820563_INSPECTIONS_20171231

NURTH CAROLINA
Department of Environmental Qua!
il

-14 n e e r , i. f.
_ JV) DiPU ItU111 _
» ivision of Water Qualify
Facty Number ®-j3 Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit: `'Compliance inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: 'Routine Q Complaint O Follow -'up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: ] r County:
Farm Name: Gnoak PCwa1,o L0W Owner Email:
Owner Name: Urng&�- 1"&J ,. Phone:
Mailing Address:
Physical Address: 1410 'TC—
Region:��
I
1 r
Facility Contact: steVf. iva Title: Phone:
Onsite Representative: rl No w&OL integrator: ``-
Certified Operator: 54Q✓p— kwork Certification Number:
Back-up Operator: Certification Number: f b�
Location of Farm: Latitude: Longitude:
_.
g ign fi Current �','" °:. Design Current
Desi n urrent s
C Des
Swine
Capacity Pop; Wet Poultry Capacity ,t,P,op ,t�� Cattle Capacity Pop.
Wean to Finish
F
z...z-`""'txads'
La Dai Cow
❑ NA
er
Wean to Feeder
Non -Laver Dai Calf
•
Feeder to Finish
Farrow Wean
4js �= = Dairy Heifer
to
Farrow to Feeder.
Design 1.Current D Cow
W.
D Ca l'o Non-DaivL
Farrow to Finish
.:.Poult , act
Layers Bcc f Stocker
Gilts
Non-Laers Beef Feeder
Boars
Pullets Beef Brood Cow
ficx
-7777, Turkeys
Other
Turkey Poults
Other
M 10ther
Discharges and Stream impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b_ Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes tR No ❑ NA 0 NE
0 Yes
0 No
E] NA
0 NE
0 Yes
Q No
❑ NA
ONE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Yes [:]No
Yes CS'No
Yes CR No
[] NA © NF-
NA
FNA NE
NA NE
Page I of 3 2/4/2011 Continued

]Facility umber: - 5103-1 1 Date of Ins ection: a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: NU(�$
Spillway?: ~11
Designed Freeboard (in): Q� q,
Observed Freeboard (in): 170 1
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes g No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
[' No
❑ 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
(2 No
❑ .NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
CR 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
[ R No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus 0 Failure to Incorporate
Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind ❑ Application Outside of Approved Area
1Drift
12. Crop Type(s): `6/ Df" c(}} _
13. Soil Type(s): ` L S
14. Do the receiving crops differ from those designated n 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
�rNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
N No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
CRNo
❑ NA
❑ NE
Reuuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
5a No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
N No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Designs ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. CR Yes ❑ No ❑ NA 0 NE
❑ Waste Application ❑ Weekly Freeboard (� Waste Analysis 0 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 ;K No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No RNA ❑ NE
Page 2 of 3 2/4/2011 Continued

' Faciii 3Number: Date of -Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes JU No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Callo ❑ 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 tR NA ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes CR 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
15-gi 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
M 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
CR No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliancc of the permit or CAWMP?
❑ Yes
Da No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
Cg No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
CE�"No
❑ NA
❑ NE
Use menta sof facility q scion: ter.e>r la`n any YES answers>and/or any additional recommendations or; any otherxcoluul :
omatents grefer to question: � Exp�aio.-situahoa!�.;(use additionala es as n_ec'essa �
P g ry)•.
leae OAT, 074 e- nVaj4_e lino i J' Good ± &0 da s
alas ��� S��e�o� oabove- �cfef ahid� cot^, l�` � 1����
[ ''Ae ooaAvl yto -
c�eckeJ_ - tv( cPo ` e Q Covf !ye , C ro hea l-� t s -Ca it - od
Ctrs �o��' �` dro� t a of l a+ f flne I s 1i rcef-C
T1 tjA1 ho r ! C 1✓ a �fQ 6a� �1
C l ose�P o
b
J2C�S, �? L6 e_ ► Q1 O Glu a
�s�' C 1 a ma �r�ct� r�
bei��i
" (hey dt'b'e > ;-�-I �a� yam'
` ro --�l oly'lna-� f f r rya�l C}� wa'' °!� C> �#Bs wg P c e�.
Nulse- Seefib, 0-� -�afm N 1,1/ be rewf-& :pfd i o
dS 4 recods �r j�j0od_S!qZe,' cSco�915 f be `h~ � , I h
!
no Scz op 1 t.c [�, � J. �f,n�P�r r�j U! r IGr o&
Reviewer/Inspector Name: Q �'e �'
Reviewer/Inspector Signature:
Page 3 of 3
Phone
To -g,93 -3 -me Lo6t)
Date: C)0/j
l /1 11

