820505_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quality

Facility Number:(a) - S
Division of Environmental Management
11,
Animal Feedlot Operations Site Visitation Record
Date: :27//2-/?‘'
Time: M
General Information: ��
Farm Name: �' X ¢; �-� � � i z-,. County: 3 ''`
Owner Name: Pres_. Phone No: 92- S9 71
On Site Representative: a r� :r11-4,42-S2P5-0n Integrator: PCef..6.-y..- _
Mailing Address: (2O, 1(39 1-6�y 4 ( So
2./GAtA ,N g 2.15
)
Physical Address/Location: - 113 ► � `> /9 / Z/-5N Z
� -o /
w
, , ,cam
Latitude: I l Longitude: I I
Operation Description: (based on design characteristics)
Type wine No.of Animals TYPe of Poultry No.of Animals Type of Cattle No.of Animals
ow G�L' 0 Layer -- 0 Dairy
0 Non-Layer 0 Beef
OtherType of Livestock Number of Animals:
Number of Lagoons: / (include in the Drawings and Observations the freeboard of each lagoon)
Facility Inspection:
Lagoon •
Is lagoon(s) freeboard less than 1 foot+25 year 24 hour storm storage?: Yes Cl No
Is seepage observed from the lagoon?: Yes❑ N66
Is erosion observed?: Yes❑ Nb�]
Is any discharge observed? Yes❑ No l'S
0 Man-made 0 Not Man-made
Cover Crop
Does the facility need more acreage for spraying?: Yes❑ No C ---
Does the cover crop need improvement?: Yes a Nog
(list the crops which need improvement)
Crop type: (.0-v-2)(4 ( Acreage:
Setback Criteria . _
Is a dwelling located within 200 feet of waste application? Yes Cl No
Is a well located within 100 feet of waste application? • • _ Yes 0 .No
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream? Yes 0 No U—
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream? Yes Cl No
A01 January 17,1996

Maintenance
Does the facility maintenance need improvement? Yes❑ No
Is there evidence of past discharge from any part of the operation? Yes Cl No C
Does record keeping need improvement? Yes❑ No
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes Cl No C3'
Explain any Yes answers: •
Signature: - •r�t�� Date:
cc: Facility Assessment Unit Use Attachments if Needed
Drawings or Observations:
•
•
•
•
.,• :fsi - _ - • _ - -_ _ �....i':„1.- r•r Ai •:a•zF.a _ :1!•" Air:A�.t.kM� er.�rr�:.•. � ._ - __
i..ill. i4 . .(: -. . -
•
AOI— January 17,1996

- 4 ..
- „ . rg^ri xa. " -�. -�I?, --rn.s f"cam t � , �^c-� `- -
` : ( na:ya� " � '
-
ODmsion of Son andiWterCo on,:.,„. ..,-,. .V.,5'.. :
�� V.
Type of Visit •Compliance Inspection 0 Operation Review O Lagoon Evaluation
Reason for Visit •Routine O Complaint O Follow up 0 Emergency Notification 0 Other ���� ❑Denied Access
Facility Number KM. SO Date of Visit: 1.2-/b-oC/ Time: ..:a i a cf3 S
,,..,,,,,,�� 10 Not Operational O Below Threshold I
['Permitted Wtiertified ©{Conditionally Certified D Registered Date Last Operated or Above Threshold: ..___...._.�_.
Farm Name: Q- , .C-S... _ _.... . . .... . . .... ._ County: . .SC�r�,u7• . .... . .W .. r� .—.
Owner Name: ...CC ,........I�raCfn ............_...WW_....._.....--_____-- ____ Phone No: __...,59�-517"x'
Mauling Address: P:.a:. e-QX il 3S1 C/!rz/d.Q. .. C.: ._.ag.. `r _._�� .
Facility Contact: .....h td.)c.......--4 cafe. 4.f.........Title: _... _...._ . ..W.... ._. .. . ... .... Phone No: —_......_..... ......._......
Onsite Representative: R cold dcff.occi' _—__- Integrator:..._,L.f S .....F3taa,$.......__..._.____..
Certified Operator.. .. s, , �/ 4_�.. Operator Certification Number: ��U WW_.
Location of Farm:
a,
T
wine 0 Poultry 0 Cattle 0 Horse Latitude • _' " Longitude • I' I L6
DesgA Current''''.4f-F:,--''.:7L-'1;7:-.f:4,•,..,-;Z:.4-q:
Desigp Current Dpngn Current
Swine Ca• pPo.Matron z`Poulr Capacity:Population..,° Cattle Capacity;Populatrotn 1
....fes -!: ...._'�i.'`._ -
i■ Wean to Feeder -- ❑Layer -1 Dairy
I•■ Feeder to Finish -- 0 Non-Layer . 0 Non Dairy
It -arrow toWean —"' "' 'r-' ,•_T-!,,:-. 1,-,-.-41-;::::,
a SF .�
1
I■ Farrow to Feeder ---,-.-1=t0Other
I■ Farrow to Finish -- Total Design Capacity
1111 Boars MIN -,-,f-.-.; `,` x Total SSLW
. _ m � � 1 1, I
Neer of Lagoons I D I
r
:. .camfi - .
�- :. ; ii ':.. ;Li 1-Li- .; ". « r .,.-: .. _..--,
'±--,1,`:.=:,72"-:-.:_:---.-- v.
Disrharpes&Stream Impacts
1. Is any discharge observed from any part of the operation?\ 0 Yes lalgO
Discharge originated at: ❑Lagoon ❑Spray Field ❑Other
a. If discharge is observed,was the conveyance man-made? 0 Yes SINo
b. If discharge is observed,did it reach Water of the State?(If yes,notify DWQ) ❑Yes Q.I o
c. If discharge is observed,what is the estimated flow in gal/min? .,_....---
d.
rd. Does discharge bypass a lagoon system?(If yes,notify, DWQ) 0 Yes Q-No
2. Is there evidence of past discharge from any part of the operation? 0 Yes 0-No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑Yes (n-No
Waste Collection&Treatment
4. Is storage capacity(freeboard plus storm storage)less than adequate? 0 Spillway ❑Yes CD-No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ----...... --/ --- ----..—..—.---.•. .............—....-.....
Freeboard(inches): ti 3 /"
12/12/03 Continued

'Facility Number:g —s- s Date of Inspection I -A2-OL(I
5. Are there any immediate threats to the integrity of any of the structures observed?(ie/trees,severe erosion, ❑Yes Quo
seepage,etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or 0 Yes []No
closure plan?
(If any of questions 4-6 was answered yes,and the situation poses an
immediate public health or environmental threat,notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑Yes Q.No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? 0 Yes allo
9. Do any stuctures lack adequate,gauged markers with required maximum and minimum liquid level 0 Yes pyo
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑Yes 0440
1 I. Is there evidence of over application? If yes,check the appropriate box below. ❑Yes D.No
❑Excessive PondingI /❑PAN 0 Hydraulic Overload 0 Frozen Ground 0 Copper and/or Zinc
12. Crop type CCGd0I-y►-►q// 0"a;n s
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan(CAWMP)? 0 Yes Ig-No
14. a)Does the facility lack adequate acreage for land application? 0 Yes s-No
b)Does the facility need a wettable acre determination? ❑Yes Dico
c)This facility is pended for a wettable acre determination? ❑Yes allo
15. Does the receiving crop need improvement? ❑Yes lallo
16. Is there a lack of adequate waste application equipment? 0 Yes Qo
Odor I.ssues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below 0 Yes Ergo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? D Yes lallo
19. Is there any evidence of wind drift during land application? (i.e.residue on neighboring vegetation,asphalt, ❑Yes 9110
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 [bio
Air Quality representative immediately.
Commesots(refer to question } F. plam any�YES answers aszd/or a�recommendations or-any other commeats: _ :
Use dirawrags o1 fac rty�to better explaw srtoaboas.{ase additional pages as r necessary'. Wield Copy ❑Final Notes�
z �- �cn �-a=_n- , .cam:.-r.�__ _-es-,—.�,....�i—�.,=-'_`�":=:r_._•rc.._.,:xt-_ �' W"___ ..i.;�.,r...=:_?��: _.�Y.. ... ..� .._ ..a. �._... :-a-,:r:
Reviewer/Inspector Name l '7"
Reviewer/Inspector Signature: !?n Ct^" Date. 3 -O
12/12/03 Continued
1

