820516_INSPECTIONS_20171231

NUH I H UAHULINA
Depar#ment of Envifonmental Qual

l lu S yH �I 1 t3 U
- Di'visian of Water Resources
Facilt y Number - — - S i Dfvis19 of Soil and Water Conservation
Other Agency
Type of Visit: ompliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Iteason for Visit: ("outine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: IrM1 Arrival Time:Departure Time:ja OOM County: Region: i ^1
Farm Name, :3 7h,30AI S _ 4JR141"If 1 S- Owner Email:
Owner Name: A Phone:
Mailing Address:
Physical Address:
Facility Contact: ruA-4 S 3 &-%rWtJ Title:
Onsite Representative: t t
Certified Operator: D&� Vy 0,1we"`cx
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: 6 " SkU.A
Certification Number: I & -710
Certification Number:
Longitude:
Design Current
❑ Yes
Design
Current
Design Current
Swpte .Capacity Pap.
Wet 10umitrylapacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
❑ No
�NA
Dairy Cow
Wean to Feeder
Non -La er
E3 -No
❑ NA
Dairy Calf
Feeder to Finish
0 Yes
❑-No
❑ NA
Dairy Heifer
Farrow to Wean 3 S
Design
Current
Dry Cow
Farrow to Feeder
D : P,oul
Ca act
1Po .
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other LLI
Turkey Poults
Other
Other
Dischar es and Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes L.J "'o ❑ NA [] NE
❑ Yes ❑ No E]'9A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
Q 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
❑ NE
1 2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
E3 -No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
0 Yes
❑-No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3
2/4/2015 Continued

V
Facili Number: - Date of !ns ection: W a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
�❑
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
FI-DW
❑ 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
E 11q
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
orenviron tal threat, notify DWQ
Do any of the structures need maintenance or improvement?
es
['
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E3-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
[�No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E5No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes 2 leo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window J f ❑ Evidence of Wind Drift rr''❑ Application Outside of Approved Area
12. Crop Type(s): 1� e J ltit,a & F -t P,n S D t[ G e 5 C u x. ` P
13. Soil Type(s): et( C' p tic
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [E['9o_ ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑ Yes ❑i -No
❑ Yes Q—No
❑ Yes �No
❑ Yes [.'Flo
❑ NA ❑ NE
❑ NA [] NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes Eal�o [DNA ❑ NE
❑ Yes [5'i leo ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Q o ❑ NA ❑ NE
❑ Waste Application [] Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis 0 Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑Crop Yield ❑ 120 Minute Inspections p Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Nom❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes e'No ❑ NA ❑ NE
Page 2 of 3 21412O11 Continued

[Facility Number; - S 1 Date of Inspection.
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes B` o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Q No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structures) and date of first survey indicating non -compliance -
26. Did the facility fail provide documentation of an actively certified operator in charge? [:]Yes CNo ❑ 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 [] Yes l_ '"" ❑ 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?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes rL Ko ❑ NA ❑ NE
❑Yes []No DNA ONE
❑ Yes ❑"Nlo ❑ NA ❑ NE
❑ Yes [E] No
❑ Yes C3 No
❑ Yes [TNo
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
�c
7— Co u o -,A- e7A
eel(
0- 30
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phonegiv- if33-333�(
Date: t v
2/4/2015

�� 5 15ffP LI�i
i'i;ion of Water Resources
Facility Number ®- Division of Soil and Water Conservation
© Other Agency
Type of Visit: Compliance Inspection Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: gRoutine Q Complaint 0 Follow-up O Referral Q Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: cS Regionr�
Farm Name: 14c, LU li✓` ro5 Soo Owner Email:
Owner Name: I,.J 0-100wartp Phone:
Mailing Address:
Physical Address:
Facility Contact: et, is a"'W (4 Title: Phone:
Onsite Representative: Integrator: Sirr,
Certified Operator: L)at U—.11 .C" Certification Number:
Back-up Operator:
Location of Farm: Latitude:
Certification Number -
Longitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other--
a-
ther:a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑Yes [] o ❑NA ONE
[] Yes ❑ No
❑Yes 0 N
❑ Yes ❑ No
[:]Yes [;'7No
❑ Yes [2 No
En'NA ❑ NE
[E�-NA ❑ NE
Ej NA
❑ NE
❑ NA
❑ NE
❑ NA
Design Current
_113
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Gapa ity Pop.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
Non -Layer
i
Dai Calf
Feeder to Finish Q
Dai Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dr RduItr.
Ca .acity
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other--
a-
ther:a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑Yes [] o ❑NA ONE
[] Yes ❑ No
❑Yes 0 N
❑ Yes ❑ No
[:]Yes [;'7No
❑ Yes [2 No
En'NA ❑ NE
[E�-NA ❑ NE
Ej NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page I of 3 2/4/2015 Continued

IFacWty Number: - / Date of Inspection
cl`
) Vaste Collection & Treatment
❑ Yes
2<
❑ NA
❑ NE
'4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
D -ND
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
O -NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
IT Does the facility lack adequate acreage for land application?
❑ Yes
E No
❑ NA
Spillway?:
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Ea TVD
❑ NA
Designed Freeboard (in):
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
ENo
❑ NA
Observed Freeboard (in):
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
�lo
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ETVo
0 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
Q leo
❑ 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
�To
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�'1 T�o
❑ 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
Ea<
❑ NA
❑ NE
maintenance or improvement?
r
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[ No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Oto ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): S6 a — 111VC Ue f F-e56ct e
13. Soil Type(s): A (k Q
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
2<
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[T No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[tNo
❑ NA
❑ NE
acres determination?
IT Does the facility lack adequate acreage for land application?
❑ Yes
E No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Ea TVD
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
ENo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
�lo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements E] Other:
2t. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑'No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield F-1120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ YesNo
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? E]Yes 2 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412015 Continued

