710014_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

Type of Visit (2'Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Gel outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: a S Arrival Time: Departure Time: County: JIN n M_ Region:
Farm Name: Owner Email:
Owner Name: —
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: C06c- ti E
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: [= o = 6 Longitude: C
Mom= lu
ODesi
Current
es�Current
LCapl1F0
Design , Current
Swine
Capacity Potation Wet Poultrypulation
Cattle Capacity
Population
❑ Wean to Finish
! ❑ La e:r
a iry Cow
❑ Wean to Feeder
❑ Non -La et
❑Dairy
Calf
® Feeder to Finish
3 %
❑
Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑
Dry Cow
❑ Farrow to Feeder
"
❑ La ers
❑
Non -Dairy
❑ Farrow to Finish
❑ Non -La ers
❑
Beef Stocker
❑ Gilts
�
❑Beef
Feeder
❑ Boars
El Pullets
❑
Beef Brood Cow
❑ Turkeys
Other BMW
❑ Turkey Poults
Number of Structures:
❑ Other
!❑Other
I NOW
'£
Discharges & Stream Impacts
/No
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ NA
❑ NE
Discharge originated.at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
13
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
3NNo
O No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Fa4lity Number: 9 1 —
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:
Spillway?:
Designed Freeboard (in): 2b
Observed Freeboard (in): 40
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 La/No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ENNo ElNA ElNE
,
❑ Yes � No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes td No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 3 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 2 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [ No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crrop, Window /❑� �E�viiddence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) Fc-so e
13. Soil type(s) OT4
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes EJ No ❑ NA " ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes E No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination, ❑ Yes 2No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes Q< ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
�An-M Wjs OW owrJC-9 . Fa1ZrnA Goojc..Y -JA) wwG14 i3(--rTEpL SHRPf,
riccos Ya r3E JfDATEo, 014e-AT Iles A ?Ad AAIfi- of 2SrI l►as, Lor-sz�c,-r PAS,
Goon% 4ESLG� PD6��IviO CAN Nd`t FTOO SfiDf rJCvcL PvPAf START 15
Reviewer/Inspector Named'" q ij-/� {ti �,L; z �"-h� "` Phone:
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: ? — Iq I Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to haVWWUP
components of the CAW P readily available? If yes, check
the appropirate box. ❑ Checklists Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes LI No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes L 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 [24o ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes l No ❑ NA El NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes [ o 2 NA ❑ NE
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
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
rdditional Comments and/or Drawings:
El Yes 2No El NA ❑NE
0Yes ❑ No ❑ NA ❑ NE
❑ Yes
D o
❑ NA
❑ NE
❑ Yes
L!J No
❑ NA
❑ NE
❑ Yes
L"J No
❑ NA
❑ NE
❑ Yes
2No
❑ NA
❑ NE
❑ Yes
Ej No
❑ NA
❑ NE
❑ Yes
�❑ NA
❑ NE
12128104

of Visit 4 Compliance Inspection O Operation Review O lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of visit:
gPermitted 13 Certi£r © Conditio y CertiSed ❑ Registered
Farm Name: ..._ ... .[`ilk-� ...» . ._.�............
Tune: j
)nerational O Below
DateLast Operate "A�boove Threshold: ... ......-....» .
County: - g ,lr.L �rl ._........ _ .._ » .....»... .
OwnerName: ...... ............................ »........................».._._.......»...._..._»..».._..»...... 'Phone No:
MailingAddress: .._.................. _....._.. _.._»»» . ».. ».».. »...........». »»».........»
FacHity Contact: ... _ ....__. _....._. _._ .. ___ ...... ». Title:.». ». »_ .. » _ ».. _» .. _ . Phone No:
Onsite Representative:_ ..�1...»._.»......__.... Integrator: --
Certified Operator:._ ...._.._ ».».� .., _...._._._.. __._�» _....»_» »..»..._._»_.._.....»_ Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude F_�' ° " Longitude • 4 64
Swine
iQlanan,�' ��•Eattle , _ ,' Capacity ''Peeiila6an
13 Wean to Feeder
t
❑Layer
❑ Non
CPeerier to Finish
-Layer
Farrow to WeanEl
Other
Farrow to Feeder
Farrow to Finish
^ ` ' s.
T0#al De ;
Gilts
Boars
Discbames & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon Sry
pray Field ❑ Other
a. If discharge is observed, was the conveyance than -[Wade?
Otm SSLw
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, notifv DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
m7W
Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Identifier:
Freeboard (inches):
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 ❑ 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
8. Does any part of the waste management system other than waste structures require maintenancermprovement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ❑ No
elevation markings?
Waste Adnlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
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
Air Quality representative immediately.
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Field Copy ❑ Final Notes
Palo- 1
pvfnj��,0�4c�, �a-Ga9•�-
G�/g5�V'o
�
I D f�k z2,
Gam? AZO
Reviewer/Inspector Name e Jli;.�'' ,ate
Reviewer/Inspector Signal
Date:

rFacrlity Number:. —
Renuired Records & Documents
Date of Inspection
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
RfNo
28. Does facility require a follow-up visit by same agency?
XYes
❑ No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes ❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crap Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
l2/l2/03

Type of Visit 19Compliance Inspection O Operation Review O Lagoon Evaluation G"o—L'
Reason for Visit O Routine O Complaint PKFollow up O Emergency Notification Other ❑ Denied Access
Facility Number Date of Visit:
Permitted © xtified ❑ Conditionally Certified © Registered
Farm Name:, ...... »._._._. ........._...._ .._. _....._
Owner,Name:».»...».-
Mailing Address:
Tune;
Date, Last OperZZ
r Above hold: -
County: _!Pl! ....»....»....».»- -----------
PhoneNo: _...........» »» ..»..» .»»» .».»...._..».... ...__ . .
Facility Contact: .........» ...... ^_n»._ ....�.»» _..»» Title:Phone No:
Onsite Representative: .... .... ..... W.»....._.».. Integrator:../..... .......... .........
» .»». ...._....
Certified Operator: . . ....... . . .... . .. ................. ,.»._._...„..Operator Certification Number:....... ,._......».» ..»..... _,
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 66 Longitude • 1 «
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? RrYes ❑ No
Discharge originated at: ❑ Lagoon OSpray 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 ❑ 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 XNo
SuWttue 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier : ........ /z4/ _._ _.....» ....._.» . ....» ...»...........»...... ....................
� .... ..»..»...... .. W.... . .
Freeboard (inches):
12112103 Continued

a Facllity Number: — f
Date of Inspection / D
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Aanlication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
/Excessive Ponding ❑ PAN ❑ Hydraulic Z;")
❑ Froze Gerund /❑ Copper and/or Zinc
12. Crop type'�F, /� RAZE f .. MOCK ��'JGIS �/!'lfi C
13. Do the receiving crops differ with those de`siknated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
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
Air Quality representative immediately.
-fvz.aw 4e�� Us!�W7' l
1431 A .
N po A
31��/��
'Vtj 15,
/ 2-
Reviewer/Inspector Name4
Reviewer/Inspector Signature:
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
;'Yes
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
RrYes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Field Copy ❑ Final Notes
,j
2 Z �� /vv /P,��4pr�JG-5 %J,�TE,��% 1�31�a 5A 4/1
142
l oif
2,
AO f}-c//e,o J:U
i//iG
12112103 1 Cordnued

0 Fae41r Number: Date of Inspection'
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
23. Does record keeping need improvement? If yes, check the appropriate box below.
Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
27. Did Reviewer/Inspector fail to discuss reviewCinspection with on -site representative?
❑ Yes
O No
29. Does facility require a follow-up visit by same agency?
❑ Yes
[:]No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No,
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
�'/ `��,�%�G_ /l �Cai�,O` ���v�0 I"�/� iP�/��- �✓,�'n�'r� ©/-" :��Aru-rti. �!�
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12112103

Facility Number: — Date of Inspection r�O
Additional Comments and/or Drawings `$;: ��'
.Y :..
p
0 ro zr,>,o& Pelie- 0.- AID
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f�NQ AmUOVr � Cr/fJR�- %v �Nr✓� � .
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7/25197