n
Facility No.q�+563 Farm Name !1 i 1 ' Date {
Permit �OC `� OEC NPDES (Rainbreaker
Design freeboard
Observed freeboard
Sludge Depth (ft)
PLAT An6u' altert )-
!:Z�'cif.T/at.Ti1WA'tRiles!"T1��7Ti"i*7�'!1.TiYi:'*l!Ai i'1.�i►1'.�fi�•
DesignActual Flow
Design Wi. Actual Width 1�0 =1 �04
Uffivil
Soil Test Date nJ fi Wettable Acres .� RAIN GAUGE ,
pH Fields WUP Dead box or incinerator
Lime Needed iC--) _a 0 j h a Weekly Freeboard Mortality Records
Lime Applied !! 1 in Inspections
Cu -I ✓ Zn -I 120 min Insp.
Needs P if Weather Codes
Cron Yield Transfer Sheets nth 60pr
hal
Pull/Field Soil Cro 1 Acres PAN Window Max Rate Max Amt
Verify PHONE NUMBERS and affiliations
Date last WUP FRO DatelastWUP at farm
Al
FRO or Farm Records q�
Lagoon #
Top Dike
Stop Pump
Start Pump
Conversion- Cu -I 3000= 108 lb/ac; Zn -i 3000= 213 lb/ac
App. Hardware

Type of visit 01 -Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Z-02-lD Arrival
Time: /2: SO Departure Time: 1:35g,County: Sa'`�sp"t Region:
Farm Name:_ Linlva G-'�LSom/ elpl� ! ir*6% Owner Email•
Owner Name:_ LI'A!_OU�___Mar.A-d Phone:
Mailing Address:
Physical Address:
Facility Contact: ��++ _ (.-.0 k-% S �dt� Jd 2-1� _ Title: - -• lPhone No:
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = e =I =" Longitude: = o = C =
gs
Discharges & Stream Impacts
Design Current
Design Current
Design Current
Swine
Capacity Population
Wet Poultry Capacity Popatation
Gat#!e Capacity Population
❑ Wean to Finish
❑ NE
❑ Layer
❑ Dai Cow
can to Feeder
-7$O a
❑ Non -Layer
❑ Dai Calf
eerier to Finish
(, SD Z
[:1 NE
❑ Dai Heifer
❑ Farrow to Wean
❑ No
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ NE
❑ Non -Layers
El Beef Feeder
❑ Boars
❑ NA
❑ Pullets
❑ Beef Brood Cowi
ElYes
Q4_o ❑ NA
❑ Turkeys
other than from a discharge?
Other
❑ Turkey Poults
❑ Other
12/28/04
ther
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
El Yes
❑ No
,��
AA
[:1 NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
❑ No
,L��,
LI'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
[IL-
❑ No
,�
� I A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
011'o'
❑ NA
ElNE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
ElYes
Q4_o ❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Facility Number: Date of Inspection
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
MF4o ❑ NA
❑ NE
Waste Collection & Treatment
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
��,//
Reviewer/Inspector Name je?j�,�/ e v s
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[I Yes
L'SNo
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
D`No
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: Al,
13.
Soil type(s)
Spillway?:
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
2<o ❑ NA
Designed Freeboard (in):
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
- To ❑ NA
Observed Freeboard (in): Z410
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
1.��,, Ng�o [INA
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E! No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed andlor managed
El3 Yes
_,
o
❑ 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?
El Yes
L7 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
&TO
❑ 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
Cl Yes
No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Bl' o
❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
MF4o ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
w
Reviewer/Inspector Name je?j�,�/ e v s
Phone• 910-'933,3300
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
Date: 2 — O Z — ZOl 0
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
Crop type(s) str Lc a� C �e �'�`z �/ �`'"�� �a taiN (O. S.
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
2<o ❑ NA
❑ 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 acre determination ? ❑ Yes
1.��,, Ng�o [INA
El NE
17.
Does the facility lack adequate acreage for land application? C1 Yes
l-�'No [INA
ElNE
18.
Is there a lack of properly operating waste application equipment? ElYes
Dill ❑ NA
❑ NE
Comments {re_fer toaoestion #)i Explain any YES*answ:ers and/or any recommendations or ny4otheReomments
` g tj� , p { additional pages as necessary) x
Use drawm sof facili to better explain sttuat.ons use ac yi 6
w
Reviewer/Inspector Name je?j�,�/ e v s
Phone• 910-'933,3300
Reviewer/Inspector Signature:
Date: 2 — O Z — ZOl 0
12128/04 Continued

