820708_INSPECTIONS_20171231

�AM
NORTH CAROLINA
Department of Environmental Qual

Facility Number
(0-Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0-compliance Inspection Operation Review Structure Evaluation 0 Technical Assistance
[Reason for Visit: �� -Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: O Departure Time: /Z ' County: Region
Farm Name: `iy���t- wc"'4 Owner Email:
Owner Name: K-" ci j y�Y // Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:Ir = Phone:
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 Feeder
Farrow to Finish
Boars
Other
Other
Integrator: ell.
Certification Certification Number:
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Laver
Non -Laver
Design Current
Dry Poultry Capacity POD.
Layers
Non -Layers
Pullets
Turkeys
,Turkey Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes Q No ❑ NA ❑ NE
❑ Yes ❑ No
[:]Yes ❑ No
❑ Yes
❑ No
❑ Yes
U 1 0
❑ Yes
U 1"0
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
DNA ❑ NE
❑NA ❑NE
Page I of 3 21412015 Continued

Facili Number: - C) Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Ej No
❑ N A
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ N A
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 4(�/ WZ-✓"
Spillway?: 6fjW-7__ Aj4U—F
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ "No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[3 No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
Q Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Q"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
ONo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
0—No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes C7 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):/nla
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes E]�<o ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑ Yes
[f'�No
❑ NA
❑ NE
❑ Yes
'["No
❑ NA
❑ NE
❑ Yes
[nNo
❑ NA
❑ NE
❑ Yes []'1 o ❑ NA ❑ NE
❑ Yes [3-1<o ❑ NA ❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes L414O
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E5 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ffNo
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: 7,T— - r) Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ONo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes D'�To ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes E No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes Q No ❑ NA ❑ NE
❑ Yes E]No ❑ NA ❑ NE
❑ Yes E3 No ❑ NA ❑ NE
❑ Yes E�rNo ❑ NA ❑ N E
]�No ❑ NA ❑ N E
El"No ❑ NA ❑ NE
�No ❑NA ❑NE
❑ Yes
❑ Yes
❑ Yes
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
r
4- tt' 74 rC 71,1'�
Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature: Dattee:��J9%b
Page 3 of 3 21412015

— /i;- ---120/
Facility Number
r<7 Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: eTbmplince Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: &R/outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: , jJ-/ Arrival Time: /�� , Departure Time: County: ? cry Region: [1
Farm Name: ��2- (Npcx(�//yl Owner Email:
Owner Name: �rvL ,pz- // Phone:
Mailing Address:
Physical Address:
Facility Contact: 1^rYr/ %y1Cw/ Z Title:
Onsite Representative:
Certified Operator: f�,zte'/Up��c7 54r_�j
Back-up Operator:
Location of Farm:
Latitude:
.-�.. Phone: 1
Integrator: j%/'i
Certification Number: /
Certification Number:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish 7, 1 0 c,
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Laver
Non-1,a\ er
ury rounry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
Discharges and Stream Impacts
Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes JNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes RN o
❑ Yes L- No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facili Number: - Li. Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in): 12
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
© No ❑ NA ❑ Nl
❑No ❑NA ❑Nl
Structure 6
❑ Yes ® No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[RNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
aYes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
K No
❑ NA
❑ N E
(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
O-No
❑ NA
❑ NF,
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
RLNo
❑ NA
❑ N l:
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes [&No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence/of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): ,2W L(aL
13. Soil Type(s): ZVI ,"
14. Do the receiving crops differ from thd6e designated in the CAWMP?
❑ Yes
0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0 No
❑ N A
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
® No
❑ NA
❑ NF
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Q No
❑ NA
❑ N I
18. Is there a lack of properly operating waste application equipment?
❑ Yes
K No
❑ N,A
❑ N 1:
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
q No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
a No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
1. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application E] Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ,Ul No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E] No
E] NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA E] NE
❑NA ❑NE
Page 2 of 3 21412015 Continued

Facili Number: - Z,9 Date of -inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [SI No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0 No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
r7 No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ,® No ❑ NA ❑ NE
❑ Yes Q No ❑ NA ❑ NE
❑ Yrs
� No
❑ NA
❑ NE
[:]Yes
EQ No
❑ NA
❑ NE
❑ Yes
[q No
❑ NA
❑ NE
❑ Yes
[&No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. 7
Use drawings of facility to better explain situations (use additional pages as necessary).
yfCA2xj Aa —�
Reviewer/Inspector Name: > �7�C/ G C/T y/� Phone: `�jU-Jyy jar
Reviewer/Inspector Signature: ' —" Date:
Page 3 of 3 21412015