IN
95
Type of Visit /" Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint oFollow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: F
911i
jd Permitted [3 SCe'ed❑ Con 'tionally Certified © Registered
....
Farm Name: eQ arm ._.......
Owner Name: ».Ll.,Q ;" nxff ..... ._.»»...............................
Time:
Not Operational O Below Threshold
Date Last Opera or Above Threshold:
County: t!».....»..........»....._.»._...._......,
Phone No:
MailingAddress: .. . . ........ . . .... . .... . . . . ......... . . . ....... . .. . . . . ................ . . . .... . .... . . .............
Facility Contact! ......... _........ ...».. __._.. _._Title:..__._._.._. _.._ . ».». » .. __. . _. Phone No:
Onsite Representative. v0..1lZL�? _.__... __.. Integrator: ,»,„ », ,,.._.. .......»..» .». »........ _.
Certified Operator:--___------_. __. ___..»_. _ ....._....__.._..».... Operator Certification Number: .»..... »_.... _........ ».... »_. .
Location of Farm:
..
21 Swine ❑ Poultry ❑ cattle ❑ Morse Latitude
Longitude �• �' ���
Design r ;Current h rr ' ` "5`�„ �'�Clu rent Desiign Curreat
Swine ;.Ca
Ponitry :., w
.. ,;
tzon.. :'`Po ulstion '�
.Po
nlatibn
F-
ei r1P , .Cattle .. ."Cg aci
Wean to Feeder
x ❑ Layer
❑ Dairy '
Feeder to Finish❑
Non -Layer
❑Non -Dairy
Farrow to Wean
4yy,i't ,e
Farrow to Feeder
�
Other
_
Farrow to Finishty
YI fil r A� 1:
Tota1.D'
❑ Gilts
k
[3 Boars
r 'aTotal SSM " r
Discbarses & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Idemifier: ..._....__w .». _.. _ .. _ _. . _._.... _ _. .. ._. ... ... .._..___...
Freeboard (inches):
12112103 Continued

i
Facility Number:
Date of Inspection I
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
❑ Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Lssues
17, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
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
Air Quality representative immediately.
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Field Copy ❑ Final Notes
—�i✓��6'Gr�p� ,��}) �� v ��r �F �.�C/j �,�7c��E'S (,(�if�`�e.E �,��E
4v de' 4md o l /Gz,g,Grnjp_
Cf� Azluea fir✓ "O 4 ve 'ell
(,(�/'�-��� �f " !O /'¢n/ �/'�/n//�►')'1/�D � lG��f.� �l ��2 [/ !Q /�j✓C�Gi�-
GI,Qnnv
o n
Reviewer/Inspector Name 21, 1; " r'
Reviewer/Inspector Signature:
Date:
12112103 Golmnued

0
Facility Number: - —J47Date of ,Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes .,;KNo
28. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
A 6CORO5 C4
1 : Oar, ��-� � h*��-
12112103

Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint 0 Follow up O Emergency [notification O Other ❑ Denied Access
Facility Number Date of Visit: /O ime:
O Not O erational O Below Threshold
'Permitted © Certified © Conditionally Certified 13Registered Date -Last Operated or Above Threshold: .._.. _..
Farm Name: .... !/�Q �/.4Om.................................I...._............... County:
...... .......
Owner Name:�Cil�y?e1GZf .._l..lC�l~'�»._ L P-....._..._.... ' Pbone No: _.........».......»_......»».»._.»........»»._ ..
Mailing Address:.._W_._.___._.....___.
Facility Contact: Phone No:
Onsite Representative:......., a—dj!l ... ,1,`, -. tegrator•..__. »..__». .._._.___ _._ ._.._..
l
Certified Operator:
Location of Farm:
___.__..»». »....».».. »»..»......... Operator Certification Number:._......._......__..... __....
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 " Longitude • ' «
Discharges & Stream I -I- mpatcts
1. Is any discharge observed from any part of the operation? ❑ Yes PNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (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 XNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ONo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes j2rNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure S Structure 6
Identifier: »_._._.
Freeboard (inches):
12112103 Continued

Facility Number: 7 — 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 ❑ 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
8. Does any part of the waste management system other than waste structures require maintenance!'improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
❑ No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? If yes, check the appropriate box below.
01Yes
❑ No
❑ Excessive Ponding f a PAN Jj Hydraulic Ov load ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type012n1 �.47 �D �E
13. Do the receiving crops differ with those esignated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Odor Issues
17. 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?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
❑ No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
❑ No
Air Quality representative immediately.
Field Copy ❑ Final Notes
///,� digM�S G�ir►,� � � Gt/tG/h� �TD�J 1[r�'G�iJi9� D�'FZc¢' �it% �
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P rC n 44 Sant /41,PA1Ej2 Lt%r.y
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/a��lzzc Tl �r✓o dDrr�i✓ �
Aj D ' % rie=c H �uS L 7/f �L_ ,/.JStJ�✓-
/7N ' . 1�ie� SO .��✓ /T9 �i�n�,D�n!C �. �iP, bC/t/�'>�5 G7/�O
Cp�,jSl'sQ���zO.J Gv
�� ��'oo¢O s �2G-�.�azfo��7' � �•P�P 2 s /11f�o�� � .B,E
6�P2-frrzo,�
Reviewer/Inspector Name z
Reviewedlnspector Signature:
Date:
12112103 Continued

Faci tty Number: — Date of inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
23_ Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
,Yes
❑ No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
2rNo
28. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
29. Were any additional problems noted which cause noncompliance of the Certified AWM"
❑ Yes
❑ No
NPDES Pertnitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall [] Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
ety, NoivEueg Due- ' R,6,� Aoo 65;mi
�Ra�c,Frnh ��tnl o �� �'� F Sy����• T�E C cz A- ('z©n) Cou,,o
No-r P7'012�e_rz 5
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6V 1geOoizo5 (77'9-kzCA --7-06) f '7lifAlE. WI -
I K#f�
jJ�aAucec Oubezc,o At,c A lb 4Av'-z40 3`, GA4,/� V'
AU64, 8 / /�PPGrFo 32 353 DN.'
M,& min uin AV2,to --7zda j Al -r PAR �er/Znl r.-
7,
-off
12112103

Facility Number: J —/ Date of lnspec:tion
AdcEt�ana;l, Comments and/'ar Dra,�nngs :�3" x� �ri �,€�`u 4 'x�' �s
.ffT
l " 011)
1 o,� 311010.1
3
led
/0D7<S.�
r
' �lor�����,
NL��e�g� .,0 0 25
-o Kr c c, T �i-te c i - A � roc .
Oc E r�-} u F
16F F (Ly -rE rjr� 7 � N ��N azN
o
rJ C E ,
�Culz �zEtO
7/25/97

Type of Visit j0 Compliance Inspection Q Operation Review Q Lagoon Evaluation
Reason for Visit O Routine O Complaint is Fallow up 0 Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time:
Not O erational 0 Below Threshold
Permitted 0 Certi [3 Con tionally Certified [3 Registered Date Last Operated Above Threshold:
Farm Name: RQM4 County:
Owner Name: ��� /�� �/ �WS Phone No:
Mailing Address:
Facility Contact: Title: Phone No,:/
'W
Onsite Representative: F Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
jZ5wine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 04 046 Longitude 0• 4 0 «
Design Current Design Current Design Current
Swine Capacity Population Poultry Ca aci Po ulation Cattle Ca�aci . Po ulation "
❑ Wean to Feeder I JE1 Layer I I bNon-Dairy
Dairy
Feeder to Finish ❑ Non -Layer
Farrow to Wean --
ElFarrow to Feeder
❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts I
❑ Boars j Total SSLW
Number°of L4gao6i ❑ Subsurface Drains Present
HoldingPonds{I'Solid~Traps ❑ No Liquid Waste Manai:en
Discharges _& Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
Pray Field Area
❑ Yes No
❑ Yes /❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes )ZNo
❑ Yes ❑ No
Yes ❑ No
tructure 6
Continued

