710042_INSPECTIONS_20171231

2 V
NUH I H LAHULI NA
Department of Environmental Qua!

Type of Visit (Z$ 7Routine
'pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Complaint 0 Follow tip 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 7- 3 Departure Time: County: t�e.J0�6i Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedei
Farrow to Finish
Gilts
Boars
Other
❑ Other
Title:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: [= n [= t Longitude: = °
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La eT
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
[TDry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes /No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
121<o
❑ NA
❑ NE
❑ Yes
WNo
❑ NA
❑ NE
12128104 Continued

Facility Number: — Z 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: LA(fw/ J f LA C{oa9) 2,
Spillway?:
Designed Freeboard (in): __b_0
Observed Freeboard (in): ;L_9
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 d]No ❑NA El NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes E7No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental th at, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes , No ❑ NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes 0No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El Yes No El NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes N ❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. - ❑ Yes
No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
_Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
Crop type(s)
13.
Soiltype(s) 06rLj��*L L G-o i,DS-60ft-O
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
NA
N�o[
❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'[:] Yes
,�,
01K' off❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
Lgo NA
❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
[�'Na u NA
❑ NE
fA 6Lm Ad 2, 2f--L-t6 "6 1 - Cn 00-D
Reviewer/Ins ectorName ,(91c) �i 77S P N Phone•
Reviewer/Inspector Signature: Date: �� 0
12128104 Continued

Facility Number: '�� — u'� Date of Inspection �� a
a.
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA [I NE
the appropirate box.
❑ WUP El Checklists El Design El Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspectionss E] Weather Code
22. Did the facility fail to install and maintain a rain gauge? El Yes o o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes L/1 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes ❑ No 7NA
N ❑ NE
El Yes ❑ No ❑ NE
❑ Yes No ❑ NA ❑ NE
CEINE
❑ Yes
❑ No 01
❑ Yes
No ❑ NA
❑ NE
❑ Yes
O No ❑ NA
❑ NE
❑ Yes
❑ No ElNA
ElNE
ElYes
No NA
❑ NE
❑ Yes
N ❑ NA
[I NE
❑ Yes
No ❑ NA
❑ NE
a
Additional:Comments andlor Drawings
I2128104

(Type of Visit gCompliance Inspection Q Operation Review Q Lagoon Evaluation j
Reason for Visit 9f Routine Q Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Facility Number Date of Visit:
Permitted [3 Ce 13 Conditionally Certified 0 Registered
Farm Name: . &�:A)_L�.� . .
Owner Name: _.........-44 .._
Mailing Address:
Tune:
Date- Last Opera r Above Threshold:
County: .. FM. ;
Phone No:
Facility Contact: ___ . Title: Phone No:
Ousite Representative: „ „,-� Integrator.
Certified Operator:
Location of Farm:
--- Operator Certification Number:
I
aSwine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• �' �"
Wien
?' MCanacrty ?Ponalatrbri . _Cattile s Caaacity' -Potion '
EwQ�--
I
I-E�
--
Other
TOfal D�gn` City r
m Boars
Number of Lagoons v �.�
Discharees & Stream ts
1. Is any discharge observed from any part of the operation? ❑ Yes ONO
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 ;2rNo
Structure 1 Stricture 2 Structure 3 Structure 4 Stricture 5 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? (i'e/trem, severe erosion, (] Yes ZNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes JZ 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 JZNo
S. Does any part of the.waste management system other than waste structures require maintenanceTimprovement? ❑ Yes VNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes PrNo
elevation markings?
Waste Annlication
10. Are there any buffers that need maintenancelrmprovement? ❑ Yes ONO
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes JO No
❑ Excessive Ponding ❑ PAN ❑ Ijydrau4c Overload ❑ Frozen Ground ❑ opper and/or, nc
12. Crop type �/yfOtzzll
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management P (CAWMP)? ❑ Yes )J 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 RrNo
16. Is there a lack of adequate waste application equipment? ❑ Yes XNo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ yes ONO
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes PNo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes .0 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 ONO
Air Quality representative immediately.
Woe, ![>ZeStiOg LSW!!S aIId�-� n= c8nj'tlL#T
d�lSt �i'awlll�.S'Of sty tb2itti'�GC�lBID �i��S+E G� p��15� � �} reld Copy
`
FF_k� WA'G 2z2Oz(
D<
OD'G�-f/J KIP "r
Reviewerllnspector Name t h
Reviewer/Inspector Signature:, Date: I
12112103 1 - — - • Continued

