820728_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

Di -iii onof Water Resources
Facility Number - O Division of Soil and Water Conservation
Q Other Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: �toutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time:7 c7 Departure Time: ;.3 C] County: Region:
1.
Farm Name: rr!'Yk*N— Owner Email:
t
R
Owner Name: S (k) jyx,y rGp-r~rr%— L_ L C_ Phone:
Mailing Address:
Physical Address:
Facility Contact: I (;S Title: Phone:
Onsite Representative: f �T- _ Integrator: Syy��f 7-1c�1
Certified Operator: Certification Number:% 5�3
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. is there evidence of past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [SNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[-]Yes
�'
[:]Yes
[l -No
[::]Yes
Design Current
Design
Current
Design Current
Swine Capacity Pop.
at Poultry,
Capacity
Pop.
Catik ; Capacity Pop.
Wean to Finishe
r
Fon_Layer
Dai Cow
Wean to Feeder
Dairy Calf
Feeder to Finish
Dairy Heifer
arrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
©, Ponl s
Ca aci
Po
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
OtherI
ITurkeyPoults
,'i Other
Other
�II..tlM'... W:mmq�yywl,lll�al[w ILII IIIVY[Ilx l[AId[II.VWxr:xxrVww.xrnu.erG
„-.:n:axes'..-.u:6Awx.uut:mV.a..uer-[:
V:x u. x[w[x[wVnnu
r'.,. .[[r[[aIGN!Y:
!k'
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. is there evidence of past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [SNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[-]Yes
❑ No
[:]Yes
[l -No
[::]Yes
Wo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: - Date of inspection:
/,
2—No
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
M No
❑ NA
❑ NE
4_ Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier:
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield [:1120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
Spillway?:
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
Designed Freeboard (in):
23_ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ YesLz�d_No
❑ NA
Observed Freeboard (in): yy
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑C No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
®- No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
[] Yes
No
❑ NA
❑ NE
8_ Do any of the structures lack adequate markers as required by the permit?
[:]Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
❑ No
❑ NA
❑ NE
maintenance or improvement?
Waste Apolication
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 Q No [] NA
❑ 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): Gam✓ r•! �lrll�w / 5�7 rd`~1 /1Z_1'rr1PX&V +.
❑ NE
13. Soil Type(s): �O►�/1 Gr r1�Q L� "�S �J�p /gyp % C �Gm�r 6olA
14. Do the receiving crops differ from those desigmated in the CAWMP? ❑ Yes qNo ❑ 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?
Reuuired Records & Documents
❑Yes JZNo ❑NA ❑NE
❑ Yes MNo ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
2—No
❑ 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 ❑Checklists E] Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
allo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield [:1120 Minute Inspections ❑ Monthly and I" 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?
❑ YesLz�d_No
❑ NA
❑ NE
Page 2 of 3 2/4/7015 Continued

Facili Number: - Date of Inspection: f
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes J�jNo
r 25_ Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes gNo
the appropriate box(es) below.
❑ Failure to complete annual sludge survey E] Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes f[ 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, aver -application)
31. Do subsurface the drains exist at the facility? Ifyes, 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?
;d
id/arra
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes [C No ❑ NA [] NE
❑ Yes [a No ❑ NA ❑ NE
❑ Yes [A No ❑ NA ❑ NE
❑ Yes USNo ❑ NA ❑ NE
❑ Yes [2�No
❑ Yes [,-YNo
❑ Yes �&No
Z2, -r- L/r/ LL/?pse/t Y!7 C.} ✓YQJ/ G� `-s.I 1�©�/L%rd ��.SZ`�i`'�
- A; r VY- f
Rev fewer/I nspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: �JG� -3C3 -� /.S/
Date: ✓���
21412015

Yl\ L=2 rF "' � l 1S
vE N of v F Resources
l acilitti' Number - aZ:a#
ision oflSoil and Rater Conservation
t er AgencyMR
Type of Visit: Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: routine O Complaint Q Follow-up O Referral Q Emergency 0 Other O Denied Access
Date of Visit: Lf l Arrival Time: Departure Time: County: s RegionFo
Farm Name: t'E(Dr&xv Farw f-- Owner Entail:
Owner Name: �,(� > J �� F-�Lv4 h. LI -6 Phone:
Mailing Address:
Physical Address:
Facility Contact: O 4)t' Et 11� Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
1(
{l
Latitude:
Phone:
Integrator: 110, -tc�
Certification Number: p 1S
Certification Number:
Longitude:
Design Ft_ uWE. it At
DesignCu ent
Design Current
Swine Capacity fop_
Wet Pauitr;}'
Capacity _ Pop:
C*attfe C►specify Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean A ?.O 0"
�� `
DergnCurrent
Dry Cow
Farrow to Feeder
aD : P,oultry
Ca act P;o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
113eefI3ToodCow
a
Turkeys
Other ffr�. f r
Turkey Poults
y�
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other_
a. Was the conveyance man-made? [—]Yes ❑ No [J NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) []Yes ❑ No Ej`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 DWIt) ❑Yes ❑ Na NA ❑ NE
1 Is there evidence of a past discharge from any part of the operation? ❑ Yes [?r—No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes E!j0`No ❑ NA ❑ NE
of the State other than from a discharge`?
Page 1 of 3 2/4/2015 Continued