Facility Number: — Date of Inspection[f��e�f
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes Q�No
seepage, etc.) /
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? �] Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type f F—u F ( 1
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Reauired
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
(ie/ discharge, freeboard problems, over application)
P'No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
24,
Does facility require a follow-up visit by same agency?
ElYes
/VNo
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
© No violations or deficiencies were noted during this visit. You will receive no further correspondence shout this visit.
is ti:i�L•'er.�
e, q anyrecommendations c►r- any a,4her, comments Camidents (infer to uestion #} Fxplain any YESanswcrs'andlor
y .�:.
Use drawings of facility to better explaiin situatlons (use additional pegs as necessary). ❑Field Copy El Final Notes
NO � �S���Dn1 ON uCT�p Grl� T!•� /�'� !" �i �� �G•��i�%1 � Qn �� ��>
ANA A�on� �al1NF-�4l /FaVD�-/� pN
c
'004
i �/r7�ROrJF%) d46;-"-j4C-er 4.05 ���=f1iVE=r`IG ��7
Reviewer/Inspector Name'°�
Reviewerllnspector Signature: Date: ri
05103101 Continued

Facility Number: — j 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
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
Additional Comments and./or Drawings:
Awl
Af V�-e! r:r"O 44 10-1-410 4111 .4
�C0E-5 ,�� 7�C.. %� 4F
4W �9 �Z�; f�. �-r A5
A,o� K44" '�e; 140 '0� 'e�l` 1A) I�Vdrlle,
�CTcr�r �� ���,F,2 �i✓,� �sD,g
�oK ,
05103101

information contained in this database is from non agency sources and is considered unconfirmed.
Animal Operation Telephone Lop-
DWQ Facility Number 71 —14
Date/11/2003
Farm Name Curry Comb Farm
Time I
Caller's Name IRichard James
Control Number 11716
Q Reporting O Complaint
Region WFRO
Caller's Phone # [phone]
Access to Farm
Farm Accessible
from main road 10 Yes O No
Animal Population
Confined
Depop
Feed Available
Mortality
Q Yes O No
O Yes O No
O Yes O No
O Yes O No
Lagoon Ouestions
Breached
JOYes O No
Inundated
10 Yes Q No
Overtopped
10 Yes O No
Water on
O Yes Q No
Outside Wall
Dike Conditions
10 Yes O No
Freeboard Level
Freeboard Plan Due Date Date Plan Date Freeboard
Inches (? equals blank) Received Level OK
Lagoon1 18
Spray Availability Lagoon2
Pumping Lagoon3
Equipment 10 Yes O No
Lagoon4
Available S Yes O No
Fields Lagoon5
Lagoon6
2/13/2003
0 0 0
.11.Q3..----.GaIIQx.r.QlaartQd.a..fteebaard.levQl. af..�...inGhl~$,...all.tal�r?.bY..k�tr.G.Qbb......................................
17103 (8:30 am) ---- Mr. James reported a freeboard level of less than 18 inches. Call taken by Chester
......................................................................................................................................................................................................
A3.: ---.Farm_.i>llsJza�tasf_b_y__Ch�s�r._CQbb.:and. Cxal�.�t�.nbarg,...[.�gs�Qn._levaLat. Z.�.ix��ha;�.._.1=.ieJ�ls_vary.
AU.hQ�.hous�s.�+era ,lame-s-eras- asked .t4 keep wnabfie-J_(atlaaatAeeWy�.cony mhg-
.,_......,..._.._-.._.....................................................................................................................................................................................................................................................
1.1.2101----.Earm. revisited. 4y..Cbester.. GQbb....uisit.oandu.cted.with..T.im.Hall,.Regional.Agronamiat,. and........
ason.T.umer..Render. Gounty. Sail. &..Water.,.ta.review.. racsiving-crop.... Dlarning.vi.*j.Lthe. lagaon.lavel..was...
ks�nrd tQ_b�.1_irzohes�;� determinedby.marker_.._visually._tbe_marker.appearafQ.bQ.aRRrax. 3.te.4--.---
1chae.1.Qwr..than..t?�..d.ik�..wail..:..�Ja.sQn..T �.rner...aid..thak.h ..will..k�eck..l;gQQn..mailser..ta�nQrr.Qwh....hst�ar......
......................................................................................................................................................................................................
1/1'3103 ---- Received ca11_from Jason T. � �urner-and-Richard James concerning -lagoon marker-Both-stated-
hatIhe..tbo.of.the_lag.aon.marker.w.as..about-.D.4:ft:lowe�r:ttian:?h� 1a�caSt..pQlni~�.dik�.�al1...�ktar.�far�...s-
anann level is actually at 17 inches_ Tf�e far Wm ould=h.`ave #�een-at-18-in`ches on 3/6/03 by grMjstinnt—.
Chester Cobb
Comments2

r
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up J0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit: Time:
CLN=otNot r ti nal 0 Below Threshold
O Permitted O Certified [3 Conditionally Certi led [3 Registered Date Last Operate)irr Above Threshold:
Farm Name: Q County:
Owner Name: O by ��� OL[�F'�3 Phone No:
Mailing Address:
Facility Contact: Title: MPhone No:
OnsiteRepresentative: ��2�lD7s✓S. F Etegrator:
Certified Operator: Operator Certification Number:
Location of Farm:
LI Swine ❑ Poultry ❑ Cattle
❑ Horse Latitude �' �6
Li Longitude ' i C� K
Design
Current Design.
Current ,
Deiign '' Current
Swine Capacity
Population Poultry CHURCitV
Population Cattle
Ca 'iici ' Population
❑ Wean to Feeder I
❑ Layer
,:,:. ❑Dairy
19 Feeder to Finish
0 JE]Non-Layer
-- ❑ Non-DairyJ
Farrow to Wean
❑ Other
❑ Farrow to Feeder
❑ harrow to Finish
I ,
Total Design Capacity.
1
❑ Gilts
❑ Boars
Total SSLW..
1
a �
Number Lagoons
❑ Subsurface Drains Present ❑ Lag... Area
❑ Spray Field Area r
lloldin Pondsl'
g Solid.Traps
0L•s%, , ❑ No Liquid Waste Management System
Discharges & Stream lmnacts
1. Is any discharge observed from any part of the operation? ❑ Yes 'Ile 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 PrNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes WNo
Waste Collection& Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway p rYes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
05103101 Continued

Facility Number: — Date of Inspection 1 — O�
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
❑ Yes
seepage, etc.)
tVNo
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
El No
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
PAN ❑ Hydraulic Overload
11. Is there evidence of over applicat'/n1? Excessi PondinL�-1pi—eee4-f
❑ Yes
❑ No
12. Crop type (TyQ Zo E
13. Do the receiving crops differ with those designated in the Certi fid Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a} Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
Oyes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Reaulred Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
(ie/ discharge, freeboard problems, over application)
PeNo
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
ONO
24. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
refer,tot Uestiob* Ex lain.an YES answers' ' ` ( q } P, y ! apolor any�recnmmendatinns or"zany ot5ar�cdmments
CommentsWws
L 2i hni.. a h , ya r a..< -�... rN
=1}seilrawings;of facility fn better�explain situaHons(useFadditional pages�as4necessary' r
❑Field Copy ❑ Final Notes :.:.
-
NO�fS0.01'lerev 4GoaN ,E012fF4e,9Za
Af ccokwo '00:::5R- o/n Ax. -5,1 /n ,E5
rRi✓l �if 5 �,��it,`J
//���Puj•FO.
Reviewerllnspector Name � : Al � � , ��'"�:"" "'✓/`..�' xz..�,�
Reviewer/Inspector Signature: Date: O
05103101 Condnued

• ,.
Facility Number: 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
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
ADO C NeE,omP�eo LI'E.►1EN t
6162-49 5 ��2 �/ �F� ANO Pone- 5�711A O Di Jri 504,
'� / ✓O / ®f?` /`ZGL- ;��. /1 �41.1?�2E� /�7 !J7'Z.S /�'/y�F S.QT.�
rSG- �r
-,09 A)o-r A��� y a)4'97�-
D��vF 45,0/n� 9R
rQAJO-X-TroIJ
�fiD�395- �p�22�
NCO-�o�.y► �=
05103101