Facility `umber: jDate of Inspection- 7 ,y
2A. Did the facility fail to calibrate waste application equipment as required by the permit?
[:]Yes 0-<o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes io ❑ 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 ;R'No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [;Ko ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes O<o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes [ No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the E) Yes [frNo [] 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
E!rNo
❑ 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
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[]'To
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Fd/No
❑ NA
❑ NE
(Comments (refer to question #):.Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations fuse additional pages as necessary).
Sir
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
�l EGD-�v8r��sl
Phone4you1S i 3
Date:
21412015

Type of Visit: ©'Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Grfloutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: . un. Arrival Time: —A Departure Time: 1rt 00 ounty: X-- Region
Farm Name:{, S 1 Say' _] ►�{ f�[S -}owner Email:
Owner Name: 3 Tk 0M& 1 �LJPSO f Phone:
Mailing Address:
a -
Physical Address:
Facility Contact:
Title: Phone:
1. f1. - - rte
Onsite Representative: u'4' S L2 CE 4/w [y Integrator:
Certified Operator: ff Certification Number:•••""""'
L111 T Certification Number: 6 ?t o
Back-up Operator:
Location of Farm:
Latitude:
Longitude:
Design Current��A ��Desgn Cu rent Design Current
r[Fecdcr
Capacity Pop ,�ry @apactty Pop. Cattle Capaciean to Finish La er Dai Cow
ean to Feeder Non -La er Dai Caif
to Finish * } - Dairy Heifer
Farrow to Wean MIT Yuk Design CurrentDry Cow
i +r 1�r h :
Farrow to Feeder fD�Fou1t , Ca act x. .j ;Po .F Non -Dairy
Farrow to Finish Layers Beef Stocker
Gilts Non -Layers Beef Feeder
Boars Pullets Beef Brood Cow
R Turkeys
Other Turkey Poults
Other 10thcr
Discharges and Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes l'no ❑ NA ❑ NE
❑ Yes
❑ No
[ NA
NE
[—]Yes
❑No
❑.1
❑ NE
❑ Yes
❑ No
[ NA
❑ NE
❑ Yes
❑4Z
❑ NA
❑ NE
❑ Yes
dNo
❑ NA
❑ NE
Page I of 3 1/4/1011 Continued

acili .. Number: -AT01 jDate of Inspection: L
E�j'No
❑ NA
❑ NE
❑ Yes
Waste Collection & Treatment
❑ NA
❑ NE
❑ Yes
To
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
LJ 1` o
I__I NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[:]No
E3_Mir
❑ 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
[3 -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
LJ 1"�
❑ 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
J�Ko
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[3'lTo
❑ 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
❑'110
[] NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes E "No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop
,/Window
Q ❑/Evidence of Wind
�/D�,riiftr ❑ Application Outside of Approved Area
12. Crop Type(s): 1-1 v A t�.C�� 4 b � 1' t f LC�-
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? '
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
E�j'No
❑ NA
❑ NE
❑ Yes
[�o
❑ NA
❑ NE
❑ Yes
To
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes EKo ❑ NA ❑ NE
❑ Yes
[4__,jXo
❑ NA
❑ NE
❑ Yes
;�No
❑ NA
❑ NE
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Ag=reements ❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes �No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes [(No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes GtyNo
[:DNA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

934
F cili Number: Dste n(Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes LJ.Nd' ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [3-N6r ❑ 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 ❑,Ne ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Da <o ❑ NA ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, aver -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
-3-
�l.n_
C
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
[:]Yes C; Qo ❑ NA ❑ NE
0 Yes �o ❑ NA ❑ NE
[]Yes [f]'No ❑ NA ❑ NE
[:]Yes [ 'moo ❑ NA ❑ NE
E] Yes [No
❑ Yes [fNo
❑ Yes 150 -N -0-
E]
""'
❑ NA ❑ NE
❑NA E] NE
❑ NA ❑ NE
Phone: Y
Date: Vz
21412011

type of visit: VA?bmpliance inspection V Operation Review U structure Evaluation U l ecnmcal Assistance
Reason for Visit: Gr<outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: AW Region:
Farm Name: ��Vrd 1j% o SRS `2 fyy
Owner Name: -, rk0 U g4 41) Wari S S
Mailing Address:
Physical Address:
Facility Contact: _ L�w�!'"S 6a0c.J147 Title:
Onsite Representative:
Certified Operator: D [ G
Back-up Operator:
Owner Email:
Phone:
Phone: n
Integrator:
Certification Number: 1671-0
Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes Eg-l-57--❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
0?1A ❑ NE
U- [:]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 E5NA ❑ NE
LI
there evidence of a past discharge from any part of the operation?
ere there any observable adverse impacts or potential adverse impacts to the waters
the State other than from a discharge?
age 1 of 3
[—]Yes [g ❑NA El NE
[—]Yes N[:INA ❑ NE
2/412011 Continued
Design Current„ :
� - .;� Design
Current
Design Current
Swine
Capacity Pvp
�
Wet�Poultr-y ::
P;
Capacity
Pvp. -
Cattle Capacity Pop.
Wean to Finish
La er
Da' Cow
Wean to Feeder
Layer
Da Calf
Feeder to Finish
'� ..
='"" ""'"'
Da' Heifer
Farrow to Wean
�3
Design
Current
D Cow
Farrow to Feeder
D .: P,oul
Ca aeity
Pa
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Layers
Beef Feeder
Beef Brood Cow
Boars Pullets
Turkeys
Other
TurkeyPoults
Other
Other
Discharges and Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes Eg-l-57--❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
0?1A ❑ NE
U- [:]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 E5NA ❑ NE
LI
there evidence of a past discharge from any part of the operation?
ere there any observable adverse impacts or potential adverse impacts to the waters
the State other than from a discharge?
age 1 of 3
[—]Yes [g ❑NA El NE
[—]Yes N[:INA ❑ NE
2/412011 Continued