IFacility Number:g -5-05-1Date of Inspection 13'JO-O j I
Required Records&Documents
21. Fail to have Certificate of Coverage&General Permit or other Permit readily available? 0 Yes [also
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie!WUP,checklists,design,maps, etc.) 0 Yes o
23. Does record keeping need improvement?If yes,check the appropriate box below. ❑Yes o
❑Waste Application 0 Freeboard 0 Waste Analysis 0 Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 0 Yes alio
25. Did the facility fail to have a actively certified operator in charge? 0 Yes yDNNo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/discharge,freeboard problems, over application) 0 Yes Ig-fQo
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? 0 Yes p No
28. Does facility require a follow-up visit by same agency? ❑Yes afro
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? El Yes B No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit?(If no,skip questions 31-35) ['es ❑No
31. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑Yes alio
32. Did the facility fail to install and maintain a rain gauge? 0 Yes aflo
33. Did the facility fail to conduct an annual sludge survey? acres ❑No
34. Did the facility fail to calibrate waste application equipment? EJ.Yes 0 No
35. Does record keeping for NPDES required forms need improvement? If yes,check the appropriate box below. 0 Yes laigo
❑Stocking Form 0 Crop Yield Form 0 Rainfall 0 Inspection After 1"Rain
❑ 120 Minute Inspections 0 Annual Certification Form
1134o violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit,
Addlttonal Comments"and/or=Drawrngs �' �'` ��r x _ e z1
•s
IT 33 cnd -*3L1 /11rbare ao'L S rcJ i'J 0 F f4 e t (
3 i&d9 e �C,t uPy it a e IC r'la kon 0 LI,Cjs /e /''[-a/;eh
e c,./9 P4fo .�� �t cb„it,/�4 / � y Ahs end cc /47)e 11 moody
FofM oo/(c 0aj
eaords )ecifr 5 e64
12/12/03

tis ;r= _ ` r;" r. Di`vi'sion of Willer Resources
FacilityNumber -III1.11 D Division of Soil and Water Conservation 1 ,. 1 r '
©Other Agency, w, 7,, . '4„,„.,,, ••'4,-
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: •Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: �' ry !'� Arrival Time:IO 4/s),I Departure Time:rS /l _ County: �er2rrfSOn r Region: rRO
Farm Name: 4 Owner Email:
Owner Name: 1'e ,i_•.+ 1 .PiçPhone:
Mailing Address:
Physical Address:
Pr
Facility Contact: _ Ja1*,45 Lard° Title: Phone:
Onsite Representative: N Integrator: eprvsiiroe
Certified Operator: 11 nti 5 I ()4'LJ1%
Certification Number: ggic6/
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
' Swine Capacity-- I ail WW1:: ii� ' ,Li.i. Design Current
� Dpi �y C �. r�r ��:;. try - p ty I , Safi _
.,.- ,.. . Pop ', , Wet Poul Capacity v �� Capacity ..Pop. ....
�E .� � orient , t� Design Current ti
Wean to Finish _ ,.
"; Layer `,: Dairy Cow
4 Wean to Feeder _ 'r;- Non-Layer 1'I Dairy Calf
0. Feeder to Finish ilk' i f' �` + I ( DairyHeifer
Farrow to Wean T'" �, gI�'ki, i `, ii, �, � , ,1 1, Design °S Current i'S�F Dry Cow
f'
' Farrow to Feeder . , :D . P,ou `'.Ca act .:'Por. Non-Dairy
q"- Farrow to Finish _''''? -- '; BeelStocker
Gilts •Non-La ers -- Beef Feeder
Boars II Pullets -- ,I Beef Brood Cow
11'
Other = • .,„ Turke Poults : '' v11,14
,I
,
I lOther I 1.1 Other -- i^I + : 6 °;.1..ii-, ,,
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation? 0 Yes [ No ❑ NA [] NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Others
a. Was the conveyance man-made? 0 Yes 0 No p NA 0 NE
b. Did the discharge reach waters of the State?(If yes,notify DWR) ❑ Yes ❑ No lip 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 DWR) ❑ Yes [] No 6 NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [p No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 41 No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2015 Continued

IFacilit'Number: _- 5)5 I IDate of Inspection: q/2�/ rr} I
Waste Collection &Treatment I� [[[
4. Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑ Yes In No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard(in):
Observed Freeboard(in): r
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 0 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 E No ❑ NA ❑ NE
8.Do any of the structures lack adequate markers as required by the permit? n 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 0 NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers,setbacks,or compliance alternatives that need ❑ Yes IZ No 0 NA ❑ NE
maintenance or improvement?
I I. Is there evidence of incorrect land application? if yes,check the appropriate box below. [] Yes I No ❑ NA ❑ NE
❑ Excessive Ponding 0 Hydraulic Overload 1:) Frozen Ground ❑ Heavy Metals(Cu,Zn,etc.
❑ PAN ❑ PAN> 10%or 10 lbs. ❑ Total Phosphorus n Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop
Window ❑ Evidence of Wind Drill ❑ Application Outside
eecoff Approved Area
12.Crop Type(s): CoaS4i t .r'ITli.t �s 427 .t SYtt G-1411%. 0ua'►d
13. Soil Type(s): WQ.8 / T
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No 0 NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes pa No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ONo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes [ No J NA ❑ NE
18. Is there a lack of properly operating waste application equipment? [] Yes No 0 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 DChecklists 0 Design 0 Maps ❑ Lease Agreements DOther:
21. Does record keeping need improvement? If yes,check the appropriate box below. n Yes kEl No 0 NA ❑ NE
❑Waste Application ❑Weekly Freeboard n Waste Analysis []Soil Analysis ❑Waste Transfers ❑Weather Code
0 Rainfall ❑Stocking []Crop Yield ❑120 Minute Inspections 0 Monthly and I" Rainfall Inspections ❑Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes p No ❑ NA C] NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes N,No ❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

jFacility Number: 5 I (Date of Inspection: y[21 f.7
24.Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ No [1 NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes,check DYes TI 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 tp3No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments(PLAT)certification? ❑ Yes 1p No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 0 Yes �j 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 n 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 [No ❑ NA ❑ NE
permit?(i.e.,discharge, freeboard problems,over-application)
3 I.Do subsurface tile drains exist at the facility?If yes,check the appropriate box below. 0 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 93 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes [ No 0 NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 119No ❑ NA ❑ NE
Uoe m ( oiqq_evrtngs fe facility #):Explain tiny YES'answers and/or any additional'recommendations oc.any other eom .`` 'ments r
uy to
better explain situations(use additional pages as necessary).:. i, i;Fi., . . "�
Reviewer/Inspector Name: I2D e --- o,,,Up Phone: (it() d 1�7
Reviewer/Inspector Signature: Ve Date: # Al
Page 3 of 3 4/2015

It
EtiWV Division`of Water Quality'.
Number �2 OO Division gof Soil 1 fb 0,9!.
0 ency.
•
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ®Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other q0 Denied Access
Date of Visit: CJ/74//4 ► Arrival Time: 1.; .•,/: Departure Time:105%in Countyc '1.��NJRegion:
Farm Name: PX . Owner Email:
Owner Name: Pit - Ict5Q �> Phone:
Mailing Address:
Physical Address:
Facility Contact: 1/4 -0/11--( La-----1, Title: Phone:
Onsite Representative: if Integrator: Rec4.4-
ppb/c
Certified Operator: , 4' ice+ S !1 rivk Certification Number: 9Y0
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
x }ahp,. # ��:%• `: w t"1 ' a+t- a 'r''''-m ,
' - , DesigbCurrent Ew `ice. Design Current - Design Current
1
` ' *� �pacity� -Pop., ' - '�Poultry�lCapacity� Po ;,� Cattle�� Capacity Pop.
..r -.,,. .y 1.W, W'1 - 4-1
-
- Wean to Finish Layer - Dairy Cow
Wean to Feeder 0111 Non-Layer Dairy Calf
i
Feeder to Finish - .{ Dairy Heiferl Farrow to Wean �C-�'� g' ji� `Des gn�Current Dry Cow -
Farrow to Feeder i , D D . P,oult _-_ Ca am Poi. .� Non-Dairy
Farrow to Finish ` '`x E -- Beef Stocker
Gills M. :.Non-La ers -- Beef Feeder
Boars .Pullets -- Beef Brood Cow
Other ' ,;,"+: . '-,'',-, Z''7,.'„7,5--';:-=
s' ;,
Turke Poul is -_ . •. � .
(Other U Other Mill_ -
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes p3 No 0 NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No NA ❑ NE
b. Did the discharge reach waters of the State?(If yes,notify DWQ) ❑ Yes ❑ No NA ❑ NE
c. What is the estimated volume that reached waters of the State(gallons)? _
d. Does the discharge bypass the waste management system?(If yes,notify DWQ) ❑ Yes No cig NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 0 No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes T3 No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facility Number: S 9.5 LDate of Inspection: c/,/6 I
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 pi
NA ❑ NE
Strre 1 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 p 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 Al 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 0 NA ❑ NE
8.Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA El NE
(not applicable to roofed pits,dry stacks,and/or wet stacks)
9.Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10.Are there any required buffers,setbacks,or compliance alternatives that need ❑ Yes ® No ❑ NA ❑ NE
maintenance or improvement? l�
11.Is there evidence of incorrect land application?If yes,check the appropriate box below. ❑ YesNo ❑ NA Il NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground 0 Heavy Metals(Cu,Zn,et')
❑ PAN ❑ PAN> 10%or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acce ble Crop indow ❑ Evidence of Wi 'ft ❑ Applicationn7Outside of Approved Area
12.Crop Type(s): ,� S5 ( Cm-L-0 D •
13. Soil Tes : Wag
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 [41 No ❑ NA ❑ NE
acres determination?
17.Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE
18.Is there a lack of properly operating waste application equipment? ❑ Yes I 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 ra 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 ip No ❑ NA ❑ NE
❑Waste Application ❑Weekly Freeboard ❑Waste Analysis ❑Soil Analysis ❑Waste Transfers ❑Weather Code
❑Rainfall []Stocking ❑Crop Yield ❑120 Minute Inspections ❑Monthly and 1" Rainfall Inspections ❑Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

