710078_INSPECTIONS_20171231

NUHTH UAHULI NA
Department of Environmental Qual

(Type of Visit: compliance Inspection O Operation Review �ructure Evalu ion O Technical Assistance I
Reason for Visit: O Routine O Complaint O Follow-up O Referral mergency O Other O Denied Access !j
Date of Visit: Arrival Time: Departure Time: County:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Region:
Facility Contact: Title: / Phone:
Onsite Representative: �'t "-'� S `�^� r / �� t Integrator:
Certified Operator: Certification Number: �72- 75--'
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design C+urgent
Swine Capacity Pop. Wet Poultry
Wean to Finish Layer
Design Current Design Current
Capacity Pop. Cattle Capacity Pop.
DEE]ff�i Cow
can to Feeder Non -Layer
Dai Calf
Feeder to Finish 1z vo Q
Dai Heifer
Farrow to Wean
Farrow to Feeder Dr, $Mull ,
Design Current D Cow
C_a acity Pia , Non-Dan
Beef Stocker
Farrow to Finish Layers
Gilts Non -Layers
Beef Feeder
Boars Pullets
I 113eef Brood Cow
Turkeys
Other Turkey Poults
Other 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 DW R)
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?
❑ Yes 9_< ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑No ❑NA ❑NE
❑ Yes
❑ No
❑ NA
❑ NE
es
❑ No
❑ NA
❑ NE
[:]Yes
FrNo
❑ NA
❑ NE
Paee 1 of 21412015 Continued

Facility Number: - jDate 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 ❑ NF/
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
E A
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
G'96--
❑ 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
N- o
❑ 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
C 3N'o
❑ 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
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes N�No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Ye ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? Yes ❑ 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).
lie 4�_t *_� j �-� p�.r t Pv C-.e l ( i`" 5 PC c +-, ej ;o r,
Ir<r.�Oor pr ��L LC� I r�
-
�i1��.Rt C'� t..�r lr rC f%&
Q.� ( nr CgKS to
Reviewer/Inspector Name: 06L.-.1I- 0 L-4- f (
Gas �� �T -�► � .� �-�c f � �
(l,C/1 1 C/1"SVP 5"0 n
) IL.. rasA.0 (1 0 nLlt.-%rJOV
� f'
C L+rre r filf,
Vs •� c t✓ ��r2 Phone: cif • f la 71 f 7jl.&
Reviewer/Inspector Signature: y� 11 Z✓ ' - / Date: 1.0 r6
Page 3 of 3 21412015

r
Type of Visit: O Compliance Inspection O Operation Review Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint ollow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: j 9&04Arrival Time: 39 Departure Time: z!S` County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: uu . Title: Phone:
Onsite Representative: �° rf} 1 ' r' ��^� f C� ^�a� Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Wish
S7tto
JFnish
Design Current
Capacity Pop.
Design
Wet Poultry Capacity
La er
C►urrent
Pop.
Cattle
DairyCow
Design Current
Capacity Pop.
Weder
Non -La er
EEJ
Dai Calf
9
Design
D , P,oult . Ca aci_
La ers
Current
l:o ,
DairyHeifer
D Cow
Non-Dai
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layer
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
ML_LOther
Turkeys
Turkey 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 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?
❑ Yes dNo ❑ NA ❑ NE
❑ Yes ❑ No
[]Yes ❑ No
[:]Yes [—]-No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
[DNA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: lbateof Inspection: P I fO
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes [ -No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? 0 Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2`(
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 ,D"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 [:INA
❑ 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 E]'No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA
❑'1VE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA
lE
❑ 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 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
[—]Yes [:]No
❑ Yes [—]No
❑ NA rx�
❑ NA
❑ NA NE
❑ Yes ❑ No ❑ NA 4NE
❑ Yes ❑ No ❑ NA T31NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[:]No
❑ NA
dNE
20. Does the facility fail to have ail 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
ENE
❑ 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
❑ No
[DNA
ONE
Page 2 of 3 21412015 Continued

Facility Number: - 7= Date of Inspection: c- 2/ 1C;
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA k:rNE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes [—]No ❑ NA O 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 first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes ❑ No ❑ NA ❑ E
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ N ❑ 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 ONo ❑ 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 P"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
Z NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes �❑/ 'No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
Oyes MaWo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes J�N
❑ NA
❑ NE
Comments (refer to question;#): -Explain, an YES "answers. and/oir,any-additional recommendations"q.e any other. comments;°
y
Use 'drarnns:� -« w
g ty to.beiter:ex larn:s tuationa use additi©nal' a es;as necessa affac�h„ p (� P. g
A 6J
'r; i�-- f, - -f j .0'.
r �r
7 Ce t L( 1 k'C (i'4,t 1 c /� s Prr ^, �jr(n^`e.�
J �
e e c�c {� / �, �� CAW.
Ca
Reviewer/Inspector Name:
10 It _I f.+ A -L
I %
S, r H W �A
NXi1 , , Phor
Reviewer/Inspector Signature:
����j�
Date
Page 3 of 3
21412015

s
Fol
Type of Visit
pliance Inspection
0 Operation Reviow 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
7Routine0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: I d Arrival Time: I63 Departure Time: County: �6ti0 Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title: Phone No:
Onsite Representative: Ju �^ F S r`-1 rG�� Integrator:
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
Operator Certification Number:
Back-up Certification Number:
Latitude: [ [ [= Longitude: ❑ ° = 6
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
J0 Non -La et._ - - -
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey 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 Stocket
l
❑ Beef Feeder
❑ Beef Brood Co
I
Number of Structures: 171,11
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes dNo ❑ NA ❑ NE
❑ Yes P4 ❑ NA ❑ NE
12128104 Continued