• Facility Number: Date of Inspection
Rewired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
ONO
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
[ZNo
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
0 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
0 No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
Qj No
Oe/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss reviewfinspection with on -site representative?
❑ Yes
No
29. Does facility require a follow-up visit by same agency?
❑ Yes
R No
29. Were any additional problems noted which cause noncompliance of the Certified AWIVIP?
❑ Yes
]f No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes gj 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 YieId Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112M3

Type of Visit 91 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine Q Complaint 0 Follow up Q Emergency Notification 0 Other ❑ Denied Access
Facility Number LH=j I
Date of Visit: C
El Permitted 0 Certified 0 Conditional Certified [3 Registered
Farm Name: - Pt4_:;_U T-F -5 IRR7ir Ovzgs
Owner Name: tZLLze5
Mailing Address:
Facility Contact: Title:
Onsite Representative: L 0,11
Certified Operator:
Location of Farm:
Time: I --
Date Last Operate or Above Threshold: _
County:
Phone No:
n Phone No:11
Integrator: L-f e&& S
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 06 0" Longitude ' 04 0"
Design Current Design Current Design Current
Swine Ca acity P,o ulaHon $oult . Ca aci P,o ulation Cattle Ca achy P,o ulation
ElWean to Feeder ❑ La er 10 Dairy
❑ Feeder to Finish I❑ Non -Layer I 1 10 Non -Dairy
Farrow to Wean D Z
El -Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 10 Lagoon oon Area
10 Spray Field Area
Holding Ponds 1 Solitl Traps ❑ No Liquid Waste Management S stem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ LaRzoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure S
❑ Yes 9 No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes
❑ No
❑ Yes
'pfNo
❑ Yes
VNo
❑ Yes
PNo
Structure 6
Identifier:
Freeboard (inches):
05103101 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
closure plan? El Yes [1 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
1 L Is there evidence of over application? Excessive Ponding ❑ PAN ❑ Hydraylic Overload ❑ Yes No
12. Crop type y7rKlY\U0N l HAy ) I_rKpozo 11)V
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
OfNo
c) This facility is pended for a wettable acre determination?
❑ Yes
O No
15.
Does the receiving crop need improvement?
❑ Yes
�No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
�fNo
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
J�&
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
XNo
21,
Did the facility fail to have a actively certified operator in charge?
❑ Yes
�jNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
�No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
El Yes
�No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
9No
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.
Comments (refer to.questton'#)EYplam any YES a k wers,ana/or any recommendations or any other comments. u , ,
Use err. wings of facility to better explain situations. (use additional pages asnecessary)
$E.. k;v t Field Copy ❑ Final Notes
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6fV'P�{ � a 0 s �N Gl> © � S A A P � , 0OJ 14 � R ��� RQEs SP�2R�(FZF-fps
F-OR [-f-O-A OUkj_-,_zY Ogq r°2 lAoRf-est
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cgq -zq No P 60'k.
--
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: — Y, Date of inspection 38 2
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?
Additional. Comments_ and/or Drawings.:
11�-&IXO �57
TeNQ 6 C_ 0 �WKV(' q-v �J
C��Cj�-P
05103101
❑ Yes ❑ No
❑ YesXNo
No
El Yes
❑ Yes VNo
❑ Yes P�No
[--]Yes No
El Yes /❑ No

W i
Type of Visit O Compliance Inspection O Operation Review Q Lagoon Evaluation F'qalp� 6!rATK I
Reason for Visit O Routine O Complaint 0 Follow up O Emergency Notification JIKOther ❑ Denied Access
Facility Number Date of Visit:
Permitted 13 C 'fled [3 Conditio y Certified 13 Registered
Farm Name: ge 7
Owner Name:;%ifJl
Mailing Address:
Facility, Contact:
Onsite Representative:
Date Last Operat r Above Threshold:
County:
Phone No:
Title: Phone No:
Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
V(5wine ❑ Poultry ❑ Cattle ❑ Horse Latitude a ° " Longitude 0 4 Du
Design
Swine :. Ca acitv,T
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
14nmtiei ©f Lagoon's
r YHolding Ponds l SolidTraps.,
Current Design Current - ��Design Current,
Population Poultry Ca�aci -, - Population 'Cattle ` -Ca °acfty Pa ulation
❑ Layer ❑ Dairy
❑ Non -Layer I I JE1 Non -Dairy
❑ Other
Total Design` Capacity
Total SSLW.
Subsurface Drains Present
❑ No Liquid Waste Managen
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
Area III Spray Field Area
KK, 4..
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Colitction & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Continued

Facility Number:. — Date of inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
❑ No
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste ADvilcation
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hy ulic Overload
El Yes
❑ No
12. Crop type 5
13. Do the receiving crops differ with those designatedin the Certified Animal Waste Management Plan (CA }?
❑ Yes
❑ No
l4. 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
IT 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
INO
24. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Copy U Final Notes
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Pli;� �� Gn��� �o S 1%1 oo 6-00tJ �1cca2.�
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
Dnu�O�� R �9s 616ad Ta Pane W� &WAZTrav� I rozm> r 4A� w
c�'l j t/ Q� 3 fZ(O OI. ��T�j /7�%170 '.sa57
�7� e✓ �L�/!)�FzQ.