k
Facility Number: 82 -563 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
❑ Yes
Q No
❑ NA
❑ NE
❑ Yes
©'No
❑ NA
❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
[]Yes
L7No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
[:]Annual Certification
❑ Yes
❑ Rainfall ❑ Stocking ❑ Crop Yield [:1120 Minute inspections ❑ Monthly and V
Rain Inspections Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
�O
9<6
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[�Ko
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Millo'
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�fo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
�o
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes Bl o ❑ NA ❑ NE
Other Issues ,�--,,��
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? El Yes LTNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Ijvo
❑ 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
L #'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
El Yes
,_
U,o
❑ 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
B o
❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
Uk o
❑ NA ❑ NE
�d[iitio al Comments and/or D mugs:
11128/04
11128/04

' �3l-✓its /o -os- ZM
Type of Visit QCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit l7 Routine Q Complaint 0 Follow up 0 Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit: :Z� 0 Arrival Time: 7 ! zi0 Departure Time: /� f� County: Region: 196C>
Farm Name: Lr N ea rd u/e rC/ e S&V LIOld iz+ rw�� Owner Email:
Owner Name: L r rt o yd #+,,* td_ Phone:
Mailing Address:
Physical Address:
Facility Contact: C-IAY Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
integrator GO tc r, -_ Fe v w S
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: =0 =i 0 « Longitude: =0=' =
Design Current
Design Current
, _
Design Current
Swine Capacity Population
Wet Poultry Capacity PapulationCattle
CapJ.acity Po6.pulation
❑ W n to Finish =110
Layer
❑ Dairy Cow
an to Feeder -% sa G1411 1
IFJ Non -Layer I
❑ Dairy Calf
eeder to Finish 7
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Non -Dairy
0 Farrow to Finish
❑ La era
-
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
[I Beef Feeder
❑ Boars
❑ Pullets
ue
❑ Beef Brood Co
❑ Yes
❑ Turkeys
,--,,�
�A
Outer
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures:
3'1 0
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
Discharges & Stream Impacts
, _
1. Is any discharge observed from any part of the operation?
El Yes
L7No
❑ NA
❑ NE
Discharge originated at. ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
ElR No
,,.. ,//
A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
,
LINA
❑ 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
1:1R No
,--,,�
�A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
3'1 0
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
P" ❑ NA
❑ NE
other than from a discharge?
71/18104
Continued

t �
Facility Number: Ba — 5to,31
Date of Inspection
Waste Collection & Treatment
❑ Yes
[TNo
❑ NA
❑ NE
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
MeNo
[INA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: 6'Als� /1
El Yes
L
❑ NA
❑ NE
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 5-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
EYNo
[INA
❑NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
E3 No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
,�,
D'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No [--INA ❑ NE
maintenance/improvement? �,
H. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Q`No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) !�
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[TNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] yes
NNo
[:]NA
[:1 NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
,E
2 No
El NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
El Yes
L
❑ NA
❑ NE
Reviewer/Inspector Name f phone; �%/d • Y33. X33 Y
Reviewer/Inspector Signature: . Date: 9'-Z1 -Z4699
Page 2 of 3 12128/04 Continued

Facility Number: 82 —5431 Date of Inspection
R. aired 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 El Checklists ❑Design ❑Maps ❑Other
❑ Yes
E!rNo
❑ NA
❑ NE
❑ Yes
B No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
L7 No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield [:1120 Minute Inspections ❑ Monthly and 1"
Rain Inspections ❑
Weather
Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
ErNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
EI'No
ElNA
[INE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
B"NNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
BeNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
lNo
[:1NA
[INE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No ❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
0'*No
❑ NA
❑ NE
Other Issues
4
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes[
'No ❑ NA
❑ NE
24. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
El"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
[K 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?
ElLf Yes
�,/
No ❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No ❑ NA
❑ NE
Additioo C `mems-dior Dray„wings:
4
12/28/04