Facility Number: Date of Inspection v$
.Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E3 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I �Sttructure 2 1 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 61 AC61At.k . vrll&A(A_iA(
Spillway?: 211
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 2 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 0 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 ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Zo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El Yes No ❑ 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?
I t . 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 I❑ Evidence of Wind Drift ❑ Application Ouside of Area
12. Crop type(s) ile�JIM t) rxQ L� 4 ) J U,0P-Lo i^% k Cori-,)
13. Soil type(s) CA C_'ro tr U,
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[T ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
N ❑ 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
N El NA
❑ NE
18.Is there a lack of properly operating waste application equipment?
❑ Yes
W❑ NA
Cl NE
FAcm PAS (Ua) 60T OF No trS
1 CM i. 'RA� r&AG,.I41 W �r-rjj'jlj
Reviewer/Inspector Name E,C�L. A' s Phone: (AW ! q 6 'ZZ S
Reviewer/Inspector Signature: Date: $ 7/ r
12128104 Continued

Facility Number: i — Date of Inspection 1 �'
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 appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
❑ Yes [N El NA El NE
ElYes �No ❑ NA ❑ NE
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 I"
Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
ElYes
EsNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Q<o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
[9A
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
El No
M A
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ET<o
[:1NA
[INE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ElNo
DN/A
❑ 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?
El Yes
��,,!!
93 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
[:�1Go ❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
�No
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
El NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes;/No
❑ NA
❑ NE
Additi6aal Comments and/or Drawings:
12128104

M
of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
(Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Facility Number Date of Visit: I lalplalTune:
O Not Oaerational O Below Threshold
Permitted © Certified 0 Conditionally Certified [3 Registered Date -Last Ope7t7gor Above Threshold:
Farm Name: \_,_[/%�_. �[�►Atrz County:
Owner Name: r _. _.L� _ _ . _ _.. _. _. 'Phone No:
Mailing Address:
Fpeility Contact: .. Title:
OnAte Representative:
Phone No:
Integrator.I7�
Certified Operator: __. _. . , , , _ , Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude w d 'IL Longitude • 4 «
Discharges & Stream
1. Is any discharge observed from any part of the operation?
❑ Yes 0No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d_ Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes P No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes XNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes Oo
Stricture 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
12112103 Continued

Facility Number: Date of Inspection
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ yes No
seepage, etc.)
tZ
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑yes No
closure plan?10
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes VNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement?
❑ Yes,,ONo
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes J'No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes ❑ No
b) Does the facility need a wettable acre determination?
❑ Yes ❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes ❑ No
15. Does the receiving crop need improvement?
❑ Yes No
16. Is there a lack of adequate waste application equipment?
❑ Yes No
Odor Issues
17_ Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below [❑ Yes No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes RlNo
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 J'No
Air Quality representative immediately-
0
Field Copy ❑ Final Notes
f 11 v ��5 �%i� �l y� ��R� � /�r4� yF.4�s, ©u��/� i`�✓nl �- � /�r�f
kf Goon 4; ��cv�,os ��fs9z f3 ff
�j Z j;?
ReviewerAWspector Naive
Reviewer/Inspector Signature: PAA
Date:
I2/I2/03 Corot UM

Facility Number: Date of inspection
Required Records & Documents
21. Fail to have Certificate of Coverage c& General Permit or other Permit readily available? ❑ Yes ❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WOP, checklists, design, maps, etc.) ❑ Yes ❑ No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes 10 No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes WNo
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes PrNo
28. Does facility require a follow-up visit by same agency? ❑ Yes ONo
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes J'No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ][_-] No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

Type of Visit ;05 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 9fRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: I / Time:
Not O erational 0 Below Threshold
Ja Permitted ©Certified C] Conditionally Certifiep 0 Registered Date Last Operate r Above Threshold:
Farm Name: 2WCounty•
Owner Name: Phone No:
Mailing Address:
Facility Contact: Title:
�
Onsite Representative: {l
C C r / Ta1ov
Certified Operator:
Location of Farm:
Number of Lagoons, °,.�Z^�
Hnld�na; Pninilc t CntiFi`'.Tranc 1
Phone No:
Integrator: �7-AaF
Operator Certification Number:
Subsurface Drains Present JJLJ Lagoon Area
o Liouid Waste Management System
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. 1s storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
structure 1 Structure Z Structure 3 Structure 4 Structure
identifier: � i?S�r
Freeboard (inches): �J
05103101
❑ Yes
❑ No
❑ Yes
No
❑ Yes
XNo
❑ Yes
121 No
Structure 6
Continued

Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
seepage, etc.)
)ZNo
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
,_/'
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
la No
//
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
�No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
El Yes
WNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
,. /
id No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN El Hydraulic Overload
El Yes
gNo
12. Crop type
11 Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ VrUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
PNo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
PYNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
VNo
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
XNo
24. Does facility require a follow-up visit by same agency?
❑ Yes
I[J No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
XNo
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments.(refertn question #) F Ezp3atp hny YES'answers and/or'an Y. re%omme tlatioiis or anv other'comtnernts:
Use drawings of:facdity to. better explain situations: (nse addthonal=pages.as necessary] El Field Copv ❑Final Note -
- -
a
'P'--/70C <A // alel&
Fro y�o• �� �2 ��� s
�PGr�p
/I C' O�i��/I�L 4� li�FSF�+ S
Ln�6
Reviewer/Inspector Name rpit�/` G
Reviewer/Inspector Signature: Date:
05103101 Continued

Facilit} Number: —) Date of Inspection
Odor Issues
26_
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
JLI No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
X,No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s). inoperable shutters, etc.)
El Yes
X/No
3 i.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No
Additioil':Commen tsars ..ar:Drawings;-�.'- -� - .::. _ _ -_
05103101

Type of Visit 16 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit t(Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time:
Not Operational Q Below Threshold
Q Permitted © Certified 0 Conditionally Certified [3 Registered Date Last Opera" or Above Threshold: W.
FarmName:.............................................................................................................................. County:.1.....�L{!�_.
OwnerName: ............... CaVAM4............................................ Phone No:............................................................................... .
FacilityContact: ...... ....... ...... ............................................................ Title:................................................................ Phone No:
MailingAddress: .................................. ........................................................ ...... .. _....._ ....
�✓i✓. _c.
Onsite Representative: ............. Integrator: .
Certified Operator: ...................................................
Location of Farm:
Operator Certification Number:
wine ❑ Poultry ❑ Cattle
❑ Horse Latitude
Longitude �• �Du
v Des_ i
Current `: -Design:
N :.
Currnf- Design
,Swine_
--. - Ca ci
.:Po ulation v P,oultry Ci a
. -Po tilation Cattle ,:- C ' .Po " latiow `=
Wean to Feeder
❑ Layer
❑ Dairy
Feeder to Finish
❑ Non -Layer
❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑Other
_
-
Farrow to Finish
Totai'D@SIg Capacitji
Gilts
Boars
- TOW SSLW
�jambep p ;agpp� : -. ❑ Subsurface Drains Present ❑ Lagoon Area
-. :
--Holding Ponds / Solid Traps - ❑ No Liquid Waste Management System
❑ Spray Field Ares
a
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?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
[]-No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
❑ No
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: ................................. .........................
Freeboard (inches):
5/00
Continued on back

�.s
Fa= ility Number: — Date of Inspection�7/ fJ�
5. Are ihere any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11 _ Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16, Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22, Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
10-ViQ1al�iQns:e d$fciejnct wire :ed atrrJog this;v}sitt • Y00 wiii•;e oito Rio fui�titgr. :
canes' oridence abotit this visit` ..................................
Comments (refer.to'gttestion #) Earpla any YES answers aiud/or any recomrneniiatioas a�r,aoy other conameaft s
-.
Use d=av ngs of facility to hette�r'explaimsifiuWcns. (use additional pages as necessary) w >
Ab
04KI69
.
Reviewer/Inspector Name D6 G
Reviewerlhispector Signature: Date: %/ �Z9%d/ 5100

- 2 _
-107
Division of Water uality '' z f
Q
s` Q ivision of Soil and' Water Conservation
O therAgencp
.r
type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
for Visit XRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
1 s i?
Facility Number Date of Visit: % Tune: Printed on: /21/2000
10 ,Nak O eration t 0 Below Threshold
Permitted, Certified ©Conditionally Certified ©Registered Date Last Operated o Above Threshold
t ` %
Farm Name: ................. 1G.t'....C:,.......... ............ County:........... (..! ................
.' .
Owner Name:...............................
. '....................................................................................
\V........................................................................... Phone No:...
Facility Contact:
................................ Title:....
Phone No:
Mailing Address: .........................
....................................................................
Onsite Representative :....... :.....�. .........� `..:- ._... Integrator:.... ............__ ........ _............... .......................
Certified Operator: ------ ._................. CAJj`a/�. ..... ............ Operator Certification Number: ...............
Location of Farm-
.,
w°
swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� �° Longitude �•°
Design Current
Swine Canneity Pnnulatinn
❑ Wean to Feeder
ET_FeedertoFinish
17—oo
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer 171 Dairy
❑ Non -Layer I I :::�::d❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lag--. Area ❑ Spray Field Area
Holding Ponds 1 Solid Traps ❑ No Liquid Waste 'Management System
Discharges & Stream lmpack5
I _ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach Water of the State'? (If yes, notify DWQ)
c. If dischargc is observed. what is the estimated Ilow in galhytin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ................ ��............_......_................_.................. .
Freeboard (inches):
5100
❑ Yes XNo
_
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes 4No
Structure 6
Continued on back