Facil ity Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ZPi6-_ ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [L.NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in
l4-2
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes
2'No-
❑ NA
❑ NE
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
FeKo
❑ 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
E jj<o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
}o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[2<o-
❑ NA
❑ NE
maintenance or improvement?
❑ NA
❑ NE
the appropriate box.
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[2<o
❑ NA
❑ NE
maintenance or improvement?
1 1. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes LA "v ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): s e � -g G 0 .P'WA"'_C�
13. Soil Type(s): i�� k) el S,+'
14. Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
[3-N-6
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2'No-
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
B<
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ YesT/o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑moo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[31N o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E:11�o
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑lo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes G�Ko- ❑ NA ❑ NE
Page 2 of 3 214/1011 Continued

C94 .1
Fac' ' Number: -Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes a K6 ❑ NA ❑ NE
25. Is'the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [3-11-o-- ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes E3<o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes Io ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the 0 Yes No [DNA ❑ 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 0 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 do ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes dNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes dNo ❑ NA ❑ NE
Comments (refer to question -4): Explain any YES answers and/or any additional recoinmemdaiAons'or:anygther co�ments
Use drawings'of,facility to better explain situations (use additional pages as necessary);. l
6V4
SZ
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
C.
1
Phone: s ~ 33
Date: � 1
21412014

Type of Visit: CgKomptiance InspectionQ Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: Ar Arrival Timer Departure Timer Count�LxHA Region:
Farm Name: �� �. r?/ �-t/ (" Owner Email:
Owner Name:p, {T bIGL Phone:
Mailing Address:
Physical Address: jj77 //
Facility Contact;CW� 1.7 t o vw teAitle: Phone:
Onsite Representative: Integrator: ae�
Certified Operator:P!L�_w
I b Certification Number::�
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
❑ NE
Design
Current
Design Current
Swine Capacity Pop.
Wet i try
Capacity
Pop.
Cattle Capacity Pap.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Nvn-La er
Dairy Calf
Feeder to Finish
Dairy heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D . I',ou1
Ea aci
Pa P.
Non -Dairy
Farrow to Finish
ILayers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Becf Broad Cow
-
Turke s
Other
Tur ey Poults
Other
10ther
Discharses and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
e, What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes Ea_Na ❑ NA ❑ NE
❑ Yes ULNo Llwr' t__I NE
❑ Yes Eallo- ❑'ft` ❑ NE
❑ Yes [—]No
❑ Yes ®'lqo
❑ Yes E�No
[! NA
❑ NE
❑NA
❑NE
❑NA
❑NE
Page I of 3 2/4/2011 Continued

Date of Ins ection
Facility Number:rli!L -1-0t
EK
❑ Yes
Cn o
❑ Yes
I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
&N66
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
Z] -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
<o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6_ Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
if any or 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
L—~"
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
mac'
❑ 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
; "
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Iwo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [g -K' ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
❑ NE
14. Do the receiving crops differ
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18, Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
EK
❑ Yes
Cn o
❑ Yes
[ Er�o
❑ Yes IVo
❑ Yes [3-Nl
❑ Yes [2,M
[-]Yes [Z .No
❑ WUP ❑Checklists p Design ❑ Maps 0 Lease Agreements ❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes D No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [:]Stocking ❑Crop Yield ❑ 120 Minute Inspections []Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes dNo
23. if selected, did the facility fail to install and maintain rainbreakers on irritation equipment? ❑ Yes FfNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA E] NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
[3 NA ❑NE
Page 2 of 3 21412011 Continued

Faeili Number: Date of inspection:
A. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [allo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes .v'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 Ievels 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 [G]'93 ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [:j.XS ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility`? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes [ o ❑ NA ❑ NE
❑ Yes L 4t'o ❑ NA ❑ NE
❑ Yes r D X6 ❑ NA ❑ NE
❑ Yes [2LNe- ❑ NA ❑ NE
❑ Yes
Ua<o
❑ NA
❑ NE
❑ Yes
[,_
[] NA
❑ NE
❑ Yes
[ o
❑ NA
❑ NE

)-pe of visit: t--i-v:ompitance inspection V uperatnon tcevtew V structure Lvatuanon t,.1 teenntcai Assistance
[Reason for Visit: Routine O Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit:
Arrival Time:
Departure Time:
County: rrt Olt}
Farm Name: �, �1r\�n,pr
S 1r{p�,�{aRn �a i�
�A{Z Owner Email:
Capacity Pop.
Wet Poultry
Capacity°
Owner Name:
ptL:ARp
Phone:
Mailing Address:
Region: Rt)
Physical Address:
Facility Contact: C V(Z�2 R GK Title: Phone:
Onsite Representative: a p P% Integrator: T,.4 peaf u T
Certified Operator: iB . \ Certification Number: 1 `71 0
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Discharzes and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made'?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [ o ❑ NA ❑ NE
[:]Yes ❑ No
❑ Yes [:]No
[:]Yes ❑ No
❑ Yes1�� o
❑ Yes �No
Eg"NA ❑ NE
Eg"NA ❑ NE
&NA
Design Current
❑ NA
Design
C*urrent
Design Current
Swine
Capacity Pop.
Wet Poultry
Capacity°
Pap.
Cattle Capacity Pop.
Wean to Finish
I 11-ayer
Dai Cow
Wean to Feeder
I jNon-Layer
I
alf
Feeder to Finish
airyHeifer
Farrow to Wean
113 SS 1 too
Design
Current
Dry Cow
Farrow to Feeder
D : pP,oul
Ca achy
Pio ,
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other Other
Discharzes and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made'?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [ o ❑ NA ❑ NE
[:]Yes ❑ No
❑ Yes [:]No
[:]Yes ❑ No
❑ Yes1�� o
❑ Yes �No
Eg"NA ❑ NE
Eg"NA ❑ NE
&NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page I of 3 2/4/2011 Continued

