310772_INSPECTIONS_20171231

NUH I H LAHULINA
Department of Environmental Qual

Type of Visit: Compliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: (3 Routine Q Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit:
Arrival Time:
Departure Time:--4u-t-�—� County:
Region:
Farm Name:
hh 4 rev,
Owner Email:
Owner Name:
Phone: 1�
Z Q
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: (O 1 Q%J `1 W^ Integrator:
Certified Operator:
Phone:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude:
Longitude:
Design Current
Swine EJECapacity Pop.
Wean to Finish
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Wean to Feeder
Feeder to Finish
2,
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design C►urrent
D , P,oult , Ga aci P,o .
Layers
Non -Layers
Pullets
Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Gilts
Boars
Other
Other
Turkeys
Turkey Poults
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes PQ No ❑ NA ❑ NE
❑ Yes
❑ No
[P NA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No CANA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 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

!Facility Number: 3 1- Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E;� No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): L {D
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
C'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?
T
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?
[4 Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[A No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
T
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes R No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window E] Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): � r .,-cY — / (Z' C
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
EA No
❑ NA
❑ NE
[:]Yes
[4 No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes t�a No ❑ NA ❑ NE
❑ Yes [ S No ❑ NA ❑ NE
❑ Yes CP No ❑ NA ❑ NE
❑ WUP ❑Checklists ❑ Design [—]maps [:]Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis [] Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes a No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
Page 2 of 3
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA [ NE
21412015 Continued

fnacirity Number: - Date of Inspection: 'Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 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 provide documentation of an actively certified operator in charge? ❑ Yes F�j No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No
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?
❑ NA ❑ NE
[] NA ❑ NE
❑ NA ❑ NE
® NA ❑ NE
❑ Yes ❑ No ❑ NA [$A NE
❑ Yes `g] No ❑ NA ❑ NE
❑ Yes Eig No ❑ NA ❑ NE
❑ Yes 5 No ❑ NA ❑ NE
[:]Yes [�j No
❑ Yes 6] No
[] Yes E� No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments_ refer to,question ft Explaineany YESoanswers and/or:any additional:recoinmendations;or;any,other eomments", �I
Use drawings of facility to iie
tter ezplain°situations,(use additional pages asnecessary).
VA �ti41q
(4 10
3o+�s
Ca�o�fq�luw 51��'��b
�Ck
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
'j0 , U
Phone: S [D I 16l 3 41
Date: 1 Z
2/ 12015

-77z-
(Type of Visit: 0 Com . nee Inspection U Operation Review 0 Structure Evaluation U Technical Assistance I
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Z /d Arrival Time: Z n Departure Time: San County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: i (CO ! 124. Ir.,
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Owner Email:
Phone:
Phone:
Integrator:
Certification Number: 2Z�
Certification Number:
Longitude:
Design C►urrent
Swine Capacity Pop.
I
Design Current Design Current
Wet Poultry Capacity Pop. Cattle Capacity Pop.
yer DairyCow
Wean to Finish
W to FeederL11INon-Layer
I
Design C**urrent
D , P,oultrf Ca Wei Po ,
Layers
Non -Layers
Dairy Calf
eeder to Finish 'ZS 0 2-g2a
Farrow to Wean
Farrow to Feeder
Dairy Heifer
Dry Cow
Non -Dairy
Farrow to Finish
Beef Stocker
Beef Feeder
Gilts
Boars
Pullets
Beef Brood Cow
Other
Other L 1.Other
Turke s
Turkey Poults
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWIZ)
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 ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes [Ej-�
❑ Yes L_I No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Facility Number: -3 - 7 -7Z Date of Inspection:
M� sto 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 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in): 7 d
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ 0 ❑ NA ❑ NE
❑No ❑NA ❑NE
Structure 6
❑ Yes r<No ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify 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 F�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 Z N ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Oo ❑ 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 E] No [] NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [] Yes LJ t o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No ❑ NA ❑ NE
❑ Yes []"No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
0 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
Ej'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
Po
❑ 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
�o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
No
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

Facility Number: IDate of Inspection: -T b
24..Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ENo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes a No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ld KA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
� - n`leG 0r C, 5 4 0 1_�
Reviewer/Inspector Name: ✓ - C �I
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
[:]Yes [[2r 5o [DNA ❑ NE
❑ Yes [;]-No ❑ NA ❑ NE
❑Yes
0"o
❑NA
❑NE
❑ Yes
[-56
❑ NA
❑ NE
❑ Yes
❑
❑ NA
❑ NE
Phone: 70 771 7-),o
Date:
214120I5

Type of Visit: Q Co ance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: f a i Arrival Time: Departure Time: County:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title:
Onsite Representative: j!'r r Qom. inn Integrator:
Phone:
Region:
Certified Operator: Certification Number: Y /-0
Back-up Operator:
Location of Farm: Latitude:
Certification Number:
Longitude:
Design C•utrent
Swine Capacity Pop.
Wean to Finish
Design C*urrent Design Cnrrent
Wet Poultry Capacity Pop. Cattle Capacity Pop.
Layer Dairy Cow
Wean to Feeder
Non -La er Dairy Calf
Dairy Heifer
Design Current Dry Cow
Dr, P,oult , Ga acit Plo Non -Dairy
La ers Beef Stocker
Feeder to Finish I.S kv
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Qther
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
[�]'I o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[:]No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
S ��.,
❑ 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

Facility Number: -7 jDate of Inspection: 1 4
V a` (r
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 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
[ o5o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:)Yes rNo❑ 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 ErNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application �,,�
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [3 1"o ❑ NA ❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[ 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
0 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
BNo
❑ NA
❑ NE
Re uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Q'fo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ o
❑ 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 ❑ 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 [� N ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - 771 1 Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0 1V u ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
�NA
❑ NE
❑ Yes
O�No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes E]-Igo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
[DNA ❑ NE
No ❑ NA ❑ NE
rNo❑ NA ❑ NE
A Comments (refer.to question #):.Explain any YES answers and/or any additional recommendations orwany. other -.comments. t
-(use additional pages as necessary). drawin s of facility to better explain situations
Reviewer/Inspector Name: VCk'L" d O `'
Reviewer/Inspector Signature: 2ZL✓J'
Page 3 of 3
Phone: [ (4 7V %,)Cly
Date: j lzl/,i
21412015

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 16 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I 1 Arrival Time: / Dy S Departure Time: 0 County:
Farm Name: F_� OL LA_ 1 IV N - Owner Email:
Owner Name: C_ 1) . Q LA t IVIV Phone:
Mailing Address: 1 1 S J 6 S I RC L.&� Lid M A C NQ"A_ n C)8 Us3
Physical Address:
Facility Contact:
Title:
Onsite Representative: Integrator:
Phone:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
Region:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design Current
Capacity Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
I INon-Lger
I
Dairy Calf
Feeder to Finish
D . P,oul
JLayers
Design Current
Ca aci P,o ,
Dairy Heifer
Dry Cow
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Nan -La ers
I lBeef Feeder
Boars
JPullets
I Beef Brood Cow
Other
Other
Turkeys
TurkeyPoults
Other
Dischar¢es and Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes _D�No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
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 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 21412014 Continued