Facility Number: — Date of Inspection Printed on: 7/21/2000
5. Are there any immediate th eats to the integrity of any of the structures obs rved? (iel trees, severe erosion, ❑ Yes KNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes VNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes VNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes (No
9. Downy stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes _I�No
Waste application
10. Are there any buffers that need maintenance/improvement? ❑ Yes �No
11. Is there evidence of over cati�n? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload El Yes INo
12. Crop type GTE
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records &_Documents
17. Fail to have Certificate of Coverage &General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
•ViOl3ftf1Y1S,01'� deGCle,IiC1�5 •W�t'E IIpI:.Q(�- [lttrFrig ��i1S,VFSIt. • Yoir will •r' eeeive lit? #'urthetr -
correspondence. abou>k this visit .:. . . . ...:...:.:.:. . ............:. . ..... . .:.:.:.:. : .: . :....... . .:. . .. .
❑ Yes LNo
❑ Yes qNo
❑ Yes [ No
❑ Yes V No
❑ Yes 1q`No
❑ Yes INo
❑ Yes ONo
❑ Yes k No
❑ Yes [?No
❑ Yes No
❑ Yes No
❑ Yes 1� No
❑ Yes lNo
❑ Yes 13�No
❑ Yes �No
Comments (refer to question I!): Explain any YES answers and/or any recommendations or any.other comments. _771
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name
Reviewer/Inspector Signature:
e
Date:
5100

Facility Number: Date of inspection dI Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor below ❑ Yes No
liquid level of lagoon or storage pond with no agitation?
2T Are there any dead animals not disposed of properly within 24 hours? ❑ Yes R10
29. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes
roads, building structure, and/or public property) \\
29: Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes tlkNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes J;�No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes TO
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes tlbTo
5100

• 13 Division of Soil and -Water. Conse�vation - Operation Review ,
E.Division of Soil and_Water Conservation Compliance Inspection w ` :-
_ _ MI Division of Water Qut hty -Compliance lnspection _ z s
13:9ther Agency Operation=Review -
is Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow of DSWC rem 0 Other
Facility Number Date of Inspection 1
Time of Inspection 24 hr. (hh:mm)
0 Permitted JaCertified 0 Conditionally Certified © Registered 10 Not Operational I Date Last Operated:
Farm Name: �-3 �I a ck N CY ., County: �r
. ................
�n rt, es
Owner Name:......... ........................... ±1n. (! Phone No:.......................... .
FacilityContact:..............................................................................Title:........._...........__.................._...................... Phone No:......................................
.............
MailingAddress: ...................................... .......... ................................ .......................................................................................................................... ..........................
Onsite Representative:ci,n-�c S D►� ..... Integrator: �Y'4 s�q�°...............................................
Certified Operator: Operator Certification Number:,,. .......................
.............................................................................:............................ ................
Location of Farm:
r....................................................................................... .
Latitude �' �� ; Longitude
=. Design Current _
7wme __ Uapaclt
❑ Wean to Feeder
Feeder to Finish i -ZOO
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Poultry _
lesign- CtirrentM.
Design Cuir'ent
ipacity,. Population Cattle Capacity Population -;
Number oft-agoons. Subsurface Drains Present ❑Lagoon Area ❑Spray Feld Area
Hold�ngPonds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field []Other
a. If discharge is observed, was the conveyance man-made?
h. If discharge is obsen�ed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3.. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: !
Freeboard(inches): ........5...............................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe.erosion,
seepage, etc.)
3/23/99
❑ Yes JE No
❑ Yes $d No
❑ Yes 9No
a 14
❑ Yes No
❑ Yes No
❑ Yes j No
❑ Yes N No
Structure 6
[]Yes JM No
Continued on back

Facility Number: — -79 Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any 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 Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? []Excessive Ponding ❑ PAN
12. Crop type
1 � �
❑ Yes
Ej No
❑ Yes
09 No
❑ Yes
:9 No
❑ Yes
R. No
❑ Yes
A No
❑ Yes
® No
S-W Pr
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This Facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Reouired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all -components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Vo violations or &.fi.c.i.e.n.a.eI were noted• du ng this.visit. • .. wiil•reeeive Rio i'urthi;r • : • .
corresD&ide. .. motif this visit..::.::::::: ::.::.::: :
NUS
ElYes JS No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes jo No
❑ Yes 12!�No
❑ Yes No
❑ Yes JEA No
❑ Yes 5jfNo
❑ Yes Cff No
❑ Yes Id No
❑ Yes IONo
❑ Yes fidNo
❑ Yes ba No
3/23/99

• Facility Number: 71 _ B Date of Inspection f ►�
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below El Yes XNo
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 1J No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes Q No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes )2 No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ,9 Yes ❑ No
Additional'. Comments and/or rawin
3/23/99