Facili Number: jDateof Inspection:
Waste Collection & Treatment
4" Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? []Yes ❑ No LJ -NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?,-
Designed
pillway?:Designed Freeboard (in): _
Observed Freeboard (in): f4 10
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
Structure 5 Structure 6
[:]Yes hfo [DNA ONE
❑ Yes C3 No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes d�,qo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes yo ❑ 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 ❑'1 to ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes do ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes dNo ❑ 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): F_cs . $w Rc . //L k y +SCS r">
13. Soil Type(s):
t3 a Fo '7-0 ✓ fe- l 0 &
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?
❑ Yes
[ No
0 NA
❑ NE
❑ Yes
®'No
0 NA
❑ NE
❑ Yes
Z�No
❑ NA
❑ NE
❑ Yes
t"No
❑ NA
❑ NE
❑ Yes
['J'No
❑ NA
❑ NE
Required Records & Documents
I9. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes dNo DNA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes dNo ❑ 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 dNo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Translcrs
❑ 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 (ff!No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑Yes E(No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of'3 .2/4/2015 Continued

Facili Number: - 7- JDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[E' oo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
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
[3"No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
E2"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:
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 []'<o ❑ NA ❑ NE
❑ Yes []t No [] NA ❑ NE
❑ Yes [7f No ❑ NA ❑ NE
❑ Yes 2[ No [] NA ❑ NE
[:]Yes 21 No
[:]Yes [a'No
❑ Yes ❑ No
[] NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Use draew ngseg4 )71E a Rim
ofjfacil ty a betier exp aims uaUvns (use add Uunal. pages as peceSsary}nd"ons o ar nyothafierc ents.
41 -W-Cl Z_D
C4 n Y 3cg- 051
Reviewer/Inspector Name:
Reviewer/inspector Signatu3
Page 3 of 3
Phone: 433-3B f'
Date: 03 [--y- D 1
21412015

PIP
1 M S 17 ryla.,A / 160
Type of Visit: WCompliance Inspection Q Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: Routine Q Complaint 0 Follow-up Q Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: 'q6ft I Departure Time: ; County: 7 l+l Region:
Farm Name: S_ W_ ' �& Owner Email:
Owner Name: ✓n Ste)f.IL 4,, _ Phone:
Mailing Address:
Physical Address:
f
Facility Contact: ,[ I-�C LQ' 11, STitle: Phone: _
Onsite Representative: u Integrator: { kt2"Q� y
r f ^
Certified Operator: CIV c;L /� ] [L j �t�t Certification Number:
Sack -up Operator: rlL a.i Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design
Current
Design torrent
Swine Capacity Pap.
We# Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
""
Dairy Heifer
Farrow to Wean r 'W
Design
Current
Dry Cow
Farrow to Feeder
Dry Poul
Ca aci
P,o .'
Non -Dai
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
11 Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes [D,146_ ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No Q>A ❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWR) (—]Yes ❑No [. KA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) [:]Yes ❑ No [3r�A ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes [�5`No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes dNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412014 Con#inued

Faeffi , Number: - Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Eple— ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [—]Yes ❑No [i]-Nile ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [] No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes GIo ❑ 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
Q'1`]o
❑ 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)
❑ NE
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
eNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes JdNo ❑ 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 Crap Window ❑nEviidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Z61_1"
13. Soil Type(s): �'{� 1�� �'�r�o ✓L
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?
[3 Yes
❑ No
❑ NA
❑ NE
❑ Yes
[:]No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[] Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ 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 ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall []Stocking ❑ Crop Yield [] 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [:]No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [] No
❑ NA ❑ NE
❑ Weather Code
[:IS ludge Survey
❑ NA ❑ NE
[] NA ❑ NE
Page 2 of 2/4/2014 Condhaed