Facili .-lumber: 1 - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 'T No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑► No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
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.) 7�
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 DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes 9 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 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes ANo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes} No
❑ NA
❑ NE
the appropriate box.
7�
QWUP ❑Checklists ❑ Design [] Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes I&(No
0 Waste Application Q Weekly Freeboard 0 Waste Analysis Q Soil Analysis ❑ Waste Transfers
0 Rainfall ❑ Stocking Q Crop Yield Q 120 Minute Inspections Q Monthly and i" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes to
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
❑ NA ❑ NE
0 Weather Code
Q Sludge Survey
❑NA ❑NE
o ❑NA ❑NE
Page 2 of 3 21412014 Continued

Ficifity Number: jDate of Inspection: JLJ
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes §No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes 4 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
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes] No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.. ..7-1
Use drawings of facility to better explain situations (use additional pages as necessary).
SOIL_ CZ-c pqzj
SLLa6F__
�.3
wpLv is
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
G.4
Phone:
Date: 1 I ! Ll
21412014

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other] �0 Denied Access
Date of Visit: fir, Arrival Time: _� D Departure Time: County: [ J Region:U01-
,
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Phone:
Phone:
Onsite Representative:
Integrator:
Certified Operator:
�� �j
Certification Number:
^� �
�d�
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design
Swine Capacity
Wean to Finish
Current
Pop.
Design
Wet Poultry Capacity
La er
Non -La er
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Design
I) , P,oul Ca aci
P.o ,
Dairy Heifer
Dry Cow
Nan-Dai
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turke �auits
Other
Discharrees and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
17JNo
❑ NA
❑ NE
❑ Yes
E] No
❑ NA
❑ NE
Page I of 3 21412011 Continued

7
Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes JrNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes VTNo ❑ 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.)
T
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes 7fNo
❑ 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
Plqo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
D Yes
ZrNo
❑ NA
❑ NE
maintenance or improvement?
T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
eNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
7 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
/ice No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
F7 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
WNo
❑ NA
❑ NE
acres determination?
IT Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
rNo
o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
VTNo
❑ 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 Vr No
ElWaste Application ElWeekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tr sfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [—]Yes Vj No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes VNo
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes VfNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes P!TNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
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 J�!J'No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes KNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[4No
❑ NA
❑ NE
❑ Yes Vf No ❑ NA ❑ NE
❑ Yes [;�[No
❑ Yes `l'"' No
❑ Yes 7rNo
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Reviewer/Inspector Signature: " I(/V�� Date:
Page 3 of 3 21412011

Type of Visit: IN59rupliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:] Arrival Time: JQ Departure Time: County:%/Y Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: - ` Title: Phone:
Onsite Representative: (C Cr (IUW /v integrator:
-�
Certified Operator: C fLidL . l��(/YN Certification Number: a oQ `'tt 0
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
III
tesignR-urrent
Wt Poultry Cacity Pop.
I JLayer
Cattle
Dairy Cow
Desigu Current
Capacity Pop.
Wean to Feeder
jNon-LMer
I
Dairy Calf
Feeder to Finish
(o
Design Current
Dr, P,oult C_a aci P,o ,
Layers
Dag Heifer
Dry Cow
Non-Dairy
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -La ers
Pullets
Beef Feeder
Beef Brood Cow
Boars
Uther
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
) No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
7�
a. Was the conveyance man-made?
❑ Yes
[]No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[-]Yes
[:]No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
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 21412011 Continued

FapiIity Nwnber: - Date of Inspection: /1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: W6608
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.) 1%
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? 0
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ` No. ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? 0
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes P R 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?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail tdsecure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
Q WUP Q Checklists 0 Design Q Maps ❑ Lease Agreements
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
[—]Yes
No
❑ NA
❑ NE
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes V No
❑ Waste Application i❑ Weekly Freeboard ❑0 Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
Q Rainfall ❑ Stocking Q Crop Yield Q 120 Minute Inspections Q Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes N
o
21412011 Continued

FakMty Number: -7� 1 - -T�. Q I I Date of Inspection: J
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of fast 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)
3 L Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No
❑ Yes No
❑ Yes [ No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.:
Use drawings of facility to better explain situations (use additional pages as necessary).
LA
Reviewer/Inspector Name: 5 Phone: ��
Reviewer/Inspector Signature: Date:�����
Page 3 of 3 214112011

Type of Visit: Mcompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: �Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
-- . _ ..
Date of Visit: I RZ711 ' Arrival Time: a Departure Time: County: Region:
Farm Name: 4 CC"(y � 1NN Owner Email:
Owner Name: A-- tZ 2 aL Y� . � L." 1 /Vly Phone: f U � d �� —� LO (D _
Mailing Address: 1 J J u 5�] CAAC) Z3 m L'l N U Ll G .0 I-63 4,4 (4 7
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: Q.(LO L O�(A 1 NAJ Integrator:
(� ao I 1
Certified Operator: Eyz zo L 'lam • Qk 1 /SIN Certification Number: � d Li 1
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine C*apacity Pop.
Wean to Finish
Design
Wet Poultry Capacity
Layer
Current
Pop.
Cattle
Dai Cow
Design
Capacity
Current
Pop.
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
8
D esign
D , P,uult . Ca aci
Layers
Curren
Rio , t
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
her,
Other
Turke s
Turkev Poults
Other
Discharites and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
�No
❑ NA
I] NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

lF'aciliNumber: [ - ZI TfnTl Date of Inspection: j
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ANo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑] No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 1 q.s
Observed Freeboard (in): L�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes I No ❑ NA ❑ NE
b
(i.e., large trees, severe erosion, seepage, etc.) ONo
6. Are there structures on -site which are not properly addressed and/or managed through a ElYes ❑ 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 W 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
0 maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes A
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, et .)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): R�Ed O '�'C—A(L
13. Soil Type(s): ALA- !AU I L-L&
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 0 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [% No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
WUP ❑ Checklists 0 Design ❑ Maps [:]Lease Agreements
❑ Yes r" No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No 0 NA ❑ NE
❑ Yes No [] NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes X No
❑ Waste Application Q Weekly Freeboard 0 Waste Analysis 0 Soil Analysis ❑ V aste Transfers
❑ Rainfall 0 Stocking ❑ Crop Yield [] 120 Minute Inspections Q Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [] Yes 9No
❑ NA ❑ NE
❑ Weather Code
El Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number; - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
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
N(No
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
A
ElApplication Field ❑ Lagoon/Storage Pond ❑ Other:
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes Jallo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes *0 ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or: any other comments ;' .U.
Use drawings of facility to better explain situations (use additional pages as necessary).
�h�J� � � •a
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ql0-A9613CA
Date: `"t f )
2/4/2oil