Division of Water Resources
Facility Number - %O, " O Division of Soil and Water Conservation
O Other Agency
Type of Visit: FRoutine
Hance Inspection Operation Review p Structure Evaluation O Technical Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: 0 Departure Time: ,' � County: l u
Farm Name: /�� � Ez / Pyt, Owner Email:
Owner Name: e yl S 4, f / Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: q,a_
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
(him
Latitude:
Region: PfFD
e _ Phone:
Integrator: �fy/, i _J TZ 4
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry CaD8city Pon.
Layers
Non -Layers
Pullets
Turkeys
,Turkey Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ )'es [3-No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes allo
❑ Yes EjG,No
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Page I of 3 21412015 Continued

Facility Number: 70 Date of Inspection:
Waste Collection & Treatment
• 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[g-No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: �t
Spillway?:
Designed Freeboard (in): c
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
L�j No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[ a No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
JQ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
allo
❑ N A
❑ 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
5?[No
❑ N A
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
2 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [R No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s)://72up1^� f
13. Soil Type(s): V,
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
allo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
EZ-No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
®. No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[allo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[E� No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Eg No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
Q No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[�JNo
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

Facility Number: - gj Date of Inspection: Z� - 7
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ®. No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [3-No ❑ NA ❑ N E
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of fast survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? 0 Yes E�jNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus lob assessments (PLAT) certification? ❑ Yes o No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes allo ❑ NA ❑ NE
❑ Yes �a No ❑ NA ❑ NE
❑ Yes allo ❑ NA ❑ NE
❑ Yes [�qNo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes JR] No ❑ NA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes RNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes J2�No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
viz
Reviewer/Inspector Name:
Reviewer/Inspector Signatuz
Page 3 of 3
Phone: 91-V -::�.-VU-1
Date: IP7 ; /,/,
21412015

ivision of Water Resources
Facility Number Fy-771 - F=
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: G Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ?—,")-Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I INP-J-1-1Arrival Time: / ; 3 Departure Time: ; O d County:
��•— Region:
Farm Name: l-1/,r�t9�eri d✓lti. Owner Email:
Owner Name: r' \Y"X-L 5 // Phone:
Mailing Address:
Physical Address:
Facility Contact: 1'(A: e'r_ Title:
Onsite Representative: �1tY�vv� r
Certified Operator: p(
Back-up Operator:
Location of Farm:
Swine
Latitude:
Phone:
Integrator: J! �,
Certification Number: / '� I-// X
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Wean to Finish
Wean to Feeder
Y.Feeder
to Finish
1
c
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Othcr
Design Current
Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
,Turkey Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
jet
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes fElNo ❑ NA ❑ NE
❑Yes ❑No ❑NA ❑N_:
❑Yes ❑No ❑NA ❑M[,
❑ Yes ❑ No
❑ Yes [2--No
❑ Yes a No
❑ N A ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412014 Continued

[Facility Number: Date of Inspection: //—/ p - /r
Waste Collection & Treatment
• 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes [2�No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 1
Observed Freeboard (in): d-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[:]Yes
[3-No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
ayes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
®,No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]Yes
allo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
®. No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ®-No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):Ynrl�c,,�e� Z fJtle!� ,rrJ
13. Soil Type(s):�•-
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Callo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 3-No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes � No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes E3,No ❑ NA ❑ NE
[-]Yes EB-No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [allo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes S No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [D No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [2� No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes 0 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
DNA ❑NE
Page 2 of 3 21412014 Continued

Facility Number: - 70 Date of Inspection: `l
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No
' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check []Yes allo
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes allo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes 13 No ❑ NA ❑ NE
❑ Yes [Z No ❑ NA ❑ NE
❑ Yes n No ❑ NA ❑ NE
[:]Yes
E![,No
❑ NA
❑ NE
❑ Yes
P�_No
❑ NA
❑ NE
❑ Yes
Eg-No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
j l� , / / , �^- r i— l�
Q _ c,c cJ Eno v Bzr t� QS S 00— 1f_
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: "-�`3 �3 e o
Date: �/ /b --
21412014

Division of Water Quality
Facility Number - O Division of Soil and Water Conservation
O Other Agency
Type of Visit: 43rCompliance Inspection 0 Operation Review Q Structure Evaluation p Technical Assistance
Reason for Visit: routine 0 Complaint 0 Follow-up 0 Referral 0 Emergence 0 Other 0 Denied Access
Date of Visit: j!4:d2jj I Arrival Time: / / Departure Time: 3 O County: Region: '
Farm Name: U f +�—_ Owner Email:
Owner Name: t-\ r- c, p t �� Phone:
Mailing Address:
Physical Address:
Facility Contact: G_ f-,- MbDeZ_ Title:
Phone:
Onsite Representative: �� _ I Integrator:
Certified Operator: �� <«;�� 1� 5,�� /� Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
Other
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry Canacitv Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [M No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑Yes ❑No ❑NA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes E� No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ❑ No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Number: - Date of Inspection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes KNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I -
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Ej� No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
JR No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify D«'Q
7. Do any of the structures need maintenance or improvement?
❑ Yes
N No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Z No
❑ NA
❑ N E
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[:]Yes
® No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops di er from those designated in the CAWMP?
❑ Yes
O No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
RLNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
LK No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
" No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
KNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[ [ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
a No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
UNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
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
MNo
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Facili Number: - 70e jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 4 No DNA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑. No ❑ NA ONE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative'?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
L�( No
❑ NA
❑ NE
❑ Yes
N No
❑ NA
❑ NE
❑ Yes Z No ❑ NA ❑ NE
❑Yes L4No ❑NA ❑NE
❑ Yes 2 No ❑ NA ❑ NE
❑ Yes ZNo
❑ Yes � No
[:]Yes Dj_No
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawines of facility to better explain situations (use additional napes as necessarv).
l�_
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: �/j0 — dV5— 3-3D0
Date: 2a�2_L�y
21412011
Page 3 of 3