[Facility Number:- S I [Date of Inspection: q/Z$l/b
24.Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ki 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 pi No ❑ NA ❑ NE
27.Did the facility fail to secure a phosphorus loss assessments(PLAT)certification? 0 Yes M No ❑ NA El NE
Other Issues •
28.Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes y.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 Ea 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 [g No ❑ NA El 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 I 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 3 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes its No ❑ NA ❑ NE
34.Does the facility require a follow-up visit by the same agency? ❑ Yes 173No 0 NA ❑ NE
Comments(refer toquestion# • Explain anyYES answers'and/or anyadditional recommendations or anyother-comsnents:" 'y
)• P _
Use-drawings of facility to better explain situations(use additional pages as necessary).
Reviewer/Inspector Name: 0 M Phone:
Reviewer/Inspector Signature: , � i Date: /7-06
Page 3 of 3 2/4/2011

I/Lff!&
i Division of Water Resources
Number S Z o SSS QD Division of Soil : n Conservation
°O Other Agency -
Type of Visit: •Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: •Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: f//?> i f r Arrival Time: p �, Departure Time:r County: -rbrJ Region: /f
Farm Name: Owner Email:
Owner Name: Pir'P.S- C� /-,.4-3- Phone:
Mailing Address: `f
Physical Address:
Facility Contact: S (r-.� Title: Phone:
tf
Onsite Representative: Integrator: P►l54
Certified Operator: p)V% %i f /1-4P it) Certification Number: 9$$613
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current D•'is I Current D is I
Swine "Eapacity Pop. ._ Poultry _Capacity `'Pop. = Capacity Pop.
Wean to Finish -- -- Dai Cow _—
Wean to Feeder -- •Non-La er -- n•Da- Calf --
Feeder to Finish — Da- Heifer --
Farrow to Wean MEM :$ D I Current D Cow --
MI Farrow to Feeder -- D , P,oult, Ea'aci Ito 1 •Non-Dai
•Farrow to Finish -- ,,.EDEEMEMM-- •Beef Stocker --
ill Gifts --_ •Non-La ers -- •Beef Feeder --
Boars -- •Pullets -- IN Beef Brood Cow
MBEEMIM—_
Other Turke Poults --
I lOther •Other
Discharges and Stream Impacts
I.Is any discharge observed from any part of the operation? ❑ Yes V No ❑ NA 0 NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes 0 No �i NA 0 NE
b. Did the discharge reach waters of the State?(If yes,notify DWR) ❑ Yes ❑ No 110 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 DWR) ❑ Yes ❑ No NA D NE
2.Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA D NE
3.Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 171 No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2014 Continued

(Facility Number: _ �� - 50 I Date of ins ection: • !
Waste Collection& Treatment
4.Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑ Yes F] No [] NA ❑ NE
a.If yes, is waste level into the structural freeboard? ❑ Yes ❑ No p NA ❑NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I -
Spillway?:
-
Designed Freeboard(in):
Observed Freeboard(in): 30 y
5.Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes I] 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 n No ❑ NA ❑ NE
waste management or closure plan? T'�
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? 0 Yes ka No ❑ NA ❑ NE
S.Do any of the structures lack adequate markers as required by the permit? ❑ Yes rglNo ❑ 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 El NE
maintenance or improvement?
Waste Application
10.Are there any required buffers,setbacks,or compliance alternatives that need ❑ Yes MI No ❑ NA D NE
maintenance or improvement?
11.Is there evidence of incorrect land application?If yes,check the appropriate box below. El Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload 0 Frozen Ground ❑ Heavy Metals(Cu,Zn,etc.)
El PAN ❑ PAN> 10%or 10 lbs. 0 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): 5 t .? Crorg Oa-A c5;%"" r a*,171
13. Soil Type(s): a.t.�
14.Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA El NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ip No ❑ NA El 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? El Yes pgNo ❑ 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? D YesCI No ❑ NA ❑ NE
20.Does the facility fail to have all components of the CAWMP readily available?If yes,check ❑ Yes 0] No 0 NA ❑ NE
the appropriate box_
❑W UP ['Checklists ❑Design ❑Maps p Lease Agreements ❑Other:
21.Does record keeping need improvement?If yes,check the appropriate box below. ❑ Yes No D NA D NE
❑Waste Application ❑Weekly Freeboard El Waste Analysis ❑Soil Analysis ❑Waste Transfers ❑Weather Code
D Rainfall ❑Stocking ❑Crop Yield ❑120 Minute Inspections El Monthly and 1"Rainfall Inspections ❑Sludge Survey
22.Did the facility fail to install and maintain a rain gauge? ❑ Yes 71 No ❑ NA 0 NE
23.If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0 No D NA ❑ NE
Page 2 of 3 2/4/2014 Continued

Facili Number: • - SSS IDate 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 al No ❑ NA ❑ NE
27.Did the facility fail to secure a phosphorus loss assessments(PLAT)certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28.Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 14 No [3 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 0 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 Cg 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
❑ Application Field ❑ Lagoon/Storage Pond ❑Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes NI No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 0 Yes lip No ❑ NA ❑ NE
34.Does the facility require a follow-up visit by the same agency? 0 Yes No ❑ NA ❑ NE
Comments(refer ef
er to question#): Explain any YES answers andior any additional recommendations or,-any.other comments:"
Use_d awings of facility to better explain situations(use'ridditional'pages as necess
•
Reviewer/Inspector Name: -64-244-0144/e- Phone: q/D433-33tiO
Reviewer/Inspector Signature: fir'" K 3� - Date: ////7/
Page 3 of 3 2/4/2014

R rfk 1136112
- r- •Diiis"io of Water Quality
'Y0 MI O Division of Soil CM Water Conservation
°O Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: •Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1.7!j 2 I Arrival Time: /0;00.2i*, Departure Time: //;a airn County: Region:
Farm Name: 12)C---g Owner Email:
Owner Name: PCS( _ 1- ty .tS3 i Ci Phone:
Mailing Address:
Physical Address:
Facility Contact: aatil �" `f Title: Phone:
Onsite Representative: Ccairr4 S Latil Integrator: PSS` y_
Certified Operator: Cenni S Ai ) Certification Number: 9 00 �
1
Back-up Operator: et,..‘,.., Certification Number:
Location of Farm: Latitude: Longitude:
l' _-,--t`* -•;,'4,
Design _Current- -'"ai - ,24
, 4' DesignZ. _ - s- Design Gurrent
6413 '• - z`-'4.1_ , Capac"ii Pop. ;Wet�PouItry d Capacity , F f Cap .; Pop.
•Wean to Finish --1 ElErall=-- II Dai Cow
•Wean to Feeder -- ' •Non-Laver -- II Dai Calf --
•Feeder to Finish _- : ' .4 "-` •Dai Heifer
1i Farrow to Wean �l MIll D-' I_ i '.Current •D Cow
•Farrow to Feeder =MI- D Poult sem-Ca'ad go m. •Non-Dai ME
El Farrow to Finish -- MIESEMEIMIHM=1_ •Beef Stocker
•Gilts -_ •Non-La ers -- :•Beef Feeder _-
II Boars -- .IN Pullets -- •Beef Brood Cow -- -
11161M12 --
Other - ' El Turke Poults
I 'Other I 1 ■Other --
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes Ft No 0 NA 0 NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No Oj NA 0 NE
b. Did the discharge reach waters of the State?(If yes,notify DWQ) ❑ Yes ❑ No cz 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 vi NA ❑ NE
2.Is there evidence of a past discharge from any part of the operation? ❑ Yes IN No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters 0 Yes ja` No El NA 0 NE
of the State other than from a discharge?
Page 1 of 3 2/4/2011 Continued