Lagoon Dike Inspection Report
Name of Farm/Facility _ o � / i
Location of Farm/Facility Q S
Owner's Name, Address .S PVv1;_1:7S C6,v,ye.t0- r
and Telephone Number
Date of Inspection Names of Inspectors
C- Keb AT
Structural Height, Feet Freeboard, Feet
Lagoon Surface Area, Acres Top Width, Feet
Upstream S1ope,xH: IV Downstream Slope, xH: IV
Embankment Sliding? Yes No
(Check One, Describe if Yes)
Seepage? Yes No
(Check One, Describe if Yes)
Erosion? Yes No
(Check One, Describe if Yes)
Condition of
Vegetative Cover
(Grass, Trees)
Did Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes No
Engineering Study Needed? Yes No
Is Dam Jurisdictional to the Dam Safety Law of 1 No
Other Comments Ff od 4,o-

Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream S1ope,xH: IV
Embankment Sliding?
(Check One, Describe if Yes)
Lagoon Dike Inspection IRRert
Z$ Names of Inspectors -
Yes No
Seepage? Yes No
(Check One, Describe if Yes)
Erosion?
(Check One, Describe if Yes)
Condition of
Yes No
Vegetative Cover
(Grass, Trees)
Did Dike Overtop? Yes
Follow -Up Inspection Needed? Yes
Engineering Study Needed? Yes
Is Dam Jurisdictional to the Dam Safety Law of
Other Comments 1
Freeboard, Feet
Top Width, Feet
Downstream Slope, xH:1 V
No If Yes, Depth of Overtopping, Feet
No
No
No

P ^wised And 20, Z oag
JUSTIFICATION & DOCUMENTATION FOR MANDATORY -WA DETERMINATION
Facility Number Operation is flagged for a wettable
ar
Farm Name:xti acre determination due to failure of
On -Site Representative: 0Ca, -ec: Part ll eligibility item(s) F1 F2 F3 F4
InspectorlReviewer's Name:
Date of site visit
Date of most recent WUP: z
-
Annual fame PAN deficit ---24256 pounds
Operation not required to secure WA- --
determinafion at this time based on
exernption . ,El E2 t=3 - - E4
Operation -pended for. wettable acre
determination based on P1 P2 P3
Irrigation Systerri(sj - circle lT-. 1-:hard-hosetaveier;2_center-pivot system; 3..Iinearmove system;
4. stationary sprinklar:systern wlpemanent pipe-; :S. stationary sprinkler system wlportabie_pipe;
5. stationary gun system wfpemianent pipe; .7. stationary gun .sum w/poriabie pipe
PAR-1 L rf . Determination Exemptions (Eligibility failure, Part lt, overrides Part.] exemption_)
El Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an 1 or PE..
E2 , Adequate D, and DzlD3-irrioaiion operating parameter sheets, including map
depicting .wettable acres, is complete and signed by an l or PE.
E3. Adequate D, imaabDn operating parameter sheet, including map depicting
wettable acres, is complate and signed by a WUP.
E4 750/1D rule exemption as verffiad in Part lit. (NOTE: =r S % examniion -cannot be
aDpiied rD 1-arms that ;ail the eiigibhi y checklist in Flart Il_ Complete -eiigibiiiiy
checklist .Part II - i 1 2 =3, beiare completing .comDuiaiionaltable in Par If[).
'ART.11.75%.RuleEligibii4-Checi:iisL.and:Do=mentaUonvi VIrA�Determination -
Requirements._WA-DeFerrunationTequiredblcaus oprrabDnfails-Dnez)fihe eligibUity
-eydi�marr� iisredd�lov��
1 Lack.nfm =agewhJdh7�ulUdannva=, on:spray-
Reid(s)��arriingd��ami�daatiwa�ars�;:i;rigatinr���s-.
�2 Unclaar,-Aeoible,-Dr lack Df zmarrr-auonirnan.
�i=3 Obvinus�air�zimi�ior��(numarr�r:s�iici�as;�a'3iz�.a�r��adz��gdir�d�-.�- . . . .
burrarlsaibackacryago nr��°1ai�noiat aga�das im ni3€n AWi`7dP.aiiciuciss_-
small,.irrrgulari�i;ar--dfields= �albsdassii;ar L raveier�r�=s ;an
2 acrDs-iar ►ationarysnrinklYrs)=
�o4 WA der..rminaiion nquired -becar.s_ acreag..fn -e,.c2--s :-
a; 75% of the respective field's total acreage as rioted -in fable in Part ill.

P,=%'is-d ApHl 20, 2a99
Facility Number �-
Part Ill. Field by Field Determination of 75% Exemption Rule for WA Determination
TRA NUMBERi��
-
FIELD
MMEN.�
'30
3
5. 7-
2oz
6.0
s'
2
Iz31
t.y I�oeel
J
I
I I
I ==
i
n
=F=! D-NULIBA'-.hydrW#,'puU.zane,-orpointnumbersTnay bee rsed.in piacexaf -held numb---, ert ending on CAMP
and type of,hicaborrsystar - ti puts, =pi-- cross7nmet-,an -one Wlll have it) combine -"-ids to
�alculaY-_75°� Id.i�y rnfd o rrnsc:aison rax� +iiQn; uil r►nrise Dp —a o vviEl br suii�� its 1NR, date io::_
I�NUN13 must iae cl'. a rdeiisaiesdn„m-ap.
OMNiENW - back ap field_s wUh CAWMPzcF age2e=aeQing-75% or lisio;a)zzi--s-and t;avingTeeaived less kian 0%,
ritsannual-PAN asmomws- ntediniliasarm=s-previouslwa(-Y;...arsfP99i_&-i998)DfJrdgabor-x_-=rds;-zannotmeive-as the
,Qie�ass�:r¢auiringa 1NA�'3�r�_ riorz:�a:�aza�.�dsst�Trst~d�rs�e�ars�a�iion��a�ess�ie-- - --
-y micatimmys erm
'art. IV. Penciing W; A-Determiracions7.
1>2
Flan ja rks:foilowing informaiiori:
PfanT-_visian-nay_sausjY7.5% rule-basad .on adequate -overall _PAN dericR:and :by
adjl;siingallijAidmcrrageio:below75% use3ms
P. Dth9r`(lafjn process Df insalling naw irrigauDn stem);