Type of Visit O Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit O Routine Q Complaint Q Follow up Emergency Notification O Ot�heer-;—ems--� ❑ Denied Access
Facility Number Date of Visit: 2y Time:
Y ....//.. Nat O erational Below Threshold
[Permitted [b Ce -lied [3Conditionall Certified DRegistered Date Last Operate or Above Threshold: j
Farm Name: Gr-County:. ���f/e _ �✓�
Owner Name: 11,4
&4z z Phone No:
Mailing Address:
Facility Contact: 4
-1 Title:
%Phone No:
Onsite Representative: /" � 42V- � _ _ Integrator:
Certified Operator:
Location of Farm:
Operator Certification Number:
EySwine ❑ Poultry ❑ Cattle ❑ Horse Latitude 9 u Longitude ' ° K
Wean to FeederLILJLayerFeeder to FinishFarrow to WeanFarrow to Feeder
Farrow to Finish I #=
Subsurface Drains
No Liauid Waste A
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes JJ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes WrNo
❑ Yes Z No
❑ Yes ❑ No
Structure 6
Continued

Facility Number: Z Date of Inspection LZ 2
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Annlication
10. Are there any buffers that need maintenance/improvement?
It. is there evidence
12. Crop type LIL_/ 1
13. Do the receiving crops differ with those designated in the Certi
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?
Plan (CAWMP)?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
❑ No
❑ No
❑ No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did ReviewerlInspector fail to discuss review/inspection with on -site representative? ❑ Yes 'PTNo
24. Does facility require a follow-up visit by same agency? XYes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes [:]No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Field Copy U Final Notes
AleTZ�z�,o
.q-
%�nJ.ziyl
4ND !_'9/-/
ReviewerlInspector Name f
Reviewer/Inspector Signature:
Date: 22 OZ
05103101 Continued

Facility Number: :7-— �7 I Date of Inspection 'LZ
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
7r P,,-ZZ;�5,0 f� A)b ucme)zW
5�w %SEE tYrt%�Eie /UO r- eAl-m A Y,�OL. e/ll 7&1 6z?
2�) F�wuP 1N ,��rz�.r /w��k .By 4VE C46C
vie
TXF LACovn) L F-ucc gf\7T-�,E5 .�� �y�l/ivr
(%/O) 399,00S-3�a2�,
05103101

Facility Number j c f Z Date of Visit: I1 2 O) Time: 1,3 Dp
Q Not Operational Q Below Threshold
0 Permitted D Certified D Conditionally Certified 13 Registered Date Last Operated or Above Threshold: WW_ .....
Farm Name: ........ j j.:.. �.'.� rr....� �l�r Xl. .!' ......... ........................... County: civet .r'........._......... ..., . ......
OwnerName: ............ `..!.: .:..... �.......... . 1� ..r ...s....................................................... Phone No: .................. .............................. .......... ._... ....... .
Facility Contact: ............................................................................... Title:................................................................ Phone No: ............ ...... ................
..»....»»
MailingAddress: .............. . ....... . ................................. ................ . ....................................... .................................................................................
Onsite Representative:.... .. .. p.s.... � �t i l i � �r • k� t i � �1 ntegrator. .Yl C��!`I�O ��.:�......... __.... _
�.... .........................
Certified Operator• ........... Operator Certification Number:.. ..............__
Location of Farm:
❑ Swine' ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 61 Longitude • 6 «
Design ' Current = Design Current Desrg�a Current
Ga ci Pa uiatzon-.. PoWtry -° Ca aci Po ulatioU. Cattle Ca a .:Po 'idritlon
Wean to Feeder ❑Layer ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer ❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish
Tots MSign Capacity^.
❑ Gilts
❑ Boars Total Skw
Number, of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area x
Holdug Pond§ / Solid'Trsps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes j2f No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes JQ`No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes A!fNo
c. If discharge is observed, what is the estimated flow in gaUmin? h IG
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes Mo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ,ONo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes O10
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes A:�No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......................................................................................... ..........
Freeboard (inches):
5100 Continued on Lack