Type of Visit Compliance Inspection O Operation Review O Structure Evaluation U Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: ® Departure Time: County: C=I /N Region:
Farm Name: FCL2yL ((tA/N Owner Email: nn
Owner Name: F_V_no'Ll .l_ Q I N-Al ,�y� Phone: /� n- d
Mailing Address: 14 S S6 j 1 CLOLA �[_C_ 1 I A�a JV[)L `. /V dS `/ Iss"
Physical Address:
Facility Contact: Title:
Onsite Representative: CE rtc-J/Sli1r
Certified Operator: 1FUQ(- ?-, .
Back-up Operator:
Location of Farm:
�o
Latitude:
Phone No:
integrator:
PG/Co
Operator Certification Number:
Back-up Certification Number:
M Longitude: 0
CQC9
Design Current
Swine C++opacity Population Wet Poultry
Design Current Design Current
Capacity Population Cat#te Capacity Population
❑ Wean to Finish ❑ Layer
❑ Dai Cow
Wean to Feeder ❑ Non -Layer
❑ Dairy Calf
Feeder to Finish
Farrow to Wean Dry Poultry
❑ Farrow to Feeder
❑ Farrow to Finish El Layers
❑ Gilts ❑Non -La ers
❑ Boars El
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
lki
Number of Structures:
❑ Turkeys
Other ❑ Turkey Pouets
❑ Other ❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
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 )kNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El NA
❑NE
El Yes
El No
❑ Yes
o
❑ NA
[INE
❑ Yeso
k
❑ NA
❑ NE
12128104 Continued

acility'Number: 3 —} Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes KNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Cq�cd]Ci
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Vo
5. Are there any immediate threats to the integrity of any of the structures observed? Cl Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ;�] No ❑ NA ❑ NE
through a waste management or closure plan? 1
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental rest, 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 P§No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) A
9. Does any part of the waste management system other than the waste structures require ElYes No ❑ NA [INE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA [INE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 7LNo ❑ 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) `g� ( EC_
13. Soil type(s) f t4-JV,.A U t `L
v
14. Do the receiving crops differ from those designated in the CAWMP?
❑Yes
0No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
gNo
❑ NA
El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
9 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
,KNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ONo
❑ NA
❑ NE
r
,Comments refer toquestion #) an Explain any YES answers andlor y recomEnendat'tons or _any other�cominents-
Use,drawl gs of facility to'better explain siW:4tions (use additional pages as necessary) y
. A
Moll'o o . SS)
Reviewer/Inspector Nameki " ' Phone:
L/�G.. a
Reviewer/Inspector Signature: L `'. oul Date:
Page 2 of 3 12128104 Continued

Facility Number: 3! Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No El NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes No ❑ NA ❑ NE
the appropriate box. 0 WUP ❑ Checklists [] Design 0 Maps El Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes XNo ❑ NA [3NE
❑ Waste Application ❑ Weekly Freeboard 0 Waste Analysis ❑ Soil Analysis ❑ ste Transfers❑ A nual Certification
Q Rainfall ❑ Stocking B Crop Yield 0 120 Minute inspections 0 Monthly and 1 ° Rain inspections 0 Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
XNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
14No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
4 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
XNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
)?fNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes �No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
�No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
KNo
❑ NA
❑ NE
General Permit? (ic/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
KNo
ElNA
ElNE
33.
Does facility require a follow-up visit by same agency?
ElYes
ViNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit � Routine O Complaint 0 Fallow up O Referral O Emergency 0 Other ❑Denied Access
Date of Visit: S131WArrival Time: La730 Departure Time: �� County: w.'y Region:
FarmName: Ego(- Q l.I,IAW Owner Email:
Owner Name: e &JLQ L Qu-iNN �y/� Phone: %�
Mailing Address: 195 , 2s S T P � l 1 r ,t 0U'q " Ac G�01-1
Physical Address:
Facility Contact: Title:
Onsite Representative: �]'N'y
Certified Operator: � �- - & n>&1�
Phone No:
Integrator:
Operator Certification Number: DQ -f n
Back-up Operator: Back-up Certification Number:
Location of Farm:
Latitude: = 0 = ' El « Longitude: = ° = 4 = «
Des►go
Current; Desigdy Current' Designapm_
Capacity
;.
Population Wet Poultry Capacity Ppiilatton C the Cap ity�on
_
w _.•
": ❑ La er ElDai Cow
❑ Non -Layer El Dairy Calf
"�� ,, El Dairy Heifer
Dry Poultry �5 .A�� El Dry Cow
R
'"�' ❑ Non -Dairy
ElLa Layers ElBeef Stocker
�
ElNon-Layers ❑Beef Feeder
El Pullets
�m. ❑ Beef Brood Cowl
Turkeys
Other, -
❑ Other
- TurkeyPoults � � • -
El Other Numbe of Structures:
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
❑ 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
XNo
❑ NA
❑ NE
Discharge originated at: ❑Structure ❑Application Field ❑Other
a. Was the conveyance man-made?
El Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DW Q)
❑Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
XNo
❑ NA
[INE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
ANo
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Facility Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: Lacl "
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes )A No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes
X No
❑ NA
❑ NE
❑ Yes
KNo
❑ 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 Anplication
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 qqNo ❑ 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. Croptype(s) Se.,
13.
Soil type(s)
u
L LC
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
PQNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
0 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
l7.
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
bd No
❑ NA
❑ NE
(A_� . P
`gyp foel l.�`
s j93)o 9 I.
Reviewer/Inspector Name / } 14NF-3 Phone: 9/(-) 'P%
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Contdrraed

Facility 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 [XNo ❑ NA ❑ NE
the appropirate box. 0 WUp 0 Checklists Design 0 Maps [3 Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
El Waste Application ❑ Weekly Freeboard [I Waste Analysis ❑ Soil Analysis ❑ Yaste Transfers
////// ❑ Aual Certification
0 Rainfall 0 Stocking El Crop Yield 0 120 Minute Inspections Q Monthly and V Rain Inspections (3Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
3 l . 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 V No
❑ NA
❑ NE,
❑ Yes
ANo
❑ NA
❑ NE
❑ Yes
A No
❑ NA
❑ NE
❑ Yes
ANo
❑ NA
❑ NE
❑ Yes
X No
❑ NA
❑ NE
❑ Yes 16 No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes &I No ❑ NA ❑ NE
❑ Yes XNo Cl NA ❑ NE
Page 3 of 3 12128104

R A Division of Water Quality
Facility Number O Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0,compliance, Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit x Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: t7 Arrival Time: ® Departure Time: County:
Farm Name:
Owner Email:
Owner Name: El aqtc� L_ OL& I N)v Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representatives R� QLXI/vN
Certified Operator: r �'� L t�>• O u J NAI
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Phone No:
Integrator:
Region:
Operator Certification Number: "1 d
Back-up Certification Number:
Latitude: = o = g = Longitude: = o = ,
Design Current Design Current
Capacity PopulationWet Poultry Capacity Population.Cattle
I I ❑ La er
E❑ Non -La er
Other
❑ Other - k
Dry Poultry
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design '-Current
Capacity Population "
❑ Dai Cow
El Dai Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cod
I
Number of Structures: �l
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
a
zI
❑ Yes MNo ❑ NA [INE
El Yes ❑No El NA El NE
El Yes El No ❑NA El NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ) ] No ❑ NA ❑ NE
❑ Yes ;X(No ❑ NA ❑ NE
12128104 Continued

acility Number: � — Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �j No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LA-60cw
Spillway?:
Designed Freeboard (in): �qnn5
Observed Freeboard (in): 3 0L
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ElNA ElNE
(iel large trees, severe erosion, seepage, etc.) 9
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? 10
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes XNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes WNo ❑ 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 d�rNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes kNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 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
jNo
❑ NA
❑ NE
H. Does the receiving crop and/or land application site need improvement?
❑ Yes
KNo
❑ 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
WNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
O No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or.auy. other.comments.
Use.drawings of facility to better explain situations. (use additional pages as necessary): .
601 u C, To Mom CAC,( IO ! 'b1r-& Sdohl
Reviewer/Inspector Name F Phone: c -�
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: 3 Date of Inspection rLLy3,J
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes XNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes XNo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes gNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
XNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24,
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
)J�No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
_0�No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
J `No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
ElNE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
JU�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
rt3-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
IP No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
,KNo
[I NA
❑ NE
a] Comments and/or Drawings:
Page 3 of 3 12128104