IFacrfiity Number: 31- - $ I 'Date of Inspection: q/Z' j-7_
Waste Collection&Treatment r f
4.Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑ Yes pi No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes IOU No cEl NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard(in):
Observed Freeboard(in): 3
tl
5.Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes IX2 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 IS 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 ❑ 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 Application
10.Are there any required buffers, setbacks,or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11.Is there evidence of incorrect land application?If yes,check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground 0 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 ❑ Evidenc of Wind Driftsc ❑ Applicationp (�� Outside of Approved Area
12.Crop Type(s): f„Yu 4C s 1 �- t 6L CJ42
13. Soil Type(s): 1,0a-}3
14.Do the receiving crops differ from those designated in the CAWMP? ❑ Yes fa No ❑ NA ❑ NE
15.Does the receiving crop and/or land application site need improvement? 0 Yes VI No ❑ NA ❑ NE
16.Did the facility fail to secure and/or operate per the irrigation design or wettable [] Yes 11 No ❑ NA ❑ NE
acres determination?
17.Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE
18.Is there a lack of properly operating waste application equipment? ❑ Yes ® 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 El Checklists D Design []Maps ❑ Lease Agreements ['Other:
21.Does record keeping need improvement?If yes,check the appropriate box below. 0 Yes JJ No ❑ NA ❑ NE
❑Waste Application ❑Weekly Freeboard ❑Waste Analysis ❑Soil Analysis ❑Waste Transfers ❑Weather Code
❑Rainfall 0 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 qg No ❑ NA ❑ NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Jo No ❑ NA 0 NE
Page 2 of 3 2/4/2011 Continued

FacE 'ty Number: �.,- 5 Date of Inspection: 27 i Z
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.
0 Failure to complete annual sludge survey ['Failure to develop a POA for sludge levels
❑Non-compliant sludge levels in any lagoon
List structure(s)and date of first survey indicating non-compliance:
26.Did the facility fail to 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 ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ® No El NA El NE
and report mortality rates that were higher than normal? T
29.At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes Vel 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 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 rgl No ❑ NA ❑ NE
0 Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 0 Yes ® No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? El Yes ® No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 111 No ❑ NA 0 NE
Comments(refer to question#): Explain any YES.answers:and/or any additional recommendations or any other,comments= "F ° ;1
Use drawings of facility to better explain situations(use additional pages as necessary).:
Reviewer/Inspector Name: % -1--p449 0a Phone: go-Li-33-33w
Reviewer/Inspector Signature: TLi ' /t Date: 91211 11-
Page
2Page 3 of 3 2/4/2011

R7 t5 -7\-1-14 /s 1k
'Y 'AI -'s: ': _:: Division of Water Resources
Facility,Number 5C ©Division of Soil Water Conservation
`- F w 0Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: r Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: L 017-nyl Arrival Time: n ' Departure Time:N' Q, County:5 lt,4 i/ Region.'
Farm Name: yp •-•'' S Owner Email: _
Owner Name: (e 3-L ECL(rn'S ___‘..CC
Phone:
Mailing Address:
Physical Address: _
Facility Contact: JQ_kNNe__ loY&\-- Title: Phone:�
Onsite Representative: �a � I .Ilw[] Integrator: k >TeS
Certified Operator: P,_,,/iii 4111.N. Certification Number: gSS6l
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
.;,.`.7.„-:., Design ',Current `4 Current D. Current
D
Swine ,q, '-'-*Capacity •Pop Poultry Capacity i Capacity Pop.
Wean to Finish r ''' .11===-- - •Da' Cow-
Wean to Feeder •Non-La er --' •Da' Calf
Feeder to Finish "`;' - •Da' Heifer --
'- }a Farrow to Wean ~[ ,,p.. gyz- Design i . • a Cow --
Farrow to Feeder D. Poul' Ca+aciPo •Non-Da' --
zs Farrow to Finish • y.ii •Beef Stocker -
_
Gilts Non-La ers ; . Beef Feeder
Boars •Pullets 1111 C. •Beef Brood Cow --
-- ' . .. I y Y 11 5x$. .,
Other& „ -. , r •1111
Turke Poults -- ,, _
'1 !Other 1 1 ,IN Other IIMIIM
Discharues and Stream Impacts
1.Is any discharge observed from any part of the operation? ❑ Yes [)No ❑ NA 0 NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑No ®NA 0 NE
b. Did the discharge reach waters of the State?(If yes,notify DWR) ❑ Yes 0 No ®NA 0 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 RI NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? n Yes W No n NA 0 NE
3.Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes n No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2014 Continued

1Facilit)Number: $ - 505 Date of Inspection: , 7Z/'( I
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 ® NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: i _ -
Spillway?:
Designed Freeboard(in):
Observed Freeboard(in): 3d "
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 n 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 0 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 Application
10.Are there any required buffers,setbacks,or compliance alternatives that need El Yes ® No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application?If yes,check the appropriate box below. ❑ Yes koJ No ❑ NA ❑ NE
0 Excessive Ponding p 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): 5L1 . rMtuc+a_.C�vf .s ` c SM f+c�1 1. - -
13. Soil Type(s):
14.Do the receiving crops differ from those designated in the CAWMP? ❑ Yes El)No n NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No 0 NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 0.No 0 NA ❑ NE
acres determination?
17.Does the facility lack adequate acreage for land application? ❑ Yes ® No [ J NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 0 No 0 NA ❑ NE
Required Records& Documents
19. Did the facility fail to have the Certificate of Coverage&Permit readily available? ❑ Yes ® No ❑ NA 0 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 El 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 0 Weather Code
❑Rainfall ❑Stocking ❑Crop Yield D 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 INo ❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

Facili Number: $ - 50 Date of Inspection: L2/7ir
24. Did the facility fail to calibrate waste application equipment as required by the permit? I ❑ 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 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments(PLAT)certification? ❑ Yes 0 No ❑ 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 2 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 ® No ❑ NA El 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 No 0 NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes ® No ❑ NA El NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ® No ❑ NA ❑ NE
Comments(refer to question if):Explain any YESianswers and/or any.:additional recommendations orjany other comments .
We,dr ngso.diitivingslof facility to better explain situations..(nse additional pages as necessary). : _4 W1a,
Reviewer/Inspector Name: C41 Phone: 7'10 J3-,
II
Reviewer/Inspector Signature: ���� r - Date: l912/is(
Page 3 of 3 2/4/2014

i DfVigion of Water Quality .
t a i
, ,,m,.-m.
!1 0 ©Division of Soil Conservation
d Other Agency
Type of Visit: i Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: •Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I q-iq-i, Arrival Time: O'I Departure Time:L ave.. County: , fVRegion: 649
Farm Name: P)c, 3 Owner Email:
Owner Name: 12,e Si Phone:
Mailing Address:
Physical Address:
Facility Contact: grilYkaof Title: Phone:
Onsite Representative: s f .7 Integrator:P g ePre��
Certified Operator: )e410151411/017Z
p14/lti Certification Number: 968 (j��
Back-up Operator: r Certification Number:
Location of Farm: Latitude: Longitude:
Destgn` Current D • I. ! Design Current
�t, D Captc� Pop % Poultry Capacity Pop Capacity Pop.
0
Wean to Finish - "M,: --k Dairy Cow
Wean to Feeder a•Non La Cr -- 4: _Dairy Calf
Feeder to Finish „ Dairy Heifer
'� Farrow to Feeder Farrow to Wean 7,ja r1gL Design Current Dry Cow
-
- Non-Dairy
�D . P,oul Ca�aci _;Po
Farrow to Finish Beef Stocker
Gilts Non-La ers , Beef Feeder
Boars II Pullets -- :rte Beef Brood Cow
.--* mss : E --
Other !” - . 14 •Turke Poults --w_
Other Other -_." a
.,
� _
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? 0 Yes 1-41No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? 0 Yes ❑ No VI NA ❑ NE
b. Did the discharge reach waters of the State'?(If yes,notify DWQ) ❑ Yes ❑ No ITO 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 IV NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ YesNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters E] Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2011 Continued

Facility Nt mber: 01�� LDate of Inspection: 94,1-1/
Waste Collection&Treatment
4.Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑ YesNo ❑ NA ❑ NE
a. If yes,is waste level into the structural freeboard? ❑ Yes NonipNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Struen6 6
Identifier: 1 -
Spillway?:
Designed Freeboard(in):
Observed Freeboard(in):
5.Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 11 No ❑ NA ❑ NE
(i.e.,large trees,severe erosion,seepage,etc.) TT
6.Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes [i►] 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 ❑ 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 0 NE
maintenance or improvement?
Waste Application
10.Are there any required buffers,setbacks,or compliance alternatives that need ❑ Yes I'No NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes {N No El NA ❑ NE
O Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals(Cu,Zn,etc.)
❑ PAN 0 PAN> 10%or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window _d❑ Evidence of Wind Drift ❑/ �Application Outside of Approved Area
12. Crop Type(s): .i1&►inlb c S . Ckat �,'ue ^k'
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 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes a No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes EZI No 0 NA ❑ NE
Required Records&Documents
19. Did the facility fail to have the Certificate of Coverage&Permit readily available? ❑ Yes [ No 0 NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check n 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 Ep No ❑ NA ❑ NE
❑Waste Application ❑Weekly Freeboard ❑Waste Analysis ❑Soil Analysis ❑Waste Transfers 0 Weather Code
❑Rainfall ❑Stocking ❑Crop Yield ❑120 Minute Inspections El 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? El Yes No ❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