Facili Number: 26 A - JDate of Inspection: 4 a7 1 -X-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 0' NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier:
18. Is there a lack of properly operating waste application equipment?
❑ Yes1❑/
No
Spillway?:
Designed
❑ NE
Required Records & Documents
Freeboard (in): a�
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Observed Freeboard (in): y
[TNo
❑ NA
❑ NE
5_ Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Ea No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
the appropriate box.
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
DNo ❑ 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
[grNo ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[Q"No ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[DeNo ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ol
[g No ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
Co"No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or W 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): � MM UOA ( 1-t+A,y l Gito L .! I S • G -o- C dRH . Sev 6t_An
S Fusc.0
1=_
13. SoilType(s): �AN2 �\j'4.L1 yocx�Inr) bn 4 Go�[g35br&u A-
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [TNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [✓7 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes allo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
1 f No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes1❑/
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[TNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[�rNo
❑ 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 [ k to
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes dNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
Ea/NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: a, - S j Date of Inspection: 770,
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ 4io ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes [ frNo ❑ 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 D"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 +dNo ❑ 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?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes [L"No ❑ NA ❑ NE
❑ Yes [t"No ❑ NA ❑ NE
❑ Yes [!3/No ❑ NA ❑ NE
❑ Yes [ (No
❑ Yes g No
❑ Yes [�No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings offacility to better explain situations (use additional uaees as necessarv).
Reviewer/Inspector Name:
S Phone: Ql(} 3UF� 1aC5S1
Reviewer/Inspector Signature: Date: �, 'X11\�
�c
Page 3 of 3 21412011

type of visit: (-'Compliance Inspection V Operation Review V Structure Evaluation U Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Y"'o—O.Z Departure Time:1 County: �SP31_ Region:
Farm Name_&,.wner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: &A�j Eacwt Title: Phone:
Onsite Representative: �I.im�� Integrator: l�
Certified Operator:Certification Number: ACG 7/0
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
_.
Y ftDeslgM�Uurrent. -. Desrgn Current -
Design Current
Swine -x 40
CapcPop:
Cattle Capacity Pop.
[] Yes
„WetrPoultry
❑ NA
❑ NE
Finish
La er
Dai Cow
Feeder
Non -Layer
❑ Yes
Dai Calf
Finish*
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Dai Heifer
o Wean /
pFarrowtoFinish
E<A
DesgnCurrent
D Cow
o Feeder
DPoW
Ca acs Po
Non -Dairy
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
La ers
Non -Layers
❑ No
Beef Stocker
Beef Feeder
❑ NE
Boars
Pullets
�Ko
Beef Brood Cow
A r
Turkeys
❑ Yes
E 10
Other
Turkey Poults
Other
Ligther
Dischar es and Stream Impact
L Is any discharge observed from any part of the operation?
[] Yes
To
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
E<A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
EV<A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
�Ko
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
E 10
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili Number: JDate of Inspection:
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Waste Collection & Treatment
4. rs
1240
�
<o
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
UR'
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
5D<A
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
Identifier: ct�1, J
❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
Spillway?:
0 -No
[:]NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
C] Yes
Designed Freeboard (in):
NE
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E30<o
❑ 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
Eg-Ko
❑ 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
EJ'NO
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
®.14o
❑ 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
52.14
❑ NA
❑ NE
maintenance or improvement?
_Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes
[ErNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
B;P<o
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 5
'S04IW&A]
13. Soil Type(s): {, t cx-1 -
14. Do the receiving crops differ from those designated in the CAWMP?
❑Yes
I_J 110
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E3<o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Po<o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
L; "o
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
L'e
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
1240
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Ea "o
❑ 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
LIS<
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[:]Yes
0 -No
[:]NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
C] Yes
C:] No
NE
Page 2 of 3
L
21412011 Continued

Facili Number: - Date of Ins ection: /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes t o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 5, Ko ❑ NA 0 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
L+�1 o
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
G211A
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes lfd"e"o ❑ NA ❑ NE
and report mortality rates that were higher than normal? l
29. At the time of the inspection did the facility pose an odor or air quality concern? [] Yes a� o ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the [:]Yes ❑ N*o' ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below_
❑ Yes
g;I- o ❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
E] Yes
11
Z3'lNo ❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No NA
❑ NE
34. Does the facility require afollow-up visit by the same agency?
EJ Yes
To 0 NA
❑ NE
Comments (refer to question ff): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pagers as necessary).
Reviewer/Inspector N
Reviewer/Inspector Si
Page 3 of 3
Phone:��D —
Date:
12;412A

Type of Visit O Sompliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit outine Q Complaint 0 Follow up 0 Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit: 2-02`10 Arrival Time: /O: /$ Departure Time: County: SS`s Region:
`s
Farm Name:auavd Se•�/ �SawF.�..4, Owner Email:
Owner Name: Z-• I4e .JC't__14 Phone:
Mailing Address:
Physical Address:
Facility Contact: C� srW f c- Title: t Phone No:
Onsite Representative: Integrator, ��'L1''• e- ��
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: [=O
= = Longitude: =0=1 = "
Design Current
Swine Capacity Population
Design Current
Wet Poultry Capacity Population
Design Current
Cattle Capacity Papulation
❑ Wean to Finish
❑ La er
❑ Dai Cow
❑ Wean to Feeder
❑Non -La er
El Dairy Calf
❑ Feeder to Finish
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
❑ Dai Heifer
arrow to Wean 11,3 670
Dry Poultry
ElD Cow
El Farrow to Feeder
❑ Yes
❑ Non -Dairy
El Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
❑Pullets
ue
❑ Beef Brood Co
❑ Turkeys
Other. -
❑ Other
❑ Turkey Poults
❑Other
iNumber of Structures:
B A
❑ NE
Z. Is there evidence of a past discharge from any part of the operation?
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
❑ Yes
U No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
,�/
L7 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
0'�}A
❑ 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
❑ No
B A
❑ NE
Z. Is there evidence of a past discharge from any part of the operation?
ElYes
E No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
G o
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