Facility Number: 1771 — 2_ Date of Inspection j Z O
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes _0*0
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ff 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? ❑ YesdNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes .0 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 �' o
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ,❑i'No
12. Crop type (3¢r,--udzj
13. Do the receiving crops differ with those designated 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?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0:.�?•Yi���i4ns:e�- dgl�c}envies •rv�re n9�� during �his�v�s�t; • Yotji wiii•xeegiye nfl further
ctiriesi ondeiki about this visit .................................. .
❑ Yes ,�TNo .
❑ Yes ZNo
❑ Yes RrNo
❑ Yes ONO
❑ Yes j'No
❑ Yes ,ETNo
❑ Yes )�No
❑ Yes ,,ETNo
❑ Yes j'No
❑ Yes eNo
❑ Yes ONO
❑ Yes )ZrNo
❑ Yes _O'No
❑ Yes 'ETNo
❑ Yes AEMo
Use dray of f$ciiity to'.better a plain -sift attong. {tree add>tiona pales:kgneces§ai
19. A)ee4 1e 6e sure 4o wce A ijot-sae al►j., yyris v�Gt-�ed wi��;yt'
60 a(ayS o-F eve,145' 4o GolctliG4e -Fke ncqa'P ed
Qn 4Lx -_Te & Z-/r i 411;S- sL-toL&jd 6e do; -le Fr'- h I c 6r_4-a6-- loo/e b
T_co ! alp!' �Pa,-.s '6'1 s.►-tAll 9n�in > 'need -fie �a� hew V^,�vlc
P7o W aid necet lcu lcile q !'Lc,`h iYt 111a,��= bCr b v$ 4t�t s i10�
215. t�r"Ows.^
a er� � 0 As,� q /�i��; �o apply r� .�n� art -
�P SO !bs . r Win-! : G �o,�P r ha sew, Svrti now -I " qVF
Reviewer/Inspector Name 'S?o v1cwG111=.:r'�-�
Reviewer/Inspector Signature: _ Date: rl z �' pi 5/00

Facility Number: — Z 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 xYes ❑ 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_A!fNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes J2rNo
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 _Z 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_.ETNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 'PNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
AddifionW-omments an or_ Drawings•.
r a+e, t1a ✓e pi e-f beot- 4, I t o t,"ed .
N�-fe= TG�e Fact 1+ �1►-1dGo�ds �,fe ver% v�eQ�! keP�• /
7A 2 S r^q, i E LG� S
5/00

�-� a Division'
IQLRoutine O Com laint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
F_
Facility Number Z Date of Inspection
Time of Inspection L24 hr. (hh:mm}
Permitted 0 Certified E3 Conditionally Certified 13 Registered 113 Not Operational Date Last Operated:
Farm Name: [.�r..�s 1'Q'1`�?llrr5�.. county:
!f�............._...........�.:..._.... +....................................... ..............................
Owner Name: ...........Al.......... ..... Phone No:....
Facility Contact: � 11�.fu ' &�} 3......Title: �1 f �1 ............................... Phone No: ...................................................
MailingAddress:...............6...............................Y.........................`..............................................................................
Onsite Representative: . .........Lri2 ......... ........................... Integrator ......... ......................`:/.3..........................................
Certified Operator:.................................................:.................................................I............ Operator Certification Number:..........................................
Location of Farm:
e_.... ----- .. ,...... ....... _ ......... .............. ..... I... ........................................................... � ..t
Latitude 0• 4 " Longitude • A «
Design--_ ` urrent = Design Current- ,Design -.; ;Current,
_%Swine
fCa acity�PpnPoulty CaaciyPuatte,.. Ca'act = Po ulaiion ,
❑ Wean to Feeder ❑ Layer ❑ Dairy
r ❑ Feeder to Finish ❑ Non -Layer ❑Non -Dairy `s
Farrow to Weanp
❑ Farrow to Feeder 10 Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ ]Boars=TotaUSSUW >:
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area JE1 Spray Field Area
Holding Ponds / SoEid-Traps ❑ No Liquid Waste Management System
Disebarees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 No
Discharge orisinated 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 gaVrnin?
d. Does discharge bypass a lagoon system? (If ycs, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes M No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [5(No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 04No
Structure `Strut tore 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: � m...�[Dr
Freeboard (inches): V............ .................................... ....................... I.—........
5. Are there any immediate"threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
3/23/99 Continued on back

