820533_INSPECTIONS_20171231

NORTH CARULINA
Department of Environmental Qual

UM51 I y 0U
Type of Visit: ompliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up Q Referral O Emergency O Other O Denied Access'
Date of Visit: a rf Arrival Time: i S Departure Tune: /a ret County: 4 1PT;' 7/0 Region: rj['}
Farm Name: ^,a&M, ss �.� y Owner Email:
Owner Name: r ,Tut c & Ft LyUksaLV Phone:
Mailing Address:
Physical Address: jr '� 7
Facility Contact: GwT�S E# -W FGI ` Title: Phone:
Onsite Representativel�yy l f Integrator: rq 13 S
Certified Operator: %, It r- I CT-IWj II -T- c` of Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
IMM
Design 'Current
-.:-
Design
Current
Design Current
Swine
Capacity Pop:.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
4 (7 i
Non -Layer
DairyCalf
Feeder to Finish
-
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D . P,o_ul
Ca act
P,o P.
Non -Dairy
Farrow to Finish
l..:...
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
4
Boars
Pullets
Beef Brood Cow
m,
Turkeys
Other:.I
n
TurkeyPoults
Other
Other
- -,�-� ,n
,... ms=s -�
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes [ j'No ❑ 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 DWR) ❑ Yes [—]No NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No IA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ❑`flo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes E]rl o ❑ NA ❑ NE
of the State other than from a discharge'?
Page 1 of 3 21412015 Continued

- 3.3 Date of Ins ection: 2 T M
riiectieo�n
/91
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
p Heavy Metals (Cu, Zn, etc.)
& Treatment
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
EjN9__❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
E9-1q.A`
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ Yes �]i'l\lo
Identifier:
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes I 3 ''o
❑ NA
Spillway?:
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑'0
❑ NA
❑ NE
acres determination?
Designed Freeboard (in):
Observed Freeboard (in): IZC)
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
GD K -o
❑ 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
EL -Ko
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
2<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
❑,No-
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[3`5o
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [] No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
p Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of AcceptableCrop WindoLw` E] Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop Type(s): CI`I _ j3 f P scy
13. Soil Type(s): t�
14. Do the receivin- crops differ from those designated in the CAWMP?
❑ Yes �]i'l\lo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes I 3 ''o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑'0
❑ NA
❑ NE
acres determination?
17_ Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes ❑Ko ❑ NA ❑ NE
[:]Yes ❑,N -o ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available'? ❑ Yes [3'�N"o ❑ NA ❑ NE
20. Does the facility fail to have all components ofthe CAWMP readily available? Ifyes, check ❑ Yes [] N ❑ 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 ❑'oto
❑ 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? 0 Yes [:}No
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
❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

24 - Tber: P Z - 533 1 1 Date of Inspection:
e e facility fail to calibrate waste application equipment as required by the permit? [—]Yes [D -No ❑ NA ❑ NE
25. is the z`acility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes to ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any Iagoon
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 [JAit' ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ET 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, 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?
Calf6("'41q-'� q 16
GA —gro - 3o*4 -s 1
`Lt'7
Reviewer/Inspector Name: 1� t (t 00
r �
Reviewer/Inspector Signature:
Page 3 of
❑ Yes Q,Ncr— ❑ NA ❑ NE
❑ Yes 1_.T11O ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes Q-4065" ❑ NA ❑ NE
❑ Yes
Q,?°
❑ NA
❑ NE
❑ Yes
L.;PN`6
❑ NA
❑ NE
❑ Yes
l�t"No
❑ NA
D NE
Phonell0- q 3 3
Date: l8
21412015

- 1 1n of Water Resources
Facility Number L__SL_J - 3-3 Division of Soil and Water Conservation
© Other Agency
Type of Visit: Q�mpliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: eF Routine Q Complaint 0 Follow-up Q Referral 0 Emergency 0 Other Q Denied Access
01
Date of Visit: Arrival Time: .ro Departure Time: County: RegionhF�_
Farm Name: LyalsAr, A -r -%f Owner Email:
Owner Name: Ot t Phone:
Mailing Address:
Physical Address:
Facility Contact: (!704) C7 694Atjek Title:
Onsite Representative: {{
Certified Operator:Gni�/j
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: A &>_S
Certification Number: 11 o z 6
Certification Number:
Longitude:
Discharges and Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes Fe ❑ NA ❑ NG
❑ Yes ❑ No
❑ Yes [:)No
ETVA [] NE
[:T'NA [] NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No []'�4A ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes [ffNo [] NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes EfNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2015 Continued
Design
Current 8 s
Design
Current
- Design Current
Swine
Capacity
Pop. WeY Poultry
Capacity
Pop.
Cattle Capacity Pap.
Wean to Finish Layer
Dairy Cow
Wean to Feeder
I 7(910
tZOV Non -Lay r
I
Dairy Calf
Feeder to Finish
�" "'ice -
"' M
Dairy Heifer
Farrow to WeanDesign
I
C,rrent
Dry Cow
Farrow to Feeder
D P uC .
Ca aci
P.o .
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Other
11 Other
Pullets
Turkeys
Turke Poults
Other
Beef Brood Cow
Discharges and Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes Fe ❑ NA ❑ NG
❑ Yes ❑ No
❑ Yes [:)No
ETVA [] NE
[:T'NA [] NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No []'�4A ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes [ffNo [] NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes EfNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2015 Continued