f
Facility Number: SZ - S/(y Date of Inspection 2 -aa -Io
Waste Collection & Treatment �,../�
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ETNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [Ko ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 50711 %_ / T Z 7--3
Spillway?:
Designed Freeboard (in):
3�z"
Observed Freeboard (in): V inrk✓co�+u«,4� w � ,ht, T- ► -A,ti 7-3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 2K ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes ETNo ❑ 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 ETNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes B o ❑ 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 ff No ❑ NA ❑ NE
maintenance or improvement?
Waste Application ETN"
-o Are there any required buffers; setbacks, or compliance alternatives that need [-IL7 Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 9'lao ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) � yJ C44 -Al_ .Sc -, to e4.15 Fe sG't l.t r`�I Y A�ru r /S
13. Soil type(s) _tc5� y ✓r��ti.v.s _
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
,�,�
LThlo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
El NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
[:1 Yes
,f��110
L7 NoNo
[:1 NA
[__1 NE
17. Does the facility lack adequate acreage for land application?
[-IYes
[]'go,
L3 NA
El NE
18. Is there a lack of properly operating waste application equipment?
El Yes
Bl o
❑ NA
❑ NE
;Comments (refer to question #): Explain apy YES, answers and/or any recommendations or.,any other comments
g ty p { pages } �..
Use driiwm s"�o1' facility to better explain situation§. use' additional as necessary
Reviewer/Inspector Name
Reviewer/Inspector Signature:
c.V eJ5 _ J Phone: 9/O� y33, 330 0
Date: Z -e' Z — ZO /0
12/28/04 Continued

i a
Facility Number: 82 —ia Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ONo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[I<o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspectionss E] Weather
Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
Ngo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
,B
Ngo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
,L.,s�
oo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
,C
o
❑ NA
❑ NE
25. Did the facility fail to have an actively certified operator in charge?
❑ Yes
,E
E9 o
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes B< ❑ NA ❑ NE
Other Issues �,�
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? El Yes L7No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
LJ'lvo ❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
_ ,�
EKO ❑ 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
CTNo ❑ 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
Nom❑ NA
F-1NE
33. Does facility require a follow-up visit by same agency?
ElL Yes
E
go_ ❑ NA
❑ NE
1228/04

Z_th(S r -4. e_d /o — bz—Zoee
Type of Visit (9-Co-mpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit (31fo—utine O Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit. 9'��0% Arrival Time: /O; 3I` Departure Time: �Z ��r,.. County: �Region:
Farm Name: —77 T�oa+c5 hwv'j f So j Owner Email:
Owner Name: ZT, -7to ►-u s Phone:
Mailing Address:
Physical Address: II
Facility Contact: Cu, *, -s Title: 1 e4 Phone No:
Onsite Representative: Integrator: � e " ,
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: [=O
=t
=6. Longitude: =0=4
°0` [� `s
DesignC*urNI
Design Current
Design Current
Swine CapacclPopulation
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ NA
❑ Dairy Cow
Dairy Calf
❑ Wean to Feeder I ILI Non -Layer I
❑ Feeder to Finish
❑ Dairy Heifer
arrow to Wean 113 S 1092-
pr;y Poultry
❑ D Cow
❑ Farrow to Feeder
ETNA
L_.,, NSA
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
El Pullets
❑ Beef Brood CoNd
❑ Turkeys
El Yes
Other
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures: D
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
LJ No
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
ENo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
Yes
ElElJ
No
ETNA
L_.,, NSA
ElNE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
ElD No
A
❑ NE
e. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system`? (If yes, notify DWQ)
El Yes
El No
��
MINA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
LJ No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
B<o
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
E No
Facility Number: 82- 5/�y Date of Inspection 9-2_J
(Not applicable to roofed pits, dry stacks and/or wet stacks)
Waste Collection & Treatment
//
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
El Yes
B No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
2 No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
10. Are there any required buffers, setbacks, or compliance alternatives that need
Spillway?:
LNo
CT/
❑ NA ❑ NE
Designed Freeboard (in):
Observed Freeboard (in): 3-% 3� F�✓ +'� %I w,A T-3
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ETNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
El Yes
,�/
L� 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?
ElIJ Yes
No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
E 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
/
B No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
El Yes
LNo
CT/
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc_)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) ( w L_ Cl._ t 1 Corp
13. Soil type(s) will,
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Ifl� No
El NA C] NE
15. Does the receiving crop and/or land application site need improvement?
[I Yes
1� No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
[? o
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
EK
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
9<o
❑ NA ❑ NE
Reviewer/Inspector Name � -F/0. Y33.333
Phone:
Reviewer/InspectorSignature: 15 �'^-�� ' Date: 9J�2i`2009
Page 2 of 3 12/28/04 Continued

Facility Number: S,Z - s/(o Date of Inspection
Ree wired Records _& Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUp (] Checklists ❑ Design ❑ Maps ❑ Other
❑ Yes ffN. ❑ NA ❑ NE
❑ Yes [3< ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
ON"o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 124 Minute Inspections ❑ Monthly and V
]fain Inspections
Weather
Code
22. Did the facility fail to install and maintain a rain gauge?
El Yes
J❑
� No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
BElNA
❑ NE
ElNE
31. Did the facility fail to notify the regional office of emergency situations as required by
24. Did the facility fail to calibrate waste application equipment as required by the permit?
ElYes
L7 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
LTJ No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
ONoo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[<o
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
2 o
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
EIONo
❑ 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
IJ No
EK
❑ 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
BINo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ YesNo
NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑Yes
No
❑ NA
El NE
'A`ddiho al�Coinr�ieats andlor�Dra"�virigs� a'� _ - �''
A&
12/28104