Q'givision of Water Quality _
Facility Number 0 Division of Soil and Water Conservation 6
0 Other Agency
Type of visit: ,.,ommppliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: tD Koutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: /3 Arrival Time: Departure Time: County: r— Region:
Farm Name: %(/`� %t //'ham Owner Email:
Owner Name: �r�tos �� ��`a�..-s Phone:
Mailing Address:
Physical Address:
Facility Contact: �1/tY/ Inl rc— Title:
Onsite Representative:
Certified Operator: 2r."i eaA ts _S,p Y ll
Phone:
Integrator: "�.4 1Ji liu�fL
Certification Number: z p//%
Back-up Operator: Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood CoN�
❑ Yes [�JNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
0 Yes [:]No
❑ Yes ®. No
❑ Yes E No
❑ NA ❑ NE
DNA ❑ NE
❑NA ❑NE
DNA [:]ME
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

FaciliNumber: - Date of -inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
allo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: nd
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
M No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
a No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
KYes
-No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
JKNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
'N
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
allo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes INo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Xeyyn�u 1©=1
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[Z,,No
❑ NA
❑ N1,:
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
U_No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
O No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
C&No
❑ NA
❑ N 1
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
RNo
❑ NA
❑ N F
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Lg-No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
0 No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
;Z No
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Facili Number: - Date of Inspection: — 9—/
y 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes & No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes [� No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? []Yes No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes [Z No ❑ NA ❑ NE
❑ Yes [�j No ❑ NA ❑ NE
❑ Yes Ig No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
2q No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawines of facilitv to better exnlain situations (use additional naves as necessarv).
J�7,4WI:;A�e A_�--7 0--- AIV
Reviewer/Inspector Name:
Phone: ,9-/!7 2�633al�
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412011

c0 -3e)1'7_--p' —6—?,
&O"Division of Water Quality
Facility Number -WE O Division of Soil and Water Conservation
O Other Agency
Type of visit: &Tompliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: 1?xoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: I/p- - Arrival Time: p : oc> I Departure Time:County:
Farm Name: (,(j �, a/W - Owner Email:
Owner Name: tfka_rlY.S ta-m-3 Phone:
Mailing Address:
Physical Address:
Region: "Izb
Facility Contact: t2 r ree- Nt-w-L Title: ✓ G re Phone:
Onsite Representative: �f�.y�Integrator: o�f vl'04
J
Certified Operator: �r / tUc�Dcj Certification Number:
Back-up Operator:
Location of Farm:
Swine
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Wean to Finish
Wean to Feeder
.Feeder to Finish
li DU
Q
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Discharees and Stream Imuacts
Design Current
Dry Poultry Canacity Pon -
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
1. Is any discharge observed from any part of the operation?
❑ Yes
allo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
M! No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

• Facility Number: - [Date -of Inspection: / a
Waste Collection & Treatment
• 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[a No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: Lou wr
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
[:]Yes
® No
❑ N A
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
Z. No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or ens ironmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
P,No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[a No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes U .No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop TYPe(s): &-d`WL'.-Ju /
13. Soil Type(s): bua
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
jKNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
allo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Z[ No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Z No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Eq No
❑ NA
❑ NE
Reuuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
allo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
ayes
o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
LSWaste Transfers
❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[ No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
® No
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - 7p Date of Inspection: Q—//
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
• 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 2L No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes allo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes G&No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes 54No ❑ NA ❑ NE
❑ Yes R1 No ❑ NA ❑ NE
[:]Yes Q No ❑ NA ❑ NE
❑ Yes C&No ❑ NA ❑ NF
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
g No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
©C , No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
01 No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: 511 o —4�T3—33a c
Date: /(�) _ /f
21412011
Page 3 of 3

51tl
ivision of Water Quality
Facility Number F7,21 - I - pS,f 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: lj1, �717 County:=*;�-�-- Region:
Farm Name: �t/fj,� %(��j / R/N1i Owner Email: ��
Owner Name: �'�24/`/c�'3 �✓ /�itt��3 Phone:
Mailing Address:
Physical Address:
Facility Contact: G/�'r-�,'" %i!'�i�•"� Title:
Onsite Representative:
Certified Operator: 1'�KY, z, ��
r
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator: 1 u�•y
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
qaer
Non -Layer
Design Current
Dry Poultry Canacity Pnn.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ® No
❑ Yes [g No
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
Page 1 of 3 21412011 Continued