Division of Soil and Water Conservation ❑ Qther Agency
jj Division of Water Quality
Q Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review Q Other
Date of Inspection
r- Facility Number
Time of Inspection � 24 hr. (hh:mm)
13 Registered JO Certified [3 Applied for Permit © Permitted JE3 Not Operational 1 Date Last Operated: •••.••••
Farm Name: �- c ( Count �� ............
...... 1..� .(---....-JAI5.....................•.....-...J'.`.�``............-.... r ......... n.�,.........................................
Owner Name:......... !`..........................................kP"T� rt.......................... . Phone No: �� ..J .__.. .........................
K- e.. v.. z......
Facility Contact: ---. •s: ff:-- ... ........... Title: �� . .................. Phone No:
Mailing Address: Z t' ,1 ` ................................ .f�..LlT. g. ...............................
Onsite Representative------ ------- Grn
h...4.............................................. Integrator: .... .-.R+s
Certified Operator........ �•�-..1 ...f-L............................................ Operator Certification Number:.........................................
Location of Farm:
MC
G
Latitude 0• =' =" Longitude 0. 0' ="
°Design Current Designer .Current Design Curiceizt
Capaaity. ;Population Pot tryu Capacity Population; Cattle Capacrtyy,Popolation.
EIZE-1
Feeder ••.' ❑Layer ❑Dairy
E o Finish 170D I IJ ❑ Non -Layer ❑ Non-Dairy�❑ Fw to Wean -
❑Farrow to Feeder r ID Other
❑ Farrow to Finish
Totat Design Capac>Ity
❑ Gilts b u
P_'.Boars Total SLk
SLW
xy
Number of Lagoons / Hdlding ID Subsurface Drains Present ❑ Lagoon Area JE1 Spray Field Area
r: ❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ANo
2. Is any discharge observed from any part of the operation? ❑ Yes ;P No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes No
c. If discharge is observed, what is the estimated flow in-at/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes No
7/25/97

Facility Number: ? 1 —
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lap-ogns.Holding Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Stricture 2 Structure 3 Structure 4
Identifier:
Freeboard(ft): ........Z.............. ....... I ................................... ........................................................-----
10. Is seepage observed from any of the structures;
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes jo No
❑ Yes ,) No
Structure 5 Structure 6
❑ Yes 1ZNo
❑ Yes ;0 No
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15. Crop ...................................................... G
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss reviewrinspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0-No'vitilatians-ocdeficiencies:were-noted-duringthis.vAsit.,.Y.ou:vKilliec6ve'_Ro,furilier' :-
:. correspQQde�tce, ab;oui friis:visit: :. .: .
,Z Yes ❑ No
❑ Yes ® No
❑ Yes A No
❑ Yes R No
❑ Yes [(No
❑ Yes ONo
❑ Yes Q, No
❑ Yes No
❑ Yes No
XYes ❑ No
❑ Yes RNo
❑ Yes (O No
❑ Yes 4Q_No
Z �... t� `T� Ic r p Gin C�Jb, G�vPi� lLc ttrv� Ps . N e tf�t 7-0 r r.4
ni' A ,x
1 7/25/97 H

0$i13i1998 10141 FROM HUMPHREY FIRMS
i 35971704 P,gt
Ij 4\1 c iz,

Fonm laR-2 Lagoon Irrigation Fields Record
One Form for Each Field per Crop Cycle
Tract �
Field Size (acres) -(A)
Farm Ovvner
Owner's Address
Owners Phone 0
Facilily Number c - 1a y -
Wgm1Icn Operator
Irrigation Operalor's I =
Address
Operator's Phone lr
From Waste Utilization Plan
Crop Tree , , AOoonwMrrdedPAN LoaairV
in 991 m ra► M rn is :a, rim ore
'� 2�!
,'•ice ;, 5 3 a.
Oaee .'
nrHweld, ''
SHM ileac
ind TY,w
Total
' \firxtaa
�1 • ISx
WNarbn
1 ♦ 215prt mis
Operoing ' Flow Rai*
(palMrin)
7o al Vak me
� l
ie1 ■ tsi r iq
Volur:c
30r atre
7paUecrel
�71
TVasre Anafyiir PAN'
�bJ1000 pa1F
PAN llhracra
_IB]AI�L
1000IAIL
Nye elaa�r � i
A • 00i
f
-
r
I
I
l
}
:-Crap Ogcle ToWds. I..
Omem S gneluref�_' I `- +: Otis ratict's Sig nature
' erti�-razor Print) No_ �_