Facility Number: Ir — [f Z Date of Inspection
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 partof the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
"Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding IPAN
12. Crop type
13. Do the receiving crops differ with those designated in t�e 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?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22, Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes 4No
❑ Yes R No
❑ Yes VNo
WYes ❑ No
❑ Yes XNo
PLYes SNo
❑ Yes Af No
❑ Yes ❑ No
❑ Yes ❑ No
JM Yes ❑ No
❑ Yes g No
❑ Yes J�INo
❑ Yes XNo
❑ Yes [(No
9 Yes ❑ No
❑ Yes N No
❑ Yes kNo
❑ Yes j,No
[:]Yes J'No
❑ Yes J*No
❑ Yes [(No
0 10 vi61ati6ris'oi- de#iciencie5-�i-ere h6 ed• durit�tg #his'visit' - You will-reeeiye uo furthgr
corres• 6fidence. about this visit_ : '
Use:drawin of facilr to, better -.ex lain situations use additional a es as n
Comieiedts (refer to• uesbon # Ex laid an YES answers and/or an 'recom endations or any other comments
s t3 / P (_ P g ecessary) H / }
9 Aw A- Tck.t,r� S�ilGta±t�sf d��eYw�r►1,/ acG IAYM �� st �r` Cam+"-
s t t �'a �t�vti++' c kD ; u — J D� 10 r rwr w ;tin_ ��i►-ot1 V S o� t- WOW G+�
dr oson wil'w C"yepli's . Q.ewwv-. a6 L-J4 ,_L W WU t,, oKce, 414,%, is
TIV
dt•k,im;V'LA • (e !
O ve Y Af---
Reviewer/Inspector Name
Reviewer/Inspector Signatur ; Date: Lr _ jjlj

Facility Number: Date of Inspection F 7—it-7-0-1
Odor 1ISrSEies•
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes N0
liquid level of lagoon or storage pond with no agitation? r
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes (ONO
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes [XNo
roads, building structure, and/or public property)
24. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes M"No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes gNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes XO—
Additional.
XNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? El Yes
omments an or rawin
wwt Wf 1 WO )70m 0'^ h{ w Otcr cA615 or '; vr; ,�,� �a►,� —� w-� _
• Y�unn i.�u�^�� (11iQ) 3�5'3�iba dr
It
j�6"e FW p sew (j
. r0
��. ��dWW WRbl�c. rSls Y
60 Ak,S
VQ
tZ-1 cam"
W t lm
C3�5 � ti PC) _ C-�+'t�►- yj/rLc fh GIB-�
� 3�'f: Z
1
3/23/99
1
3/23/99

Revised April 20, 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number 7r - /{e4-
Farm Name: ;//I
On -Site Representa rve: Afigs -0,10s
InspectorlReviewer's Name:litttr Y�6.1 e.� r
Date of site visit: - dU
Date of most recent INUP:'%"Ci
Annual farm PAN deficit: pounds
Operation is flagged for a wettable
acre determination due to failure of
Part 11 eligibility items) F1 F2 F3 F4
Operation not required to secure WA
determination at this time bas on
exemption E1 E2. E3
Operation pended for wettable acre
determination based on � P2 P3
Irrigation System(s) - circle : 1. h se traveler; 2..center_pivot system; 3. linear -move system;
4_ stationary sprinkler system wlpermanent pipe; 5. stationary sprinkler system wlportabie pipe;
6. stationary gun system w/permanent pipe; 7..stationary gun system wlportable pipe
PART 1. WA Determination Exemptions (Eligibility failure, Part It, overrides Part I exemption.)
El Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D2[D3 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 Ill. (NOTE:75 % exemption cannot be
applied to farms that fail the eligibiffiy checklist in Part 11. Complete eligibility
Checklist Part 11- F1 F2 F3; before completing computational .table in Part I11).
PART If. 75% Rule_ Eligibility Checklist and. Documentation of WA Determination
Requirements. WA Determination .required because -operation fails one of the .eligibility
reouirements"listedhalow:
i-I lick.ofm reagawhichTesuliedinzver�pplication�f-wastewater_-(PAN) onepray_:
field(s)accordinglofamn'sdasttwo-years:ofirrigation-zecoais --.
F2 UnclearjIlegible, nr lack of informationlmap:
F3 Obviousield-iimhationslnumerous-ditches;�ailure:-ioldeductTequired::Y.
bufierlsetback-acreage;zr25%'-ofdotai:acreage-identmed:idLAWNiIP-,7.1ricludes ._
small ,-irregulariyzhapedfiields= fields_less-Jhan-a�cres-for#ravelers:or.lessfhan
2 acres for.staiionarysprinklers).
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 Ili.