0 Division of Water Quality
�r Facility Number Q Division of Soil and Water Conservation
O Other Agency .
Type of Visit
o pliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
Routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: OUP{7=) Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: C a52s]Lt' G-20- M -J _ __ - __ - Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = 6 Longitude: 0 ° [=] , =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La ei
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stockei
❑ 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 0No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
L�
�No
El NA
❑ NE
El Yes
L7
❑ NA
❑ NE
12128104 Continued

Facility Number: 31 Date of Inspection
j 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: [_gC,gm n)
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3�;
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 2rNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes WNo
No ElNA ❑ NE
ElYes ❑ 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? ElYes Qi//. ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes LI✓ 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 U/No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes WNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 101bs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
El NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
El Yes
YNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
12<0
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
(2/N
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
C 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):
Reviewer/Inspector Name JaH aJ q L,Lk_ Phone: M16) Cl (, - 13 9,0,0
Reviewer/Inspector Signature: Date:
lzlzolulf uonunuea

I.Ficility Number: 31 — Date of Inspection lc�
i
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 CAW MP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps
p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ,/❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes o El NA El NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? El No ❑ NA ❑ NE
❑ Yes[ �o ❑ NA ❑ NE
❑ Yes LI No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes E No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes 31go ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ElKo ❑ NA ❑ NE
Other Issues
"No
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
El
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
O/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
L"J No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
dNo
❑ 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
CI'N(o
[INA
ElNE
33. Does facility require a follow-up visit by same agency?
❑ Yes
U No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Facility Number Z.
("ivision of Water Quality
0 Division of Soil and Water Conservation
Q.Other Agency
Type of Visit Q; Co pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other
f �' ❑ Denied Access
l/�
Date of Visit: g j Arrival Time: ® Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: /J Title: Phone No:
Onsite Representative: �� P_L_1 6 �w Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: =1 o =1 = " Longitude: = ° = 6 = tl
its
Design Current Design Current Design Current"'.'
Swine Capacity Population Wet Poultry Capacity- Population ' ` Cattle . Capacity. Population`
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish D S6
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ La er
❑ Non -Layer
Dry Poultry
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Coid
Number of Structures: � A
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 I of 3
❑ Yes [ o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑Yes [3 No ❑NA ❑NE
❑Yes El No ❑NA ONE
❑ Yes &VN ❑ NA [3NE
El Yes ❑ NA ❑ NE
12128104 Continued

Facility Number: — Date of Inspection
Waste Collection &Treatment ,�
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑Yes Ll,P�o ❑ NA El NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 4�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) /
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental thfeat, 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 ETo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ZNc ❑ 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 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) SDy %%1yjr —r
13. Soil type(s) Uja LJ_4�
6
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes LINO ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 9p ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ❑,14o ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes NWO
❑ Yes W/O
El NA El NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations of any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):,-,
Reviewer/Inspector Name Phone: 9Q) 1;
Reviewerfinspector Signature: Date: DG
Page 2 of 3 12128104 ' Continued

Facility Number: — Date of Inspection
I Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Cj No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes tNo ❑ 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.
es
El No
❑ NA
ElNE
ElWaste Application ElWeekly Freeboard ❑ Waste Analysis ElSoil Analysis ElWaste Transfers
04 nnual
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?
El Yes
/❑
l 3 o
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
D-Ko
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Eaxo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[Jwo
❑ 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? El Yes B 1vo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[3'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
d ❑ 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
El,. Yes
I ?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
0 <No❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
�No❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Type of Visit Compliance Inspection O Operation Review O Structure Evaluation
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency
Date of Visit: 1101111,05, 1 Arrival Time: }� Departure Time: ; ountyt
Farm Name: N Owner Email:
Owner Name:�vL �Cnlnl Phone: _
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Q Technical Assistance
O Other ❑ Denied Access
Region:
Phone No. -
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = 1 Longitude: = ° = , =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turke Pouets
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Daity Heifei
❑ DryCow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: ED,
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?
El Yes VNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes XNo
❑ NA
❑ NE
❑ Yes XNo
❑ NA
❑ NE
12128104 Continued

Facility Number: —774Date of Inspection jD r
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?
El Yes
❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?: 0
Designed Freeboard (in): __ r
ham}
Observed Freeboard (in): w
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
,� No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWQ
7. Do any oft he structures need maintenance or improvement?
❑ Yes
/�No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
ZNo ❑ 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?
IL - Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
XNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
El Outside of Acceptp�rle CrgAWindow El Evidence of Wind DL1%,❑ Application Outside of Area, ,
clLC/' L
.. .- `.!.✓��� r►��- t���/ �_ `�:�.�,.v �1 _IIIG'�i�_ Lam. � :��i71_�_%l•�i
•�' /
14. Do the receiving crops differ from those designated in the CAWMP?
,�(
El Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`
❑ Yes
ONo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
o
ElNA
❑ NE
18. Is there a lack of properly operating waste application equipment?
ElYes
tNo
❑ NA
❑ NE
�5 J Ya P 5 ham- Cat 4
41,4
Reviewer/Inspector Name _ ` Phone
Reviewer/Inspector Signature: Date: / o // a
_j
12128104 Continued

Facility Number: — Date of Inspection
Reauired 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 appropirate box. ❑ WUP ❑ Checklists ❑ ❑ Maps
Design
g p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
V(No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
/No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
VNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
VNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
X No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
;ZNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
ElYes
No
X
ElNA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
ElYes
XNo
ElNA
❑ 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? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[ No
!21
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
26) GrOPo��F�,�1 G(�GIrO /jfr�,� /��rQr�x,� p,� /:'dZsN lGzc�s► �zo.�AZ_ Zle&6,41
i
,ice ze-6/'Y'o A-4,/
12128104