Facility Number: jDate of Ins ection: ' 3—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes a No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: uQCi.'
Spillway?: �—
Designed Freeboard (in):
Observed Freeboard (in):_�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
.q Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E0 No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]Yes
[0 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[S No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes JZ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):,��/u
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [�j No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ® No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes pC No ❑ NA ❑ NE
❑ Yes JZ No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [RNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design [:]Maps [:]Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes LK No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes � No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection: — 3--"
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes © No
the appropriate box(es) below.
0 Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes ® No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 2 No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes Z No ❑ NA ❑ NE
❑ Yes E,No ❑ NA ❑ NE
❑ Yes [�j No ❑ NA ❑ NE
❑ Yes Z. No ❑ NA ONE
❑ Yes S No
❑ Yes ❑ No
❑ Yes 0 No
❑NA ❑NE
❑NA EjNE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional Daees as necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

Q�Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation 41--
0 Other Agency
Type of Visit ISel6ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
&
Reason for Visit 1outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: l h / i- Arrival Time: Departure Time: County: Region: F9 D
Farm Name: ia.4, 74�r l.,! ,,A Owner Email:
Owner Name: Cori act le S Phone:
Mailing Address:
Physical Address:
Facility Contact: Ar-­l t� l� Title: dun Phone No:
Onsite Representative:✓rY✓ 411El91� Integrator: at
Certified Operator: �Y� ��� Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = o = = Longitude: = o = , ="
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish ❑ Layer
❑ Wean to Feeder 10 Non -Laver
Feeder to Finish VD(� Qua
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures: 7
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 ❑ N F
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
®.No
❑ NA
❑ NE
❑ Yes
JKNo
❑ NA
❑ NE
Page I of 3
12128104 Continued

Facility Number: U, — b- Date of Inspection 7701
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: 46w,r /
I I
Spillway?:
Designed Freeboard (in): g lei
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes E,No
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes 2. No ❑ N A ❑ NE
❑ Yes RNo ❑ 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 C6No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑-No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes D�-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 oNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable
//Crop Window ❑/Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) AZ6lf
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ONo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
allo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
tO No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
RNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
f'No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any 'recommendations or any' other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name -.3*Tt er Phone: g /0­ 4.�--.T3ov
Reviewer/Inspector Signature: Date: 1%--/ 7 —,,ze
Page 2 of 3 12128104 Continued

Facility Number: 9 — Date of Inspection �17�
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes allo ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes BNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
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?
al Comments and/or Drawings:
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
C&No
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
q No
❑ NA
❑ NE
❑ Yes
6No
❑ NA
❑ NE
❑ Yes
S No
❑ NA
❑ NE
❑ Yes 5INo ❑ NA ❑ NE
❑ Yes [ZNo ❑ NA ❑ NE
❑ Yes 9-No ❑ NA ❑ NE
❑ Yes ®,No ❑ NA ❑ NE
❑ Yes KNo ❑ NA ❑ NE
[]Yes ;-No ❑ NA ❑ NE
Page 3 of 3 12128104

7-2c�`% K-/—
Division of Water Quality
Facility Number 2 %G fj O Division of Soil and Water Conservation
Other Agency
Type of VisitC.,ommppliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Koutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date ol'%'isit: /2-07-0`/ Arri+'al Time: Departure I ime: County; Sa.++PSc,✓ Re -ion:
Farm Name: Wki-MW OO d 5 IP:tVrv► Owner Email:
Owner -Name: C kay (G 5 W ► l) f ams Phone:
Mailing Address:
G/.?, 0
Physical Address:
Facility Contact:y reLr l�oa: �' 'Title• 7C.c-4, . Soe-c . Phone No:
Onsite Representalive: Integrator: Al- 8/'UW/ p
Certified Operator: aerw,-,ocI k • sn<-11 Operator Certification Number: AW4 _ 19II
Back-up Operator:
L,ocatiou of Farm:
Swine
Back-up Certification Number:
❑O ❑ ❑" n ❑O ❑.
❑ u
Latitude: Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑
Wean to Finish
❑
Wean to Feeder
Feeder to FinishSrUc-
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Puults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes CI'No ❑ NA ❑ NE
❑ Yes
❑ No
E- NA
❑ NE
❑ Yes
❑ No
[�1A
❑ NE
�A
❑ NE
❑ Yes
n No
❑ Yes
E5NNo
❑ NA
ElNE
❑ Yes
E No
❑ NA
❑ NE
12128104 Continued