FacilitvOumber: Date of Inspection: a77 1
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 [3 No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): g.
Observed Freeboard (in):O
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ffNo ❑ 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
❑ So
❑ NA
❑ NE
waste management or closure plan?
❑ Yes
f] No
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[2 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[�T`No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ NE
the appropriate box.
9. Does any part of the waste management system other than the waste structures require
❑ Yes
E3 -No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
allo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [f No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > tO% or ]0 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. CropType(s):
13. Sol] Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ET -No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [! No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes Rl"�No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
(ff'No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
f] No
❑ NA
❑ NE
Required Records & Documents
111�_
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
ET -No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard [:]Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Ef No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [I No ❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Facility, Number: - 3 Date of Inspection: 2l Aft
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ ~leo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check D Yes No
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 [ Vo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 1]Ko
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:
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes dNo ❑ NA ❑ NE
❑ Yes ZNo ❑ NA ❑ NE
❑ Yes C7No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[21No
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[!fNo
❑ NA
[] NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [:I No ❑ NA ❑ NE
Comments (refer to question #):.Explain any YES answers and/or any additional recommendations or any other. comments.
Use drawings of facility to better explain situations fuse additional pages as necessarv).
CSC 10- 3p - 45 i
Reviewer/Inspector Name: ` Phone�V"i3 3`
Reviewer/Inspector Signature: Date: I '(_ —
Page 3 of 3 21411015

S 21 1"ouzi t
IType of Visit: 42rCom fiance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: alroutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: ! County: 196 M Region:
Farm Name: L L v4S Owner Email:
Owner Name: I'(/� r S Phone:
Mailing Address:
Physical Address:
Facility Contact: CL A349M V b EpTitle: Phone:
/ f
Onsite Representative: � l Integrator: Y�1
Certified Operator: fk&- Certification Number:
v C! fI[7
Back-up Operator: Certification Humber:
Location of Farm:
Latitude:
Longitude:
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
Design Current
❑ NA
Design
Current
Design Current
Swine
Capact y, Pop.
Wet Poultry
Capacity.
Pap.
Eattle Capacity Pop.
Wean to Finish
❑ No
Laver
❑ NE
Dai Cow
Wean to Feeder
Non -La -er
Dai Calf
Feeder to Finish
-
Dai Heifer
Farrow to Wean
Design .Current
Cow
Farrow to Feeder
Dr, iPoul
Ca aci...
1?0
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La vers
Beef Feeder
Boars
Pullets
Beef Brood Cow
',..
Turkeys
Other
��;:
Turkey Poults
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
�lA
❑ NE
0 Yes
❑ No
PoWA
❑ NE
❑ Yes ❑ No
❑ Yes &No
❑ Yes �o
LZ NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

1*acili Number: - Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes A ❑ NE
a. If yes, is waste level into the structural freeboard? D Yes D No [3-N7C�D NE
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
Structure 5 Structure 6
❑ Yes Rp4o D NA D NE
D Yes Bio ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No D NA ONE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes E34o ❑ NA D 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 LJ No D NA D NE
maintenance or improvement?
Waste Annlacation
10. Are there any required buffers, setbacks, or compliance alternatives that need D Yes 0 No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. D Yes E3<o D NA D NE
❑ Excessive Ponding D Hydraulic Overload D Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN M 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): A{ y4A
13. Soil Type(s): A 1G
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �o D NA D NE
15. Does the receiving crop and/or land application site need improvement? [] Yes to ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes vo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reouired 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 L J— o
❑ Yes
❑ Yes ENo
D Yes C No
D NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes No D NA D NE
[:]Waste Application ❑ Weekly Freeboard ❑ Waste Analysis D Soil Analysis ❑ Waste Transfers D Weather Code
❑ Rainfall D 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 1 o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [] Yes YNo ❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

JFkility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ELXo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [Ko ❑ 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: J
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ' 4, 0. ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes T3`No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [? 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
[�r<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
FK. .
❑ 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
[3 o
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[T No
❑ 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 a follow-up visit by the same agency'?
❑ Yes
E(N o
❑ NA
❑ NE
Comments (refer to quest,on {):Explain any YES answers and/or any additional recommendations,or any other comments
Use drawingsof facility to betfer explain situations (use additional pages as necessary).
c�4
Reviewer/Inspector Name:
V
Reviewer/Inspector Signature:
Phone: vk 7 ) '
Date:
Page 3 of 3 1 2/4/2011

I ype of visit: %.14 av npliance Inspection U Operation Review U Structure Evaluation U Technical Assistance j
Reason for Visit: 421ioutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access I
Date of Visit: Arrival Time: Departure Time:01 / «1B it I County:�'i Region Ta_
Farm Name:
Gtx_
v
Owner Email:
Capacity Pop.
We#PoultryCapty Pop.
Owner Name:
t
S
Phone:
❑ NA
Wean to Finish
Mailing Address:
Physical Address:
Facility Contact: a.�, <�►�f Title: Phone:
a
Onsite Representative: Integrator: 3 _
Certified Operator: �,i ��'' % t a- Certification Number:
Jt
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design. Current
,� Design C rrent
Design Current
Swine
Capacity Pop.
We#PoultryCapty Pop.
e Capacity Pop.
k.
❑ Yes
[ ""
❑ NA
Wean to Finish
La er
Cow
AD
Wean to Feeder
�'� p
Non -Layer
Calf
Feeder to Finish
jDairy Heifer
Farrow to WeanDesign_
Current
D Cow
Farrow to Feeder
D . ;P�oiil .�Ca aci P.o .
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
on -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
_
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure p 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 []-}'�❑ NA ❑ NE
❑ Yes
❑ NoQ'
A
❑ NE
❑ Yes
❑ No]�NA
❑ NA
❑ NE
[:]Yes
❑No
❑`NA
❑ NE
❑ Yes
[3 -.Wo
❑ NA
❑ NE
❑ Yes
[ ""
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