Facility Number: Date ofInspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? [] Yes [5No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [B'Ro
the appropriate boxes) 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 E3 -No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Wo
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 ❑ LagoonlStorage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewerilnspector fail to discuss reviewlinspection 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 [2*"No E3NA [D NE
❑ Yes ENo ❑ NA [] NE
[] Yes Ca"No [] NA ❑ NE
[:]Yes EfNo ❑ NA ❑ NE
❑ Yes No
0 Yes [?f No
❑ Yes [ErNo
�NA ❑NE
NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers andfor any additional. recommendations or<any other,comments
Use drawings of facility to better explain situations (use additional pages as necessary).
w -D -N
e; — Ey- 3(-I<
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 43 3
Date:
21412014

l ype of visit: �y ompnance inspection V Vperatiou iteview U structure Evaluation V I ecmntcal Assistance
Reason for Visit: OrRoutine Q Complaint O Follow-up Q Referral O Emeaency O Otho O Denied Access
Date of Visit: Arrival Time: Departure Time: County; C Region:
Farm Name: sl`tl' got'.' Owner Email:
Owner Name: S�(,tj ,�e�W ✓�.- Phone: M _
Mailing Address:
Physical Address:
Facility Contact: 1tifqL( ,,,t „� S Title: �C_& Phone:
r r ,
Onsite Representative: !r Integrator: v1 rrttOL.,
Certified Operator: Certification Number:����
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[3'No ❑ NA
VOR j
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
JgRm.urrent
Swine
Capacity Pop.Wet
!rlyfcapacity
a. Was the conveyance man-made?
Pop.
Cattle Capacity Pop.
Wean to Finish
[] NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
La er
EEr<A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
Dairy Cow
Wean to Feeder
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
Non -La er
[2-<A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
lDairvCalf
EJ'No
Feeder to Finish
-Dai
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
�No
❑ NA
Heifer
Farrow to Wean
�LCiDesign
-Urrent
Dry Cow
Farrow to Feeder
D . Point .
Ca aci
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
OtherL__ffurkey
Poults
OtherI
I Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[3'No ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[3 No
NA
[] NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
EEr<A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
[2-<A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
EJ'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 21412014 Condnaed

Facility Number: - Date of Inspection: t
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 E3<A ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ®'KO ❑ 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
[D'go
❑ NA
❑ NE
waste management or closure plan?
[] Yes
DIN
❑ NA
[:3NE
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
C3 -No
❑ NA
0 NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E '"o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
9. Does any part of the waste management system other than the waste structures require
❑ Yes
CTM
❑ NA
❑ NE
maintenance or improvement?
❑ Rainfall C3Stoeking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
o
Waste Application
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
YNo
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
1 l . 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): g In.. -1& _5% V V.r fC_-
13. Soil Type(s): co ro r N d "r-
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ®No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [] Yes [3] No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes �o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? [3 Yes [�No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes DINO ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[] Yes
DIN
❑ NA
[:3NE
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 [f Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[D4°
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall C3Stoeking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
YNo
❑ NA
[] NE
Page 2 of 3 21412014 Continued

Finsinty Rumber: M - jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes -H]-No- ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Cl -go—
1V o ❑ 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?
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?
R
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes [g -N6'— ❑ NA ❑ NE
❑ Yes [o ❑ NA ❑ NE
Ej Yes Fo ❑ NA ❑ NE
❑ Yes F,—o ❑ NA ❑ NE
[:]Yes No ❑ NA ❑ NE
❑ Yes ETNo ❑ NA ❑ NE
❑ Yes Eg-5ro
❑ Yes [�No
❑ Yes a"No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Phone: 0 ?_3 W
Date:
214/2014