, • 3 a i i.f` t 1a. a..-��
LP d
4�a�
1 i �;�3t iil
,.
siib u of oingnd �'i+ster 1A,
� ��V►�er-A�'ni�
�
03 tS ti-., r_dr �r�. _.3 o, __f:{. , ,, '.> Fiat a._�_'. t t, ->. .s j ,<.a ;•,p#.r ..!�. ,,_, t., �..' ,ate, .u, .,n ..> ?!1h E�._', po .
Type of Visit P.-Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Il Routine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number !late of Visit: % Time:
N t O erational QBelow Threshold
13Permitted ® Certified ❑ Conditionall Certified 0 Registered Date Last Operated a Ab ve Threshold:
Farm Name: County: �ii d
Owner Name: Phone No:
Mailing Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Location of Farm:
Phone No:
Integrator: am x
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 r--• OK Longitude ram• • "
Design, urr e
Design u`tree
5ririe
Ca acity. Po nlahion'.P66ItrF "
CDes
e'!...`.aacity <Poulata C;tteaeitfE'Po ulatiotn
❑ Wean to Feeder
r
❑ La er '
I
❑Dai
i.;.�
Feeder to Finish
54-72-
JE1 Non -Laver
[] Non -Dairy
Farrow to Wean
_,.. ..
'JE3 Other
❑ Farrow to Feeder
❑ Farrow to Finish
" °�
�TotSlaDesign CapadtV�'"`
_
❑ Gilts'
❑ Boars
t
� Total' SSLW . -
, ;z ;
Number,ofLagaons I ❑ Subsurface Drains Present ❑ La oon Area ❑ Spray Field Area
�s ."' a,, `
Holdirtg'Ponds! Solid Traps p .°.i;� i u ❑ No Licluid Waste Management System '`;
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less -than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): 22
❑ Yes 8-90
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
M-No
❑ Yes
ET1T5
❑ Yes Ed'o'
Structure 6
05103101 Continued

Facility Number: T — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes Ll 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 B-fro
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? 8-Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes Em0
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes P�No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes �Mo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes E oo
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes E'Ro
14. a) Does the facility lack adequate acreage for land application? ❑ Yes MN
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 E'IVo
I6.
Is there a lack of adequate waste application equipment?
❑ Yes
❑'No
Re wired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
nNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[! No
19.
Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
Erfes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[�TRo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
l3-mb
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
E3-No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
[9-No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
03-No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ZWo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
( 9 ) }1 y YES answers � � a �
Cointents referu uestiun`# Ex Ialn an andfor;any recommendations qr any other comnsents. 4
Use drto: better, sttvattons� (nse as
expiam tsdididon1allpages necessary) 5 1 , [ Field C onv ❑Final Notes ry ,
7 /� or idt �'P '_C� =s f o,�C�dt v4- 4e-e� ,r
��� �.'YI1Pr %�` d�il/h g 2 Tr �� � 7'��it( d- !ri/< � �'� �f' i 4r dd.✓d✓'"I
,�Cr [rl4Gs %`s/rf 17/1" Gl/f "-o'e'
124
_.,.,..kn- .., y.,, m.. _. .. .F... •!:'•M,•f t i ^ 1{�� 3ii'
Reviewer/Inspector Name i ='
_.
Reviewer/Inspector Signature: Date: _e lie
05103101 1v Continued

P
Facility Number: 71 - 41 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
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt..
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?.
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
El Yes E� No
0 Yes �io
El Yes 2mo
ED Yes Z-KD
El Yes 2�o
C-1 Yes 21-1-lu
C3 Yes 9-110
rAdditioiial'Comments,and/or: Drowingx:
7,; 79 777; 173 M17", AIL
A? //7
eo Z- 6
YAreq e- e"4 047 Z-Ce 7/-
05103101

Type of Visit l& Compliance Inspection O Operation Review p Lagoon Evaluation
Reason for Visit 4PRoutine O Complaint O Follow up O Emergency Notification 12LOther ❑ Denied Access
Date 0Visit: � g bY. Time: 2+3D m
Facility Number 7
O Not Operational O Below Threshold
® Permitted 15 Certified j3 Conditionally Certified © Registered Date Last Operated or Above Threshold: - ............
Farm Name:' ......�.t1a✓V ....�°!'! b.....1 AV'm.......................................... County: ....... p��;blK...................... .................
OwnerName:.-----[�Gfl--s--��--•---- ....»._._,..-------- Phone No: -----_._._..---._._.___._._----------------
MailingAddress:.................................................................................................. .............
FacilityContact: ...........................................................Title:................................................ Phone No: ......................................
Onsite Representative:._ n t-_-_iwh/-------_---------_._..____ Integrator:._.(4KnrL---------------------------•
Certified Operator: .................................... : ............. .............................................................. Operator Certification Number:.........................................
Location of Farm:
[]Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude- • A 64 Longitude • 6 4+
« . g
', Des tt' Current
g
Design Qurrent
Swme_ , ".:Caeaci
on
Pouulatit
Poultry Ca aci " ,Po illation `;, Cattle Ca sett 'Pti uI' 66n
❑ Wean to Feeder
❑Layer
❑Dairy
09 Feeder to Finish
3
❑Non -Layer
;'':;
❑Non -Dairy
❑ Farrow to Wean
. ,.,.
❑ Farrow to Feeder
❑Other
Farrow to Finish
", 3 Total Design Capacity
❑ Gilts
; :.i
❑ Boars
ot
Tal SSLW
�,;UuNumbei of Lagoons�a
❑ Subsurface Drains Present
❑ Lagoon Area
I0 Spray Field Area
_
Holden Ponds /:Solid Tra s g
�:
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 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 []No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............ I .............. ............................ .......................... ........................... ............................•--•--...................
Freeboard (inches): ZZ
neino in* r._..,r.....

Lonllnueu
Facility Number: 71 — J Date of Inspection $ 6z
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do 'any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [:]No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Application
to. Are there any buffers that need maintenance/improvement? ❑ Yes [:]No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
13 Yes
❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
" " (#f)�` >Jzp am any T an wer`sand or an recomrne at ons atr an ottierAcomments. ,.
:Comments refer to uestion
.. r �..
Use d" faciqlFity !o befter°explaih sifuations:(ase,ad`dltlonal' ages as"neces ry):'
wings of
❑ Field Copy ❑ Final Notes
N rl 441i14, 4V;tsC, �4WA rSk JU G JNS� �Q my 0-0 �IA� /a 7-'4Q
jcelld _c moll w44 441. 4 en d�`�`i�,oJ�''B.� --v ikvesf j'�e
'IbC�HIt/� /7/t ,s� 4� ltlo9or
S`G � r�""!G �tf� yp '' 6 S/v✓LG inuPSy�f t-)1
f to a r rel C6M Troy s4iWefZ a�0 • 44f
r --yTM ^rr-�T__- r..,.-v r rr-i w« k�7
Reviewer/Inspector Name ��"v �'. �� Son
Reviewer/Inspector Signature: Date: dZ

Facility Number: 71 — 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
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Additional Comments and/or Drawings* ., -
i'Eu wAelle w fc ee� l.1 ti4re co,� ors e C�kv y Coy trn�
`
s fld, .r ep�ld �4 �a if con lam/ to y 9
� mg y
Ine, /03 ,,� -ft O hce, he, h&-,� G l. IDom e— t4vec k A mores j r'�2t '
nn4,L4
hfialn ez t-form Ak'1-'-f�l pfal'i AV- PC,, also
0,Af 1n !41414 0AM 1' 04� ,Aues �;A*ft7.
4AeO, A's -Ael6l war niue .�C
6ia
�A q �&,e weLfe/. When .9: askew kx 4k6of A)
hd ��ztH�}►rT �v�f�i aR,t Olee hAd
�p 171n p
1
vOe 1 06va nef ddle-`fl
y -4011'O'd fete/ s�;%/ *
SD fi r'G ,� :J: C't�'7ll�L Ao' Z,47/� I u L�' / 4 .f 5
t ✓r01'40> ` 4ft4 Vt� ��cr✓t/ CIA a Fart Woef Hit
�� -fd�l'DuJ�d DA O1L 1r'..gr-t�•/ sc/JA-
5 I
�tJ�► �D
05103101