Facili Number: .001— Date of Inspection: 14 1 r
Waste Collection & Treatment
❑ Yes
[D<o
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
U l
❑ NA
❑ NE
a. If yes, is waste level into the structural frechoard?
❑ Yes
❑ No
CE[IM
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier:
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
GH ttr
0' NA
Spillway?:
the appropriate box.
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
U 1"0
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
E; <o
E] NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
13 -Ko
❑ 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
L'J To
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload [] Frozen Ground ❑ 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 E] Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):[J C,
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [D No [:INA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes EFNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑`go— ❑ NA ❑ NE
acres determination?
17. Does the facilitylack adequate acreage for land application?
❑ Yes
[D<o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑'leo'
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
GH ttr
0' 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 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 [JNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [E Kb ❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facility Number: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes []I-Np ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes u 1Vo ❑ 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 [[p4o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ®-ITo— ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes [:�Wo— ❑ NA ❑ NE
❑ Yes. [3 -No— ❑ NA ❑ NE
❑ Yes [3 ~ o ❑ NA ❑ NE
[—]Yes ❑'1 o ❑ NA ❑ NE
❑ Yes
❑ Yes �
No
❑ Yes F�(No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Signature:
Page 3 of 3
Date: 174,j
21412014

1304 s
M
l ype or Visit:Com fiance Inspection V Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County
Farm Name: ---� L i Owner Email:
Owner Name:Q� '",t� &� Phone:
Mailing Address:
Physical Address:
Region:F0
Facility Contact: IS SGV YA Title: Phone:
Onsite Representative: L( integrator:
Certified Operator: a Certification Number: �q o 87
Back-up Operator:
Location of Farm. -
Latitude:
Certification Number:
Longitude:
4 ..Design Current
t Design
Current
a Design Current
Cap ity Pop.
Wet iPouItry
C p city
Pop.
Cattle Capacity Pop.
ENo
❑ NA
❑ NE
Wean to Finish
La er
Dai Cow
Wean to Feeder
Non-LaMr
Dairy Calf
Feeder to Finish
-
Dairy Heifer
Farrow to Wean
::.
77 esign,
Current.
I Dry Cow
Farrow to Feeder
D , PF).ul
Ca act
Pop.
Non -Dai
Farrow to Finish
La ets
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
...�
Turke s
Other _ _
Turks Points
Otber
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other -
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
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 D410 0 NA ❑ NE
❑ Yes ❑ No � NA ❑ NE
❑ Yes ❑ No EJ14A ❑ NE
Yes
❑ No
❑ NA
❑ NE
Yes
Q?No
❑ NA
❑ NE
❑ Yes
ENo
❑ NA
❑ NE
Page 1 of 3 2/4/7011 Continued

01
Facili Number: - Date of Inspection:
Waste Coll D & T t t
ec on rea men
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 3-11-001,1_1 NA ❑ NE
a. If yes, is waste level into the structural freeboard? 0 Yes ❑ No L7 1 A ❑ 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 L J No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or enviroqafflntal threat, notify DWQ
7. Do any of the structures need maintenance or improvement? eso [:]NA [:]NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No [DNA ❑ 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 2f"No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc_)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Cro Window [] Evidence of Wind Drift [:]Application
Outside of Approved
Area
12_ Crop Type(s): & Nh -( 0 (�' QKA
13. Soil Type(s): q,
14. Do the receiving crops differ frin those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design [:]Maps []Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis [:]Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes ❑No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment`? ❑ Yes ❑ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA 0 N
Page 2 of 3 21412011 Continued

Facility Number: JL1 jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
■ 25_ Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes E3,M6— ❑ 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 g�V�n ❑ 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 [n 'No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29, At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes �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
— ,�,Je
❑ Yes
�No ❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
�No ❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[rNo [:INA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative?
❑ YesWNo
�o [:]NA
El NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑ NA
❑ NE
Corntnents (refer, to,questtoA;#1): Explain any YES answers and/or any additional recommendations or any othercom�"n
Use kdrawings.o facility to better explain..situations (use additional pages as necessary)Ca((_(lo4tw4,
Reviewer/Inspector Name-
Reviewer/Inspector Signature:
Page 3 of 3
el
Ito L173A333
Phone. j�
Date) 1'
214& 111

�ypelui visit: y t ompuance inspecnon v uperanon xeview v birucrure r:vatuanon V iecnnlCal ASslstance
Reason for Visit: • Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ;3Da�, Departure Time: County: Psph% Region: !U -Q-4
Farm Name: Lt\yJ5Q.O P4 IULL,2er'v Owner Email:
Owner Name: I r'mV`TLt V l L4�ASMA Phone:
Mailing Address:
Physical Address:
Facility Contact: F—Mil -41 � ( ..trjLaj Title: Phone:
zi
Onsite Representative:
Certified Operator: N
Integrator: LnUA-My–PruJ n
Certification Number: 1904f6
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
11, iiiii11
Design Current` _ Design Current "�� '�� Design Current
Swine
Capacity Pop.
-Wet Poultry Capacity Pope
s Capacity Pop.
La er
eeder
QO CV
Non La er
0 NA
inishDai
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
Fleifer
"WeanFininish
Wean
❑ NE
f _ Desin Current
D Cow
Feeder
D • Poul @a aei P.o
Non-DaiFinish
❑ Yes
❑ No
® NA
La ers
2. Is there evidence of a past discharge from any part of the operation?
Beef Stocker
No
NA
❑ NE
Nan -La ers
❑ Yes
Beef Feeder
Boars
❑ NE
of the State other than from a discharge?
Pullets
Beef Brood Cow—j--
owTurke
Turkeys
s
Other
Turkey Poults
Other
Other
Discharges and Stream ImnaCts
1. Is any discharge observed from any part of the operation?
❑ Yes
�E No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
0 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
0 NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
® NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes]
No
NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page l of 3 2/4/2011 Continued