hype of Visit: Qy7ROutine
Hance Inspection C_,) Operation Review V Structure Evaluation () Technical Assistance
Reason for Visit: Q Complaint Q Follow-up O Referral O Emergency Q Other Q Denied Access
Date of Visit: at / Arrival Time: Departure Time:
Farm Naive: �t`f �{,c�4 y �� r Owner Email:
Owner Name: Y L% SaS,v G.�"`� L LG Phone:
Mailing Address:
Physical Address:
County: --— Region>i vd
Facility Contact: IZON ItiL j> t Ll iG M S Title: Phone:
Onsite Representative: I � Integrator: Vh
Certified Operator: `` Certification Number: 2111Y-3.
Back. -up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Dischar es and Stream Im acts
I _ Is any discharge observed from any part of the operation?
Desi n- .Current
L.R-No
❑ NA
Design
Current
Design Current
Swine
Capacity
. Pop.
Wet Poultry
Capacity
P.pp.
Cattle Capacity Pop.
Wean to Finish
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
La er
I
❑ NE
Dairy Cow
Wean to Feeder
Non -La er
I
❑ Yes
Dairy Calf
[t NA
Feeder to Finish
2. Is there evidence of a past discharge from any part of the operation?
❑Yes
No
[:] NA
❑ NE
Dairy Heifer
[] Yes
�N.
Farrow to Wean
2p8'
of the State other than from a discharge?
Design
rrent Cu
D Cow
Farrow to Feeder
D ; P,oul
Ca aci
P,o .
Non -Dairy
Farrow to Finish
Le ers
Beef Stocker
Gilts
Beef Feeder
Non -La ers
Boars
Pullets
Beef Brood Cow
Turkey s
Other]Turkey
Poults
Other
10ther
Dischar es and Stream Im acts
I _ Is any discharge observed from any part of the operation?
❑ Yes
L.R-No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[] No
L3'5iA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
] No
[3 -NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
& Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
[t NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑Yes
No
[:] NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[] Yes
�N.
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 2141ZOII Continued

IFacgity Number: I Date of Inspection: Gi
,Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Q -3W ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �--
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ©"No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ErRo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ YesF2r'Noo ❑ 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 I rJ<o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ YesNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �o ❑ 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): KA(11(.tj bov r D v `v
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[�Noo
❑ NA
❑ NE
acres determination?
IT Does the facility lack adequate acreage for land application?
❑ Yes
4 o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
YNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
ErNo
❑ 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 UX6 ❑ 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 �fo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes to ❑ NA ❑ NE
Page 2 of 3 2/412011 Continued

Factlity Number: IDate of Inspection: .,
r'24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [3 ivu ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 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 to provide documentation of an actively certified operator in charge? ❑ Yes 10 ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes10 ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
0,Pd5
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
CfNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
34. Did the facility fail to notify the Regional Office of emergency situations as required by the
[-]Yes
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[] Yes
ONo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
CJ 1V
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑Yes
Na
❑ NA
[j NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #1): Explain any YES answers and/or any additional recommendations,or anyrother,cummen-ts.
Use drawings of facility to better explain situations (use additional pages as necessary).
s rc,
ry
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone 0 kJJ 3
Date: 30
2/4/2014

type or visit. n t-ompuance inspection v vperauon Keview lJ �rrucrure rvaivarnon l._! ieenmcai Assrsranee
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: ( ►y I Arrival Time: ,'J Qt++1 Departure Time: County: e\ Region: r R0
Farm Name: 1�0 �k1z �1"c�wEst, 'Ft>Ctw\ Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: a+�
FacWty Contact: R CNf1y1iP �7j \\ j.0fg , — Title: Phone:
Onsite Representative: T-_ Integrator:2Cit 0
Certified Operator: 5 Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation.?
Discharge originated at; ❑ Structure Application Field [] Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
I
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[]Yes [)Q No C3NA []NE
Yes No ( j NA NE
E] Yes No rM NA [] NE
❑ Yes [] No
Yes No
[:]Yes No
FA NA Q NE
Law
�NA NE
NA NE
Page l of 3 214/2011 Continued
WZ'61,e���•,stgnDignr�Currentacity
Pop.
Wes uitry Capaci.+�
Finish
La er
Dai Cow
Feeder
Non -La er
Dai Calf
o Finish
;
Da' Heifer
o Wean
r
llesign Current
D Cow
o Feeder
D . Ro t , Ca aci P,o .
Non -Dairy
o Finish
La ers
Beef Stocker
Non -La ers
Beef Feeder
Pullets
Beef Brood Cow
Turkeys
"ars
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation.?
Discharge originated at; ❑ Structure Application Field [] Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
I
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[]Yes [)Q No C3NA []NE
Yes No ( j NA NE
E] Yes No rM NA [] NE
❑ Yes [] No
Yes No
[:]Yes No
FA NA Q NE
Law
�NA NE
NA NE
Page l of 3 214/2011 Continued