.-
• Bliv ;, 9--o41-08 Rie -
Type of Visit CrCompliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: S'z0' O $ Arrival Time: Departure Time: %i 3d County: .r4MaSoA/ _ Regiou:
Farm Name: Li nlD� v� �ac.t� r d i '/
6"J (Old 61— } Owner Email:
Owner Name: L ; NaQrc1Phone:
Mailing Address:
Physical Address:
Facility Contact: Gu'"`}` S 9arwi L k- Title: %��� r!,C- • _ Phone No:
Onsite Representative: Integrator: Co�ar
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: [--]' [—] ' [--]" Longitude: [_—] ° =
Discharges & Stream Impacts
Desiga Current 4�
- _ Des n Current
Design Current ig
wine
Capacity PopuEahon Wet Poultry
Capac tyl'apulahou Cattle Capacity Population
❑ Wean to Finish
❑ Layer
�1
❑ Dai Cow
rWean to Feeder
'7 30 � ❑ Non -Layer
' ❑ Dai Calf
Feeder to Finish
fa SO g
l r gz­El Dairy Heifer
❑ Farrow to Wean
JEI
D,-� Pqult ry
_- ❑ D Cow
❑ Farrow to Feeder"�
❑ Layers
❑ Non -Dairy
❑Farrow to Finish
[_1 No
El Beef Stocker
Gilts.❑
Non -La ers
Beef Feeder
l Boars
❑Pullets❑
❑ Beef Brood Co
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
=ivy ElTurkeys
- -
Other
❑ TurkeyPoults
2. Is there evidence of a past discharge from any part of the operation?
❑ Other¢
0 Other
Number of Structures:F72- I
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
ElE Yes
�
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
El No
,/
ETNA
[:INE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[I Yes
[_1 No
[3NA
❑ 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
❑] NNo
�A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
[I Yes
Q1io
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
B o
❑ NA
EINE
other than from a discharge?
Page I of 3
12/28104
Continued

Facility Number: Sz-S63 Date of Inspection
❑ Yes
D<o
Waste Collection & Treatment
No
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
[T
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes
L3go
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure
5
Structure 6
Identifier: /11
EK
❑ NA
Spillway?:
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Designed Freeboard (in):
❑ NA
❑ NE
Observed Freeboard (in): g Z G
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
01ffo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes
B<o
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
[3'�o
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
[3<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
,,__,,//
2 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
L7 No
❑ NA ❑ NE
maintenance/improvement?
I L Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes
L No
B"
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload [:1 Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% 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 Area
/
12. Croptype(s) (67"tr� fi_sG ;c)
I3. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
D<o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[3
NNoo
❑ NA
EINE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
B No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
EK
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
El No
❑ NA
❑ NE
rclo ift�nts {refer to.queshon#} Explain any YES_answeis andlor aay rerommendatioo ayothe�comments.
_Use,drawmgs of facility to better eaplain�situattons. (use addtttonal pages as necessary) � � f F : 3
Reviewer/Inspector Name F_R, c, Re ✓C75 Phone: 1/0, y�3. 3330
Reviewer/Inspector Signature: Date: 8-26 - zoos
Page 2 of 3 12/28/04 Continued

Facility Number: Z — S63 Date of Inspection IR -20-361
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E3<o ❑ NA EINE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E3<o ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists [3 Design ❑Maps E] Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes LTlvo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall []Stocking ❑ Crop Yield [:1120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes B<o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E3<o ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0-5o
❑ NA
EINE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0'go
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
[3'No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
E3,&o
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[3Io
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes
[rNo
❑ 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
8 -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
[3 o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
El Yes
,�
L7 No
❑ NA
[:1 NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[�No
❑ NA
❑ NE
Additions Comments and/or
Page 3 of 3 12/28/04

