400119_INSPECTIONS_20171231

NUH I H LAHULINA
Department of Environmental Qual

INSPECTIONS
INSPECTIONS
i
INSPECTIONS

i Site Requires Immediate Attention:
Facility No.,(
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATION SITE VISITATION RECORD
DATE: P a S , 1995
Time: f : t(q
Farm Name/Owner:
Mailing Address:
County:.._.Ct!Cm�-
Integrator. Phone:
On Site Representative: Phone:.__ _q_ _ !�590p_
Physical Address/Location:
Type of Operation: Swine Poultry Cattle L.--
Design Capacity: LA,&-r r- Number of Animals on Site: G6 ­'g 'ram
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: " Longitude: ' " Elevation: Feet
Circle Ye or r\No
Does th An
Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
Appro ' tely 1 Foot + 7 inches) Yes or No Actu Freeboard: Ft. Inches
,Was any se age observed from lagoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate 1 d available for spray? Yes or No Is the cover crop adequate? Yes or No
Crop(s) being u ' 'zed:
Does the facilityet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste st iled within 100 Fee of USGS Blue Line Stream?\Yes or No
Is animal waste land apple d or spray irrigated w in 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged i to waters of the state b man-made ditch, flushing system, or other
similar man-made devices Yes or No If es, 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
Inspector Name Signature
cc: Facility Assessment Unit
Use Attachments if Needed.
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