It
RTKAS G -n44 -^Q PD - - -
Type of Visit (9'Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: %I; 3SArt County: Region:
Farm Name:` ���� 5a�1 FaivM - Sot.] Owner Email:
Owner Name: 146L..ic. V so j f=ares.[ 5 LLG Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: Integrator: C�o � a ►—r P__ ��` vw� S
Certified Operator:
e
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: [�] c =' = Longitude: = o ='
= u
Design Current Design Current Design Current'
SwineCapacity Population Wet Poultry Capacity Population Cattle Capacity Populatibn
❑ Wean to Finish
❑ Wean to Feeder
❑ Fr&der to Finish
Farrow to Wean r'/ 8' // 75
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -Laxer
Dry Poultry -...
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1- Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Dairy Calf _
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood C
Number of
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
r
El Yes ENo 0 N El NE
❑ Yes
❑ No
D rvA
❑ NE
❑ Yes
❑ No
3<A
❑ NE
3<
❑ NE
❑ Yes
❑ No
❑ Yes
B-lq—o
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page I of 3 12/28/04 Continued

r �
�l�'k ,t.,- Awmaa.l S
Facility Number: Date of Inspection
Waste Collection & Treatment
�/
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes LENo El NA NA ❑ N
l
a. If yes, is waste level into the structural freeboard?
El Yes L7 lvgo ❑ NA ❑ Nli
Structure Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: S01_2� 7--1 7-2. 'T 3
❑ NA
Spillway?: -
15. Does the receiving crop and/or land application site need improvement?
Designed Freeboard (in):
[Noo
L73Na
Observed Freeboard (in): SD it 19 3 z- 9
❑ NE
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.)
❑ NE
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes l " No ❑ NA ❑ NE
through a waste management or closure plan?
❑ NA
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? ElD Yes o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the perrnit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) ��,��
9. Does any pan of the waste management system other than the waste structures require [I Yes E Na ❑ NA ❑ NE
maintenance or improvement?
Waste Auntication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes L4 No ❑ NA ❑ NE
maintenance/improvement?
1. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) / Sru berz,Gyf S re~ SGe;4 e..
�l�'k ,t.,- Awmaa.l S
_
.r
13. Soil type(s) A idvj -v,;11<- �
Reviewer/Inspector Signature: r1 Date: $ -20 ZaOS
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[Noo
L73Na
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
No
❑ NA
❑ NE
IT Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of property operating waste application equipment?
Yes
ElL
,1
?No
Cl 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):
P;uS c_ 1P 'I IJct..1 rntc Sk P/A"v r` �► bec, r
.r
Reviewer/Inspector Name Re_q?_iS Phone: 91D.4Q3e3330
Reviewer/Inspector Signature: r1 Date: $ -20 ZaOS
12/28/04 Continued

Facility Number: SZ —,S/(o Date of Inspection F18-2-0—Di-31
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ ❑ Mans Desicm g p ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 1_1Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly )Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield [:1120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
❑ Yes ►' No ❑ NA ❑ NE
❑ Yes No ❑ NA [:INE
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 ,[3io [INA El NE
ElL
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes ,,��< [INA El NE
25. Did the facility fail to conduct a sludge survey as required by the permit? El Yes 1��,'N/o El NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? El Yes L7NNoo [__1NA [:3NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ElD Yes o ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes ,O<o ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes 2 �o ❑ NA ❑ NE
[--]Yes E3 o [_—INA ❑NE
❑ Yes 3<7 El NA ❑ NE
❑ Yes D'No ❑ NA ❑ NE
Additional Gumments 'an`d/or Drawings_ a�
T
Page 3 of 3 12/28/04

® Division of Water Quality
Facility Number$2, j /�s 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 19 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: ED -04<-07 Arrival Time: Departure Time: //. ,3�,it� County:
Farm Name: T -t -1-rA Owner Entail:
Owner Name: mks Phone:
Mailing Address:
ZV
Region: fir/
Physical Address:
Facility Contact: t r. k Title: �t�+ iva V—. Phone No;
Onsite Representative: CuA-S� $av w i GSL _ Integrator:s'1 1�4-Y/i'IS
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Latitude: = [=. =" Longitude: =0=1 ❑ "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -La ers
❑ Pullets
❑ Turke s
❑
Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any pan of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑
Da Cow
❑
Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Plumber of Structures: ©,
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [A No ❑ NA ❑ NE
El Yes
[8 No
El NA
El NE
❑Yes
No
El NA
El NE
❑ NA
❑ NE
❑ Yes
No
❑ Yes (0 No ❑ NA ❑ NE
❑ Yes P1 No ❑ NA ❑ NE
12/28/04 Continued

11 _ Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes UNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failurc to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12_ Crop type(s)
13. Soil type(s)T Ra�
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Qd No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [9No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes I No [INA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes [ 9 No ❑ NA ❑ NE
l8. Is there a lack of properly operating waste application equipment? ❑ Yes Ll No ❑ NA ❑ NE
`Comments.(refer to question #): Explain any YES answers and/or any recommendations or any other., oments.. .T
Use;trawin Sof facilityto better explain situations. (use additional pages as necessary):
z -
Reviewer/Inspector Name KlG� J�2.V f—US Signature: e
Phone: 11,9,5133.3300
Date: 14 -vy— ZeO7
Page 2 of 3 12128104 Continued
Facility Number: SZ —5j Date of Inspection —o—a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
El Yes
Wj No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
in 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
❑ 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
T No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
W 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
V1 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 UNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failurc to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12_ Crop type(s)
13. Soil type(s)T Ra�
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Qd No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [9No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes I No [INA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes [ 9 No ❑ NA ❑ NE
l8. Is there a lack of properly operating waste application equipment? ❑ Yes Ll No ❑ NA ❑ NE
`Comments.(refer to question #): Explain any YES answers and/or any recommendations or any other., oments.. .T
Use;trawin Sof facilityto better explain situations. (use additional pages as necessary):
z -
Reviewer/Inspector Name KlG� J�2.V f—US Signature: e
Phone: 11,9,5133.3300
Date: 14 -vy— ZeO7
Page 2 of 3 12128104 Continued