I!.1
40
Facili Number: - 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
Identifier: 41 a
Spillway?:
Designed Freeboard (in): 3
Observed Freeboard (in): 3�
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Structure 5
170 No ❑ NA ❑ NE
❑ No NA ❑ NE
Structure 6
❑ Yes V) No ❑ NA ❑ NE
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes q No
❑ NA
❑ NE
waste management or closure plan?
❑ NE
15. Does the receiving crop and/or land application site need improvement?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
acres determination?
9. Does any part of the waste management system other than the waste structures require ❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
❑ Yes
Q No
Waste Application
❑ NE
18. Is there a lack of properly operating waste application equipment?
10. Are there any required buffers, setbacks, or compliance ahernatives that need ❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
Required Records & Documents
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.)
❑ Yes
50 No
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
[N No
12, Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
( No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[4 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Q No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[4 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
50 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[N No
❑ NA
❑ NE
the appropriate box.
❑ WUP F1 Checklists ❑ Design [:]Maps ❑Lease Agreements ❑Other:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes M N
Laq
El Waste Application E] Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis E] Waste Transfers
F-1Rainfall E] Stocking ❑ Crop Yield ED 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? E] Yes No
23, If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:3 Yes No
No
❑ NA ❑ NE
❑ weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 2/412011 Continued

J, ►
Facili Number: - a. Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[] No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
[n No
❑ NA ❑ NE
27_ Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
IM 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:
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 14 No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes M No ❑ NA ONE
❑ Yes No
❑ Yes No
❑ Yes [ No
❑ NA ❑ NE
[] NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Signature:
Page 3 of 3
Date:
2/4/2011

F,
(Type of Visit: igFCompliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: 0 Routine 0 Complaint d Follow-up 0 Referral 0 Emergency Q Other 0 Denied Access
Date of Visit: Arrival Time: LT, 30AM I Departure Time: Coifnty:Region:
Farm Name: SRW N[ Po y Feym Owner Email:
Owner Name: ShN �[i1W PUIm LL[_ Phone:
Mailing Address:
Physical Address: 15.3 RQu 01110 DiT
Facility Contact: d n it WMI&C Title:
Onsite Representative: ` r t
Certlfied Operator: _R_L"j0_?jt l !01( !n
Phone:
Integrator:
Certification Number: 16?!y
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
Capacity Pop.
_
d
Vet I?iiultry
Layer
[Non -Layer
D , Poul p
Layers
Design
Capacity
Design
.Ca aci
Current
Pop.
Current
Po ,
Design Current
ty P
Cattle Capaciop.
Dairy Cow
Daia Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
Gilts
❑ No
Non -Layers
Beef Feeder
2. is there evidence of a past discharge from any pari of the operation?
Boars
® No
Pullets
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
Beef Brood Cow
No
❑ NA
Other.
Other
of the State other than from a discharge?
Turkeys
Turkey Poults
Other
Dischar es and Stream Im acts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure [] Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes ® No ❑ NA ❑ NE
❑ 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 pari of the operation?
❑ Yes
® No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Pate I of 3 2/4/2011 Continued

FaciliNumber: Date of Ins ection: a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [RNo ❑ 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): . S
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
® Yes ❑ No
[-INA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes 19 No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
9. Does any part of the waste management system other than the waste structures
require ❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
_Waste Application
❑ Yes
No
❑ NA
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
❑ NE
❑ Sludge Survey
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.)
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ PAN ❑ PAN > 10% or 10 lbs. [] Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
[] NE
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12_ Crop Type(s):
13. Soil Type(s):
14. Do the receiving; crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
O No
❑ NA
❑ NE
acres determination?
[—]Other:
17. Does the facility lack adequate acreage for land application`?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[5�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
®No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis [:)Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
N 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 2/412011 Continued

jFacility Number: - %,) Date of Fns ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes RNo ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes CR No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No CR NA NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
® No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
r -No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
®'No
❑ NA
❑ NE
p Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[S No
❑ NA
❑ NE
33_ Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[0 No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
allo
❑ NA
❑ NE
Cumments (refer to question #} Explain any°YES answers..andlor any additioQal recommendations or n_ y other comments.
a
Use drawings of facility to better explain situations (use it itional`pages as'in A , 7.i
_7, P)ea e hVo-k t, bare.tfo+s o� Ya114
Surve due DDI,), halm he ,�?x�fi`� [�" CY�%O�L `�1r yPQ�1,
Pomp YYa r r d �t I� D -V1 a o0q,
� y
FOim hey i ioWeble i(�f) L'af � a )4ca�Du �lu� 500 set- -�ierdjr
Reviewer/inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone: C62 I, I
j
Date: � 3 t �r
�[`fifp)
2/412011