Facili . Number: &2 - _15-3s 1 jDate of Inspection: to
t i.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
0 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
® NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): &7&
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(i.e.. large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
M No
[DNA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9_ Does any part of the waste management system other than the waste structures require
❑ Yes
� No
❑ NA
❑ NE
maintenance or improvement'?
Waste ADDlication
I0. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Y No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ 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):
I
13. Soil Type(s): Wan Yam —Oct Q
P '
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [�j No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [�q No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes P No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes] No ❑ NA ❑ NE
the appropriate box.
❑WUP E] Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EP No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes [P No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EPNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

Facifi Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [�] No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes M No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [�j No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [D No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes [N No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes §d No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes ® No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes C$g No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [�3 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes V No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes W No ❑ NA ❑ NE
Reviewer/Inspector Signature:
Page 3 of 3
Date: b12-
21417011

Ii ype of visit: w uompuance inspection v operation xeview U structure r vamanon V i ecnntcai Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: _"jQ2.� Departure Time: / : County: = VV4 Region: rim
Farm Name: �, Ub•dLo F'c uAr_r' i- Owner Email:
Owner Name: t� �t.•OtS . Phone:
Mailing Address:
Physical Address:
Facility Contact: pYa4l "IVITitle: Phone:
Onsite Representative: 0 Integrator: MunsWA14u�
N
Certified Operator: Certification Number: �
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
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 T No ❑ NA ❑ NE
❑ Yes
[] No
M NA
❑ NE
❑ Yes
[] No
1EP NA
❑ NE
❑ Yes ❑ No
❑ Yes No
❑ Yes No
EPNA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 214/2011 Continued

FacHity Number: Date of Inspection: ll
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. if yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
No ❑ NA ❑ NE
❑No ®NA ❑NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2.�4
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes r] 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
❑ YesNo
No
[:]NA
[:]NE
waste management or closure plan?
❑ Yes
No
❑ NA
❑ NE
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?
❑ YesNo
❑ NE
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
� No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
Waste Application
❑ 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?
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
4 ] No
❑ NA
❑ NE
maintenance or improvement?
1kj No
[:INA
NE
Page 2 of 3
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [P] 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 E] Evidence oWind Drift ❑Application Outside of Approved Area
12. Crop Types): 01.v V "� � ky-e�)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes M No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes Q No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ® No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[] Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
It No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[R No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
1kj No
[:INA
NE
Page 2 of 3
2/412011 Continued

1F'acili Number: aa- Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes M No ❑ NA E] 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? ❑,YesNo [:]NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes] No
[-]NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
T
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
0 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 EPNo
❑ 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 a follow-up visit by the same agency?
❑ Yes No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or.any other cornments�
Use drawings of facility to better explain situations (use additional pages as necessaiy).
d` .
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: U 1"l r {
2/4/2011

IType of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit *Routine O Complaint O Follow up 0 Re€erral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Qj (j Arrival Time: i Departure Time: I ITQ.ti^I County:
Farm Name: Owner Email:
Owner Name: ► J iv. Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: P'� — U, l.'LA� Title: Phone No:
Onsite Representative: 67 Integrator:
Certified Operator: Operator Certification Number:
rC?68
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o =.
='s Longitude: =0=A
0=A = If
Design Current
Design Current
Design Current
❑ NE
Swine Capacity Population
Wel Poultry 6 it-
yj Population
Cattle Capacity Population
❑ NE
❑ Wean to Finish
10 Layer
❑ Dairy Cow
Wean to Feeder I 200117002_1
JLI Non -Layer I I
❑ Dairy Calf
❑ No
Feeder to Finish
(� No
❑ DairZ Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
_
DNon-Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
[3 Beef Feeder
❑ Boars
El Pullets
❑ Beef Brood Cowl
❑ Turkeys
the
❑ Other
U'Turkey Poults
IF1 I
Number o€Structures:
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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �&No ❑ NA ❑ NE
❑ Yes
❑ No
PNA
❑ NE
❑ Yes
❑ No
gNA
❑ NE
F NA
❑ NE
❑ Yes
❑ No
ElYes
(� No
❑ NA
❑ NE
❑ Yes
f�) No
❑ NA
❑ NE
Page 1 of 3 12128/04 Continued

Facility Number: — Date of Inspection
❑ Yes
[IfNo
Waste Collection & Treatment
❑ NE
15. Does the receiving crop and/or land application site need improvement?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ YesNo
[INA ElNE
a. If yes, is waste level into the structural freeboard?
El Yes
rNo A El NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
❑ Yes
Y No
Spillway?:
❑ NE
I8. Is there a lack of properly operating waste application equipment?
Designed Freeboard (in):
4 No
❑ NA
R
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
0 No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
0No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
( No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9_ Does any part of the waste management system other than the waste structures require
❑ Yes
No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[ No ❑ NA ❑ NE
mai ntenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
It 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 Wind o ❑ Evidence��o``f��Wind ❑ Application Outside of Area
p�Drift
12. Crop
type(s)
13. Soil type(s) PaAaLm — Uji
V
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[IfNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
Q9 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
Y No
❑ NA
❑ NE
I8. Is there a lack of properly operating waste application equipment?
❑ Yes
4 No
❑ NA
❑ NE
Comments (referhto question, #): Explain any YES answerstand/or any i recommendations or.any other comments.
Use'd facility #o better explain situations (use additioiialpages as necessary)
AL
Reviewer/Ins ector Name r `" k `TM"
P utt Phone: !O Ota
Reviewer/Inspector Signature: Date: � ho
Page 2 of 3 12/28/04 Continued