Facility Number: 82 —S�(Q Date of Inspection
Required Records & Documents ,,me�
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes A No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [A No ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists [:1 Design E] Maps [:1 Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [A No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
_V1 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[A No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
10 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
M No
ElNA
ElNE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[4 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
P No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
�9 No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[4 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[9No
❑ NA
❑ NE
Comments and/or Drawings:
12/28/04

Type of Visit ® Compliance Inspection Q Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of visit: Arrival Time: /O,'O 17 Departure Time: County: 197dL PSTN Region: AfA
Farm Name: _I _irlr j&AzxS /Awal" _ -5AO1S "'_ 50.:3 Owner Email:
Owner Name: _ 1 i%omaS Hns,"Vck _ Phone:
Mailing Address:
Physical Address:
Facility Contact: 'C>ntrv-ka l k4v,�aaird _ Title: Phone No:
Onsite Representative: C -41C T L laicWj [. k �AV►r�. c jntegrator: e7_ ilrri t. _
Certified Operator:
Back-up Operator:
Location of Farms:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedei
Farrow to Finish
Boars
Other
❑ Other
Operator Certification Number:
Back-up Certification Number:
Latitude: =0
=, ❑ Longitude: = ° =, =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑
Layer
❑Non -La et
Dry Poultry
❑ Layers
❑
Non -Layers
❑ Pullets i
❑ Turkeys
❑ urkey Pouits
❑ Other
Discharses & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
i�
❑ Dairy Calf Ij
❑ Daily Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker I:
❑ Beef Feeder
❑ Beef Brood Cowl� 4 __�r,
'Number of Structures:
b_ Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does dischar(ye bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge's
❑ Yes �A No ❑ NA ❑ NE
❑ Yes
[9 No
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
P No
❑ Yes
X No
❑ NA
❑ NE
E] Yes
V1,
El NA
El NE
12128/04 Continued

4
Facility Number: $� — 5/(o Date of Inspection FT —0 O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [3No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes rO No El NA El 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 [�J 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 allo ❑ 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 Cg No ❑ NA EINE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes P No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ;9 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 No ❑ NA ❑ NE
mai ntenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes W No [INA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ 'Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) (_r` r-ni l KJ
13. Soil type(s) Av k— :mlle—
' r
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination: ❑ Yes
P�No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[g No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
10 No
❑ NA
El NE
Reviewer/inspector Name 's Phone:
Reviewer/Inspector Signature: Date: S dz — zao (a
12/28/04 Continued

L
Facility Number: �Z —S/(p Date of Inspection 5 02-0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Cff-No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design g ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EgNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
(9 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
JA No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[)9 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
NNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
C4 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
IV No
❑ NA
❑ NE
Other Issues
28" Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
CR No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
®No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
P 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
M No
yu
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
0 No
❑ NA
❑ NE
AddchanalCom'ments,aoii%or Drawiings '``
12/29104
12/29104

O DEvlSlon of Water Quality . , *
O Division of Soil and Water Conse_ rvatton
- O OtherAgency
Faeility{dumber:..
❑ Layers f
h
❑ Non -Layers
❑ Pullets
❑ Turkeys
- �`r �r�
IT 10
SI tr
Type of Visit IN Compliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine © Complaint O Follow up Q Referral O Emergency O Other ❑ Denied Access
Aare of Visit: 3 r♦ /b 4t Arrival Time:
v6 Departure Time: County: Saw. Region:
Farm Name: _ cjr� Q�6 Y� �.s _�,Fy is LLc_ Owner Email:
Owner Name:
Phone:
IT 10
slC 7 -
SI lei
Mailing Address:
Physical Address:
Facility Contact: /n., /-io wa � Title: �r�ta Phone No:
Onsite Representative: integrator:
Certified Operator: e-1,4 f /_ -�o�y,e � Operator Certification Number: -7 # c'
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 00 =. = Longitude: =o ={ =61
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
® Farrow to Feeder (r �� U ;
❑ Farrow to Finish
❑ Gilts
❑ Boars
F
Other
❑ Other
❑ La er
❑ Non -La et
Dry Poultry
❑ Turkev Points
❑ Other
❑ Yes Qff
Discharges & Stream Impacts
1- Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made`'
❑ Dai Cow
❑ Dai Calf
❑ Dai Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Design Current
Capacity Population
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ®No ❑ NA ❑ NE
❑ Yes ZI
12/28/0
No
❑ NA
❑ NE
4 Continued

Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone: 9/0 'Y4'C / S`fl
Date: T 3 /Jo/y.-
12/28/04 Continued
Facility Number: ,2 — S (. Date of Inspection 3 /T'
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 I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: /
Spillway?:
Designed Freeboard (in): )V a4'
Observed Freeboard (in): 3a t`
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[�j 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
[3 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
9 No
❑ NA ❑ NE
maintenance/improvement?
1 1. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
® No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s) syc� ea �.� F _ , - M CL---
13. Soil type(s) R.l'n i
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 acre determination%❑ Yes
[0 No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
Up No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Ep No
❑ NA ❑ NE
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone: 9/0 'Y4'C / S`fl
Date: T 3 /Jo/y.-
12/28/04 Continued