Facility Number Jf -�
Revised April 20, 1999
Part Ill. Field by Field Determination of 75% Exemption Rule for VITA Determination
TRACT
NUMBER
FIELD
NUMBER'S
TYPE of
IRRIGATION
SYSTEM
TOTAL
ACRES
CAWMP
ACRES
FIELD
%
COMMENTS)
5.1
5.31
11_�57d
11.3I
-1.4
5-6,
1
k
k
k
1
i
k
l
l
I
k
k
1
i
1
k
k
f
k
l
k
k
k
k
k
k
k
I
I
4
I
1
FIELD NUMBER' - hydrant, pull, zone, or:pcir t- ;cumbers may be used in place of field numbers depending on CAWMP
and type of ir'igation-system_- If pulls, etc. cross -more -than one field, inspectorireviewer will have to combine fields to
catcu;ate 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 fields with CAWMP acFe2ge:exceedingg5% of its total. -acres and having -received less .than 50%
of its annual PAN as -documented in theiarm'sprevious-two years' (1997 & 1998) of.inigationTacords,- cannot serve -as -the
soie basis -for -requiring a WA De#emminaiion_;.Back-unfieids- nust-be noted in the-commentzecuonznd mustbe accessible
by irrigation -system.
Part IV. Pending WA-Determinati ns -
P1 Plan -lacks :followinginformation: lit...,) qw\ ��.�� v �• .1��� Gti
P2 Plan -revision -may:satisfy-7b% rule based on adequate overall PAN deficit -and by.
adjusting -all field acreagedo-below 75% use rate
P3 Other (ieTn process of installing new irrigation system):

.,,
[Division of Soil and`Water Conservation'- Oper`,ation Review
rnsyon of Sod and Water Conservation -Compliance Inspection -�
Dion of Water Quality Compliance ec Insption: ? "
[`Othiviser Agency - OPeration-Review-
Routine OComplaint 0 Follow-up of DWQ inspection
0 Follow-up of DSWC review 0 Other
Facility Number
Date of Inspection I Z
Time of Inspection
I 24 hr. (hh:mm)
#Permitted Xcertified E3Conditionally Certified
0 Registered
I Date Last Operated:
p
JE3Not O erational
a
Farm Name: .......!.:._ �_+......... . .............
a Y` +yl ¢ r5
.... County:
peg1 'l
"+.....D v
��1� ...---I._ . .......
OwnerName: ........ R...?�.
...- ------ R
'..1. 1p
......I. Phone No:.. ....................................................
.........................
Facility Contact:....................•---..._.....---..---......_............ ...._. Title:...................... Phone No:
Mailing Address: _............................ ........ ......................
iOnsite Representative:............ .! ...... .......................................... Integrator:..........a�.�.......'.-.._...ra dl`l
f.................................
Certified Operator:---. ...............
Location of Farm:
Latitude Longitude
Swine =
.............. Operator Certification Number:.............
Design Current Design Current Design . , Current
�.
Capacity. Population ,.=_CattlCapacity Population Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
fZFarrow to Wean
Z
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Number-4❑Subsurface Drains Present JrLagoonArea ❑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?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
h. 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. Dries 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: 4 Z
Freeboard (inches): 2 5~ Z S
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
Continued on back
3/23/99
❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �TNo
❑ Yes $(No
❑ Yes No
Structure b

Facility Number: — Date of Inspection
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 maintenarice/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
I�W
12. Crop type 15 e" y" S. �
13. Do the receiving crops differ with those esignated 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?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
_ _ this:Asit. - Y:oi} :will •receive dd further
P . ................•.._....
corres ' de' abbot. this visit_ .. .....................
o.v�o a ns or• a �ctencies were n e r<n:.' '..
Comments{refert0 question #}; Explaiwany_ YES answers; -and/or any recommend atton&or any -other commeni �
ise drawings of facthty :to -better ua explain stttions (use additional pages -as necessary) _ = -
{, Lc-nocil 132— Z�Oc.�p 6vf- f4Oeon) hata�5 ►ti4� 9G�� '►�irkli✓ ��,Sl►uc.Gvr✓Yti�
I xo"-P t '6-4.
❑ Yes )%No
❑ Yes No
❑ Yes XNo
XYes ❑ No
❑ Yes '�rNo
❑ Yes ,INo
KYes ❑ No
❑ Yes )(No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �No
❑ Yes P4o
❑ Yes Vl�o
❑ Yes ONO
❑ Yes 3dNo
❑ Yes ONo
❑ Yes NfNo
❑ Yes 12(No
❑ Yes gNo
❑ Yes 0No
❑ Yes �(No
13 - Re, ,se- I — UP 4-skoh/ .6 yb,.*;, k Cp.K , wk4�0"_ roI-
AL
3/23199

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 ❑ Yes
liquid level of lagoon or storage pond with no agitation?�No
ti
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes o
28. Is there any evidence of wind drift during land application? (i.e_ residue on neighboring vegetation, asphalt, ❑ Yes K 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 o
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 o
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
Additional -Comments and/or Drawin _
i
3/23199