Facility Number: — Date of inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No P NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes VbNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes oE§No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No PTNA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
TTNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Q3 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ 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 revicwlinspection with an on-site representative?
❑ Yes
tD No
❑ NA
❑ NE
Page 3 of 3 12/28/04

r
1
Type of Visit 6 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral Q Emergency O Other ❑ Denied Access
Date of Visit: 1 01'X0107 I Arrival Time: Q(i yt, Departure Time: /Q • County: '✓ Region:
1 i1
Farm Name: `ro�ti/ Owner Email:
Owner Name: __q—r fyto7l2�,� L'Sq _. Phone:
Mailing Address:
Physical Address: f
Facility Contact: anf�l7 Title:
1
Onsite Representative.
Certified Operator:
Back-up Operator:
Location of Farm:
c1
Phone No:
Integrator:
Operator Certification Number: 19Ogg
Back-up Certification Number:
Latitude: = Q =I=,, Longitude: = ° =I = u
DesignCurrent
Swine Capacity Population
❑ Wean to Finish
Wean to Feeder
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Design C+urren#
Cxttte Capacity Population
❑ Dai Cow
❑ Dai Calf
Feeder to Finish
❑ Yes
❑ Dai Heifer
❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
Non -Layers ers
❑Beef Feeder
❑ BoarsTurkeys
❑ Pullets.
❑Beef Brood Co
RNo
❑
❑ NE
Other
❑ Other
❑ Turkey Poults
❑ I
Humber Structures:
Other
of
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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c, What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [�No ❑ NA ❑ NE
❑ Yes
O No
❑ NA
[:INE
❑ Yes
[�3 No
❑ NA
❑ NE
[:INA
❑ NE
❑ Yes
No
❑ Yes
�] No
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
12/28/04 Continued

t
Facility Number: — Date of Inspection L10
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ONo
❑ NA EINE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
�DNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier -
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 q
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [1PNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes [�ONo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ® No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes §d 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 $m 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 �C] 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 ElEvidence of Wind Drift ❑ Application Outside of Area
)I
12. Crop type(s)�d4 C -"V S5 SI%t . :5.. llte+_
13. Soil type(s) t*�iq
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes f�+No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes y No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 1� No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes 01 No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes PNo
❑ 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. situateonsa(use 4tibnal pages as necessary} y 9
Reviewer/inspector NamePhone:
9r'n--Y33
Reviewer/inspector Signature:<_44b." _ _ Date: Iop&/09
12/28/04 Continued

r'
Facility Number: — Date of inspection
Re 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
f�No
[:INA
❑ NE
❑ Yes
T No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. (--]Yes P No ❑ NA EINE
❑ 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
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
EpNo
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes [`� No ❑ NA ❑ NE
❑ Yes �9 No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
ERNo
❑ NA
❑ NE
❑ Yes
CIPNo
❑ NA
❑ NE
A�'dditioaal�@omments antlor"Dra�ngs;"
IZ,28/04
IZ,28/04

Type of Visit 40 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine Q Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: I Arrival Time: Departure Time: EOCounty: sem' Y St)A)
Farm Name: *-r. url _ ilan Piot
i of ` ►W SQ,r �a Owner Email:
Owner Name: TLOlr, T`�OI�LL�. Phone:
Mailing Address: i
Physical Address:
Region: FAV
Facility Contact: F('OA O i"� L4;0.1 Title: Phone No:
Onsite Representative: U Integrator: N(fi&ak"-' - &zW P
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = I ❑ .1 Longitude: ❑ ° 0 I = N
Discharges & Stream Impacts
Design CurrentF Design Current-
Design Current
Swine
Capacity Popp is ionWetPoultCapacity Populatton
Cae Capacity Population
❑ an to Finish
-10 Layer
ia Cow
Wean to Feeder
f3l Co 651W
JE1 Non Layer I
i Calf
❑ Feeder to Finish
't y_ $ �'
DryPoultr
° ` u
❑ Dairy Heifer
❑ D Cow
❑Farrow to Wean
NA
❑ Farrow to Feeder
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
• Non -Dairy
❑ Farrow to Finish
❑ NE
❑ Las
❑Beef Stocker
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
❑ No
ue
❑Pllts
❑ Turkeys
❑ Turkey Poults
❑ Beef Brood Co
y
Qther
❑ Yes
(FNo
`� ❑ Other
Numberroi�Struetures:
❑ Other
❑ Yes
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes
�No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
❑ No
ONA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
(FNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
PINo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/78/04
Continued

Facility Number: Pa—!Eo Date of Inspection Q 2�
Waste Collection & Treatment
14. Do the receiving crops differ from those designated in the CA WMP?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
t] No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No PNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
EPNo
❑ NA
Spillway?:
17. Does the facility lack adequate acreage for land application?
❑ Yes
Designed Freeboard (in):
❑ NA
❑ NE
Observed Freeboard (in): u
❑ Yes
t No
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
EPNo ❑ 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
J�j No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
qlNo ❑ 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
t0. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No ❑ NA ❑ NE
maintenance/improvement'?
U. . is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
[)jNo ❑ NA CINE
❑ 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 le Crop Window ❑ EvidenceofWind Drift ❑ Application Outside of Area
12. Crop type(s) �rj` ((Mp� � S A4 � , 5M . i�0-f �
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
IP No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
10 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
EPNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
t No
❑ NA
❑ NE
Reviewer/Inspector Name Phone:V49 92 610) y333�C17
Reviewer/Inspector Signature: Date: Q p
Page 2 of 3 1.2128104 Continued