C
Facility Number: 82 -70$ Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
����
E o
❑ NA
ElNE
a. If yes, is waste level into the structural freeboard?
❑ Yes
94 o
❑ NA
❑ NE
Structure 1 S, n)Fture 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: 0 / ""`Z.
Spillway?:
Designed Freeboard (in): / 9. 5 19.5
Observed Freeboard (in): .30 V 36
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
2<o
❑ NA
❑ N E
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
B<o
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ l'es
allo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 2'�o ❑ N A ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 0'lo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ET Ko ❑ NA ❑ N E.
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ['�lo ❑ NA ❑ N E
❑ 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 ❑ Evidenceof Wind Drifl ❑ Application Outside of Area
12. Crop type(s) Jae* k&uJ - 64" f 'PaS4u r0 , SK•.0 OvwSee J
13. Soil type(s) W0.q M WX
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
L��, NNo
El NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ET'NNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`: ❑ Yes
NNo
❑ NA
El NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
,ET
ffNNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
ElD Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name RI CA<', e_'J e l s Phone: 9/0• *33,.3300
Reviewer/Inspector Signature: R e Date: /2-07-2009'
12128104 Continued

Facility Number: 8Z —3 Date of Inspection /z-e 7 -o
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ICJ No ❑ NA 0 NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 2 No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[EK
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and V Rain Inspections ❑ Weather
Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
NNo�o
❑ NA
[I NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
,,��,,
[4 o
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[� o
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
io
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
[
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
Bl o
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
M *NNo
❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
U No
❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
�/
E No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
E No
❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
o
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ElNA El NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
,
a<0
❑ NA ❑ NE
Comments and/or Drawings:
12128104

vision of Water Quality
Facility Number gZ -% fj 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit (?Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0' o"utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I2-CV-OS Arrival Time: //:O Departure Time: /Z.'p/ County: Q hA. SOd/ Region:
Farm Name: LOLA 11) b 0 Owner Email:
Owner Name: C -0j,-1e-8 i.J;111.61 Phone:
Mailing Address:
Physical Address:
Facility Contact: �T«-✓ %l'�va�- Title: Ce4 . cam- Phone No: pp
Onsite Representative: Integrator: /�-i �3ldr✓N
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Operator Certification Number:
Back-up Certification Number:
Latitude: a c = , = fl Longitude: = ° = 6 = «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑
Wean to Finish
❑
Wean to Feeder
Feeder to Finish
1. 4toe,7
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
Dry Poultry
❑
Layers
❑
Non -Layers
❑
Pullets
❑
Turkeys
❑
Turkey Poults
❑
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures: F4
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 [3' o ❑ NA ❑ NE
❑ Yes
❑ No
0'�(A
❑ NE
❑ Yes
❑ No
D15'A
❑ NE
t_TIVA
❑ NE
❑ Yes
❑ No
❑ Yes
2INo
❑ NA
❑ NE
❑ Yes
057
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: g?— 0 Date of Inspection 12 vy O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
�
ElI[�Yes No ElNA ❑ NE
a. If yes, is waste level into the structural freeboard?
ElYes E _No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: 46jt / I -At Lai 2 13
Gr
Spillway?: AI d /d D
Designed Freeboard (in): R, S— J 9. 5—
Observed Freeboard (in): 210 26,
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes BNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes E No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes [ITo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes 3,90 ❑ 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 E2,I�o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes B"No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Elm— ❑ N A ❑ N E
❑ 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 ElApplication Outside of Area
12. Crop type(s) 1Jcen
I �• :� Sc�cwGI �s ��; .v ( O's
13. Soil type(s) 4)a.
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [INo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes [T*5o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
2' —oo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
[]'No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
[�F<o
❑ NA
❑ NE
C6ififiilents (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name �`L k -� e. J e_j S Phone: 1A V33, 333t='
Reviewer/Inspector Signature: s.�, a �- Date: /Z —O — Zoe7 0
Page 2 of J tonunuea

Facility Number: Date of Inspection �2 -tw-
Required Records & Documents , �
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ 0No Yes ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �o ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Q-No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections E] Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes D o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
LJ No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
D-5-o
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
2'1�o
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
[3'llo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
B No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ©-lo- ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑<o_
❑ N A
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
3-f�io
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
O'90
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑-iq-o
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
QN-6-
❑ NA
❑ NE
nal Comments and/or Dra
Page 3 of 3 12128104

Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
O Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of County: Visit: � Arrival Time: :3�4�. Departure Time: � � /h 5Am1S0.✓
Farm Name: 30 963 Owner Email:
Owner Name: C�44'_�s OJI&I LM5 Phone:
Mailing Address:
Physical Address:
Facility Contact: M16 A-h,v"104 "Title: Phone No:
u I
Onsite Representative: _ Integrator: [N`'pv1M
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Region: F-7"�O
Location of Farm: Latitude: F--I e = ` =" Longitude: = ° = , [� "
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
r ❑ Non-Layet
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharzes & 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)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: FT
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 [PNo []NA ❑ \ I
❑ Yes
❑ No
P NA
❑ N F
❑ Yes
❑ No
[P NA
❑ N 1.
❑ Yes
❑ No
[11N A
❑ N F
❑ Yes
[)?No
❑ NA
❑ N 1
❑ Yes
M No
❑ N A
ElN I
12128104 (ontinu d