ltjFacility No. � mai Farm Names W Ve IPfj, Date qjw
Permit COC �'� OIC: NPDES (Rainbreaker PLAT Annual Cert }
Pop. Design Current
Type
�i
FB
A
[noon 1 2 3 4 5 6 7
Spillway
Design freeboard
Observed freeboard in
Sludge Survey Date
Sludge Depth ft
Liquid Trt. Zone ft
Ratio Sludge to Treatment Volume
Calibration Date
Design . Design Width
---�--
Actual Flow
--�---
Actual Width
si.---�--
Soil Test Date
1,01(4110
Wettable Acres -�
pH Fields
WUP
Lime Needed
6-x?
Weekly Freeboard ✓
Lime Applied
Cu -I / Zn -I
1 in Inspections ►�
120 min Insp.
Needs P
Weather Codes
Crop Yield
Transfer Sheets u^ rr�; al Ste/
RAIN GAUGE
Dead box or incinerator
Mortality Records
L� Cdr' LIQ
MSC% Ih } Cal
bzn LM -7 lis r
Amt (lb11000 Gal)_
Verify PHONE NUMBERS and affiliations
Date last WUP FRO TI(t)Ioq Date last WUP at farm s App. Hardware
FRO or Lagoon Fate `oras
Qj
Top Dike .'i��i' Of �r� rr-`-R ��,p► '�:, y
Stop PumpI ,
Start Pump
C -1081bl ; Zn -1 3000= 213 Iblac
qheo
•
• s
MINM0
IT 0�1111111111111111
Verify PHONE NUMBERS and affiliations
Date last WUP FRO TI(t)Ioq Date last WUP at farm s App. Hardware
FRO or Lagoon Fate `oras
Qj
Top Dike .'i��i' Of �r� rr-`-R ��,p► '�:, y
Stop PumpI ,
Start Pump
C -1081bl ; Zn -1 3000= 213 Iblac
qheo

.2?Tws 8-azo/o
- - — t�evision of Mater Quality
iFaCiiity Number 2 ' 7Z Division of Soil and Water Conservation
Other Agency
Type of Visit Orl6ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 8 /d /O Arrival Time: 9.35 Departure Time: S'La� County: ,a�.� Region: F/
Farm Name: _ 5 14 (A) b�)664 T _rctYh., Owner Email:
Owner Name: �_t�_W _�Pw F rm LLC Phone:
Mailing Address:
Physical Address:
Facility Contact: )o nrNi e. ON1, 7'" S Title: � ""'�5��✓ Phone No:
Onsite Representative:
f} � r Integrator:
Certified Operator: +�t1nrw►i U I�''U�a 1AJ Ira�++_�,.- Operator Certification Number: -2 -*1s5
Back-up Operator: Back. -up Certification Number:
Location of Farm: Latitude: =0
=s
=" Longitude: ="=, ❑ u
Design Gurrent
Swine CPopulation
§D—acit-
❑ Wean to Finish
❑ Wean to Feeder
DesigNO-Current
Wet apacityopulation
�.C.
❑ Layer
❑ Non -Layer
Design Curren
Csatile Capacity Poprllation
❑ Da Cow
❑ Da Calf
❑ Feeder to Finish
❑ Yes
❑ Da Heifer
Farrow to Wean S
Dry poultry,
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑Beef Stocker
El Gilts
❑ Non -Lavers
❑ Beef Feeder
❑ Boars
❑ Pul lets
❑ Beef Brood Cowl
,_,
2<0
❑Turke s
❑ NE
Other
urkey Points
El
�] Other
Number of Structures:
Discharees & Stream Impacts
I . Is any discharge observed from any pan of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c_ What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑Yes 3 o ❑NA I--] NE
❑ Yes
❑ No
E1<A
❑ NE
❑ Yes
❑ No
B A
❑ NE
0<
❑ NE
❑ Yes
❑ No
❑ Yes
oo
❑ NA
❑ NE
El Yes
,_,
2<0
❑ NA
❑ NE
Page 1 of 3 12128104 Confinued

Facility Number: $2 -%Z Date of Inspection
Waste Collection & Treatment ,��,,/
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes L'�'Na ElNA ❑ NE
3
a. If yes, is waste level into the structural freeboard? ❑ Yes o ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier. .# 1 Z
Spillway?: f10
Designed Freeboard (in):
Observed Freeboard (in): la Z/ a
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑"�lo ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage.. etc.) ,/
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes E 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? ❑ Yes •' �o ❑ 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 [9 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 M<o ❑ 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) Fe $er�•,.��a. ws�. ►'aiN
13. Soil type(s) 'moi. &bA FA, r uN4o-,_
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
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18_ Is there a lack of properly operating waste application equipment? ❑ Yes
y : �,.: ,� �� •_
Comments (refer to question #).{ Explain any YES answers and/or any recommendations or any other�comments r ;Z -
Use drawings of facility to better ezplam situations. (use additional pages as necessary): ;
El NA
El NE
,L5'No
Lf No
❑ NA
❑ NE
E
El NA
[__1 NE
�No
Ei
El NA
ONE
��O_
❑ NA
❑ NE
y : �,.: ,� �� •_
Comments (refer to question #).{ Explain any YES answers and/or any recommendations or any other�comments r ;Z -
Use drawings of facility to better ezplam situations. (use additional pages as necessary): ;
rr
Reviewer/Inspector Name c V is Phone:
Reviewer/Inspector Signature: Date:
I2/28/04 Continued