ONDivtslon of Soil and Water Conservation [3 Other Agency
[30ivision of Water Quality
O Routine O Complaint 0 Follow-u of MVQ inspection 0 Follow-up of IISWC review 0 Other
Facility Number
Date of Inspection "T�3�--t
Z
Time of Inspection � 2.4 hr. (hh:mm)
© Registered © Certified 0 Applied for Permit [3 Permitted 10 Not Operational I Date bast Operated:
Farm Name: ...`.`.J..�.t�s '�-?...?,1 5.. ......... County:....le:..............................................
OwnerName: ......A ...................................... ................................... ........ I............................ Phone No:.......................................................................................
Facility Contact:
Mailing Address:
Onsite Representative: ... 14
Certified Operator;....-(,,. ( &'
Location of Farm:
Title:.QFf.. ...................... Phone No:...........
................................... .............
a:......../: ................... ...�f�e.
1. s................................. Integrator: ... ,e%J?.�1.......s........................................
V.LI.�`GLP�................ Operator Certification Number .........................................
.......... .................... ....V. ............... ..:. ...A!1tLl.. 5.........!r':...&...... ja.191.' ........ !a- ......................
'
.............. .. ......... .....
Latitude 0• 0' fL Longitude 0• =` 11 ,
`Current, Desi Current: De Current estgn . gn" "`.
Swme Capacity Pbputation Poultry Capacity ,Populatwn Cattle Capacity Population
-- .... .
❑ Wean to Feeder ❑ Layer ; ❑ Dairy
�; ❑ Feeder to Finish ❑ Non Layer ❑ Non Dairy
1g aiIOW CO Wean ik
❑ Farrow to Feeder ❑Other
R' ❑ Farrow to Finish"
T©tal Design Capacity Z [
El Gilts
'. 171-
❑iota 'S)� rw % fi
Boars c
x ..
y
Numlter bf Lagoons /Holding Ponds; Subsurface Drains Present ❑Lagoon Area Spray Field Area g"
s
"., , 3
� �
-u... ❑No Liquid Waste Management System _ .
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
RNo
2. Is any discharge observed from any part of the operation?
❑ Yes
KNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
$0 No
b. If discharge is observed, did it reach Surface ?'Water? (If yes. notify DWQ)
❑ Yes
FJ No
c. if discharge is observed, what is the estimated flow in gaVmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
Ej 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
Q1 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
0 No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
0 No
7/25197
Continued
on back

Facility Number:-7—
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (LagoonsMolding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Freeboard (ft): .........a ...................................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
Structure 5
❑ Yes ANo
X-Yes ❑ No
Structure 6
❑ Yes 0 No
❑ Yes &jNo
12.
Do any of the structures need maintenance/improvement?
❑ Yes KLNo
(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 RNo
Waste Application
14.
Is there physical evidence of over application?
❑ Yes ANo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type .............5.&r............................................................................................_...........................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes Ea No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes kNo
18.
Does the receiving crop need improvement?
❑ Yes jq No
19.
is there a lack of available waste application equipment?
❑ Yes AgNo
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 JWNo
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes UNo
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes E9 No
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes ® No
[j, No.violatiorts-or. de'f cieincies. were - noted -during' this',visit.- You.will receive no•ft riher- :
correspbndehce. about this visit.
Reviewer/Inspector Name
L`t' ` ke.1 v.- i-
7/25/97
Reviewer/Inspector Signature:
Date:

10 Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Date of Inspection 3/27197
Facility Number 71 42
Time of Inspection 13:00 24 hr. (hh:mm)
Total Time ('m fraction of hours
Farm Status: Qr i md.................... ...- (ei:1.25 for 1 hr 15 min)) Spent on Review 2.25-
Inspection 'cue travel and ce s'
Farm Name: Ehul�ip kat a�x ....� . W » .»..... .. ._ County: Render ......... » ...... W.iRQ------
Owner Name: d A► ............ ... ..-ilil�ips ._ ... - . - ... -._ . __ . Phone No:
Mailing Address: 114.Pith&.Djft.e.................. ........»....-............................................. . ............. 28.46.6 ..............
Onsite Representative: .Mpg .P �......_.-................Integrator:,Carr.1►U's.1p.Qda.laC......... _..... ......
Certified Operator.a�rd�y. Operator Certification Number.
Location of Farm:
Latitude 34 • 42 1 1$ Longitude 77 • S86 FIG a
© Not Operational Date Last Operated: .......... .... ...._. ._. m-..........._.....»
General
1. Are there any buffers that need maintenancef mprovement? ❑ Yes N No
2. Is any discharge observed from any part of the operation? ❑ Yes ® No
a. If discharge is observed, was the conveyance man-made? ❑ Yes N No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes N No
c. If discharge is observed, what is the estimated flow in gal/min? NIA
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 N No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes N No
5. Does any part of the waste management system (other than lagoons/holding ponds) require N Yes ❑ No
maintenance/unprovement?