'
Type of Visit Compliance Inspection O Operation Review p Lagoon Evaluation
Reason for Visit (6 Routine O Complaint. O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Q ^ 3-07 Time:
Q Not Operational 2 Below Threshold
#Permitted [3 Certified [3 Conditioonally Certified [3 Registered Date Last Operated or Above Threshold:
FarmName: ..(�:... ... cz- - �7................................. ........................... County:.......''"4`.�........................... .......................
OwnerName: ................................................... ........................................................................ Phone No:........................................................................................
FacilityContact:............................................................................... Title:................................................................ Phone No:...................................................
MailingAddress:.......................................................................................................................................................................................................... ..........................
OnsiteRepresent ative:..C.. .................................................................... integrator:...Alwff.....................................................
Certified Operator: ................................................... ............................................................. Operator Certification Number: ..........................................
Location of Farm:
i
❑ Swine ❑ Poultry ❑ Cattle ❑ Morse Latitude Longitude �• �' �"
a :' Design " 'Current Design Current , Design ` J Current , F
Ci aci ` .Po uladon Poultry .Ca" aci Po ulation„ Cattle Ca aci ,.':Po illation
❑ Wean to Feeder ❑Layer ❑ Dairy
Feeder to Finish D- ❑ Non -Layer ❑Nan -Dairy
' ❑ Farrow to Wean
❑
❑ Farrow to Feeder Other
❑Farrow to Finish ,
Total,Msi Ca acit
❑ Gilts P Y
❑ Boars Total SSLW
;4 Numbeu6f Lagoons ^ , Subsurface Drains Present ❑ Lagoo ❑ Spray F ❑ n Area geld Area
Holdmig Ponds 19oi1d;Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 9No
Discharge originated at: []Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
h. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes C�No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ONO
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...............uu.....i................................................... ................................... .................................... .................................... ....................................
Freeboard (inches): "! 1
5/00 Continued on back

Facility Number: I— Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes *o
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes gNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? %Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes ONo
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 XNo
11. Is there evidenchof over application? ❑ Excessive Ponding P(PAN ❑ Hydraulic Overload ❑ Yes 04No
12. Crop type +Q_Y J-Q_ gv--�U_
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
,gNo
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?
gYes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
J'No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
P5No
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
tKNo
19,
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
XYes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
JXNo
21,
Did the facility fail to have a actively certified operator in charge?
❑ Yes
J4 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
jufNo
24,
Does facility require a follow-up visit by same agency?
❑ Yes
E�No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
OfNo
*.00'iAtiolls'Or. 0eileiepolii 40 1004. 0009 this'visit; • X00 w11i-xee$ito Igo otthoe
coriesporidence:about this visit.:
- - I 1 - f ! f�-
Cawments (refer to question #) ;Explsia any YES, answers jand/or any lrecommendatlons or any, ptl>iei� cnmtrients.
i- y f
! . i -5., e. 1 j#1� 9< i 33 1 61 11. ;! 1,
Usc d awiitt di ,#c"',,y. to better explain sitnations {nse addif3oeial'pages as necessaryrr, �•r
�,� „ ,,. „ ., s ..1,
P°ape wez� ---4�..�
t -.
Reviewer/Inspector Name it 1.� °
Reviewer/Inspector Signature: CK Date: (t j d k 5/00

Facility Number: — Date of Inspection 3— G
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below .YesN0
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
KNo
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
P No
.AdMonal t;omments and/or urawtngsa I AL
/ 4LAS sic-�. d' 1
sL �� . Rom- 1

Revised Apri120, 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number -_ Operation is flagged for a wettable .
Farm Name: acre determination due to failure of
On -Site Representative: Part 11 eligibility item(s) F1 F2 F3 F4
Inspector/Reviewer's Name: k4
Date of site visit: L(-, —�—GC
Date of most recent WUP:_ —1:T3
Annual farm PAN deficit: pounds
Operation not required to secure WA
determination at this time based on
exemption El E2. E3 E4
�! Operation pended for wettable acre
determination based on P2 P3
Irrigation System(s) - circle # 1. and -hose traveler, _2..center--pivot system; 3. linear move system;
4. stationary sprinkler system w permanent pipe; 5. stationary sprinkler system w/portable pipe;
6. stationary gun system w/permanent pipe; 7. stationary gun system w/portable pipe
PART I. WA Determination Exemptions (Eligibility failure, Part 11, overrides Part I exemption.)
E1 Adequate irrigation design, including map`depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D21D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an I or PE.
E3 Adequate D, irrigation operating parameter sheet, including map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part III. (NOTE:75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part II. Complete eligibility
checklist, Part I1- F1 F2 F3, before completing computational -table in Part 111).
PART II. 75% Rule. Eligibility Checklist and.Documentation of WA Determination
Requirements. WA Determination .required because. operation .fails :one of the .eligibility
requirements listed below:
_F1 Lack.of acreage:which Tesultedin=over_applicabonmf.wastewater_(PAN) on--spray-
field (s):according-iofarm's last two -years mcf-irrigation7ecoui s: -
_ F2 Unclear,JIlegibie, or lack of information/map.
F3 Obvious_field-limitations-(numerous:ditches;failure:fo;deductTequired:.....
bufferlsetback-acreage;-or25°/ of total_acreageidentifiedin'_CAWNIR]ncdudes
small ;-irregulady-shaped.fields fields:less-than 5�cres:for.:travelers :or.less:than
2 acresfor.-stationarysprinklers).
F4 WA determination required because CAWMP credits field(s)'s acreage -in excess
of 75% of the respective field's total acreage as noted in table in Part 111.

Revised April 20, 1999
Facility Number
Part III. Field by Field Determination of 75% Exemption Rule for WA Determination
TRACT
NUMBER
FIELD
NUMBER',Z
TYPEOF
IRRIN
SYSTEM
TOTAL
ACRES
CAWMP
ACRES
FIELD
%
COMMENTS3
E
FIELD NUMBER' - hydrant, pull, zone, or:point numbers may be used in place of field numbers depending on CAWMP
and type of irrigation system. If pulls, etc. crossTnorethan one field, inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption; -otherwise operation will be subject to WA determination.
FIELD NUMBER' - must be clearly delineated on map.
COMMENTS' - back-up melds with CAWMP acFeage=exceeding''5% of its total:acres aqd having -received less than 50%
of its annual PAN as docuitmented in the farm'sprevicus-two years' (1997 & 1998) of irrigation -records, -'cannot serve -as -the
sole basis for requiring a WA Determination.✓Back-upfields -must -be -noted in the-commentzection-and must be accessible
by irrigation system.
Part IV. Pending WA'Determinations -
V P1 Plan Jacks :following information: CAhs4,e c� _tP.�•r o��t�c�f
P2 Plan revision may:satisfy75% rule based on adequate overalI-PAN deficit -and by
adjusting -all field -acreage Jo below 75%use rate
P3 Other (iern process of installing new irrigation system):

Facility Number t3ate of Visit: S G(S Time: SGU Printed on. 7/21/2000
O Not Operational O Below Threshold
Permitted © Certified ['] Conditionally Certified © Registered Date Last Operated or Above Threshold : .................
Farm Name: w-r ..... .�.... County: ..... v........................................................_'..................
Owner Name:...........
Facility Contact: ......
Mailing Address:
.............. ........ ........................................................... I.... ['hone No:.........................
....................... Title:.......
................... Phone No:
.......................................................................................................................................................................................................... ..........................
Onsitc Representative:. .................................................. ............ Integrator:..... sp y....................................................
Certified Operator: ................................................... ............. Operator Certifications Number:................
Location of Farm:
Vq
IT
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �' �� ��� Longitude �• �� �fc
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder JE3 Layer I I ❑ Dairy
Feeder to Finish (,T);;k❑ Non -Layer I I JE3 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons JEJ Subsurface Drains Present I ❑ Cage-- Area 111 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 KNo
Discharge originated at: ❑ Lagoon ❑ Spray Field []Other
a. Ii'dischargc is observed, was the conveyance man-made'' ❑ Yes ❑ No
b. If discharge is observed. did it reach Water of the State'? (If yes, notify DWQ) El Yes ❑ No
c. If discharge is observed. what is the estimated Ilow in gal/min?
if. 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 b'No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes allo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ,KNo
StFUCtUrc I Structure 2 Structure , Structure 4 Structure 5 Structure 6
idcntifier:.......................................................................................................................................................................................................................
Freeboard (inches): 3'l
5100 Continued on back