Facility dumber: ,' / Date of Inspection 9 Z
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes EP No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes RNo ElNA EINE
the appropriate box. ElWUP ❑ Checklists
ElDesign El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes &No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ 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
Plo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
VNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
19 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[ANo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
F No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
t9No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
05,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
ip 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
Q 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
1p No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
tA No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128/04
Page 3 of 3 12128/04

0 Division of Water Quality v/
Facility Number a S33 0 Division of Soil and Water Conservation
- 0 Other Agency
Type of Visit 40 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit *Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: i0 ►/ 7 Arrival I e Time: Departure Time: /PI!t2�y� County: SQ'r`1P'SpA)
Farm Name: b sat. it ANt f f'$Pin / Owner Email:
Owner Name: / 11/r1Q-({7 N F. LI 1� dsa, -' Phone:
Mailing Address:
Physical Address: f ty LVJS Ci
Facility Contact: �An
QS-r Title:
Lf
Onsite Representative:
Certified Operator: _
Back-up Operator: _
Location of Farm:
Swine
Other
❑ Other
U
Ph �ne No:
Integrator:
Operator Certification umber:
Back-up Certification Number:
Latitude: =n 17' F-1 Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
070) I �DO ❑ Non-Layet
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?
b. Did the discharge reach waters of the State? (If yes, notify.DWQ)
Region: FAO
n
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑
Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: F71i
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any pan 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
Fj No
❑ NA
❑ NE
❑ Yes
❑ No
Ep NA
❑ NE
❑ Yes
❑ No
W NA
❑ NE
0
EINA
❑ NE
❑ Yes
❑ No
❑ Yes T No
❑ Yes ERNo
❑ NA ❑ NE
El NA El NE
12128104 Continued

1
Facilih Number: a Date of Inspection DiPPED
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
V9 No
Waste Collection & Treatment
❑ NE
15_
Does the receiving crop and/or land application site need improvement?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes P No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
91NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: I
No
❑ NA
❑ NE
Spillway?:
Is there a lack of properly operating waste application equipment?
❑ Yes
® No
Designed Freeboard (in):
❑ NE
Observed Freeboard (in): 41
5. Are there any immediate threats to the integrity of any of the structures observed?
Cl 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 1� No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
S. 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 JW No ❑ NA ❑ NE
maintenance or improvement?
Waste ADDIiCatiOn
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ( No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > ]0% 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)
13. soil type(s)
rn
Sri, . i;,-, OW
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
V9 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
No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone: ABI
Reviewer/Inspector Signature: A1.1 14f Date:
11/18/04 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes R, 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 (H 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
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
® No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[b No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
f] 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
® 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
q9 No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12/28/04

fl
Division of Water Quality
Facility Number Division of Soil and Water Conservation
Other Agency
Type of Visit 19 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: t ' fw Departure Time: M County: Region: Region:
Farm Name: T• rLI nd5aq Pi A o(w$e'�/ Owner Email , f
Owner Name: _ Fcan W ik � u. _ n ` Phone: 610)67 — �a9 _
Mailing Address: a%o �l''� � `-�' n�� )x xB 3a$
Physical Address: jj�� jj I
Facility Contact: ErgLAkA � t rt0 +-1 Title:
Onsite Representative: FranVtoki L,1,,ds!Lj
Certified Operator: f r<U,',% L,�A9�'
Back-up Operator:
Location of Farm:
Phone No:
A
�
Integrator: ' "1
Operator Certification Number: ` r onv
Back-up Certification Number:
Latitude: =0
=,
Longitude: =()=, °0,
Design Current
Design Current
Design Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Popularion
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
Wean to Feeder 100 X04 1
10 Non -Layer
I
❑ NE
❑ Dairy Calf
El Feeder to Finish
❑ No
❑ Dairy Heifer
t Farrow to Wean
Dry Poultry
❑ Dry Cow
1 Farrow to Feeder
❑ Non -Dairy
❑ Layers
Farrow to Finish
[]No
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
El Pullets
❑ Beef Brood Cowl
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Turke s
[ANo
Other
❑ Other
❑ Turkey Poults
10
Number of Structures: r1l
Other
Page I of 3
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
PfNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
[]No
qNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
[]No
-PNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[�PNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
[ANo
❑ NA
❑ NE
other than from a discharge'?
Page I of 3
12/28/04
Continued

ti
Facility Number: Date of inspection
❑ Yes
[�[No
❑ NA
Waste Collection & Treatment
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�j No
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
J� NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: �L
❑ Yes
W No
❑ NA
Spillway?:
Designed Freeboard (in): _ ,Q
Observed Freeboard (in): 3 7"
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ YesNo
[INA ElNE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
JKNo
❑ NA EINE
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
§d No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
�U 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
,M No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E�LNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
W No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 1 O 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) CCaCOW &4rrvtv4L�n
13. Soil type(s) V40,6
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
�j No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
W No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments:-` j
Use drawings of facility to better explain situations. (use additional pages as necessary): =.
000 it�eg d'' © �b�s rnCerrec-[- o^ ces-� ;,CA
I
Fe hr• Is l l 5 w Ci 5 Rwro (.J4
g !IDI) Weaj+A � � 1 ' r L_ yid SAvI w i � Cci,(�
+-o J - cure o h W"
Reviewer/Inspector Name p Phone:
1� -j3Oo
Reviewer/Inspector Signature: VLQA Date:
/D /l 66
Page 2 oJ3 12/28/04 Continued

Facility Number: a 15�� Date of Inspection Ljgl
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes R No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ 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
129 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
X] No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
1} 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
tR 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
EP 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
PNo
❑ 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
Pq No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[A No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Da_v, 6a:(t�y AaS mcu� reco s
.�
Page 3 of 3 12/28/04