�'�.► n, � ij � Y?,n 11y
FORM iRR-2
Lagoon Irrigation Fields Record
One Form for Each Field per Crop Cycle
Tract 0
Field Size tscresj = (A)
Form Owner
Owners Addn3ss
Owner's Phone i
Field 0 !
Facility Number i -. 14
irrigation Operalar ' ,.,
irrgation Operator's I ,
Address
Operators Phone N r
► N e
0 tx y S, 3 e
' From Waste Utiiiza8on Plan t!opTYDe Ratamrtx%* PANLoacru,p
!11 19t NI 1i, rn to f75 rA ,V, Am 1111
Cole
e,
irAgallaa
Wawa Amovsb PAN'
Ilbli *00 gail
7 I
Parr /►ppied
Nacre)
( 1300
`
M wF1 eata*ru+
OWacral
tOj
{ ] /
2.0 it
Stall Time
Eno Taere
Tavel
Mimes�oscslinq
0 d Spnnklem
mew A n e' '
Tcla1 Vokime
- t9allasul
>t.tl9 - ,41 I
Volume
aer kae
r vevaaa1
rra—
=II•�'�
clan
l:ia
r1
+s
,.700
zn
d
3
" --� Crao,C r Ae Totals
Owners Signatlue .i:, . I '_ atflr§ Signature
C+$rttFer[ (Print) ; ����•�{{•'. +_aS..- "{ `_ 'air i :,.'^� Y.�1�ijiQ_'3'IIi'$��'i�.�1i0. '
r •f+

m
u
.0
m
m
A
FORK JRR-2 Lagoon Irrigation F#elds Record W
One Form for Each Field per Crop Cycle „
0
tract #
Feld Slzo (acres) = (A1)
Farm Owner
Owners Address
r Owners Phone #
Field it
.i G.1 • ra+ff6 �•
Facirily Number F -1 -
x
c
krlgalion Operator , .
3
V
s
Irrigation Operators tit
m
Address
<
Operelcies phone N ��
�+
—n
w�
From Waste. Ul ltization Plan
M
Ln
C0 Type
{�';�� �y
�• t,'c� •,sa
Rapanrr�Orrp9d ?+1N Loeding
rDrare) •lgM
� O 4�4
1
s
fe
91
fie
i
rVasts Me I'MI'
?AN AVOW
Neaw eehr*9 }
ircRu
";,
Date
rms" yr
5t�r17irtN
7alal
r of 9pri�kleq
Operming
Rwaats
°Ta�sl Voiurtw
Acre
per Ace
QCf10Da1}
0 9
Ilhrar op
Al . 191
III"
S53• ItW
end :one
1linutoe
s
_����
yalloral
SgWleasi
i0a0
.a
'A
i 1
�O
A..lf!
1
y
i �S� ~�1��wC,
�f
Z,
^i tl
t.'t '{i 1„1
{
tR
1.
;�'
�•� .
G57
f
Y"
I
l
1
�
r^'
Crop Cycle TdTats
a
Con iec Operator; Frbo)
• ' � �.L
�c
.�
,:;:;:=> s.3:rrs";
1ir 'yen ,YQ.Y
a���a
.
-

Four IRR-2
Tract 4
Field SIze (acres) a (A)
Fam Owner
Owner's Arid reas
Owner's Phone I
Lagoon Irrigation Fields Record
One Form for Each Field per Crop Cycle
Facilltyh1urnber 1 -7) 7
Irrigatlo r . �Al,
Irrigation =rar
Address
Operator's Phone #
From Waste UtIlIzatIon Plan
CMVTY Fleommanded PAN Leading
0wacte) a A
ill RA MI 'Al A% tr ti rys an Mt rim n 11
L Reid #
7 2L I I
Date
MrrddF+ SUrt Time
End Time
70MI
A -nut"
inigation
ftf SP IMM
CPO= F;cw PA,* I
Tbal'/Clume
31 51 -.9) 1,4
Volume
perAcre
wavacro
—!ZL
Waft dwivals PAN'
(141"01300S)
?AN ApAad
ivacro)
Lai x f6l
10(10
MlWn Balance
;WCQ)
t
U
.Crop cycle Tatars j
'To
%.�wner,s Sig ignm
. � ��7:
M
M
(4
OD
4�
W