Facility Dumber: — Date of Inspection / I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No Q NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
F] No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
09 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
® No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
E] No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
f�] No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
[:]Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
`1d No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�d`�], No
El NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination, ❑ Yes
ICI No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
R No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
is refer to question #): Explain any YES answers and/or any recommendations or afiyother comments:
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name i j Phone: /G' _-'�' �'1j00
Reviewer/Inspector Signature: Date: '% S p'
/212810 C nntinurd

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ('� No ❑ NA ❑ NE
the appropriate box. ❑ W`Up ❑ Checklists ❑ Desig
n ❑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 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
MNo
❑ NA
ElNE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
6 No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
J] No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
Q9 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[R No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[� No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
PS No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
�3 No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[)"3 No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
`� No
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of'3 12128104

10'6ivision of Water Quality r.w,�j�� _L`°
Facility Number Z.. �° 0 Division of Soil and Water Conservation S1
0 Other Agency �j 0 ` 1
Type of Visit A�outine
ce Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: EIAME�;p Arrival Time: Departure Time: Coun RegioV
Farm Name: (' Y� 3CF-t lU Owner Email:
Owner Name: GO Phone:
Mailing Address:
Physical Address:
Facility Contact: A ' \ �-.1ttsm -_-, Title:
Onsite Representative: �' Imo_ 3- I \ nn S
Certified Operator: � 0,- mVy-1
Back-up Operator:
Location of Farm:
Phone No:Q to
Integrator• LXAJ
C'
Operator Certification Number: S ` `
Back-up Certification Number:
Latitude: = e = g = Longitude: = o = , = {{
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
eeder to Finish
❑ earrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Burs
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes *o ❑ NA ❑ NE
❑ Yes ❑ No A ❑ NE
❑ Yes [--]No_ A ❑ NE
❑ Yes ❑ NoA ❑ NE
❑ Yes o ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
12128104 Continued

Facility Number.vt,
0A— Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes K
o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No A -A ❑ NE
Strur 1 Structure 2 Structure 3 Structure 4 Structure 5 tructure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes o ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) ��''
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ,�Nd ❑ NA ElNE
through a waste management or closure plan? '
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ 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 o [INA ❑ NE,
maintenance or improvement? �0
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o ❑ NA ❑ NE
maintenance/improvement? )��
11. Is there evidence of incorrect application? If yes, check the appropriate box below. Ell �' Yes �o ❑ NA ❑ NE
❑ Excessive Ponding [IHydraulic Overload ElFrozen Ground ElHeavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. CroP h'Pe(s) m a — UnW- -swat I C tai ✓l - Lea-:-,/
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes � o ❑ NA ❑ NE
❑ Yes1?�No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 9No El NA ❑ NE
17. Does the facility lack adequate acreage for land application? El Yesto
``'' o ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name (_R Z K)C' Af7Q Phone: I V6 4f33 3, r_�
Reviewer/Inspector Signature: —Ga Date: 4y6 rS7 Zxiy
T-1 V'6 uj J 1Z/Z0/U r t-ununuea

Facility Number: a,— Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes )4No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes M No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists ❑Design El Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes JVNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections ❑
Weather
Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes I*
No
[I NA
El NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
1 o
EltNo
❑ NA
El
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes VNo ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes �5*0 ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No ❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No ❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No ❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
kNo ❑ NA
❑ NE
rAdditional Comments and/or Drawings:
Page 3 of'3 12128104

Facility No. o� —� I�� Time In Time Out t (� Date
Farm Name I �-Y ��Y`�Y� �� �O Integrator
Owner Site Rep ECU rnoyi
Operator M 1cR YVV�S No. - 9 Q � "�"1
Back-up
COC �� Circle: General
L
or
No. _
PDES
Design
Current
Design
Current
Wean — Feed
Farrow — Feed
ish
Farrow — Finish
Feed — Fi '
Gilts / Boars
Farrow-— Wean
Others
FREEBOARD: Des' �rJ
Sludge Survey D �—
Crop Yield
Rain Gauge
Soil Test D
Weekly Freeboard
Spray/Freeboard Drop
Weather Codes
PLAT
Observed
Daily Rainfall
Calibration/GPM
Waste Transfers
Rain Breaker j
Wettable Acres
1� 1-in Inspections
120 min Inspections
Waste Analysis: A 1 IY
Date Nitrogen (N)
U(a-1
s ,f l (� 1.�5 f Z• 3
Date Nitrogen (N)
2� 1-7 'ZA Z J .7
c1c ,
9t c�
CL
PL``"n
Pull/Field Soil Crop Pan Window
v
v