IFacility Number: Pia„.-. 15- T Date of Inspection: 9-H11 1
24.Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No ❑ NA 0 NE
25.Is the facility out of compliance with permit conditions related to sludge? If yes,check ❑ Yes Fl 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 cgi No ❑ NA ❑ NE
27.Did the facility fail to secure a phosphorus loss assessments(PLAT)certification? ,❑ Yes �; o NA ❑ NE
Other Issues /
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 0 Yes T`�" 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 b 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 51 No n 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 p No ❑ NA ❑ NE
p Application Field 0 Lagoon/Storage Pond p Other:
32.Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ca No 0 NA ❑ NE
33.Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes No 0 NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes X No ❑ NA ❑ NE
Comments(refer to question#):Explain any YES answers and/or any additional recommendatrons,orany other•comments Y
Use:drawings`of facility tWbetter explain situations(use additional pages as necessary). " ,,.1 t 1,� , ,�, ; `
Pec - -cc rT" ) 9,11-((
.
` c0—a,u� 9-(q-//
Ilk
Reviewer/Inspector Name: f?--C6214 MQ.je Phone: 1I0"11.3 39cV
Reviewer/Inspector Signature: 149
(-4Date: l't✓y-a
Page 3 of 3 2/4/2011

.1
Division of Water Quality
gbgEWNI I b• IrMI=1 5o5 O Division of Soiln-rMitvGonservation
o Other Agency , J
Type of Visit •Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit • Routine 0 Complaint 0 Follow up 0 Referral Q Emergency 0 Other ❑-Denied Access
Date of Visit: I [0 1 fp[0 Arrival Time: oZ*f i Departure Time: 40.';co County: •541/1P-50/0 Region:
Region:
Farm Name: X D • �-' Owner Email:
Owner Name: Precy Y"cu-rykS J C, Phone:
Mailing Address:
Physical Address:
Facility Contact: fgarrti Pa Title: Phone No:
Onsite Representative: 0716-0_ 6 ' ') Integrator: Pr-e.S- ye-_
Certified Operator: h I'S Ole hl.t i _ Operator Certification Number: / 06/5-
Back-up
6 5-
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: e il
Longitude: nen' n
A.
Design igtaMi Design Gnrrent Design O Current
Swine Capacity Population MIPoultrT C*apacity Population &Mb Capacity Population
❑ Wean to Finish -- ❑La er -- ❑Dai Cow
❑ Wean to Feeder ❑Non-La er -- ❑Dai Calf
❑ Feeder to Finish -- - ❑Dai Heifer
rii Farrow to Wean JrsZCVPoultry 1=1D Cow
i Farrow to Feeder-=IN ❑Non-DaiMEI
❑ Farrow to Finish ❑ La ers MEM ❑Beef Stocker
E l Gilts --� ❑Non-La ers -- ❑Beef Feeder
❑ Pullets
❑Boars --: == ❑Beef Brood Co
❑Turke s
Other ❑Turke Poults--
I❑Other ❑Other -- Number CMCM:15aZia I f
Discharges& Stream Impacts
I. Is any discharge observed from any part of the operation? ❑Yes [p No ❑NA ❑NE
Discharge originated at: ❑ Structure ❑ Application Field ❑Other
a. Was the conveyance man-made? ❑Yes ❑No 173NA ❑NE
b. Did the discharge reach waters of the State?(If yes,notify DWQ) 0 Yes 0 No p NA ❑NE
c. What is the estimated volume that reached waters of the State(gallons)? 1
d. Does discharge bypass the waste management system?(If yes, notify DWQ) ❑Yes ❑No ,N NA ❑NE
2. Is there evidence of a past discharge from any part of the operation? 0 Yes al No ❑NA ❑NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State 0 Yes Wo 0 NA ❑NE
other than from a discharge?
Page 1 of 3 12/28/04 Continued

Facility'Number: *—eje551 Date of Inspection ]0((l f D
Waste Collection& Treatment l[
4. Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? 0 Yes [ri/No ❑NA CINE
a. If yes,is waste level into the structural freeboard? ElYes CINo NA ❑NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 tructure 6
Identifier: i
Spillway?:
Designed Freeboard(in):
Observed Freeboard(in): 3IP(
5. Are there any immediate threats to the integrity of any of the structures observed? 0 Yes ®No ❑NA CINE
(ie/large trees, severe erosion,seepage,etc.) t
6. Are there structures on-site which are not properly addressed and/or managed ❑Yes (p,No 0 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 0 No ❑NA ❑NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑Yes y3No 0 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 ISNo ❑NA 0 NE
maintenance or improvement?
Waste Application
10. Are there any required buffers,setbacks,or compliance alternatives that need 0 Yes pij No ❑NA ❑NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑Yes (a No ❑NA ❑NE
0 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 zL{ Nf�Acceptable Crop Window ❑ Evidence of Wind Drift CI Application Outside of Area
12. Crop type(s) �TG' 4 &eel&S ) Spi. O&&iccder
13. Soil type(s) _ (A Vk
14. Do the receiving cropsdifferfrom those designated in the CAWMP? 0 Yes r3 No ❑NA 0 NE
15. Does the receiving crop and/or land application site need improvement? 0 Yes tNo ❑NA D NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? ❑Yes qi No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? 0 Yes p No ❑NA ❑NE
18. Is there a lack of properly operating waste application equipment? 0 Yes li No ❑NA ❑NE
Comments(refer to,question.#) Explain any YES answers and/or any recommendations"or any other comments ,
.
Use drawings of faci ity to better explain situations (use addalitto� pages as-necessary) ?ti W,„ m1W
r
V
.. .. ., h .i4�
5. &1�.,k _ '9 J' I�' . .I'i
VION
J
Reviewer/Inspector Name F-74319.e� • 34i.f s Phone s 0 ti'33e0
Reviewer/Inspector Signature: 1 Date: I Off r
Page 2 of 3 12/28/04 Continued

•
TFacility Number: <- Date of Inspection ( 17
Required Records& Documents
19. Did the facility fail to have Certificate of Coverage&Permit readily available? 0 Yes fr No ❑NA ❑NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes,check ❑Yes 0 No ❑NA ❑NE
the appropriate box. ❑WUP 0 Checklists El Design ❑Maps ❑Other
21. Does record keeping need improvement?If yes,check the appropriate box below. ❑Yes No ❑NA ❑NE
❑ Waste Application ❑Weekly Freeboard El Waste Analysis ❑Soil Analysis ❑Waste Transfers ❑Annual Certification
0 Rainfall ❑Stocking ❑Crop Yield El 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑Yes pi No ❑NA ❑NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑Yes 0 No Oa NA ❑NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? El Yes 93INo 0 NA ❑NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑Yes T No ❑NA ❑NE
26. Did the facility fail to have an actively certified operator in charge? El Yes No ❑NA ❑NE
27. Did the facility fail to secure a phosphorus loss assessment(PLAT)certification? ❑Yes Eitallo El NA ❑NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? El Yes [,No El NA 0 NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document El Yes [p No El NA 0 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 02 No 0 NA ❑NE
If yes,contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑Yes ®No ❑NA ❑NE
General Permit? (ie/discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑Yes Et No ❑NA El NE
33. Does facility require a follow-up visit by same agency? El Yes re No ❑NA ❑NE
Additional-Com-mints and/or Drawings:
Page 3 of 3 12/28/04

Division o "ater Quality
NumberJ, �� o Division of Soil CEIDM2P Conservation
_ o Other 45.14y
Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 61/210e1 Arrival Time:I 0.1.09d, j/9d, Departure Time: I I =r z"- County: iiPft/1/Region: FAD
Farm Name: PX -6 Owner Email:
Owner Name: ?r'e5 � Fcurnis J ' ' Phone:
Mailing Address:
Physical Address: ,,
Facility Contact: r'Q` �Q1 A'e/'Y Title: Phone No:
Onsite Representative: (-o ° Integrator: Pre54a,--
Certified Operator: Per wl 1 5 >-Ipn n Operator Certification Number: (7114: 6/5.—
Back-up
/cBack-up Operator: Back-up Certification Number:
Location of Farm: Latitude: n a =1 n" Longitude: n°FT n
Design rDesign Current • Design Current
ID Wean "_ Finish C apacity Population La Poultry Capacity Population Capacity Population
-- -- ❑Dai Cow
❑Wean to Feeder = ❑Non-La er -- ❑Dai Calf
❑ Feeder to Finish -- ❑Dai Heifer
Farrow to Wean Poultry' • ❑D Cow --
.. I. Farrow to Feeder-- ❑Non-Dai --_
❑ Farrow to Finish ❑La ers --
-- "
0 Beef Stocker
❑Non-La ers --
Gilts —_=. ❑pullets -- 0 Beef Feeder --
❑ Boars -- . 0 Beef Brood Co =111.-. ❑Turke s
Otherµ .n ❑Turke Poults
❑Other —_ :_ ❑Other -- NumberC Structures: •,
Discharges& Stream Impacts
1. Is any discharge observed from any part of the operation? ❑Yes No ❑NA ❑NE
Discharge originated at: ❑Structure ❑Application Field 0 Other
a. Was the conveyance man-made? ❑Yes 0 No .qa NA ❑NE
b. Did the discharge reach waters of the State?(If yes,notify DWQ) ❑Yes 0 No 0 NA ❑NE
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) ❑Yes 0 No NINA ❑NE
2. Is there evidence of a past discharge from any part of the operation? ❑Yes ( No ❑NA ❑NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State 0 Yes igNo ❑NA 0 NE
other than from a discharge?
12/28/04 Continued