6. Is facility not in compliance with any applicable setback criteria?
❑ Yes
® No
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/1/97)?
❑ Yes
® No
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
® No
Structures (Lagoons _and/or Holding Ponds)
9. Is structural freeboard less than adequate?
❑ Yes
® No
Freeboard (1i): Lagoon 1 Lagoon 2 Lagoon 3
Lagoon 4
10. Is seepage observed from any of the structures?
❑ Yes
® No
IL Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
®No
12. Do any of the structures need maintenancerunprovement?
® 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 adquate markers to identify start and stop pumping levels?
❑ 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 .............. ................1xisI1.�Ixt.Ll�kte�l.H�zltrY
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
❑ Yes
® No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
® No
18. Does the cover crop need improvement?
❑ Yes
® No
19. Is there a lack of available irrigation equipment?
❑ Yes
® No
For Certified -Facilities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
®No
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
❑ Yes
®No
22. Does record keeping need improvement?
❑ Yes
® No
23. Does facility require a follow-up visit by same agency?
❑ Yes
® No
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes
® No
112. Low lying area in spray field,near farm pond needs to be graded and revegetated to prevent run off into pond. In addition, the bare
ea in the center of spray field needs to be allowed to dry and revegetated. Operator needs to take precautionary actions to ensure that
aste does not pass through road culvert into fields that are not in his CAWMP. A berm needs to be built around field hydrant to prevent
scharge into field ditch.
was also suggested that minor erosion be corrected on inner lagoon wall.
[edical waste was observed in the lagoon. It was recommended to operator that this situation be connected.
-VI
Reviewer/Inspector Name
Reviewerdnspector Signature: Date: 3I�/tj j

Site Requires Immediate Attention: 1� a
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
• ANIMAL FEEDLOT OPERATIONS SITE vIS1TATION RECORD
DATE: S - 4$ - , 1995
n Time: 1030
Farm Name/Owner: Ni u C ii es 4 r `61Pr
Mailing Address: , . I � 4 ct C9_ La 4-6
•
County: Nesk&v
Integrator: C R Z_" L.L5 _ _ Phone: 2I0Zsr— -11 FY.
On Site Representative: A►'_�, I�i I i�S - _ Phone: q tO �S S I t t �-
Physical Address/Location: W C5 R 1 O
Li sty 1301
Type of Operation: Swine Poultry Cattle
Design .Capacity: Z- 920�s —S4 W Number of Animals on Site: u
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 34 23 Longitude: 11 59 ` 30 Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm. event
(approximately 1 Foot + 7 inches) Yes or No Actual Freeboard: Ft. Inches
Was any seepage observed from the lagoon(s)? Yes oA,� DoWas any erosion observed? - Yes or No
Is adequate land available for spray? Yes or No Is the cover crop ade uate? Yes r No
Crop(s) being utilized: Gerluv N
Does the facility meet SCS minimum setback criteria? 200 Feet from DwellingsT, or No'
100 Feet from Wells? (Ear No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes oQ
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes oCNDo If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? cyl�
or No
Additional Comments: k*a 1�� c, to V�c►-
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.

OPERATIONS BRANCH - WQ Fax:[phone] Jul 18 '95 12:26 P.04/04
Site Requires ImMediate Attention -
• I Facility Number:
SITE VISITATION RECORD
DATE: Lu1 14 1995
Owner: .-Angus phiilivu - - Farm Name: Phillips Partners
County;
Agent V'ulting Site: KaMeth 29-ok fgnder S D Phone: (910) 229:A305 —
Operator -Mike- and Angus Phillips — Phone: [phone]
On Site Rcprescnfative: Mike and Angus Phillips Phone: Same
Physical Address: 124 Phil l R1 Dr.
Wallace NC 28466
Mailing Address: Sams
Type of Operation: Swine x Poultry _ Cattle .
Design Capacity: 2400 Sam Number of Animals on Site: 2400 sows Farrow -Wean
Latitude: 0 -' " Longitude: _°
Type of Inspection: Ground X Aerial
i
Circle Yes or No
Does the Aaimel Waste Lagoon have sufficient freeboard of 1 Foot + 25 you 24 hour storm avent
(approximately 1 Foot + 7 inches) V> or No Actual Freeboard: 3 Feet 2 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)? Ycs ot(�as there erosion of the dam?: Yes o$:&)
Is adequate land available for land application? diir No Is the cover Crop adequate? di�or No
Additional Comments-,
Fax to (919) 715-=559 Signature of Agent