Division of Water Quality, , to
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency � X '
Type of Visit © Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: F,* r-wt 307(o Owner Email:
Owner Name: L QS W -, L�IPhone:
Mailing Address: I T73 Mali c+, - &&&a z _Z) _(a7sek_�L _
Physical Address:
Facility Contact:
Title:
Onsite Representative: Carlr
Certified Operator: *A S _
Back-up Operator:
Location of Farm:
Swine
Region: _f:_4e-0
Phone No:
Integrator: ____
Operator Certification Number:
Back-up Certification Number:
Latitude: [= o = g = Longitude: = ° = 6 =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ on -Layer
❑ Wean to Finish
❑ Wean to Feeder
® Feeder to Finish
(08(0
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes (ZNo ❑ NA ❑ NE
❑ Yes
❑ No
[ tNA
❑ NE
❑ Yes
❑ No
NA
❑ NE
(M NA
❑ NE
❑ Yes
❑ No
❑ Yes
M No
❑ NA
❑ NE
❑ Yes [�No ❑ NA ❑ NE
12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E.No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes Q No ❑ NA ❑ N E
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: i Z
Spillway?: V1.0
Designed Freeboard (in): ('j .s
Observed Freeboard (in): " j I �j 2
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
n No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[ZSNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
11 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
El Yes
� No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
� No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
AM
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
[ZNo
❑ 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 Drifl ❑ Application Outside of
Area
ZW so
12. Crop type(s)y �� g x- .�•._ /
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
L] No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
VNo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑
Yes
54.No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
4 No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[K No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
t.�t� i 5 a �ea K j v` a rt�S 1Li � ?
P( ,` re >�- ,d— as Somas poss�tok . U 1
Reviewer/Inspector Name ( A � Phone: 7/0 -YfJ�
Reviewer/Inspector Signature: Date: Z41 d 67
12128104 Continued

Facility Number: 8Z — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes R�No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP read/il available? If yes, check El Yes [8 No El NA ❑ NE
the appropirate box. ElWUP/❑ Checklist/ ❑ Desig; ❑ Ma psi❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ElYes 19 No ❑ NA ❑ NE
ElWaste Applicatiotf '❑ Weekly FreeboarQ'❑ Waste Analysis/❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall- ❑ StockinK ❑ Crop YieW ❑ 120 Minute Inspection9/❑ Monthly and V Rain Inspections&-❑ Weather Codev
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
5No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
LgNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit? ft e%bk ❑ Yes
A No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
MNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
5JNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
5ZNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
;K No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[?I No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
9 No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
U No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
;j�No
❑ NA
❑ NF
Additional Comments and/or Drawings:
l2, 2S/0.1

r '
0 Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
(Type of Visit • Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: Did Time: = /S
Facility Number .? '7 D
0 Not Operational 0 Below Threshold
13 Permitted [3 Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: .............?� .:!:r,Z......0.3.0.91=............................................................... County: .......
Sca!'!�is4.n..............................F��......
OwnerName: ................................................... ........................................................................ Phone No:.......................................................................................
MailingAddress: ..................................................................................................................... ..................................................................................... ..........................
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
Onsite Representative:......... n.2....................x.:17.4..................................................... Integrator: ...... m!!h!:49. ..".....:Aiw.rk............................
Certified Operator: ,Q ` } ............... Operator Certification Number: ai ;E'7 b
Location of Farm:
.,
I+
EJ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' �� �« Longitude �• �� �44
Design Current
Swine Canacitv Ponulation
❑ Wean to Feeder
(�J Feeder to Finish
(,yob
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
1❑ Layer ❑ Dairy
[:] Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons
Holdini!
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min? N A
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 [)d No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ''4 ........ ........................................................
..................................................................................................................................... ..............
Freeboard (inches): y,3 �� G
12112103 Continued

Facility Nubber: 8„ t p
Date of Inspection 16 h2y 16411
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
❑ Yes 50 No
❑ Yes M No
❑ Yes 1A No
❑ Yes [�) No
❑ Yes (V No
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 13C r .ala 14 «. 5•++OL
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
ICJ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
[j No
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
(kj 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 [�a 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, ElYes 1)9 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 [B No
Air Quality representative immediately.
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): ® Field Copy ❑ Final Notes
aQCr rn tsela. a- : e. bi,r i�rcvr air rl hose q r0.tS Go r., io, . �iOh. �I I��e
�-o r�Ow �or C�v�aQ 'ts�L.c S'�'cPt 'ru �w.proVtr CrVP �►� ♦�pse d"CiCc
��. 0lob r% bQ..1c. %jai Sbn.•a %arm tPa-tr. Ck'.��.� ?o werk is
t..,. ►.ovc
+'Z• is c . �
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: - o Lf
12112103 4�1_ l Continued