Facility Number: � 1.-505" Dale of Inspection I
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 ]g NA ❑NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure
Identifier: I
Spillway?:
Designed Freeboard(in)_
Observed Freeboard(in). `f e ie
5. Are there any immediate threats to the integrity of any of the structures observed? 0 Yes No C]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 1412No ❑NA 0 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 [ No ❑NA ❑NE
maintenance or improvement?
Waste Application
10. Are there any required buffers,setbacks,or compliance alternatives that need 0 Yeso ❑NA 0 NE
maintenance/improvement?
II. Is there evidence of incorrect application? If yes,check the appropriate box below. 0 Yes 0/No ❑NA ❑NE
❑Excessive Ponding ❑Hydraulic Overload ❑Frozen Ground ❑Heavy Metals(Cu,Zn,etc.)
❑PAN 0 PAN> 10%or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
❑Outside of Acceptable Crop Window ❑Evi ence of Wind Drift 0 Application Outside of Area
12. Crop type(s) 00450 Pinwilda -"5 ) J�111 n
13. Soil type(s) tt,120i?.til\
14. Do the receiving crops differ from those designated in the CAWMP? ❑Yes It-No ❑NA ❑NE
15. Does the receiving crop and/or land application site need improvement? ❑Yes Erio ❑NA ❑NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'❑Yes lJ No ❑NA ❑NE
17. Does the facility lack adequate acreage for land application? 0 Yes ll�/J NNo ❑NA ❑NE
18. Is there a lack of properly operating waste application equipment? ❑Yes [2No ❑NA ❑NE
Comments(refer to question#): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations.(use additional pages as necessary):
•
Reviewer/Inspector Name 3) Phone: q,o- 3j -3,
Reviewer/Inspector Signature: Date: Q �
12/28/04 Continued

•
•
Facility Number: fig--5-051 Date of Inspection r _ _
Required Records& Documents f
19. Did the facility fail to have Certificate of Coverage&Permit readily available? ❑Yes +h No ❑NA ❑NE
20. Does the facility fail to have all components of the CAWMP readily available?If yes,check 0 Yes ( 'No 0 NA ❑NE
the appropriate box. ❑WUP ❑Checklists 0 Design ❑Maps ❑Other
21. Does record keeping need improvement?If yes,check the appropriate box below. 0 Yes [ No ❑NA ❑NE
❑ Waste Application ❑Weekly Freeboard ❑Waste Analysis ❑ Soil Analysis 0 Waste Transfers ❑Annual Certification
❑Rainfall ❑Stocking ❑Crop Yield 0 120 Minute Inspections ❑Monthly and 1"Rain Inspections_�//❑Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑Yes L✓J NNo ❑NA ❑NE
-23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑Yes [12<lo ❑NA ❑NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes 12(No ❑NA ❑NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑Yes [✓'No 0 NA 0 NE
26. Did the facility fail to have an actively certified operator in charge? 0 Yes �( 'No ❑NA ❑NE
27. Did the facility fail to secure a phosphorus loss assessment(PLAT)certification? ID Yes to ❑NA ❑NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 0 Yes ErNo 0 NA 0 NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document 0 Yes [T/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? 0 Yes E No 0 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 I/No 0 NA ❑NE
General Permit? (id discharge,freeboard problems,over application) ,,��//
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 0 Yes EI NNo 0 NA 0 NE
33. Does facility require a follow-up visit by same agency? 0 Yes I No ❑NA ❑NE
'Ad[4tionCo'mm�end1D swings ;'
12/28/04

�D�vivision ofeWater uahty, " t �r "
�Farutty NrIm6e ,4'--41;a '''''''''-'4:::2-45—'
� � pDs_-, eofand•Warerery
Consation -
Other'Agency. ¢ 4.4,_ . _
Type of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for VisityQ•Routine 0 Complaint Q Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: :170 1# Arrival Time: 6,%co,w Departure Time: 1 6' County: 5/9/V4910r Region: P`/('""
Farm Name: PX —S Owner Email:
Owner Name: PSS- Y&.c C. Phone:
Mailing Address: ���JJJ
Physical Address: 1
Facility Contact: gatTar a Title: Phone No:
Onsite Representative: Integrator: 17` `� + "y '�
p
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: I° ' CI. Longitude: n° n n u
A.
Design Current Design Current Design Current:
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
❑Wean to Finish ❑ Layer __ ❑ Dairy Cow
❑Wean to Feeder 0 Non-Layer ❑ Dairy Calf
❑ Feeder to Finish ❑ Dairy Heifer
%Farrow to Wean 70, '7 j Dry Poultry . ❑ Dry Cow '
❑Farrow to Feeder — - ❑Non-Dairy
IDCIFarrow to Finish ❑ Layers ,I
Beef ef Stocker
❑Gilts ❑ Non-Layers
ID Pullets
ID Beef Feeder
0 Boars - ❑Beef Brood Cow
❑Turkeys
Other
❑Turkey Points '6
(❑Other I ❑Other Number of Structures: I ,
Discharges& Stream Impacts
1. Is any discharge observed from any part of the operation? ❑Yes ONo 0 NA ❑NE
Discharge originated at: ❑ Structure ❑Application Field 0 Other
a. Was the conveyance man-made? 0 Yes ❑No p NA 0 NE
b. Did the discharge reach waters of the State?(If yes,notify DWQ) ❑Yes ❑No 0 NA ❑NE
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) 0 Yes ❑No ,NA 0 NE
2. Is there evidence of a past discharge from any part of the operation? El Yes No ❑NA ❑NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑Yes No ❑NA ❑NE
other than from a discharge?
Page 1 of 3 12/28/04 Continued

Facility Number: els" Date of Inspection
Waste Collection &Treatment
4. is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? 0 Yes xi No 0 NA ❑NE
a. If yes,is waste level into the structural freeboard? 0 Yes 0 No IONA ❑NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: i
Spillway?:
Designed Freeboard(in):
Observed Freeboard(in): 514
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes PNo ❑NA ❑NE
(ie/large trees,severe erosion,seepage,etc.)
6. Are there structures on-site which are not properly addressed and/or managed 0 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? 0 Yes pNo ❑NA 0 NE
8. Do any of the stuctures lack adequate markers as required by the permit? 0 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 0 Yes fgNo 0 NA 0 NE
maintenance or improvement?
Waste Application
10. Are there any required buffers,setbacks,or compliance alternatives that need 0 Yes L No ❑NA ❑NE
maintenance/improvement?
Ii. Is there evidence of incorrect application? If yes,check the appropriate box below. ❑Yes 0 No ❑NA ❑NE
❑ Excessive Ponding 0 Hydraulic Overload ❑Frozen Ground ❑Heavy Metals(Cu,Zn,etc.)
❑ PAN 0 PAN> 10%or 10 lbs ❑Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
❑Outside of Acceptable Crop Window ❑Evidence of Wind Drill 0 Application Outside of Area
12. Crop type(s) :t _ s . S c , l f/ ZA OVIVQ24(
13. Soil type(s) ttiagra - (,t1Gd
14. Do the receiving crops✓✓ differ from those designated in the CAWMP? 0 Yes DS No 0 NA 0 NE
15. Does the receiving crop and/or land application site need improvement? 0 Yes No ❑NA 0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑Yes tA No ❑NA ❑NE
17. Does the facility lack adequate acreage for land application? 0 Yes ®No ❑NA ❑NE
18. Is there a lack of properly operating waste application equipment? 0 Yes INo 0 NA 0 NE
�a.. . ..
Comments(efer to queshon�#)' IEttpiartt any YES�;an vers and/or�any recamtnendahons,nr
Use drawings iiffacrli to bene eegplatn situation`s (u e,addttional pages2as neze 6F Y'-
Reviewer/Inspector Name Phone:( 35'. 3c0
Reviewer/inspector Signature: Date: 2"O3
Page 2 of 3 12/28/04 Continued