=. .
Facthty Number
® Division of Water Quality
O Division of Soil and Water Conservation
Otlier.Agency x
Type of Visit * Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: S d Arrival Time: p r v p Departure Time: County: SOO Region: I ,?o
Farm Name: T L ��,'a A -11 ,r sena _ Owner Email:
Owner Dame: Phone: 17/0- S_G�- 'x'091
Mailing Address: S�Q^E, leo[�r �p � C �:�7�� /V L 29���
Phvsical Address:
Facility Contact: Fi�a�1C�%s ._%e_ls .Title•
Onsite Representative:
Certified Operator: F, -.,A
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
eanto Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator:.42/'ro ll s C &
Operator Certification Number:
Back-up Certification Number:
Latitude: =0
=4 Longitude: = ° =I
0 u
Design Current Design Current
Capacih' Population Wet Poultry Capacity Population
404 ❑ Laver
1 7pbn ❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑
Turkex 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 convevance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑
Dairy Calf
❑
Dairy Heifei
❑
Dry Cow
❑
Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes. notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes.. notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes D -5b ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
® Division of Water Quality
O Division of Soil and Water Conservation
Otlier.Agency x
Type of Visit * Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: S d Arrival Time: p r v p Departure Time: County: SOO Region: I ,?o
Farm Name: T L ��,'a A -11 ,r sena _ Owner Email:
Owner Dame: Phone: 17/0- S_G�- 'x'091
Mailing Address: S�Q^E, leo[�r �p � C �:�7�� /V L 29���
Phvsical Address:
Facility Contact: Fi�a�1C�%s ._%e_ls .Title•
Onsite Representative:
Certified Operator: F, -.,A
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
eanto Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator:.42/'ro ll s C &
Operator Certification Number:
Back-up Certification Number:
Latitude: =0
=4 Longitude: = ° =I
0 u
Design Current Design Current
Capacih' Population Wet Poultry Capacity Population
404 ❑ Laver
1 7pbn ❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑
Turkex 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 convevance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑
Dairy Calf
❑
Dairy Heifei
❑
Dry Cow
❑
Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes. notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes.. notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes D -5b ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
P`No
❑ NA
❑ NE
❑ Yes
2 No
❑ NA
❑ NE
12/28/04 Continued

Facility Number: &2 — 5-33 Date of Inspection
❑ Yes
El NA
Waste Collection & Treatment
15. Does the receiving crop and/or land application site need improvement?
El Yes
,9-�No
L1d'No
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
['No
❑ NA
EINE
a. If yes, is waste level into the structural freeboard? ❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure
5
Structure 6
Identifier:
El Yes
,❑,,
[3*N/o
❑ NA
Spillway?: In
Designed Freeboard (in): Q Lf-
f~Observed
ObservedFreeboard (in): 33 "
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
9 -go
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes
E lV0
❑ 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
R'No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑-iqo ❑ 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 �o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E?SlO ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 21C ❑ 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
.275-
12.
27s12. Crop type(s) eers
13. Soil type(s) Wa13
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
El NA
EINE
15. Does the receiving crop and/or land application site need improvement?
El Yes
,9-�No
L1d'No
❑ NA
0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'❑ Yes
❑ No
❑ NA
9-f4E
17. Docs the facility lack adequate acreage for land application?
❑ Yes
No
[:]NA
I_7 NE
18. Is there a lack of properly operating waste application equipment?
El Yes
,❑,,
[3*N/o
❑ NA
EINE
Comments (refer to question #) Explain any S answers and/or anrr commendations or any other eommeats.
Use drawings ofsfacthty toybett6r explam� tu�ayyti6n & (dse additional pages as _n es
4. re.+iL$sZ4f.'Cn-s3`a ..._._,..R. - ..r. r. .w.� L}�.i3:.a•
1ei�t over 6'0.al �a� 12sem 6 v .s��.;,,9 Fa c�ec)
Aare Po c�� wgu;n So Lye_ w:11 -7df 44.,Xe d loe
ReviewePhone: 910- - J rwt'>7a ectorName
Reviewer/Inspector Signature: Date: S - ]a_ or

Facility Number: — 57.331 Date of Inspection F6_.2o-a3
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ElB Yes o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMMP readily available? If yes, check [► 'fes [:1 No [__1 NA [INE
the appropirate box. El❑Che sts E� Design ❑ O r
21. Does record keeping need improvement? If yes, check the appropriate box below. 1[ Kes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ d ❑ ❑ ❑
❑ aaiaa1.1 ❑&eeking [gCrop Yield ❑ i ❑ ns ❑ `" ^-
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
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?
25'es ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
ElNt
❑ Yes
❑ No
❑ NA
(ZINE
❑ Yes
❑ No
❑ NA
11'<E
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
94
❑ Yes EK ❑ NA ❑ NE
❑ Yes 2"No ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
❑ Yes PfNo ❑ NA ❑ NE
❑ Yes
Y,No
El NA
❑ NE
El Yes
[;Ko
❑ NA
❑ NE
A"iti6naECommedts'and/orDrawings:
�D Pleuse con «c 5a�+,Ps�,� IV RCS u.hd 04: 0% µ 6d, -y 0f
des �gti f°�0010'1 r'ecc, rp(/S �
�r Rev;e wo( G rvp y P rfd or,,,s
Pie. ,e Ensto-j� G rurh c}ava�E,
12/28/04