Type of Visit 0 ZRoutine
pliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit O Complaint O Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number �Z Date of Visit: g 6 Tune: 9 oO
Not Operational O Below Threshold
Permitted Certified Q Conditionally Certified 0 Registered Date Last Operated or Ab`ove� Threshold: .....................
Farm Name: .......G? t..... J t-!1�....... ......... ............ .......... ..................----------••---- County: ._. `.s1.{?��!� � ....� � ._........_.. .._ ..
OwnerName: .. . . . . . . . .... . .......... . . . . . ....... . ..... ..... . .......... _. .._..........._ ...... Phone No: ..................
_ _ �� ..................... ..... �.......
MailingAddress:................................................................ _....
Facility Contact:....._...................................................� ..._. Title: - - -------- �.�._.WW. Phone No:
Onsite Representative: L „„•Q!�N Integrator: 5
... �a-C------ -------- --
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 69 Longitude • 4 49
-z r
-; Cuizent = Design �'•Ciirrent Cuireat
•yDesigA
.w m .
Swine <_Ca ";
- a -Po` elation
Po Madan_.7'I'oultry�_- LyCa`aci uPo Wafrbn
;-Cable _Ca��aci
❑ Layer ❑ Dairy
Iff
60 1-7 ❑ Non -Layer ❑Non-Dairy477
10 Other -
_ �7,
a
- Total Design' CaP3'
r €� y�r x
L��Nmnber of Lagoons
,
_ Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Discharges 8 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. Dies discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes [�No
❑ Yes ❑ No
❑ Yes ❑ Na
❑ 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 [jNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes E40
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ......... ..... j,.................. .......................... ....... ... ................................ ................................... ............................ -..... .......... ........................
Freeboard (inches): Z'7
12112103 Continued

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑^No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes LI No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? [ Yes ❑ No
S. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes [JINo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes El"No
elevation markings?
Waste Anulication
10. Are there any buffers that need maintenancefimprovement? ❑ Yes ["To
I I . Is there evidence of over application? If yes, check the appropriate box below. r] Yes 0160
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12_ Crop type a�tiYh t cv� L s
13_ Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWNIP)? ❑ Yes V1,0
14. a) Does the facility lack adequate acreage for land application? ❑ Yes
b) Does the facility need a wettable acre determination?❑ Yes [N
c) This facility is pended for a wettable acre determination? ❑ s To
15. Does the receiving crop need improvement? Yes ❑ N
re 16. Is thea lack of adequate waste application equipment? ❑ Yes 7No
Odor Issues
17_ Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes E31NO
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes +i
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 90
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
Air Quality representative immediately.
_ " ® aaSW!!� Dthel m�tS.r s—
Ca`(IYCI t7Ef gitlS�oII��a.w!'w"' 9II� Ai 9IId�OT 1n�' _ y BOO ' -
-.
Lls drawer cfac�t9 0 bettccplaen-�ataos- ❑ Field Copy ❑ Final Notes
=_ e
A DikE A Lu ia✓Eh (��
•
CoA/TZ W EEb CaJ'�2e4
FLjMPau�, Cv&wr r�►E� St40ul Nab' Fxc.E.�� Hl�Onat Tc FL( -LP L°�K1,
LA660J ANAi eSgS &v6) r2 SArhF(.,E DATA.
Reviewer r Name
Reviewer/Inspectar Signature: Date: g cl
12112103 Continued

Facility Number: _ 77 Date of inspection Z
Required Records & Docnmentss
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23_ Does record keeping need improvement? If yes, check the appropriate box below.
❑ 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?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did ReviewerAnspector fail to discuss reviewimspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWNTI
NPDES Permitted Facilides
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes Q No
❑ Yes 04
❑ Yes O'No
❑ Yes [] No
❑ Yes [r No
❑ Yes 121 o
❑ Yes [R'90
❑ Yes 9-*o
❑ Yes [aKo
Eyes ❑ No
❑ Yes o
❑ Yes [rl�o
❑ Yes 0440
❑ Yes
❑ Yes C70
12112103

t
Type of Visit F Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O hollow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: Time:
Facility_ Number
xP
Not O eratiional Below Thresholdermitted ©Certifie (] Conditio IN Certified ❑Registered Date Last Operate Above Thres old:
Farm Name: Z County:
Owner Name: J Phone No:
Mailing Address:
Facility Contact: Title:
Onsite Representative: _ v L t*aZ 01tj
Certified Operator:
Location of Farm:
one No.
Integrator
Operator Certification Number:
swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �' 0 �" Longitude 0'
0
:Design Current Design Correia; Desig�t _ Current
_ .:
-Swine �� ..Ca aciri � �'Po uladon .�e Poul#n . �` '�Caacrty _wPo �lation ��Csttle �:� -Cii acitr --population ..=
❑ Wean to Feeder € ❑ Layer Dairy
Feeder to Finish ❑ Non -Laver Non -Dairy
i-e
.,
Farrow to Wean-
❑ Farrow to Feeder ❑Other
El Farrow Farrow to Finish 'COtal DCSIen :Capacity
❑ Gilts
❑ Boars Tl)ta1 SSLW ;
Number t3f Lagoons ❑Subsurface Drains Present ❑ Lagoon Area ❑ Spray Feld Area],
Holding`PondiU Solid Traps 10 No Liquid Waste Management System
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes RTNo
Discharge originated at: ❑ Lagoon ❑ Svrav 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 gaUmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes ❑ No
2. is there evidence of past discharge from any part of the operation?
❑ Yes O No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes ZNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes WNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Freeboard (inches):
05103101
Continued

Facility Number: Date of Inspection
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.) Id
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 VJ 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 9rNo
11. Is there evidence of over applicatiorl? ❑ Excessive Ponding. ❑ PAID ❑ hydraulic Overload r ❑ Yes ZfNo
12. Crop type
13.
Do the receiving crops differ with those designs d in the Certified Animal Waste anagement Plan (CAWMP)?
❑ Y s , No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
[IN0
b) Does the facility need a wettable acre determination?
❑ Yes
VNo
c) This facility is pended for a wettable acre determination?
❑ Yes
P(No
15.
Does the receiving crop need improvement?
❑ Yes
VNo
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
XNo
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
9,No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
El yes
UdNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[;rNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
VNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
1XNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
VfNo
E3 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to questtan;#): Explain any YES•answers�and/br any�recbmmend i6onsv any otbe`r euinmepts ';
Use [drawings of#'acility to Better egpliiliii'situatrans..(use Gild i2al pages as neces ary) ❑Field Cony ❑ Final Notes
y,o „a „.
_x 4
L�� K �oT NCO �i i R�.ts, F Ot. kaDUSr, I Le5CPr7F__
Vr , F76R -©m FrAt,). R PArR L&AK.
` F�-71A &L �v C R F-S �D (zmzro A-7 r4 Zoo �Ef—,
®N���Dz
Reviewer/inspector Name :.:
Reviewer/Inspector Signature: Date:
L-7
05/03/01 y r ��� L r T Continued

4 .
Facility Number- 24 Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge allor 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 permanentltemporary cover?
❑ Yes (XNo
❑ Yes "No
El Yes /V No
❑ Yes No
❑ Yes � No
El Yes ( No
El Yes /❑ No
Additional Comments and/or:Dr2wings:_
-TO Puuc 5O87- FZrr � COV -A-
-PtAtL-5 CD RNA . Qboa- � a `� �ND Or q r-e �a
k F7y9'VT f P, �� F�-�J & n) k ICY (N fF-
�c...r r�F-L--O P4-J Q 'rp �rs 5z5 r fin) F5 7146
PFCF-00�iVc— , 2-0c-) o;zz- R 14- lav,
fC r 57 P,,C 1 F_ 5 tv�-rt /�6e0R,05 A No
�� s Q K Ok -
zs�-:5't4'- ;2;�/
/�19rfe-
-r .6 us,:5 C� �0'
O5103101