Facility Number: 82 =7Z$ Date of Inspection
Required Records & Documents `
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
the appropriate box.
❑ WUP El Checklists El Design ❑Maps El Other
❑ YesNo ❑ NA ❑ NE
❑ Yes 13 o ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
E44o ❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking [3Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections E] Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
NNoo ❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
,L��
NNo ❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
,E
N/o ❑ NA
LE:10,10EINA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
NA
❑ NE
26.
Did the facili fail to have an activel certified o erator in char e?
facility Y p g
❑ Yes
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
EINo ❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Vo ❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[R<o ❑ 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?
El Yes
,�,
L4No ❑ 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
ElYes
M"0 ❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
El Yes
,_,,
M<_01 ❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
LH'No ❑ NA
❑ NE
Additional`Com: ents� dJo� D�arriugs: ,
I d
Page 3 of 3 12/28/04

I
-9riKS 11 -2 -3 -zoo i
Type of Visit eTompliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit outine Q Complaint O Follow up Q Referral O Emergency Q Other ❑ Denied Access
Date of Visit: I/'Zo -d % Arrival Time: Departure Time: County: SsN-.oSaN Region: Y�'d
Farm Name: 6 d ag, Fctt. t,,- _ Owner Email:
Owner Name: S H tit Sc:.J rare.... L. L C Phone:
Mailing Address:
Physical Address:
Facility Contact: enlnlj lAlj 1,' ow, s Title:
Onsite Representative: �onint i t Edi ti ��—S
Certified Operator:
Back-up Operator: a 'j d °''-'- e -&I S
Location of Farm:
9 Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: [=a 0L Longitude: =0
=4
Design Current
Design Current
Design Current
Swine Capacity Population
«et Poultr♦ Capacity Population
Cattle Capacity Population
❑ an to Finish
JEI Layer
I
❑ Dairy Cow
❑ NE
❑ an to Feeder
❑ Non-Layer—I Non -Layer -I
❑ Yes
[3<o
❑ Dairy Calf
Feeder to Finish
❑ Yes
❑ Dairy Heifer
[farrow to Wean 32.0 33Z,0
Dray Poultry
❑ Dry Cow
❑ Farrow to Feeder
El
El Farrow to Finish
ElN era
El Stocker
❑ Gilts
❑ N ayera
ElBeef Feeder
El
❑ Boars
Mets
El Pullets
El Brood Co
❑Turke s
Qther
❑ Other
❑ Turkey Poults
❑ Other
Numlyer of Structures:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a, Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes L'7 No ❑ NA ❑ NE
❑ Yes
❑ No
L SNA
0 NE
❑ Yes
❑ No
G A
❑ NE
['N'A
❑ NE
❑ Yes
❑ No
❑ Yes
[3<o
❑ NA
❑ NE
❑ Yes
Gillo
[:INA
❑ NE
11/28104 Continued

r
Facility Number:
Date of inspection-zo� 09
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?
❑ Yes M'No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: NO
Designed Freeboard (in): .32. 5
Observed Freeboard (in): 47, O
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes [ No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes e< ❑ 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 B No ❑ NA ❑ NE
maintenance or improvement? r
_Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement? B"
No 1. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes L� 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) $nyw,.�d.�., �Iicil �INrlI G.p� �O,S•�
.4se'ye- lH6y
13.
Soil type(s) 66A F6 ka� i o .- � k .�, �� iAr;..cdJ A10A
Reviewer/Inspector Name S.Phone: 9�a, X33. 3300
-
14.
Do the receiving crops differ from those designated in the CAWMP?
El Yes
,�,�
L3No ❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
To ❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
�XNo ❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
" No NA El NE
I &
Is there a lack of properly operating waste application equipment?
El Yes
L�'No IJ NA ❑ NE
omments refer to question x aan an YES
gt . q ) l? y ( p g :. Vis} er cdmments
:.answers andlor an recommessa��..�,,�
'-, endanonsm- an path_
Use drawin s,of facilityto better ex lain situations. use additional a es as nee
se.
i
s
Reviewer/Inspector Name S.Phone: 9�a, X33. 3300
Reviewer/inspector Signature:u.� /. �..— Date: !J-zo -Zoog
12/28/04 Continued