•
Facility Number: E369.7 — Date of Inspection S Zi i
Required Records& Documents
19. Did the facility fail to have Certificate of Coverage& Permit readily available? ❑Yes kg,No 0 NA ❑NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes,check 0 Yes 5.No ❑NA ❑NE
the appropirate box.
❑WUP .❑Checklists ❑Design 0 Maps ❑Other
21. Does record keeping need improvement?If yes,check the appropriate box below. ❑Yes 1 No 0 NA ❑NE
❑Waste Application ❑Weekly Freeboard 0 Waste Analysis ❑Soil Analysis ❑Waste Transfers ❑Annual Certification
❑ Rainfall 0 Stocking ❑Crop Yield ❑ 120 Minute Inspections ❑Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? 0 Yes rp No 0 NA ❑NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑Yes 5 No ❑NA ❑NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes No ❑NA ❑NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑Yes M No ❑NA 0 NE
26. Did the facility fail to have an actively certified operator in charge? ❑Yes ®No ❑NA 0 NE
27. Did the facility fail to secure a phosphorus loss assessment(PLAT)certification? ❑Yes El No ❑NA ❑NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 0 Yes Cig No ❑NA ❑NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑Yes gi 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 rEl No ❑NA ❑NE
If yes,contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑Yes tEiNo ❑NA 0 NE
General Permit? (ie/discharge,freeboard problems,over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑Yes En No ❑NA ❑NE
33. Does facility require a follow-up visit by same agency? ❑Yes ]No ❑NA ❑NE
A'dditional:Comments`and/or Drawings ' `r i'a f C '*ti u: ` � �f j
T
Page 3 of 3 12/28/04

4 Division of Water Quality 6-0)13,-
. Facility Number ''--1.5.: . 0 Division of Soil and Water Conservation
y � ' O Other Agency l[o ci
(Z
Type of Visit compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit '*Routine 0 Complaintrr0 Follow up 0 Referral 0 Emergency 0 Other El Denied Access
•
Date of Visit: j 9 Arrival Time: G at) Departure Time: I 2.2.0 1 County: Region: _.
Farm Name: X C�r� _ Owner Email:
T
Owner Name: res"` i`t--O4 Yne4 Phone:
Mailing Address:
Physical Address: NI
Facility Contact:CP6Lu7'� Title: Phone No:
Onsite Representative: Integrator: R.C,64, li,t
1
Certified Operator: Operator Certification Number: _
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: =°
=I' 011
Longitude: 1-1° u
A.
w
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
0 Wean to Finish I ❑Layer ❑ Dairy Cow
❑Wean to Feeder 1I 0 Non-Layer _ 1:1 Dairy Calf I I. I
El Feeder to Finish ❑Dairy Heifer I
"s farrow to Wean Z1 Z `7 Dry Poultry
0 Dry Cow
❑ Farrow to Feeder ❑ Non-Dairy
❑ Layers
❑Farrow to Finish ❑Beef Stocker
❑Gilts 0 Non-Layers ❑Beef Feeder
❑Boars 0 Pullets }
❑Turkeys ❑ Beef Brood Cow
-
Other 0 Turkey Poults
❑Other I 1 ❑Other Number of Structures: I
Discharges& Stream Impacts
I. Is any discharge observed from any part of the operation? 0 Yes 51No ❑NA 0 NE
Discharge originated at: ❑ Structure ❑Application Field ❑Other
a. Was the conveyance man-made? ❑ Yes 0 No In NA 0 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)? r"'—"
d. Does discharge bypass the waste management system?(If yes,notify DWQ) ❑Yes 0 No... NA ❑NE
2. Is there evidence of a past discharge from any part of the operation? 0 Yes [ No ❑NA ❑NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑YesNo 0 NA ❑NE
other than from a discharge?
12/28/04 Continued

Facility Number:1)...—Sb5 Date of Inspection614-1
o1
Waste Collection & Treatment
'4. Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? 0 Yes g No ❑NA 0 NE
a. If yes, is waste level into the structural freeboard? ❑Yes gi No ❑NA ❑NE
Structure 1 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
(ie/large trees, severe erosion,seepage,etc.)
6. Are there structures on-site which are not properly addressed and/or managed 0 Yes No 0 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? 0 Yes V,No ❑NA ❑NE
8. Do any of the stuctures lack adequate markers as required by the permit? 0 Yes (3 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 14 No ❑NA 0 NE
maintenance or improvement?
Waste Application
10. Are there any required buffers,setbacks,or compliance alternatives that need 0 Yes to No ❑NA 0 NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes,check the appropriate box below. ❑Yes [ No 0 NA ❑NE
0 Excessive Ponding ❑Hydraulic Overload 0 Frozen Ground 0 Heavy Metals(Cu,Zn,etc.)
0 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) +J - C--r
13. Soil type(s) B
14. Do the receiving crops differ from those designated in the CAWMP? 0 Yes kJ No ❑ NA 0 NE
15. Does the receiving crop and/or land application site need improvement? ❑Yes I No ❑NA 0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑Yes [ No ❑NA 0 NE
17. Does the facility lack adequate acreage for land application? 0 Yes 10 No ❑NA ❑NE
18. Is there a lack of properly operating waste application equipment? 0 Yes 14 No 0 NA ❑NE
Comments(refer to question#): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations.(use additional pages as necessary):
Reviewer/Inspector Name ► [ goo l I r4 (Nu Phone: 9/0 V33 33OO
Reviewer/Inspector Signature: Date: S 1
12/28/04 Continued

Facility Number:';6a— S Date of Inspection L\/ 1
'Required Records& Documents
19. Did the facility fail to have Certificate of Coverage& Permit readily available? 0 Yes 1,1,No ❑NA ❑NE
20. Does the facility fad to have all components of the CAWMP readily available?If yes,check 0 Yes NI No ❑NA ❑NE
the appropirate box_ ❑WDP ❑Checklists 0 Design ❑Maps ❑Other
21. Does record keeping need improvement?If yes,check the appropriate box below. 0 Yes 0 No ❑NA ❑NE
❑Waste Application ❑Weekly Freeboard 0 Waste Analysis 0 Soil Analysis ❑Waste Transfers ❑Annual Certification
0 Rainfall 0 Stocking ❑Crop Yield 0 120 Minute Inspections 0 Monthly and 1"Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? 0 Yes 1 No 0 NA ❑NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ❑No VA 0 NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes 'No ❑NA 0 NE
25. Did the facility fail to conduct a sludge survey as required by the permit? 0 Yes . o ❑NA ❑NE
26. Did the facility fail to have an actively certified operator in charge? 0 Yes 2. No 0 NA 0 NE
27. Did the facility fail to secure a phosphorus loss assessment(PLAT)certification? 0 Yes ❑No }NA ❑NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 0 Yes No 0 NA ❑NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document 0 Yes pi No 0 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 [3 No ❑NA ❑NE
If yes,contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by 0 Yes / No 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? 0 Yes No 0 NA ❑NE
33. Does facility require a follow-up visit by same agency? 0 Yes No 0 NA ❑NE
Additional Comments and/or Drawings:
T
12/28/04

�� ision of Water Quality
Facility Number •� O Division of Sotl Neir� Conservatton 0* R
O Other Agency i 1 014
Type of Visit erc,�_,�ommpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
C
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other El Denied Access
Date of Visit: Arrival Time: f) Departure Time: p) 0 County: ()Sri- Region:
Farm Name: T IC S6 Owner Email:
Owner Name: Phone: -
Mailing Address:
Physical Address:
Facility Contact:
Title: Phone
No:
Onsite Representative4
ISe- J Integrator: ls-L°t
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: ° g n Longitude: n°n' w
Design Current Design = -5.x Design Current
Capacity Population Poultry ,,Carty Population- '.. Capacity Population
❑Wean to Finish - ❑Layer ❑Dairy Cow I
❑Wean to Feeder ❑Non Layer ❑Dairy Calf I I -
El Feeder to Finish -- ..,„:,v,1:..7-- 7` " 4� ❑Dairy Heifer
arrow to We.n A�� �� T , ❑Dry Cow
1 PBnit r�,„,, �e
❑Farrow to Feeder-- _ ;'- -" , `:-: ' 0 Non-Dairy
❑Layers
❑Farrow to Finish -- `; € 0 Beef Stocker ,_
❑Gilts --L, ❑Non-Layers ❑Beef Feeder
❑Boars ❑Pullets
-- a ❑ Beef Brood Cow
❑Turkeys 2 '.,---',.1- /'
ey
Other �,�.� 0 Turkey Poults •
Fx f
0 Other -- ,�:❑Other •r Nitmberrof•Str'uctur res:-.
Discharges& Stream Impacts
1. Is any discharge observed from any part of the operation? ❑Yes No ❑NA El NE
Discharge originated at: ❑Structure ❑ Application Field 0 Other
a. Was the conveyance man-made? ❑Yes ❑No tiNA 0 NE
b. Did the discharge reach waters of the State?(If yes,notify DWQ) ❑Yes ❑No 124A ❑NE
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) ❑Yes 0 o A ❑NE
2. Is there evidence of a past discharge from any part of the operation? 0 Yes yo 0 NA ❑NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State El YesNo ❑NA El NE
other than from a discharge?
Page 1 of 3 12/28/04 Continued