Tyle of Visit (0 Compliance Inspection O Operation Review 'O Lagoon Evatuation
Reason for Visit SRoutine O Complaini O Fo11ow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: Time:
Facility' lumber rj
ro Not Operational Below Thresbold
0-fermitted 0-6i4ed D`Conditiionally Certified?q Q Registered Date Last Operated or Above Threshold:
Farm Name: F!'LI+R�c : L+^1s�� P Ala.,'set, , lirstor�/i, County: Sain FRC'
Owner Name: I1"o o >ti�y L: n0'5 Phone leo: O- 5- ' cf - v © 9
i+,Iailing.address: _'25-6r0i$ricra�_ Rd �•0'kon NC -7,93-79
Facilitc- Contact: Fr 4., k (,., l.. dsa y Title: Phone No -
Onsite /
Representative. Fr-, (i.n �%n `v Integrator: �
rO+u
Certified Operator: F!^C�-7/?li'"7 i_nd5�y Operator Certification Number: /109&
Location of Farm:
LtYSwine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 0 0 Longitude �' 0• �•�
Design Current
Swine rmn9Aift Pnnntatinn
❑' can to Feeder 1
❑ Feeder to Finish
❑ Farrow to Wean �
❑ Farrow, to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Laver❑ Dairy
❑ Non -Laver I 1 ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons 10 Subsurface Drains Present ❑Ls oou Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ leo Li uid Waste Management System :'-'r='H4- , .! - ._'
Dischar!res & Stream Impacts
I . is any discharge observed from any part of the operation?
❑ Yes R o
Discharge originated at: ❑ Lasoon [] Spray Field ❑ Other � �
P. if discharet is observed, was the conveyance man-made? ❑ Yes Lo
b. if discharge is observed. did it reach Water of the State? (if yes, notify' DWQ) ❑ Yes [].<
c. if discharge is observed. what is the estimated flow in salhnin? 1
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes4
2. is there evidence of past discharge from any part of the operation? ❑ Yes GIZO
3_ Were there any adverse impacts or potential adverse impacts to the waters of the Stale other than from a discharge? ❑ Yes �o
waste Collection 8 Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes Q-wo'
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1_
Freeboard (inches):
05IV3101 CondYnued

Facility Number: —
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes M—Ko
❑ Yes ❑q<o'
❑ Yes 31�o
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [Ko
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes G<o
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes EINO
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes
12. Crop type C7e/md 5 a G Q
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes EK0
14_ a) Does the facility lack adequate acreage for land application? ❑ Yes [4}1Qo
b) Does the facility need a wettable acre determination? ❑ Yes 9 -Ko
c) This facility is pended for a wettable acre determination? ❑ Yes ENO
15. Does the receiving crop need improvement? ❑ Yes ETNo
16. is there a lack of adequate waste application equipment? ❑ Yes ❑-Idb
Required Records & Documents
t7_ Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
L-?1Vo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
;4e ap
dor rP%Gs
(ie/ -Alt" ch=44ists, desi&nr, 7lFaps, etc.)
❑ Yes
[g -No
19. Does record keeping need improvement? (ie/ i ation, fr ard, w ysis & soi r s
El Yes
©'leo
20. Isf facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
B14o
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
QNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ dischargf,—freeboar ms,ov sx )
❑ Yes
M -No
23. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
9.9
24. Does facility require a follow-up visit by same agency?
❑ Yes
0 -Ko
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes Q -Ko'
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Gon meats (iefer toFquestion ft Explaui any YES -answers and(or:any recommendatibns or any.other comments.
Mara wings ofifaciltty to.�better explain'situations. (use additioria! pages as necessary)
;. field Copy ❑ Final Notes
ReV'ea.e fch71 6v "le 4aalys�`>
even 15.
Alt. t' ""'16#7 S dv44 Adg f
Zu9o0'1 W�►Lh ;/ S felm,'lo,
Go dlal.5
fJ"efole or
;4e ap
dor rP%Gs
p/oAs �o
ow Wroyh.�(
Reviewer/InspectorName j %"tart( Qts: P '4!.-C44'j_ Ca a
Reviewer/Inspector Signature: Date: `0y
O5103101 Continued

Site Requires Immediate Attention: _tvm±�
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: AT" _, 1995
Time: - t 1:o9
Farm NanulOwner: %Affi.r
Mailing Address: _ _ x g 8 _Ct s ti;'tsr► fit✓ as 3,1R
'gator: Co• Phone:, (aio p
s-s3_i:s�
L
.On Site Representative: A,"t6sca I Ca.-otti &24. Phone: I4t0) s�
Physical Address/l-ocation: „�rR 13.-M !6 E111 .
Type of Operation: Swine X Poultry Cattle
Design Capacity: Number of Animals on Site: AF5 5 � ( �+a.•:••4 Os, 4
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude:_3,1- .t' meq' Longitude: 22 ° ;L T 433«
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approxinuvely I Foot + 7 inches) Yes or No Actual Freeboard:_2.Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or I�o Was any erosion observed? Yes or
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No+
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Wor No
100 Feet from Wells? 3Q or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or N�D
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or No tje�- ea61„114
Is animal waste discharged into water of the state by man-made ditch, flushing system, or -other
similar man-made devices? Yes or W If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No ►- -at 41 *+
--Additional Comments:
L Pec 1-t e. -j
Nj
1
S�f-e+•� i�,l dti rS�«"� C�t^KBE• Tl;b /,mk "olcl 6e qeV eSSL_C -'-'w eJ"&41�{.
Qleas.-- cc_-� aL [410) 541 c.J t,ek4i been ,j 0�e'4. J
1 Q j� �.►1\, C�1 V. i Ql i.SF
Inspector Name Mxr Signature
S�; fit. 7�� �aLGrov:� Qtd.
cc: Facility Assessment Unit Use Attachments if Needed.
/ J / �F i�iG �ELa1are/� r�/oS 0�se'ruedj i4.-b,-b,dreoL _546 al d�
d
IV