Facilit Number: — Date of Icispection 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 K 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 k�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
XNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
XYes
❑ No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
XNo
11. Is there evident of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
[I Yes
�-No
12. Crop type
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
KNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
14No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
XYes
❑ No
15. Does the receiving crop need improvement?
bzlyes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
4No
Renuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes D,No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(icl WUP, checklists, design, maps, etc.) txYes ❑ No
19. Does record keeping need improvement? (iet irrigation, freeboard, waste analysis & soil sample reports) XYes ❑ No
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ,gNo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes JUNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency'?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
�'�10 yiolatiogs •ot• Oficie des -mere noted• during 4h#s;visjt! • Y:oir will Teceive ito furl then • •
cor'resp&idence about. tlzIS visit. ... • •
Comments (refer to question #): Explain any YES answers and/or any recommendations or any.other comments.
Use
drawings of facility to better
\explain situations. (us{e' additional pages as necessary):
�1`�
QQ,� Li G��s�tdQ l.l��j Qut.�► � �� ��C;�c1 � �Gcti t-�11,
❑ Yes JErNo
❑ Yes Z No
❑ Yes 19 No
❑ Yes ZNo
St.SSerT I A,
` 1 (k :ro f i
r
�
�iQ-ect��l ��. KP.A Act?i Pd:P
Reviewer/Inspector Name lz� Lc
9 10--39s-39 o a X
Reviewer/Inspector Signature: �10 LA `�� Date: la-5_Go 5100

Facility Number:r-7 l — `L� Date of Iuspection GU 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 brelow ❑ 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 �TNo
31. Do the animals feed storage bins fail to have appropriate cover? Cl Yes VNo
32. Do the flush tanks lack a submerged fill pipe or a peimanent/temporary cover? ❑ Yes NNo
Additional'Cornments:andor .rawtngs:
1 t-�✓tom l ao,,,
r��� ��s�5�,
dt-,� six tS
cQ �-�e ►,ee� FIB--c►-e s��
mac, �..� L'� ,s
a jc �zj \5 �. �@ c d
5100

3 Divi ion of S6il'an'd 'a'itertonserva ' 'perat.i,
c i-ReAWT;':J,-
T r
V.;A$ 3)ivision of S611andWaterl onser*aton—Compliance , nspectiom
Oivision of Water Quality! -,,ComphanceJns.pecfion
Other Ageqcy,.Operation Review, Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow -tip of DSWC review 0 Other
Facility Number Date of Inspection
I Time of Inspection QZL= 24 hr. (hh:mm)
)f Permitted xCertified [3 Conditionally Certified [3 Registered 10 Not Operational Date Last Operated: ....... . .................
arne* -e✓
Farm N . . ...... C.O.'r _0 County: ......... F
................................................................ ............................... . ...................
Owner Name: ........... .... .... ...... ............................................ Phone No:
FacilityContact: .............................................................................. Title: ......... . ..................................................... Phone No: ...................................................
MailingAddress: .......................................................................... . ......................................... ..................................................................................... ..........................
15.
Onsite Representative:.....C, ....-Z.. ......................................................... Integrator:...!...........................................................................
Certified Operator: ................................................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
................................. ..............................................................................
Latitude Longitude
Design . Current:', Design, Current Design Current
h ift, I
Swine ,.,,,-_,�. Capacity Population ;�VOJI ry Capacity _Population Cattle Capacity Populatio n
E] Wean to Feeder El Layer ❑ Dairy
❑ Non -Layer j[3Non-Dairy
❑ j
Feeder to Finish _4�2_
Farrow to Wean
❑ Farrow to Feeder O]EI Other
❑ Farrow to Finish
T btal D6ijo 1��pi I t ty
❑ Gilts,
❑4
Boars Total SSLW
Number of lAgoons'. Subsurface Drains Present In agoon Area ❑ Spray Field Area
Holding Pon& Solid Traps JE] No Liquid Waste Management System
Discharges & Stream ImRacta
1. Is any discharge observed from any part of the operation? El Yes XNo
Discharge originated at: C1 Lagoon El Spray Field ❑ Other
a. li'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. Docs discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ' El Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters tithe State other than from a discharge? El Yes KNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? [3 Spillway El Yes WNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): .......... ............... ................................... .................................... ................................... ................................... ...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie I trees, severe erosion, 0 Yes �INO
seepage, etc.)
3/23/99 Continued on back

Fucility Number: (late of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes
(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 XNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings'? ❑ Yes )dNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes �fNo
It. Is there evidence of over application? [:]Excessive Ponding []PAN ❑ Yes xr�o
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes XNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes o
b) Does the facility need a wettable acre determination? ElYes No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes WNo
16. Is there a lack of adequate waste application equipment? ❑ Yes Wo
Required
Records & Documents
17,
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
WNo
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
t�lqo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
AYes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at_the time of design?
❑ Yes
'(No
21.
Did the Facility fail to have a actively certified operator in charge?
❑ Yes
[(No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
(CNo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
KNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
�No
0: �46'*'1 aiiOtis-or ileticieneies -were 00 ed• O(ktitrig tbis:visit: • Y:oii will •teeeiye tid #'uktho -
corre' S otiden& abG' U' f this :visit:
Comments (refer toiqueshon #) Ezplatn''any YES answers'and/or any, recoinmendlations�or; any other corniments ;.? {f, ,!
'USe drawinks of facthty 'to better explain 5itUat101t5 (u5esaddlhOnal'pa
61 ges RS�neCe5SSl}t)
qutQclai►t4— PAA/ �'��L��` -
,t.:E• l.� 1 - in 3 �fr d: I uro eJ! I( r�.r� t �i �"'
Reviewer/Inspector Name n; fi,4.'.
L,
Reviewer/Inspector Signature: Date:
3/23199

Facility Number: Date of Inspection 23-�
.' Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28, Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
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 -KNo
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.) ❑ Ycs No
31. Do the animals feed storage bins fail to have appropriate cover? El Yes No
3/23/99

y ` YO ivision of Soil and Water Conservation 0 Other Agency
1112 Division of Water Quality
19 Routine O Complaint O Follow-uu of DWO inspection O Follow-up of DSWC review O Other
Facility Number
E3 Registered Certified Applied for Permit © Permitted
Farm Name: ��' �'r• �`" FG r
Owner Name: ............. 1z; C. �A'd J_rq "'k
...................................... ..........................................................
Date of Inspection
Time of Inspection : 3 D 24 hr. (hh:nun)
10 Not Operational Date Last Operated :.................
........ County:.....�.�.....'..................�✓....................I............�..... ..
......... Phone No: ......�.r.d.....z:.'r...q.....0 Ja...........................
FacilityContact: .............................................................................. Title:....................................................... Phone No:
Mailing Address: ...... ...2 2 S �e_5 .11 J 1•t � � .... .....z. .. ..........................
o k .. ti It= ,
.................4 ................I....... ...... . ..............:......a.
Onsite Representative :.......... J.!..� �`......................... a.°�. e .�...................... Integrator: ............. d.....................................
Certified Operator, .................. ..r ....................... Operator Certification Number;.,...,,.... ....._....
..�.G-�.---....----....................... ...---..............
Location of Farm:
C
G
Latitude • 0' 0" Longitude • ' 0"
..ut.ua...�ayrc;
vHu saawu._:;:
❑ Dairy
❑ Non-Dairy
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes No
2. Is any discharge observed from any part of the operation? ❑ Yes ?2_1�o
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/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?
7/25/97
❑ Yes P-90
❑ Yes
❑ Yes )�No
❑ Yes �No
❑Yes rl_N_
)dyes 0
❑ Yes �N0
❑ Yes VNo

' Facility Number: - f L
r 8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes VNO '
Structures (Lapaoons,llolding Ponds, Flush Pits, etc,)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes XNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure
6
Identifier:
Freeboard(ft):............3....................................... ........................................................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
kfNo
11.
is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
No
12.
Do any of the structures need maintenance/improvement?
❑ Yes
�No
(Ir any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
�(No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
)dNo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type � Gu c-'
........................................................................................................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
Xlo
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
o
/to
18.
Does the receiving crop need improvement?
❑ Yes
19.
Is there a lack of available waste application equipment?
❑ Yes
WNo
20.
Does facility require a follow-up visit by same agency?
❑ Yes
WNo
21.
Did Reviewerlinspector fail to discuss review/inspection with on -site representative?
❑ Yes
ONo
22.
Does record keeping need improvement?
Yes
/
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yesx,No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
XNo
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Y��o
0 No.via[ations'or deficieitcies.were'noted'ducing this:visit:•:You:will ieceive,ilo'Itirther
0rr6006deice about tnis:visit: :
z2: kaep rvcck(y Fec.e6alt' f rccurd7 off 5;4e
c� h,►�a,� s epe.�•t� met r�,;b �c,j15 ort Spry Jy�i��
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: / b/ZO,