1.V
0 Division of Water Quality
Facility Number $Z srP 3 0 Division of Soil and Water Conservation
-- 0 Other Agency
Type of Visit & Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: / ;3Q Departure Time: z;/j` art County: d 3d 4/ Region: r�0
"►ND�IibI AS AJard It 91 A! �� � _V
Farm Name:. ;„ Owner Email:
Owner Name: ` i -k 'i. ra Phone:
Mailing Address:
Physical Address:
Facility Contact: (2a-"4L_s 84 ►-tnrt cr- Title; C ---NU, r+ Phone No:
Onsite Representative: C4 Y s _ H!Ee_jAJ iC_ _ Integrator:
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = e =I ❑ 11
Longitude: =0[=i
u❑i ❑
66
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
® Wean to Feeder 7
® Feeder to Finish Q
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Im acts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
ONon-Dairy
❑ Beef Stoeket
❑ Beef Feeder
❑ Beef Brood Co
Design Current
Capacity Population
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes,,notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [P No ❑ NA ❑ NE
El Yes
1PNo
0 N
0 N
❑ Yes
P No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
7 No
❑ Yes
J;j No
❑ NA
❑ NE
O Yes
(gNo
❑ NA
EINE
12/28/04 Continued

. - . Z
Facility Number: gZ -563
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: /11:�' ri
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): .�—
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ 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?
❑ Yes QTNo ❑ NA ❑ NE
❑ Yes J!YNo ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes RNo ❑ NA ❑ NE
❑ Yes N 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? ❑ Yes ® No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes �R 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 CkNo ❑ 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 El Evidence of Wind
Drift El Application Outside of Area
12. Crop type(s) cc—'t e_�_ j'`tCf�
13. Soil type(s) L
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 7No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes C61 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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes )d No ❑ NA
❑ Yes EA No ❑ NA
❑ NE
❑ NE
Reviewer/inspector Name�i ,fit/ c.��S Phone: ` ��• X33, 3300
Reviewer/Inspector Signature: Date: ld-o —zoo?
Page 2 of 3 12/28/04 Continued

Facility Number: g�Z -$63 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [XNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [jFhlo ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists El Design [:1 Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes UNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and ]"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?
Additional Comments and/or Drawings:
❑ Yes
[i No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
Pe No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes [Z No ❑ NA ❑ NE
❑ Yes ;B No ❑ NA ❑ NE
❑ Yes PNo ❑ NA ❑ NE
❑ Yes r No ❑ NA ❑ NE
❑ Yes
YS No
❑ NA
❑ NE
El Yes
L
41 No
❑ NA
❑ NE
12128/04

Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up Q Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: 11-'W a, Departure Time: County: ow SoN Region: r�C?
Farm Name: L - 4,v Lia -44 So,j (aid Fat, -w.) Owner Email:
Owner Name:_ Li ..Joa. -j _ 146W XVCL - _ Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: Cuv-4,s B x+rW, C_K Integrator: Ci�tANt L
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 =I
= Il Longitude: =0=1 = u
I Design
i YCurrent Des�D Current `.' K Design Current
Swine Capactt�Population Wetalout„ try Cap city Poulahoa Cattle'{` Capacity Population
❑ Wean to Finish "' ❑ Layer I Dairy Cow
® Wean to Feeder -73-0 -72 $ 1: ❑ Non-Layet ❑ Dairy Calf
® Feeder to Finish❑Dairy Neifet
❑ Farrow to Wean `
Dry Poultry" ❑ Dry Cow
❑ Farrow to Feeder - El Non -Dairy
❑ Farrow to Finish Lavers
❑Beef Stocket
FE]
Gilts ". ❑ Non -La ers
❑Pullets '`` ❑ Beef Feeder Boars ❑Beef Brood Co
❑ Turkeys Via,
Other{ El Turkey Poults
❑Other ❑Other Nu er of Structures:
Disc, haraes & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes
MNo
❑ 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
[9No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
0 No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

facility Number: Date of Inspection 5-02'O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ® No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ® No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: TbR i"4' - _ 4 -A- "�k vS-v
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): -
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [A No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes ® No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [9No [INA ❑ 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
[2j No
[INA ❑ 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
[2No
❑ NA EINE
❑ 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
Hare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) Qtrwt tA 40— i G ra d� sMa
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
[%No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
159 No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determinations ❑ Yes
® No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
W No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
IX No
❑ NA ❑ NE
Reviewer/Inspector Name ! <. k ' G V' S F ` L " Phone: Coro) St;, 'lS
Reviewer/inspector Signature: Date: S - G z - Z OU (v
12128/04 Continued