Facility Number: 1 —,�/G Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [8 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 appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
® Waste Application ❑ Weekly Freeboard [A Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
® No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
® No
❑ NA
❑ NE
24_
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
[0 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
0 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
® NE
Other Issues
Nb O11Gr c`aja):L.k.e:`
�41A oGCA.cFrc�.,
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
@ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
50 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
®No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
AdSdEtibm(O�COlnments and/or Drawings
IN I
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t`s . �- �, . �. O
� a S b ju
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�tea�c »-►oi�� SLA_ ` rQ+�
r..����
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�41A oGCA.cFrc�.,
12/28/04

iType of Visit WCompliance Inspection O Operation Review Q Lagoon Evaluation
Reason #or Visit Gri outine 0 Complaint O Fallow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: EK y o Time: �J
Q =Not rational O Below Threshold
Urfe ruitted EMertified [j Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .
Farm Name: �a"``'.�'. /�owIdw4 Sows i�ar1..-�`owt sw
County: » ... Sen
Owner Name:... ._ .....! a'_ _. .... .�. I �.1tlr�j �!?f !� �/bC..�I.f?- LPhone No: f' ^S,
fading Address: -------- AM . �s�_15 �. - .�� - �_�� W . _ _� Vi �__ �C_ _� Wit -
Facility Contact: ............... ..i Mn........A._...------- Title- ... ...OuAteR ................_..»» �, � Phone No:
Onsite Representative:.. . _ ��'u►`�is.. �at�lr`eK ......_.--------------.... --- Integrator: ` »._ �„ '-G_.. ... ....»._ --_ W_W ......
Certified Operator:.._ , � !_ N °�+ d Operator Certification Number: /401O. -
Location of Farm:
[wine ❑ Poultry ❑ Cattle ❑ Horse Latitude • i &° Longitude • ` "
Discharges & Stream Impacts
1. Is any discharge observed front any part of the operation? ❑ Yes RrNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. If discharge is observed, what is the estimated flow in gm/min'?
d_ Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any pact of the operation? ❑ Yes B'1Go
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes EkNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes RITo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......... ._. ................ .............
�.._...,..-
Freeboard (inches): �`
12112103 Continued

Facility,Number: Date of Inspection
1.
S- Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 210
seepage, etc.)
6_ Are there structures on-site which are not properly addressed and/or managed through a waste management or E3 Yes [,To
closure plan?
(IS 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 maintenancelimprovement? 0 Yes Q$io
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes [klo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
EWO
elevation markings?
T
Reviewer/Inspector Name Ac"
Waste Application
10. Are there any buffers that need maintenance/improveinent?
[] Yes
RRo
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ yes
[94o
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12_ Crop type rw►w e5G MOIL t „a
13_ Do the receiving crops differ with those designated in the Ce 'Led Animal Waste Management Plan (CAWMP)?
❑ Yes
2NO
14- a) Does the facility lack adequate acreage for land application?
❑ Yes
IRSlo
b) Does the facility need a wettable acre determination?
❑ Yes
2No
c) This facility is pended for a wettable acre determination?
❑ Yes
B"No
15. Does the receiving crop need improvement?
❑ Yes
2No
I6. Is there a lack of adequate waste application equipment?
❑ Yes
[flo
Odor Issues
IT Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
Dqqo
Liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
[Ilo
19- Is there any evidence of wind drift during land application? (i.e- residue on neighboring vegetation, asphalt,
❑ Yes
ml� o
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
Dg-f4o
Air Quality representative immediately.
Comments (refer to gneshon #} Ezplam any�YFS answers and/or any Ws eoa tmendations or any orae anmmaptt5.
'Use di_i "w if .x �iaduse'btaial g�� as�. eld CoFPy ❑Final Notes� 4
T
Reviewer/Inspector Name Ac"
ReviewedLnspector Signature: Date: ". v
12112103 0 Continued

)Facility Number: p _S''(o Date of inspection
ddtttonal Comments and/orDrawtngs
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Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
(1io
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
8140
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
&RO
❑ Waste Application ❑ Freeboard ❑ Waste analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[?I�o
25- Did the facility fail to have a actively certified operator in charge?
❑ Yes
&No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
Yes
ZIvo
(ie/ discharge, freeboard problems, over application)
❑
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
WAO
28. Does facility require a follow-up visit by same agency?
❑ Yes
No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
©'rio
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes [(No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
ddtttonal Comments and/orDrawtngs
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Be Swt.iv
A�eT "(
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re
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� 1
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12112103

�2(
I
Facility Number:. Ej ��
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
Dater f�
Time: ,
General Information:
Farm Name: _ _ �: d w.A s �-� c,r c� �j� r-,.., County: o
Owner Name: a e T_ H ­ rl� _ Phone No: 56 -1 --c- 5
On Site Representative: ,- - integrator: e_._
Mailing Address: 13 (� "� w
r ell nnC- 3
Physical Address/Location:� 'rz Se s _ oVn � me1.l_ .— Sa !� 3
Latitude:__35__/Q 5 / 9 Longitude: 78 13 3 _j _A_2,3
Q eration Description, (based on design characteristics)
Type of Swine No. of Animals Type of Po Wiry No. of Animals Type of Cattle No. ofAnimali
lasow �- 2-4 ❑ Layer ❑ Dairy
❑ Nursery O Non -Layer ❑ Beef
D Feeder
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?--
Is
torage?:Is seepage observed from the lagoon?:
Is erosion observed?:
Is any discharge observed?
O Man-made O Not Man-made
Cover Crop
Does the facility need more acreage for spraying?:
Does the cover crop need improvement?:
( lisr the crops which need improvement)
Crop type:
Setback Criteria
Acreage:
Is a dwelling located within 200 feet of waste application?
Is a well located within 100 feet of waste application?
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream?
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream?
AOI — January 17,1996
Yes ❑
No
Yes Q
N �
Yes ©
No,0
Yes U
No�3
Yes O
No�
Yes Q
Na�
Yes 0
No�
Yes ❑
No�d
Yes Q
No
Yes ❑
No

1 • Maintenance
Does the facility maintenance need improvement? Yes U No
Is there evidence of past discharge from any part of the operation? Yes ❑
Does record keeping need improvement? Yes ❑ N
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes D No
Explain any Yes answers:
Signature.- _ C _ Date:
c�
cc FacilityAssessmant Unit
Drawings or Observations:
AOI -- January 17,1996
Use Attachments if Needed