J _i O ,tJ_e .n �G 11" '� A 1 F{.iw 10 _e 7L � �A] a f..�A/.• s-.ell.a C < L s , _J IA_LAFT V
Reviewer/Inspector Name
Reviewer/Inspector Signature: (:x� „ T k/j -
Date: -r 11-7 j A
cc. Division of Wafer Quality, Water Quality Section, Facility Assessment Unit 4/30/97

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