FOAM !RR-2
Tract X
Field Size (acres) = (A)
Farm t vgner
Owners Address
Owners Phone #
Lagoon Irrigation Fields Record
One Form for Each Field per Crop Cycle
Y Field 0
.g A .(4—
"J� r► dilu4I y'I q
roc, w V. C• �.
Ile, 4L
Facility Number -
lrrigatlon Operalor
IrrotIon Operalor's t,
Address
Operalor's Phone b r+
From Waste UIIftation Plan
Mop 7 IY� PftMnrrndW PAN 14a"
! Wave) = Iel I —
oil m OA OLI tS7 r% nls -M uni 't t4
• h71Cg1iOrl
lo4tt7e
Late !I al sprkmags
+ fit Start ThT* TOW oparel avr �OrB Talat Vckmv* J& A00
4nd : 9" i4MAN '� s epomsi � Wvauej
p} Ill •G�Ihnln} 1Bj ■ ,�i 1-4 [ .
• r �r i3
C. ' �' .i _'" : a.L �.� 1 - i i� '7 . c.. � � °� 3 7 i'I"
iVeSle AnilySi! i'Are'
,Ih�}�0 3$
�
� t � i
PAN Applied Hlvogen stare'
(ThIM e} lu"j.
°-6I • o iai ll �l
4-7 {
rZ s "� �i • �-� r,
!
l
17
•-
t
q
1
f
-
1
i
I -
-', Crop Cycle i stale l 1
Cwneea Signature , L_ '%A ;:. ' L. e L�.e_..r� - .;"Ocawcr'Si.S+ lute M
Cerlffed Cperalor (Pum) t T ... �,<- ;+ '� " `t �a s ar atbet�fo:
m
m
(A
CD
m
A
M
0
3
is
w

•
Site Requires mediate Attention
1 I -1-7
Faciliry Number: 7 1 ` 7
S1T VISITATION RECORD
DATE: 1995
Owner. _ J �_W. Connor `'.. _ _ Fa= Name; Bl c jack Farm _
County: Pender
Agenr Visiting Site: Jeff Raifsnider Phone: [phone] _ _
Operator. Jim gonngr Phone: (910) 259AU2
On. Site Representative:. Jim Connor Phone:
Physical Address: North parts On Crooms Bridge Rd., 0.1 mile north of Hwy 53.
South part: So
MaUing Address: 7211 Hwy 53 East
Burgaw, N.C. 28425
Type of Operation: •'Swine x- . Poultry Carde
North - 1860 ' North: 1240
Design Capacity: gam,+�, _ , -74 Nurnber of Aaimals�oa Site: Soutri. 10nGL.._r..
Latitude: a Longitude: a
Typc of inspection: Ground X , Aerial
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard q out + 25 year 24 hour storm event
(approxin=eiy 1 Foot + 7 inches) 0 or No Actual Freeboard: i Feet g Inches
For facilities with more than one lagoon, please address the other lagoons' freeboard under the
comments section.
Was any seepage observed from the lagoon(s)? Yes o C(DWas there erosion of Te am� or No
Is adequate Iand available for sand application? @ or No Is the cover crop adequate? 0 or No
Additional Comments: North lagoon has actual, freeboard of 2ft 6 in. Need to re -
vegetate spots on North lagoon. South lagoon needs revegetation. Jim is in the
process of developing a waste utilization plan with Pender Co SWCO. Has 70 acres
of Coastal Bermudagrass to spray on.
Fax to [phone] ` SignW= of Agent.

•
Site Requires Immediate Attention: :3 V
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT I
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: ��1 , 1995
Time: i 1 1
Farm Name/Owner: S . W . C c ryg i 3 J�Q �Gz � k - liiCs L
Mailing Address:
County:
Integrator. 'P,2.s t _ _ Phone: ' 0 D a- _
On Site Representative: Phone:
Physical,Address/I
Type of Operation: . Swine ✓ Poultry Cattle
Design Capacity: Q " " Number of Animals on Site: E} 6 c-D
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude:_° _�Co ' S7 Longitude: _' /Z Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) (S or No Actual Freeboard: Zk-Ft. Inches
Was any seepage observed from the lagoon(s)? Yes o Ni N Was any erosion observed? - Yes o No
Is adequate land available for spray? Yes or No" Is the cover crop adequateT Yes or No
Crop(s) being utilized:]�-�--
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Ye or No "
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state -by man-made ditch, flushing system, or other
similar man-made devices? Yes oz N 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)? es or No
Additional Comments: (AeV s C, U a
Inspector Nanie
Signs e
cc: Facility Assessment Unit
Use Attachments if Needed.

Site Requires Immediate Attention:
Facility No. 71
• DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time:
Name/owner: W — / 3 ,�
Farm N�c/� — S - -- - C� yr Crn -
•
•
Mailing Address: _--1 d-11 �-kr.._ S_S 1 4 6 aT-
County: f n
Integrator �''�S�°` `� _ - _ Phone: 'aTc7 — "4Leaa-
On Site Representative: cnO r _ Phone:
Physical Address/Location: I r 131 z)
Type of Operation: Swine Poultry Cattle
Design Capacity: Number of Animals on Site: I QCb0
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude:_" ' .3Q Longitude: 14 `f� S`a " Elevation:- Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes or No Actual Freeboard`s j Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed?o or No
Is adequate land available for spray? Yes or NoIs the cover crop adequate? Yes or No
Crop(s) being utilized: a�SA
Does the facility meet S minimum setback criteria?, 200 Feet from Dwellings? es r No'
100 Feet from Wells? fes 6 No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? ,Yes o No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or�N0 1 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 r No ,�, nn
Additional Comments: "�se A � -2 A � � w c�LV '—� 4 0
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.