State of North Carolina
Department of Environment
and Natural Resources CEIVE
Division of Water Quality Jutd 1998
.lames B. Hunt, Jr., Governor
Wayne McDevitt, Secretary BY:
A. Preston Howard, Jr., P.E., Direc or
May 29, 1998
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Richard S. James
Curry Comb Farm
2205 Cypress Creek Rd.
Maple Hill NC 28454
Farm Number: 71-14
Dear Richard S. James:
1 � •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
You are hereby notified that Curry Comb Farm, in accordance with G.S. 143-215.1 OC, must
apply for coverage under an Animal Waste Operation General Permit. Upon receipt of.this letter, your
farm has six 60 days to submit the attached -application and all supporting documentation. In
accordance with Chapter 626 of 1995 Session Laws (Regular Session 1996), Section 19(c)(2), any
owner or operator who fails to submit an application by the date specified by the Department
SHALL NOT OPERATE the animal waste system after the specified date. Your application must
be returned within sixty (60) days of receipt of this letter. Failure to submit the application as required
may also subject your facility to a civil penalty and other enforcement actions for each day the facility is
operated following the due date of the application.
The attached application has been partially completed using information listed in your Animal
Waste Management Plan Certification Form. If any of the general or operation information listed is
incorrect please make corrections as noted on the application before returning the application package.
The signed original application, one copy of the signed application, two copies of a general location
map, and two copies of the Certified Animal Waste Management Plan must be returned to complete the
application package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Non -Discharge Permitting Unit
Post Office Box 29535
Raleigh, NC 27626-0535
If you have any questions concerning this letter, please call Sue Homewood at [phone]
extension 502 or Dave Holsinger with the Wilmington Regional Office at [phone].
Sincerely,
w
A. Preston Howard, Jr., P.E.
cc: Permit File (w/o encl.)
Wilmington Regional Office (w/o encl.)
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

FFacility Number 71 14 Date of Inspection ll21197
Time of Inspection � 24 hr. (hh:mm)
Registered ® Certified 0 Applied for Permit [3 Permitted 10 Not O erational Date Last Operated:
Farm Name: Curry...Camlb.f.arm ....................... ......... County: Eendtit:.................................
.....................................................
Owner Name:Riehard.5............................. Amu .......................................................... Phone No: 910-259.010....................
Facility Contact: Richardlasttcs.........
Title: QtY.ner................................................. Phone No:
WI.i.Q.........
Mailing Address: 2 0 . Xl1ri~�s..Cr�tilc>id,................................................................. 1 UPjejUU..NC..................................................... 2R454 ..............
Onsite Representative: ........................................................................................................... Integrator: lijlirilhYF.alftjarms........................................
Certified Operator:Rirba.rd.S............................ .[Antes................................................ Operator Certification Number::L70.QZ .............................
Location of Farm:
Latitude F 34 • 41 ' 24 144 Longitude 77 •F 42 ' F 00 "
Swine
Design Currertt
Capacity Population Poultry
❑ Laver
❑ Wean to Feeder
® Feeder to Finish
3672
Ej Farrow to Wean
Lj Farrow to Feeder
Farrow to Finish
t is
Boars
sign Current Design Current
ty *a i Population ' Cattle Capacity Population
, ❑Dairy
[{Non -Dairy
❑ Other
Total;Design Capacity 3,672
`Total SSLW 495,720
Number of Lagoons I Holding Ponds ' 1 ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
,'.r ❑ No Liquid Waste Management System
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 ❑ No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gat/min'!
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes ❑ No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ❑ No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes ❑ No
7/25/97 Continued on back

.lYacility Number: 71-14 '
a —,rIN
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ❑ No
Structures (^Lanoons,Holdina Ponds. Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ® Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(ft):..............1..12.................................................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes ❑ No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes ❑ No
12. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes [--]No
Waste Application
14. Is there physical evidence of over application? ❑ Yes ❑ No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type...........................................................................................................................................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes ❑ No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes ❑ No
18. Does the receiving crop need improvement? ❑ Yes ❑ No
19. Is there a lack of available waste application equipment? ❑ Yes ❑ No
20. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ❑ No
22. Does record keeping need improvement? ❑ Yes ❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes ❑ 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•or. deficiencies:were noted -during this .visit. •You.vrwill,receive no further.
correspondence. about this'vjsit.'• . ..
done as a follow up for freeboard. Freeboard still in violation. A Notice of Referral will be sent to DWQ-WIRO.
7/25/97
Reviewer/Inspector Name J
p ohn M� Fitzgerald
Reviewer/Inspector Signature: Date:
Far•ility Nrirnhrr! 71 —Id darn nr lncr�nrrinn I 111 l47

Routine O Complaint O Follow-ug of DWU inspection
O Follow-up of DSWC review O Other
Date of Inspection 4
Facility Number "1
Time of Inspection ; 00 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status• Registered ❑ Applied for Permit
(ex:1.25 for 1 hr 15 min)) Spent on Review
' ❑ Certified 0 Permitted
or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated:...............
....................................».................................'.............,»..................................................
FarmName :......... CVq.. _ . &.......................................................................
County: ..........R..4�!'!�! r................................... .......................
AG���!""L........
Land Owner Name:........ .. �IJ�ti�as........................................................ Phone No:.Sftliplm=l 810.....................................»...
[.ti�lcto [....
FacilityConctact:....... ........................... Title :....aft.'..
........................... Phone No:. c]!L?�.L
Mailing Address:.... ....��1�R.`5....�...... »...........
�� [�. ,�I'l.�Q...............
»...._.........ts�)..1..1JG.................... .....2�7.......................
Onsite Representative:... iS l it ....GlfAtri� ..... ........... ..... ....... .»..........
...... ........ Integrator; .»..jrI.. ......».....»........................................
�
Certified Operator:.......... ��..»....s........................................... ......... .... Operator Certification Number: ................... ................ »...
Location of Farm:
Latitude =•EM6 61 Longitude E-Fil• 4 «
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 discharge 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?
Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
❑ Yes ® No
❑ Yes 19 No
❑ Yes IRNo
❑ Yes ED No
❑ Yes KNo
❑ Yes 0 No
❑ Yes CYNo
❑ Yes AN No
Continued on back

Facility Number: ..._U...... ......14..
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes IN No
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structurggll agoRalrg and/or }J.oldilig Pondsl
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure I Structure 2 Structure 3
........I1.1............. ............................ ............................
10. Is seepage observed from any of the structures?
Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes No
❑ Yes j No
❑ Yes f.No
Structure 5 Structure 6
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type .............. ............................................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management flan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes
Q No
❑ Yes
0 No
P9 Yes
❑ No
❑ Yes
0 No
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
® No
❑ Yes
R No
❑ Yes
f9No
❑ Yes
10 No
❑ Yes No
❑ Yes No
❑ Yes [3 No
Reviewer/Inspector Name ..f
Reviewer/Inspector Signature: Date:
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