Division of Water Quality
F
O Dttion
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit © Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 31 772 Date of Visit: 4/17/2002 Time: 13:40
O Not Operational O Below Threshold
® Permitted ® Certified r] Conditionally Certified [3 Registered Date Last Operated or Above Threshold_
Farm Name: Er. r.Q1 Qninn........................................................................... County: pjWrtu............ .------- -.............. }?4r= ....
Owner Name: Errs----- ----------- -QtWw.--------- - - - ----------- Phone No: gjQ-Z4 9 43 - -------- - ---------------
MailingAddress: 4.95.,Ii3-Strad.RoAd.......................................................................... 1!' agno1k-AC........................................._............. Z8.4.53..............
Facility Contact:........................................................... Title: ....................................... Phone No:
..............................................
Onsite Representative: ErEQ1Quinn---------------------------------_-_--- Integrator: FiceAt gr FArM---------------------------
Certified Operator:EriraJA.................................. Quina................................................ Operator Certification Number: 21410.............................
Location of Farm:
South of Kenansville. On East side of SR 1921 approx. 0.2 mile South of SR 1922. Back of farm is adjacent to Hwy 11.
ry
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 OF 55 4 00 u Longitude 78 ' 00 30 94
Design'.
Swine' = C'Anacity
it
on Poultry
❑ Layer
❑ Non -La
❑ Wean to Feeder
® Feeder to Finish
2580
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current
--Capacity Population- Cattle -
❑ Other
Total Design-1
Tota
000
Number of Lagoons 1 ❑ Subsurface Drains Present ❑ Lagoon Area ID Spray Field Area
Holding Ponds / Solid Traps_. ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ 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 11 No.
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............ _l.......... _............................. -----•--•-----•-----•--•--........................... ........................... ...........................
Freeboard (inches): 28

vrwiu< uunrinuea
• Facility Number: 31-772 Date of Inspection 4/17/2042
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes N 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 N 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 N No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes N No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes N No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes N No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes N No
12. Crop type Coastal Bermuda (Hay) Small Grain Overseed Fescue (Graze)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes N No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? N Yes []No
c)•This facility is pended for a wettable acre determination? Cl Yes ❑ No
15. Does the receiving crop need improvement?
16. is there a lack of adequate waste application equipment? -
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management PIan 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?
(iel discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
® Yes ❑ No
❑ Yes N No
❑ Yes N No
❑ Yes N No
N Yes ❑ No
❑ Yes N No
❑ Yes N No
❑ Yes ❑ No
❑ Yes N No
❑ Yes ❑ No
❑ Yes ❑ No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Caminents (refer to guestidn j Explain any YES answers andlar any!recommendi ions or°;gny ati erycamments
Use drawings of facility td better explain situat�[�ns (use addI Zonal pages as necessary] _ Co a!
- = - _ - ❑ Field Notes
2. There has been a discharge of animal waste from the hog house due to a clogged pull plug. It appears that the waste is contained in
A.
addles along the farm path. Mr. Quinn needs to routinely clean pull plugs to ensure that they do not become clogged and result in a
discharge.
14. The facility needs a wettable acres determination with a waste utilization plan written based on the wettable acres determination, and
r. Quinn needs to make waste applications in accordance with the wettable acres determination and keep his application records
accordingly. Mr. Quinn is currently using more acreage on the IRR-2's than is given in the waste plan.
Reviewer/]nspector Name Stonewa111Viathis---
ReviewerA ns pector Signature: Date: Z Q L

05103101 Continued
Facility Number: 31-772 Date of Inspection 41I7/2002
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
[Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
®No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑Yes
❑ No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
®No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
❑ No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No
Addition2lkComments and or Drawings,..-�R� ._
15. Tract 1543 Field 4 is Fescue Pasture in the waste utilization plan and is a required field to meet the nitrogen requirements for the +
farm. This field does not have fescue in it nor does it have any other acceptable crop in it. This field has not had a proper crop in it
in the 3 years that I have been inspecting this farm. Mr. Quinn needs to take immediate action by consulting with the proper persons
to determine the proper crop to be placed in the field, ensure that this crop is adequate for and written into the waste utilization plan,
and he needs to take immediate measures to plant the crop and ensure a well established stand of the crop.
Also, Mr. Quinn needs to feed bales of hay to his cattle in areas that are not included in the sprayfieid area as the spoil from
these feeding activities appears to inhibit the growth of the receiving crop.
19. Mr. Quinn needs to take soil samples for each field for soil testing purposes. Mr. Quinn needs to use a waste analysis dated
within 60 days of application events to calculate on the IRR-2's the amount of nitrogen applied.

77
I Division of Water Quality
Division of. Soil and Water Conservation
Q:Other Agency -
�� s
Type of Visit Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit _`Routine Q Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit:
Facility Number 3 j Z
Permitted 0 Certified © Conditionally Certified ❑ Registered
Farm Name: r`0 %/? ,xwl_
Owner Name: �� �` Q ..? "'tzl
c ....,•...... G2...........................................................................................
Facility Contact:
Title:
�D ni Time: I lO=5S Printed on: 7/21/2000
Q Not Operational Q Below Threshold
Date Last Operated or Above Threshold:
Ay��
Countv:
Phone No:
....................................
Phone No: ...........................
MailingAddress:...................................................................................................................._ ......................................................................_........_
Onsite Representative:.' l ....... .my!.!: t3......................................................... Integrator: .................
.....--.. .. _P/_ cL a .................
CertifiedOperator: ................................................... ........................ .................................... Operator Certification Number: ..........................................
Location'of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� ��
�•� Longitude
Design Current
Design
Current Design. Current
if 'Ca ci Po ulation
Poultry Ca ci
Po uiation Cattle Po ulation
'` Wean to Feeder
❑ Layer
❑Dairy
Feeder to Finish 2 SgQ 10
Non -Layer 1
10 Non-Dairy
Tz Farrow to Wean
Farrow to Feeder
IDOther
Farrow to Finish
Total Design Capacity
Gilts
Boars
TotalSSiW
�` Number
Subsurface Drains
Present Lav m Area
To Spray Field Area
'>Yotdiug PondszSolidTraps
No Liquid Waste Management System
Dischartes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ElLagoon [ISpray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
❑ Yes ,KNo
❑ Yes �No
❑ Yes ZNo
na
❑ Yes E]'No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ,O'No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ff No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes j!rNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ....
.........._+.-_..........
.....
...
..........................
.......
---
.................
...............
Freeboard (inches):
5100 Continued on back