Facility Number: -(5-('15- Date of Inspection
Waste Collection & Treatment
4. Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate?
CI Yes Oa/ 0 NA ❑NE
a. If yes,is waste level into the structural freeboard? ❑Yes ❑No1A ❑NE
ST 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard(in):
Observed Freeboard(in): 3 3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑Yes BZ El NA El NE
(ie/large trees,severe erosion,seepage,etc.) j
6. Arc there structures on-site which are not properly addressed and/or managed ❑Yes No El NA El 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? El Yes L'�No D NA ❑NE
8_ Do any of the stuctures lack adequate markers as required by the permit? ❑Yes at.
El 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 El NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers,setbacks,or compliance alternatives that need ❑Yes [To El NA El NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes,check the appropriate box below. El Yes 'No El NA El NE
❑Excessive Ponding El Hydraulic Overload El Frozen Ground 0 Heavy Metals(Cu,Zn,etc.)
❑PAN ❑ PAN> 10%or 10 lbs_ ❑Total Phosphorus El Failure to incorporate Manure/Sludge into Bare Soil
❑Outside of Acceptable Crop Window El Evidence of Wind Gift
ft 0 Application[ Outside of Area
12. Crop type(s) j1t1 D 16 3M `Aft A. tis/
f cE Tat
13. Soil type(s) Lotpar yl 0
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No El NA ❑NE
15. Does the receiving crop and/or land application site need improvement? 0 Yes Ll No ❑NA El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? ❑Yes '42 No El NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑Yes E 'No ❑NA El NE
18. Is there a lack of properly operating waste application equipment? 0 Yes 12No ❑NA ❑NE
Comments(refer to question#) -Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better.ex lain situations (use additional pages as:necessary):
-,
A.
Reviewer/Inspector Name ( �j rM � �'1 Phone: [phone](1)
Reviewerlinspectar Signature: :4621,41,1114k. I)atC: _mac
• • • She J
Page 2 of 3 12 8/04 Continued

Facility Number:%'2_, j Date of Inspection hittli R'
A •
Required Records&Documents
19. Did the facility fail to have Certificate of Coverage&Permit readily available? ❑Yes Lo ❑NA ❑NE
20. Does the facility fail to have all components of the CAWMP readily available?If yes,check ❑Yes L'J No ❑NA ❑NE
the appropriate box. ❑WUP 0 Checklists ❑Design El Maps ❑Other
21. Does record keeping need improvement?If yes,check the appropriate box below. ❑Yes [ o ❑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 0
Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑Yes WNo ❑NA ❑NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑Yes LJ No ❑NA ❑NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes Ef' o ❑NA ❑NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑Yes GAO ❑NA 0 NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes L No ❑NA ❑NE
27. Did the facility fail to secure a phosphorus loss assessment(PLAT)certification? ❑Yes &d No ❑NA ❑NE
Other Issues ,�/
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? El Yes Id No 0 NA ❑NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑Yes t Io ❑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 L1 No ❑NA 0 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 0 Yes �No ❑NA ❑NE
General Permit? (ie/discharge,freeboard problems,over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑Yes E(No ❑NA ❑NE
33. Does facility require a follow-up visit by same agency? ❑ Yes ao ❑NA ❑NE
Additional •o • I and/or Drawings: •
Page 3 of 3 12/28/04

Division of Watera Q
Facility Number g ,Sos a Division ofSoilftttfl Water Ganservation ti
Other(! _
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I27/of Arrival Time: /07: d e' Departure Time: County: 5 c r.p4 o,u Region: r
Farm Name: Pit — 8 Owner Email: l
Owner Name: Pr e--,S#a 9 ra e rs.s Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: R av,.aQ.,A1 Qaec.-6 .-r Integrator: Pr��Sin-1 e7
A1iem
Certified Operator: is,;# - Operator Certification Number: I L' YG3
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: ° I=1 i I=„ Longitude: n° n n
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
❑Wean to Finish ❑ Layer 0 Dairy Cow
❑Wean to FeederIDNon-Layet _ ❑Dairy CalfI
0 Feeder to Finish ( I! __ - — ❑Dairy Heifet IIii ,.
i
Farrow to Wean 7.5 7$ICIDry Poultry Dry Cow
❑Farrow to Feeder ' . , ❑Non-Dairy I.
CI Farrow to Finish ❑Layers ; ❑Beef Stockei
❑Gilts ' 0 Non-Layers ',
__ t ❑Pullets ❑Beef Feeder
0 Boars - ❑Beef Brood Cow
- - -- -- - -i ❑Turkeys ��..
Other ❑Turkey Poults _
�.
❑ /Other ! ❑Other Number of Structures: -
-
Discharges& Stream Impacts
1. Is any discharge observed from any part of the operation? ❑Yes [l No ❑NA ❑NE
Discharge originated at: 0 Structure ❑ Application Field ❑Other
a. Was the conveyance man-made? ❑Yes ❑ No ❑NA ❑NE
b. Did the discharge reach waters of the State? (If yes,notify DWQ) ❑Yes ❑No ❑NA ❑NE
c. What is the estimated volume that reached waters of the State(gallons)? I 1
d. Does discharge bypass the waste management system?(If yes,notify DWQ) ❑Yes ❑ No ❑NA ❑NE
2. Is there evidence of a past discharge from any part of the operation? ❑Yes No ❑NA 0 NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes El No ❑NA 0 NE
other than from a discharge?
12/28/04 Continued

Facifity'Number: 8.2 — 5&- Date of Inspection (5v/-7i Rs--
Waste
¢iWaste Collection&Treatment
4. Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑Yes ®No 0 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: l-+
Spillway?:
Designed Freeboard(in): /9 a .1 1/1 /0�--
Observed Freeboard(in):
5. Are there any immediate threats to the integrity of any of the structures observed? El 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 ®No ❑NA ❑NE
(Not applicable to roofed pits,dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑Yes ]No ❑NA ❑NE
maintenance or improvement?
Waste Application
10. Are there any required buffers,setbacks,or compliance alternatives that need ❑Yes ®No ❑NA ❑NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes,check the appropriate box below. ❑Yes ®No ❑NA ❑NE
❑Excessive Ponding ❑Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals(Cu,Zn,etc.)
0 PAN 0 PAN> 10%or 10 lbs ❑Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑Application Outside of Area
12. Crop type(s) t�� v.dC.6. & / 0
13. Soil type(s) Wa 13 I,f,
14. Do the receiving crops differ from those designated in the CAWMP? ❑Yes IX No ❑NA 0 NE
15. Does the receiving crop and/or land application site need improvement? IJ Yes ❑ 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 ❑No 0 NA 0 NE
18. Is there a lack of properly operatingvvwaste application equipment? ❑Yes ❑No ❑NA 0 NE
Comments(refer to guestton#);t Explam any�YES answers,and/oranytrecommendattons or any other L
Use drawings of facility#o,lietterelamsttriahons .(use aclditsonalgpages "' 1
rY- f w 7F-
I S- Fi-e_t aQ s 3 afv c I n- ins c. ,,s e c a CC' • p L('�o , A Q.. to e eaQ
--a be_ sPYa`(cC� w : a o -F pl e. Cv.-k-
$ c - e - o� ��-er +e k:b,e� co•.-�Y o( wzeG s t�-v � 5. 64/G.Yst cc. 6-A0,-�./a/ ic
!'CH+O✓C,it A. eLs /JC
•
Reviewer/Inspector Name r '/24x/ri. a <F `,',f,' ', ;,fj Phone:
Reviewer/Inspector Signatur Date: 7/b
12/28/04 Continued

Vacility'Number: 2,2 -.far Date of Inspection I q/27/6 4
Required Records& Documents
19. Did the facility fail to have Certificate of Coverage&Permit readily available? ❑ Yes ©No ❑NA ❑NE
20. Does the facility fail to have all components of the CAWMP readily available?If yes,check ❑Yes ®No 0 NA ❑NE
the appropirate box. ❑WUP ❑Checklists 0 Design 0 Maps ❑Other
21. Does record keeping need improvement?If yes,check the appropriate box below. 0 Yes ❑x No ❑NA ❑NE
❑Waste Application ❑ Weekly Freeboard 0 Waste Analysis ❑ Soil Analysis ❑Waste Transfers 0 Annual Certification
❑Rainfall ❑ Stocking ❑Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections ❑Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑Yes ®No ❑NA ❑NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑Yes ®No ❑NA ❑NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes ❑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 ®No ❑NA ❑NE
27. Did the facility fail to secure a phosphorus loss assessment(PLAT)certification? ❑Yes ®No ❑NA 0 NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑Yes Il No ❑NA ❑NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes ❑No El NA 0 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 0 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 L No ❑NA 0 NE
General Permit? (ie/discharge, freeboard problems,over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑Yes IZI No 0 NA 0 NE
33. Does facility require a follow-up visit by same agency? ❑Yes ®,No ❑NA 0 NE
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0
12/28/04