Facility N mber: 81 — 70 Date of Inspection G /3'-I1 oY
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[Z 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
5 No
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
m 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
EM No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
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)
[aj 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
[Z 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
12112103

Site Requires Immediate Attention: t�_o_
Facility No,
DIVISION OF ENVIRONMENTAL MANAGEIviENT'
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time:
Farm Name/Owner: W C W FAQ ►M s L to C 4 Ae
Mailing Address: RT 'fin X (. S A o c ►, 0 2 e 4- _.8 38-2
County: ! CAM P <'0A
Integrator VgoWn1S oi= CAQoLL4A Phone: qjo 7-53-3L00
On Site Representative: aAyK A,.L GS1 LL ► ►tic Phone: 91 o - 4-
Physical Address/Location, 11ko► E.4cr o f AI= 0 2 0
Type of Operation: Swine _ Poultry Cattle
Design Capacity: Number of Animals on Site: I.4�Qo PiN►4LUAl(r
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude:
Longitude: °
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) es or No Actual Freeboard: > L o Ft. Inches
Was any seepage observed from the lagoon(s)? Yes o No Was any erosion observed? Yes o No
is adequate land available for spray? Yes r No Is the cover crop adequate? s or No
Crop(s) being utilized:
Does the facility m et SCS minimum setback criteria? 200 Feet from Dwellings? es r No
100 Feet from Wells? es or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o Na
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 No 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)? Yes or No
Additional Comments: ►_4k i i E 1 E L)1 a o "j mA s
y
Inspector Name
Signature
cc: Facility Assessment Unit
Use Attachments if Needed.

BROwN'S
OFCAROUNA
b
WCW FARMS, INC. - GROWER #284
8 (800) FEEDER TO FINISH
STATE ROAD #1301 - SAMPSON COUNTY
�J �
CLINTON m
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DIRECTIONS: FROM CLINTON, TAKE HIGHWAY 24 TOWARD ROSEBORO.
AFTER CONCORD, TAKE 4TH RIGHT ON M_jiRION AMOS RD (LOOP ROAD SR
01301). FARM WILL BE ON LEFT APPROXIMATELY ONE MILE.
MAILING ADDRESS:
WCW FARMS, INC.
RT. 1 BOX 683
ROSEBORO, NC 28382
HOME: [phone]
303 EAST COLLEGE STREET - P.O. 8OX 487
SHIPPING ADDRESS:
WCW FARMS, INC.
STATE ROUTE 01301
ROSEBORO, NC 28382
BROWN'S OF CAROLINA, INC.
WARSAW. N.C. 28398-0,87 • OFFICE: [phone] - FAX [phone]

Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: -7 % tZ 11995
Time:
Farm Name/Owner: W G w t=a�MS k W C'
Mailing Address: + L Sox �83 Ras�3oe.o Nc Z-83 Z-
County: S M? S o N
Integrator: C>-f cc►.Mo .J q Phone: Rto / zg; • 3f�oo
On Site Representative: ch4r-l" W ll a^^S Phone: is 5 7- s - 4-1 z
Physical Address/Location: sIP, CZA4T oe 0 0
Type of Operation: Swine X Poultry Cattle
Design Capaeity: Number of Animals on Site:
DEM Certification Number: ACE
DEM Certification Number: ACNEW
Latitude: „ Longitude: `
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: _fit. Inches
Was any seepage observed from the lagoon(s)? Yes or(9 Was any erosion observed? Yes or( 1g0
Is adequate land available for spray? Yes r No Is the cover crop adequate? Xes or No
Crop(s) being utilized:
Does the facility meet $CS minimum setback criteria? 200 Feet from Dwellin s . Yes or No
100 Feet from Wells? Yes r No
Is the animal waste stockpiled within loo 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 orEo 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)? Xes or No
Additional Comments: (.2 ri F�e_07 o ���M.� �-5—, t �'^l �'�c' L`� u R�s Ly
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Inspector Name
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Signatur
cc: Facility Assessment Unit
Use Attachments if Needed.

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WCW FARMS, INC. - GROWER #284
8 (800) FEEDER TO FINISH
STATE ROAD #1301 - SAMPSON COUNTY
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LilicLU I luiN J : FROM CLINTON, TAKE HIGHWAY 24 TOWARD ROSEBORO.
AFTER CONCORD, TAKE 4TH RIGHT ON MA.RION AMOS RD (LOOP ROAD SR
i01301). FARM WILL BE ON LEFT APPROXIMATELY ONE MILE.
MAILING ADDRESS: SHIPPING ADDRESS:
WCW FARMS, INC. WCW FARMS, INC.
RT. 1 BOX 683 STATE ROUTE 01301
ROSEBORO, NC 28382 ROSEBORO, NC 28382
HOME: [phone]
BROWN'S OF CAROLINA. INC.
303 EAST COLLEGE STREET • P O. BOX 487 - WARS AW, N.C. 28398-0-87 • OFFICE. [phone] • FAX [phone]