Facility Number: Date of inspection Printed on. 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ yes pf 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 �'�io
(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 pan of the waste management system other than waste structures require maintenance/improvement? Cl Yes ,L11 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes JdNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes Ej`�No
11. Is there evidence of over application? ❑ Excessiive/Ponding ❑]PAN ❑ Hydraulic Overload ❑ Yes 0No
12. Crop type �Se✓ Ada, a Lj , S-4,7 r (9�t tF1 CCSC�Ve Vi dv le
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes JeNo
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 XNo
16. Is there a lack of adequate waste application equipment? ❑ Yes XNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes Z�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.) ❑ YesNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes /0"No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes W'No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes )ZINo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes�No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes _,Mo
24. Does facility require a follow-up visit by same agency? El Yes No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes E!rNo
:: Nd-Ab-IatiQns:or deficiencies *ere n6(ed• during this:visit; • Y:oi� vvifl •reeeive d6 further
Tories oiideRce: a1baut: this visit.: • :: : '
C©moments (refer_ toquestion #) Expiaiin any YES answers and/or any recommendaons or any oth r c mments:
q.1�rcC-0l -tend �V ��e waS� sa �oLcs cvLe 6D�4.7s so fl_aj
Co
1i /Trion� / LJI ,-e 5 ; motor l� r?0Aq I
6
ro) USE D,-vPer, aG,-e Q Cwef � ptC-1-C_0jC, �P� ertLL, s/fcty
-t).7e TIM
T�] e �� G I r'-f ix tv e l f kef
. ,�
Reviewer/Inspector Name D� �[� fj 1, ,S j
Reviewer/Inspector Signature: Date: V (o5/00

Facility Nupmber: 3 I — Date of Iuspection Q Q Printed orx: 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 ON,
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ATNo
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 [q-No
30_ Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ,ZNo
31, Do the animals feed storage bins fail to have appropriate cover? ❑ Yes J❑rNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
LionComments: and/or. Drawings:. —
J
5100

Division of Water Quality
Q ivision of Soil and Water Conservation
0 Other Agency
Type of Visit I&C_ompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
3 Date of Visit: !v Z in e: ; fL Printed on: 7/21/2000
Q of Operational Q Below Threshold
Permitted r] ed ©Conditionally Certified ©Registered Date Last Operat Above Threshold: ............
Farm Name: ........... �41`t.]r...................!'y'`—.............................. Countti:....-...... ..r.�!......................................
OwnerName: ................. .... Phone No:...............................................................................
Facility Contact: V V ) \ �'` '� ... Title ....... w Phone No:
.................................................................................
MailingAddress: ......... .......................................................... ....... ................
.
Onsite Representative: V �.14rL,....,`"`; .............. Integrator: .. �.
�`' .... :r. �...
Certified Operator: ....... Cv ...l........... ........................... Operator Certification Number:..............
Location of Farm:
FN
.S�etirte- ❑ Poultry []Cattle ❑ Horse Latitude ' ° Longitude 0 4 66
Design Current
Swine Canacity Pomilation
❑ Wean to Feeder
PKFeeder to Finish
jSN
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lag,.,n Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ 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. slid it reach Water of the State? (If yes, notify DWQ)
❑ Yes ❑ No
c. If discharge is observed. whit is the estimated flow in gal/ruin?
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 I No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? [I Yes
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes No
Structure lh Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: ...... ...��, ...,�7..............
Freehoard (inches):
5100
Continued on back

lFa ility Number: Date of Inspection � e� Printed on: 7/21/2000
S. Are there any immediate threats to the integrity of any of the structures obse ved'? (iel 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 �kNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ Yes f)-dNo
8. Does any pan of the waste management system other than waste structures require maintenance/improvement? ❑ Yes RN
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 Wo
11. Is there evidence of over application? ❑ Excessive Pondin4_ ❑ PAN ❑ Hydraulic Overload ❑ Yes �No
12. Crop type
13. Do the receiving crops er with those designated in the Certified Animal Waste Management Plan (CAWMP)? El Yes �lo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes
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 ro
M. Is there a lack of adequate waste application equipment? ❑ Yes KrNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available'? ❑ Yes KNo
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
�6No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
XNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
RNo
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?
(ie/ discharge, freeboard problems, over application)
❑ Yes
ANo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
5No
24.
Does facility require a follow-up visit by same agency'?
❑ Yes
R[No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
5(No
0: Nd- iolatioris:or deficiencies •were rtbted during this 'visit' • Y:oitf will •r"eeeiye rio i� rther
corresp rideirice'ab' ' this :visit:
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to bether explain situations. (use additional pages s necessary
Wa6
A-oJue, e w-�I—
s 1 r k. Q T
Reviewer/Inspector Name ,k , Q C l� 1 C
Reviewer/Inspector Signature: Date: L �t75100

cility-?lumber: ( -- 77 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
KNo
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
Mio
roads, building structure, and/or public property)
29.
Is the Iand application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
A 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.)
El Yes
�,�-'T
'_
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
O-No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
VfNo
.&I
J
5100

2;­ [] Division of Soil and Water Conseri+ation ;Operation Resew
= 013ivision of Soil and Watei Conseryahon"Compliance Inspection 3
a on of Water Q�altty .Compliance Inspeehon x
Other Agency. Operahon.Revrew _ a
Routine O Complaint Q Follow-ue of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number 3 bate of Inspection / 2
Time of Inspection ® 24 hr. (hh:mm)
IS Permitted 0 Certified © Conditionally Certified 0 Registered Not Operational I Date Last Operated:
Farm Name• it0 G t! rrt l� C oun D y"i'!1.................................. ......................
t} .
Ev.nd � Ul n Phone No : ................................................... ..... .......................
Owner Name:....:.....................................................�.....................................
FacilityContact: .._..- ................... Title: .............................. ................................. Phone No:..................---.--...........................
Mailing Address: ............
�r tA4J. e
Onsite Representative: �r/+d �.I1.1.�.4�.................................................... lntegrator:........... .........................................................
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
.................................................................................................................................................................................................................................................. ........ �
Latitude �_�• �` �•� Longitude �• �` ��� .
Design Current
CaDaCity Population
❑ Wean to Feeder
® Feeder to Finish
2590
7.000
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
�Nuiiniber. of 'Lagoons C
_HoldtngPonds l Solid Traps C
Design. Current_ = Design Current
Poultry Ca acity PoQulation Cattle Capaci Population
❑ Layer EC]
Dairy
Non -Layer Non -Dairy
. ❑ Other
Tdtal Design Capacity
-.-Total:-SSLW
❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 51No
Discharge originated at: El Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑Yes 14 No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes IS No
c. If discharge is observed, what is the estimated flow in gal/min'? ;1/q
d. Dues discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes [9 No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes C9 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 5J No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 0No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Freeboard(inches): ...........z.4 .......................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/.trees, severe erosion, ❑ Yes & No
seepage, etc.)
3/23/99 Continued on back