E
}
Facility Number: Date of Inspection Fa -2-1073-91
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes El"No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes L7 No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other ,�/
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes L7 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
L<o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
B, o
[INA
El NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
L3"No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
D<o
ElNA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
ElYes
[3 o
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
B o
[:1 NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? E]Yes 014 ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
2 o
❑ 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?
ElB Yes
.—,.�
�o
❑ 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
�
D o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
,�
32. Did Reviewer/inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
L�-
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
El-N-o""El NA
❑ NE
Add In r, 113jgs. �{MOM
a
12/28104

L
® Division of Water Quality
11 1 Facility Number SZ Z Q Division of Soil and Water Conservation
O Other Agency
Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: 3: ins County:G Sdiv Region: i`714V
Farm Name: S via F4 V Owner Email:
Owner Name: H V3 SOW i ark, LLC fPhone:
Mailing Address: 20,V0i "15'01V M;1k d, Smi itf;�ld. A/C 2--7577
-y -
Physical Address:
Facility Contact:Gil- Title: Phone No:
Onsite Representative: C_: Lc h ,T,II as r w i C- k Integrator: -�N�t f nr deiv
Certified Operator: —Rt &t-M,d kki, A� Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑ o F -I . F --I « Longitude: =0=4
o❑4 = ,&
Swine
IWWean to Feeder
Design 'Current is Design Current
Capacity Population` Wet Poultry Capacity Population
❑ Layer
❑ Nan -La ei
IW Farrow to Wean R20 X 1 D I:
LJ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ 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?
r
Design . Ci
Cattle 'Capacity Po:'u
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
E]Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [$ No ❑ NA ❑ NE
❑ Yes
9 No
❑ NA
❑ NE
❑Yes
PNo
[INA
EINE
❑ Yes
[2 No
❑ NA
❑ NE
❑ Yes
[7 No
❑ NA
❑ NE
❑ Yes
RNo
[:INA
❑NE
11/28/04 Continued
l�

Facility Number: $Z --72 81 ©ate of Inspection D dF
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
0 No
❑ NA ❑ NE
Waste Collection & Treatment
Reviewer/Inspector Signature: Date: j0 =4N -Z00 7
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
M No
❑ NA
❑ NI.
a. if yes, is waste level into the structural freeboard?
❑ Yes
Pff No
❑ NA
❑ N E
Structure Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
13.
Soil type(s) K'z r IJ5 Go [gleeyn U%eol:'.!j in iv A rt SA n/
Spillway?:
14.
Do the receiving crops differ from those designated in the CAW MP? ❑ Yes
[2 No
Designed Freeboard (in):
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
21 No
❑ NA ❑ NE
Observed Freeboard (in): iW gw 5lv"cnl
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
® No
❑ NA ❑ NE
17.
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.)
[3NA [INE
I
6, Are there structures on-site which are not properly addressed and/or managed
❑ Yes
No
❑ NA
❑ NF
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 r9 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ENNo ❑ 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 ADDlleatiOn
10.
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
0 No
❑ NA ❑ NE
maintenance/improvement?
Reviewer/Inspector Signature: Date: j0 =4N -Z00 7
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
[PNo
❑ 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.
Croptypc(s) Cornet 41%ecfSayL�T8.c4�(/�¢T iuce6'M4u (as'
13.
Soil type(s) K'z r IJ5 Go [gleeyn U%eol:'.!j in iv A rt SA n/
14.
Do the receiving crops differ from those designated in the CAW MP? ❑ Yes
[2 No
[INA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
21 No
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
® No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
EgNo
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
[� No
[3NA [INE
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):
r- . uNd • va? 574-1.C_76;D Al
Reviewer/Inspector Name h Rew9-ls . Phone: 9/0, sl,33 ,3300
Reviewer/Inspector Signature: Date: j0 =4N -Z00 7
12128104 Continued

..
Facility Number: $2 Date of Inspection7-421-07
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes CH No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes UrNo ❑ NA ❑ NE
the appropirate box.
❑ WUP [:1 Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E9 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crap Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
M No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
M No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[M No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Pfl No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
TNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
10 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
M 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
❑ NF
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/lnspector fail to discuss review/inspection with an on-site representative?
❑ Yes
8 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
JR No
❑ NA
❑ NE
Comments and/or
12128104