L
Facility Number: $Z —S(y3 Date of Inspection S -Oz -Ow
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 [3No ❑ NA LINE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ 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
[R 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
[Yj NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ 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
[P No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
P No
❑ NA
❑ NE
Addrttoual Goth entsa°nd/or Drawings:
��a
12/18104

va.
Type of Visit 0 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: 3 �) 0 o Arrival Time: a : �/ Departure Time: County: soma! Region: __�'�� _
``++ / y - -
Farm Name: _. Yeogoitec _l'l2,4 w�Or 1% __�. [, NfAt t j F� �wner Elnail:
Owner Name: L;; &A do a Ir ce.Wk v t j cr Phone:
Mailing Address: /1Z3 140aAl c a�3!
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: C u.4as j3a c _ j % c !~ Integrator: o h a r`i c-
- _-
Certified Operator: - 1A0 c-b��Q Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑ u ❑ , 0 di Longitude: ❑ o ❑ , ❑ i,
EI' ;
Design . �Current`L u Design `Current
Design Current
Swine �I 1�
_ 4
CapacityPopulation'
_WetPoe�ltry
... ,.
Capacity Population
. Cattle Capacity Population
to FinishWean
tv Feeder
' ❑ Layer
to Feeder
'7S0er
i
❑Non -1 a ei
to Finish
5
a
x'
Dry Poultry
EE01farrow
El
r
Number"of StruWean
Discharges
dow
to Weanow
tv Feeder
tv Finishs
&Stream Impacts
1. is any discharge observed from any part of the operation? [:1 Yes � No ❑ NA ❑ NE
Discharge originated at: ❑Structure El Application Field El Other
a. Was the conveyance man-made? El Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) El 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 ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? El Yes [A No ❑ NA ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State El Yes (� No ❑ NA ❑ NE
other than from a discharge?
12/28/04 Continued
❑
Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turke 1'oults
❑ Other
❑ Dai Cow
❑ Dai Calf
❑ Dai Heifer
❑ D Cow
❑ Non -Dai
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co

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 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
a r !.s z c�
12. Crop type(s) Be ci "-Z�a
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
[0 No
Facility Number: Date of Inspection Io Or
❑ NE
Waste Collection & Treatment
U] No
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: =� (.f'; „' e^&J-&>e__Y'i
W No
Spillway?:
❑ NE
Designed Freeboard (in):
Observed Freeboard (in);
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
® Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes ® No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes [9 No ❑ NA ❑ NE
maintenance or improvement?
Waste Auplication
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 W No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
a r !.s z c�
12. Crop type(s) Be ci "-Z�a
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
[0 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination, El Yes
U] No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
[p No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
W No
❑ NA
❑ NE
YY),-. 1-iowerdz i.1 t'lp ku,( �C"Gtcps. St'1-)ta4 caQ � "
W o r IL w ,/4 -I' i1 H G D ?=2 Q r p u b r�. t S } t H-11 . - I 10 � 0-7 1 C /
%- [�%v♦11C v
ln bore_ nG.rec� Fi�,'�sl•� •.^� 1C�av, F.<S (�•�c c.`cCdL ��Ce
Reviewer/Inspector Name � �, rt �o�(�c Phone: S/- y -F-'
Reviewer/Inspector Signature: 2-?,— 11�7 Date: /0-5-
12129104 Continued

Facility Number: of —5Ls Date of Inspection 3
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 ❑ NA ❑ NE
the appropirate box.
❑ W11P ❑Checklists El Design El Maps ❑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 [P 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 ® No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes I] No ❑ NA ❑ NE
24_ Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
VINE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
(A NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
N No
❑ NA
EINE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
® NE
Other issues
Tc C L. L !� 1 c �G r� Q 5 1 ulS Cy C
[
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[4 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 norrttal?
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
50 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
EINE
w
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12128104