Site Requires Immediate Attention:
Faciliry No. 1 - f
DIVISION OF ENVIRONMENTAL MANAGEfIE'.-'�"T
A_N'%fIAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: --i' 119967
(�e- i-ri•�sQ.
Time: 'f
Farm Name/Owner:
flailing Address: Z Zo'5 C-, P nc sS 6 ✓-.e e Ir - VVth „ 1.11
Counnr:
Inte-a.tor. Phone: ow
On Site Representative: ,N��� ��• 6 yer4 3&,C) __ Phone:
Physical Address/Location: S _
Type of Operation: Swine Poult±y Cartle
Desi---1 Capacity: Sl UCH Number of Animals on Site:
DEti[ Certification Number. ACE DELI Cerancation Nut .be:: ACN-W
Latitude: L'onae: Eie•. a -:ion:
Circle Yes or No
Fest
Does the Animal Waste Lagoon have sufficient ueeboard of 1 Foot - 25 year, 2^ hour stot_r_ evert
(approximately 1 Foot Tirchcs)61WrO Actual Freeboard: _j_Ft. _ Inches
Was aiiv see7asEt observed from the lazoon(s)? Y -Is or459 Was a,:" erosion Y �s o
Is aaecuate land ava !able for spray? or -',,,o IS Lne cover crop aceu'a--- te?
Crop(s) being utilized:
Does the facility meet SCS minimum setbaclti 200 Fee: &ors Dwellings.n�r No
100 Feet from We11s?C2!Dor No
Is the animal waste stockpiled wit:,L'n 100 Fee: of liSGS Blue Line Sue, m? Yes orCV
Is animal waste land applied or spray irrigated wi:.iill 2_5 Feet of a USGS flap Blue Line? Yes o
Is anirnal waste discharged into waters of the slate aV r_±an-made ditch, flushing syste.%, or oc-er
similar man-made devices? Yes or No It Yes, Please Exp1Ln.
Does the facility, maintain adequate waste Lmanagme:ii records (voiS m"s of EM_nure, land applied.
spray irrigated on specific acreage vAtli cover c:op)? Yes or No,
Addtnonal Comments:
Sur V1_6:CC
�1
Inspector NLne
rr. r_ 1� V_
Si_Cure
cc: Facility Assessment Unit
L. s2 IC
r

1. StATF o
aw.
N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
COMPLAINT/EMERGENCY REPORT FORM
WILMINGTON REGIONAL OFFICE
Received by: S± F- 1 CL,IZ Date/Time: 32 .Z 9 C _ d , 00
EWergency: Complaint: L:::, County: !' . _
Report Received Pram:
Agency: Phone No.
Address: Phone No.
f—�rxRt�J Cwplaint or Incident: 1.rQ yl-k-Arf TC
� -Z1�4�0:t1 _
Time and Date Occurred: ,4 7' TL3 Q.
Location of Area Affected: a-ko Is, !`tw SO f
7) 4
Sur ace watrts Involved: Grouadwate Involved: Other:
Other Agencies/Sections Notified:
investigation Details:
Investigator: Date:
EPA Region IV [phone] Pesticides 733-3556 Emergency Management 733-3847 Wr7d!{fe Resources 733-7291
Solid and Hazardous Warre 733-2178 Marine Fhherder 726-7021 Water Supply Branch'733-2321 U.S. Coast Guam MSO 343-a81,
1127 Cardinal Drive Extension, Wilmington. N.C. 284053845 0 Telephone [phone] • Fax [phone]
An Equal Opportunity Affirmative Action Employer

'---Fc"RTI0IgS BRAR,ICH - WO Fax'919 715-6048 Ad 20 ''-�5 19'1111 P. 10/ 15
Site Requixcs Immediate Avc-n ion �!
Facilir Number:
• Si'1� tiZ5lT ATZC?� RECORD
DATE: _. In I g 1-1 1995
Owner: Richard jama _ � _ Farm Name' _JaM-s Farms
County:
A;cnc Visiting Site; Kenneth CQa;j — Pc .. Fhcnc: ,M!*L2� --
( pCic�i Dr: Richard Jaatro sj Phone, .... _ On Sitz Rcpresont av':: Phone;
Physical Address: 2 miles NE of the interseC't ion of SR 1525 and +NC 50. _ Far ri read is
on
tie it .t.
Maiming Address' - 2205 gypress Creek Ltd.
tlaz�Ze ill, N.C. 28454
Type of Operation: Swine x Poultry Carle
Design Capacity: _367 F-i.n aahitaejNtlmbcr of.An :nals on Site: 5672 Finishing
Latitude: ° -- ' " Longiradt: - -- ° -
Type of Inspection.- Ground x Acrial
SCircle Yes or '40
Does dic A.z=al Wasw Lagoon have su iciei,t freeboa e of 1 i oc{ - 25 year 24 hour storm event
(approximutcly I Foot + 7 inchcs) c,s ox No Acvaal F,,cebo rd: _L_ Feer _7—^ incfle,
For fatuities with more than one lagooa, please adc.ress the ot_he: laSoons' fre--wQard under the
comments scctioa.
Wa: any seepaSe obseved from the lagotoii(s)? Yr:i o ', )Xas therw erosion o":he dxul?: Yes 0
L, atieyuuate Iand ava-lublc for land application' o or N'a Is the cover Lmp .�ic�;u�ta? Ycs ar
Addzaoaal Corrn:entS: Liquid Ieve3 iS al_k7ve flush Piro-s Y Site requir€+s imn.-Ldiate
Fit to (91 ) 715-3-539 5i nar of gcut

CJ
•
•
Site Requires Immediate Attention
Raciliry Number. <
SITE VISrrATYON RECORD
DATE: .Till % i a 11995
Owner: Richard James %, Farm Name: James Farms
County: _ Pender - --
Agent Visiting Site: _Zenneth Cook Penagr SWCD _ - Phone: (41 Q) 2g9-4305
Operator.
Richard James
Phone:
On Site Representative: Phone: --
Physical Address: 2 miles NE of the intersection of SR 1526 and NC 50. Farm road is
on Me left.
MaZng Address: 2205 Cypress Creek Rd.
,.� Maple Hill, N.C. 2B454•-
Type of Operation: Swine x Poultry Carole
Design Capacity: .-26-72 FinishingNun:tbct of Animals on Site: 3672 Finishing
Latitude: o " Longitude- a
Type of Inspection: Ground x Aerial
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm eveat
(approximately I Foot + 7 inches) es or No Actual Freeboard: � I Feet , 7 Inches
For facilities with more than one lagoon, please address the other lagoons' freeboard under the
comments, section.
Was any seepage observed from the lagoon(s)? Yes o N Was there erosion of the dam?: Yes of N
Is adequate Iand available for land application? ( es or No Is the cover crop adequate?, Yes are
Additional Comments: Liquid level is above flush pipes. Site requires immediate
Fax to [phone] Slgnamix of Agent

•
Site Requires Immediate Attention:
Facility No. 7r
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE:` 3 1995
Time:
Farm Name/Owns
Mailing Address: `d► A 0 s I 4
County: 22IZea4 - -
Integrator: Phone:
On Site Representative: t Phone:
Physical Address/Lacation:b2p -tmo L Sc ` v n[ e5
Type of Operation: Swine V"*" Poultry Cattle t S t wr
Design Capacity: _ �`lCL_ Number of Animals on Site: T
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) es or No Actual Freeboard: -..__Ft. Inches
Was any seepage observed from the lagoon(s)? Yes o<9 Was any erosion observed? Yes o� o
Is adequate land available for spray? Oor No Is the cover crop adequate? or, No v
Crop(s) being utilized: -
Does the facility meet SCS minimum setback criteria? 200 FeeC from Dwellings?(' or No
100 Feet from Wells? 0 or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes 010
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes oo If Yes, Please'Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific
Additional Comments: No,
Inspector Name
cc: Facility Assessment Unit
Ya c nr Nn
Signature
Use Attachments if Needed.

•
Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: Z�� 4- , 1995
Time:
Farm Name/Owner:
Mailing Address:
County: I
Integrator.
On Site Representative: `lC
Physical Address/Location:
1 1
Phone: q I Q - ZS9 - �7
1 R7_'7 k-� p«
Gv�
Type of Operation: Swine ✓ Poultry Cattle P, r t 511 P.r
Design Capacity: '6&-7 2 Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 54" ' 4"'1 ';�75q Longitude: 17 ' +?-' 13-(C8' Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) (Pr No Actual Freeboard: 'Z— Ft. Inches
Was any seepage observed from the lagoon(s)? Yes o fo)
Was any erosion observed? Yes No
Is adequate land available for spray? es r No Is the cover crop adequate? @s r No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings. Ye or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of.USGS Blue Line Stream? Yes o No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes o No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o oNo If Yes, Please Explain.
L;
Does the facility maintain adequate waste management records (volumes of manure, land ap lied,
spray irrigated on specific acreage with cover crop)? es or No
Addidonal Comments:
L
Inspector Name
cc: Facility Assessment Unit
49L�
Signature
Use Attachments if Needed.
11