Facility Number: 3' — 72 Data of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes JK 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 IN No
8. Does any part of the waste management system other than waste structures require maintenarice/improvement? ❑ Yes tKNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes 29 No
Waste Anolication
10. Are there any buffers that need maintenance/improvement? ❑ Yes 9 No
11. Is there evidence of over application? [:]Excessive Ponding ®'PAN I, �'1�► -T0)d Yes El No
12. Crop type ge1'eyMm 1�c+y ►,S/H��j o�rai�� rt.t��kgt , SDY&qb4GCp
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? []Yes X No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes g] No
b) Does the facility need a wettable acre determination? ❑ Yes El No
c) This facility is pended for a wettable acre determination? ❑ Yes 91 No
15.
Does the receiving crop need improvement?
VYes
❑ 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
J@ 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
X1 No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
j$Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
X No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
19 No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
ONo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
19 No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
19 No
25,
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
19No
�: No •vi9latidiis;or- deficiencies •'were potee .d(Wing phis;visit: - ;Y:oit Will •receive fio fufrthr .: • ;
correspondence. about this visit.. . . ..
Fc_
(refe'r to question #).. Explain any YES answers analog any recommendations orany other comments
.oval a es as necessa' Use,drarvin�s of facile to-better:ex lath situations .use additi' p g ~:ry) �`� '
1 .Ove�a��liica �Foh 0� 2. Lssl 6terre are r ov1 Trawk 8T516
rf`
rn vdA sljd uld be rC5Y- jfezO i p? 7rnae_- " P (e tJ 4
t q. r4rrtner Shoulet iesvMF keelo; LtRZ -C'-mNV- ! re6o,-,js.-T eke
"I, s;s gad Avr (00 ,, s Wpre art
ReviewerAnspector Name
Reviewer/Inspector Signature:
Date:
3/23/99

Facility Number: 7111 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 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 tA No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 'A No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes 9 No
_.,.lAdditional Coxnments.andlor:Drawingst-
II,"ft__7)
'P de4G Ort
Tke aerr-coes -Far fke PU[1s 00 r6t4-1 be
3/23/99

❑ Division of Soil and Water Conservation ❑ Other Agency
'Division of Water Quality
IGLRoutine O Complaint O Follow-up of DWO inspection O Follow-up of DSWC review O Other I
Date of inspection
Facility Number �� - '�
-'� Time of Inspection a a S 24 hr. (hh:mm)
© Registered WCertified Applied for Permit © Permitted [j Not O crational Date Last Operated:
�.
Farm Name: ..............................................................
Lr!�r�......`�I! �c�- ............................. .. .. CountyLi�
Owner Name:.... ..... ,.................. Phone No-
... C� AQ=q�—c!""
..... .................................................
Facility Contact: ............................................................. ----.. Title: ... Phone No:
Mailing Address: �?` .. ........�`Q....,1 e.1 ......... 5-v��c.,,� � ........................................ .......................... ...... ....., .. . (� ........
Onsite Representative: ( t'.x'. ! `�.. .6 .... Integrator:...9 ...............................
�1..... ............ .........................,....
Certified Operator;..........
Operator Certification Number: .........................................
Latitude ���_�` �" Longitude
[-. Design_ Current -Design Current Design ">' Curreztt
'�:S*Me:" Capacity Population Poultry Capacity Population Cattle Capacity=Populatton
<< ❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
>k ❑ Gilts
❑ Soars
{General
1. Are there any buffers that need maintenance/improvement? ❑ Yes No
2. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes MNo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes
i 0 No
t `t c. If discharge is observed, what is the estimated flow in gallmin? l-
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes No
3. Is there evidence of past discharge from any partof the operation? ❑ Yes No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes ONo
5. Does any part of the waste management system (other than lagoons holding ponds) require ❑ Yes PNo
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:
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes qNo
Structures (Lagoons.HoldinE Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes XNo
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
................................. .....
Freeboard (ft):.... ..3 .)� .............................
10. Is seepage observed from any of the structures? ❑ Yes 0 No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
KNo
12.
Do any of the structures need maintenance/improvement?
❑ Yes
P(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
CR'No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
9 No
(If in excess oft WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ..... L—Ve. ....................................................................................................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
83 No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
X No
18.
Does the receiving crop need improvement?
❑ Yes
(9No
19.
Is there a lack of available waste application equipment?
❑ Yes
W(No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
0 No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
O No
22.
Does record keeping need improvement?
,kYes
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
15 No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
INNo
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
($No
[� No.violations-6i deft; iencies. were-ntited-during this:visit.• Yo44411 i'ecei've,no•furih.er"
Oer0spb4deitce dliout this:visit.: :.
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: o" Date: Io/ao /C( 8

ODSWC Animal Feedlot Operation Review°
® DWQ Animal Feedlot Operation Site Inspection
izA.n
10 Routine 0 Complaint 0 Follow-up (if DIVQ inspection 0 Follow-up of DS11'C review 0 Other
Date of Inspection
Facility Number
Time of Inspection �, 24 hr. (hh:mm)
© Registered 1P Certified E3 Applied for Permit © Permitted 0 Not Operational I Date Last Operated:
Farm Name: .... Err0.`......Q.VLylyl-........ ltlk!'r........................................................... County: ...... D.L? ir..............................................................
Owner name:..... �........o. + ........................Phone No:.. `� LQ..Z` .G:.-.A.`............................................
Facility Contact: ` .... Title: Phone No.....�..... ...........
MailingAddress: /ro�......Vt............................................................. ....... hah a ... 1..1�%.c............................................
G(..���j �.......
Onsite Representative:...Crfb�.......uIAA....................................................... g "ki
Certified Operator......... E.Y.rot............ Izit. n. ..................... I..., ................................. .. Operator Certification Number,.............
Location of Farm:
"rs . r�.....1.1.... ... �.�k ..t► .. Tisch..... .C.......��...... ....... ].... Z..•.. -� Y! ..i ....4:. ...�ni ...t�..............
.-...�tt�� .... �c. �........................................ ............. ............ .............................. ...... .............................................................
.
Latitude ` 6 .9 Longitude • 1 4,
Design Current Design . Current Design.: Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder I0 Layer 1 10 Dairy
Feeder to Finish I0 Non -Layer I 1 1[--] Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts .
❑ Boars Total SSLW
Number of Lagoons /Holding Ponds ❑Subsurface Drains Present ❑ Lagoon Area ❑ spray Field Area
❑ No Liquid Waste Nfanagement System
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water" (If yes, notify DWQ)
c. if dischar-e is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation'?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25147
❑ Yes ® No
❑ Yes ®No
❑ Yes No
❑ Yes '] No
❑ Yes M No
❑ Yes ® No
❑ Yes © No
❑ Yes P No
❑ Yes j No
❑ Yes No
Continued on back

1
Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes [A No
Structures (LaQoons,Holding fonds, Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes 12 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Freeboard(ft): .............5`Z................................................................................................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
(9 No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
IQ No
12.
Do any of the structures need maintenance/improvement?
NLYes
❑ 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
CA No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
[9No
(if in excess of WMP, or runoff entering waters of the State, notify DWQ)
t5.
Crop type ............!ermil&...............................................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
tO No
IT
Does the facility have a lack of adequate acreage for land application?
❑ Yes
[4 No
18.
Does the receiving crop need improvement?
❑ Yes
D9 No
19.
Is there a lack of available waste application equipment?
❑ Yes
® No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
22. Does record keeping need improvement? Yes ❑ No
For Certified or I ennitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes 15d No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ® No
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes ® No
No'violations oc deficiencies.were-noted-during this;visit.- You. 411 receive -no further.
correspondence about this visit:•; • ;
Comments trefer.to question #): Explain: any YES'answers and/be.any recommendations yr any :other comments. a >
Use drawings of facility tohetter exptattx situations (use additional pages as necessary)
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7/25/97
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Reviewer/Inspector Name ; bf ILian- 1AA�y►Yt _ Reviewer/InspectorSignature: �,,� ,� ,AKI- Date: 1ehh-7