x
fi' � �.r�-.�`��'_' � 'rr.�:� �'',' ^z� .�^-,zr .�,�� ss - ,��a �„'_'r rte• � 'z�,_�.�{,�r-� g '"� Yt^ei .�, `-^`�" ^T '4� t����.'s-x =�� i
aur
a�u' ;._^�3a_s--ter= t� - 'x'�3' S— F --Sc 'Y•_ =��` �. rc-- a-,`y:,...
€'s'te�.
5
Type of Visit Compliance Inspection O Operation Review O lagoon Evaluation
" Reason for Visit G041 t tine Q Complaint O Follow up O Emergency Notification O Other © Denied Access
Facility Number 3 Date of Visit: Time: ;
O Not Ggerational Q Below Threshold
13 Permitted Q Certified U Conditionall
y Certified
13 Registered Date Last Operated or Above Threshold: _
Farm Name:
Owner Name: _ .� �4fr� _...._17t•%-s _... ..... _ .__ ._ _ Phone No:
Mailing Address: _i_ 11R�G . _ ._ Al
_... � _ . _ �_ ___.... ..
Facility Contact: _-4!Lftoyir __ !; ?r�_ .. Title: Out wQ ,...._..._ Phone No:
Onsite Representative:. ups? ._ L's� --------- _ _ .. Integrator:
Certified Operator: __._. �. ..... DG�r, �..� ,.— _ _ . ... Operator Certification Number:,,, L1 2t w._w._....
Location of Farm:
[4w_lne ❑ Poultry ❑ Cattle o Horse Latitude • 4 44 Longitude • ° leu
Discharges 8 Stream impacts
1. Is any discharge observed from any part of the operation? ❑ Yes GK40
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gallmitt?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes Bio
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [Ko
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes 940
Structur i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..... 1 A... _ — �� — » — 3 .. __ ........_ . _ .� ... _... .............. . .._...
Freeboard (inches): 91 3
12112103
Canlinued

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/improverncnt?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Pounding [3PAN [:1Hydraulic Overload [jFrozen Ground [3Copper and/or Zinc
12. Crop type lX.^+ rk e-
13,
13. Do the receiving crops differ with dose designated in th&&rtifidAnimal Was Management Flan (CAWM
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
I
❑ Yes [ 1qo
1
❑ Yes GrNo
❑ Yes 9<0
Yes Rf4o
❑ Yes &?�Ro
❑ Yes Rfio
❑ Yes �No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i -e- residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? if yes, contact a regional
Air Quality representative immediately.
❑ Yes 52,lqo
❑ Yes Flo
❑ Yes 52 RO
❑ Yes ENo
❑ Yes 2io
❑ Yes [�No
❑ Yes dNo
❑ Yes E?Ro
❑ Yes M'K0
,`4'�VT - M •- yy�' S3:� #� i r � r .i i 'f( Y aA.WI.'s1'..s'i` 3 S ."I: .. .. .:'T ++1. aE. ai'- ���- z���
Comments (refer to questwn l ay�YES answers aadlor stay,'` or. any otlher canents.:" r.
Use drswa�agsof factLty to bitter�explaun s�tuaboag.�(ose atldittonal pages as tsecessar3') � �ield Copy ❑_ Ftnal Notes �` �
'l � iS�. 'T ,�, c' .:ria.. - .e' - s'.�?r �`i � �i �' ' r M � .r f _ � 1 �' 13. "� y , � s ti• _ -r -r,r. .+s.« c �.
' - .G f-+„ ... �.: � rri _/� Yx�' �.b" jYF `$' f_� rY. 1 �-r r � ...'-s•.-- < is `r' .i""�i ��- ��- h .'��-� w7•.+ _
�_�` �1 JI
h'^[ `i+ •10.Aait + Lam. s e�} VV, 9IJ
v»a .� . ` y" k a�•c .+ '2 x«rxi' 'i 1 ?°' '''^ _..+�r°� '.s'^s" "1,...�,
ReviewerAnspector Name
Reviewer/Inspector Signature: Date:
12112103 �� Continued

j Facility Number: _ Date of Inspection
Re wired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(lel discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
2$. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDFS Permit? (If no, skip questions 3I-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33_ Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes E 'fqo
❑ Yes 941ro
❑ Yes 9.ice,
❑ Yes 2140
❑ Yes &No
❑ Yes VRO
❑ Yes [?No
❑ Yes &No
❑ Yes [2NO
RrYes ❑ No
❑ Yes 2<0
❑ Yes Ef"No
❑ Yes &?No
❑ Yes [?To
❑ Yes RrNo
No violations or deficiencies were noted during this visit_ You will receive no further correspondence about this visit
...d:. S.:. T.Li'3�_'X•'�.. � �'.�'�i1.�-:'e`L..i. i:'�'ix _'Y �='�?..�.—J ��-:i���5�5��•w C�l-.F.���Y %�,'e _�.Frer�-=�r."-r; �.1w.�Y.r..s•e�ivdi.X'
�i5 San, srs �ii+i ,�E (;o�irC# kftfL4/W'O C &J Ss; � yl'y k S . tit
le Sooa.
f)' Car I&
SLI! Y�*M ral►"1� �M.,
T
12112103

Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency notification O Other ❑ Denied Access
[?ate of Visit: % 'A3 Time. 1�'-3'ffl
Facility Number $ .s%..�
=Not Operational 0 Below Threshold
© Permitted ❑ certified ©'' !!Conditionally Certified © Register ed RegisDate Last Operated or Above Threshold:
Farm Name: UnO,LLIrA D Lood 4-,S 1�rm NvrrserV Count►: �-�g�tRSoh
Owner Name: L i i o a r-F[i40 LJ4r /d Phone No: WO - -5r6 *7- /aj1o�
Mailing Address: 11 73 HOW-Xr�f A • Ad vi /lieNC a.P3 ! 8
Facility Contact: Title:
Onsite Representative: . s +e v�e__ Ho w a r d
Certified Operator: S+,eve-
Location of Farm:
Phone No:
Integrator•
Operator Certification Number: y 7
[Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' �• Du Longitude a I �~
- ^Design
Current,'- Desig[t Curreet' Design
r; Current
C ac[t. _ Po utatton
Pouh Cara6- elation . - Cattie ;. , Ca aettrr _ 2Po tilatmn .
a
Wean to Feeder
to Wean
❑ Layer Dai
it
® Feeder to Finish fo �n
a
' ❑Non -Laver ❑Non -Dairy
t
❑ Farrow
❑ Gilts
❑Boars
❑ Other
Total Design Carpactri
r Tntal'SSLWti
_
Number.of L.sgoans y`®
❑ Subsurface Drains Present Ls non Area
❑ S ray Field Area
Hflidutg Ponds. /$644-t raps _ -�
No Liquid Waste Mani ement System
�
Discharges S Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑Spray Field ❑Other
a. If discharge is observed, was the conveyance
to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑Boars
man-made?
b_ if dischart~e is obsen-ed, did it reach Water of the State? (If yes. no[if. DWQ)
c. If discharge is observed. what is tate estimated flow in gallmin?
d. Does discharge by a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from an
y part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection &_ Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I St1ructure 2 Structure 3 Structure 4 Structure ail
5
Identifier: E L
Frccboard (inches):
OS/03/OI
❑ Yes LL's No
El Yes
❑ No
El Yes
❑ No
❑ Yes ❑ No
❑ Yes [Fe'No
❑ Yes 21&
6
Continued
o
❑ Yes �No
Structure

Faciliq Number: � -Si,-31 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?
K Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Annlication
❑ Yes ❑'No
❑ Yes LvJ No
❑ Yes Isd No
❑ Yes jjrNo
❑ Yes &2rNo
10. Are there any buffers that need maintenance/improvement? ❑ Yes EfNo
11. Is there evidence of over application?11 C3Excessive Ponding El PAN ❑ Hydraulic Overload ❑ Yes 2 No
12. Crop type (n A s* d B e rMy4 a
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 2No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes [�No
b) Does the facility need a wettable acre determination? ❑ Yes 2No
c) This facility is pended for a wettable acre determination? ❑ Yes 2'N
o
15. Does the receiving crop need improvement? ❑ Yes 93 No
16. Is there a lack of adequate waste application equipment? ❑ Yes 5?rNo
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
Q No
I &
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Reviewer/Inspector Name D iQr {,�� t "T -e— - -_ -
Reviewer/Inspector Signature: Date: �6 3
(ie/ VVUP, checklists, design, maps, etc.)
❑ Yes
52(No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
dNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes[v�No
21.
Did the facility fail to have a actively certified operator in charge?
El Yes
L� No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
ErNo
(ie/ discharge, freeboard problems, over application)
23:
Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
E?rNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
dNo
25.
Were any additional problems noted which cause noncompliance of the Certified ANEW?
❑ Yes
JE No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Cayrttments'(refer qu are #) Explain ariv YES answers nnuvor en recotntneadstFoo_s ar aav: other comments.
_td
drawin-e of far itj+ to better ezptam.SitEtatao se addiiioitsl,pages as aeeessary): '- - ld _2
Use ( . ❑FieCary ❑Fina! Note-,
- - - -
Reviewer/Inspector Name D iQr {,�� t "T -e— - -_ -
Reviewer/Inspector Signature: Date: �6 3
05/03/01 l Continued