820576_INSPECTIONS_20171231

NORTH CAROLINA .�
Department of Environmental Qual

Type of Visit: ('Compliance Inspection V Operation Review V Structure Evaluation Q Technical Assistance I
Reason for Visit: & outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: uyLr�[ Arrival Time: Departure Time: 177/ q5] County: f' YnPS-b N Region: I'I �
Farm Name: T yy c Owner Email:
f
Owner Name: L Phone:
Mailing Address:
Physical Address:
Facility Contact: Gid FI'S 'C -4j c CC C Title: Phone:
Onsite Representative: ` Integrator: A3
Certified Operator: 1� L{` �Ja��� `n Certification Number. 4� 7 6 1
Back-up Operator: K`� I S e�A� oV w Certification Number: 4 0 ZZ - b
Location of Farm:
Latitude:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Design Enrrent
l 3fTva
Design
Current
Design Current
Swine
Capacity Pap.
Wet Paintry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
[:]Yes
I 11-ayer
E&N'K- ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
D . airy Cow
Wean to Feeder
I INon-Layer
I
❑ No
Dairy Calf
Feeder to Finish
ic% Y
Eg,116
❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
Dairy Heifer
Farrow to Wean
❑ NA ❑ NE
of the State other than from a discharge?
Design
Current
Cow
Farrow to Feeder
D . $ouI
a
Caci
Po ,
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
urkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
l 3fTva
❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[—]No
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
[:]Yes
❑ No
E&N'K- ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does the discharge bypass the waste management system? (if yes, notify DWR)
❑ Yes
❑ No
❑-NA-- ❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
Eg,116
❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[:]Yes
�o
❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: Dateof Inspection: .tr
❑ Yes
E3 --No
❑ NA
Waste Collection & Treatment
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E fIgo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[3LNo---E] NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
0 No ©-i�A
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
7
Identifier-
dentifier:SpiITway?:
❑ Yes
E3 --No—
❑ NA
Spillway?:
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[g -?its
Designed Freeboard (in):
❑ NE
4
❑ Yes
Observed Freeboard (in): J� y 2- ULT
❑ NA
&YI
23, if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
C9'1 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
0 ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit`?
❑ Yes
ETN—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
LF -go— ❑ NA
❑ NF-
Emaintenance
maintenanceor 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 [e-3'1C��❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ 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 Drib ❑ Application Outside of Approved Area
12. Crop Type(s): C to j G G S t4 LJ E (Y— U> -
13. Soil Type(s): L )h . & 0, 9:Lh-'. ,�° -
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E3 --No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E fIgo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
• ro
❑ NA
❑ NE
acres determination?
❑Other:
17. Does the facility lack adequate acreage for land application?
❑ Yes
E3 --No—
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[g -?its
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E3 --N-6—
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[j' ]leo
❑ NA
❑ NE
the appropriate box.
❑ W UP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement`? If yes, check the appropriate box below,
❑ Yes
N -Q
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ t20 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
Q'Flo
❑ NA
❑ NE
23, if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
a No
❑ NA
❑ NE
Page 2 of 3 2/4/2015 Continued

Facili Number: 1p Z Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
OE>
❑ NA
❑ NE
25, Is the facility out of compliance with permit conditions related to sludge? if yes, check
❑ Yes
�o
❑ NA
❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26, Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
EEJ-No
[] NA
❑ NE
27, Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[io '❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[2-w
❑ NA
0 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
[3 -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
1 T No
[] NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility9 if yes, check the appropriate box below.
❑ Yes
[]' Vl'n
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
0 Yes
EIKo`
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[]rl�o
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
[—]Yes
Tfo
[:INA
❑ NE
Comments (fefer tp question'#).'Eiiplain any YES answer§'andlor any addtt7oniil recd nmendallons or any other comments.
gMt
p ( P es rye)-
Use drawi_n s ofifacili_ to bettertes laitt situations use ad_d_itional a esaas necessa
s �
6hC�-S 20k I t— Q��IL'`� -us e,
i,
Reviewer/Inspector Name: U 46-2 _ _ - _ Phone: l 1b` 3 o$- Ir -S
Reviewer/Inspector Signature: LIAA Date:
Page 3 of 3 1 2/4/2015

I ype of visit: WComptiance Inspection U Operation Review V Structure Evaluation U Technical Assistance
Reason for Visit: 0<outine O Complaint O Follow-up 0 Referral 0 Emergency Q Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: s -
Farm Name: � j � Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Regio:
Facility Contact: t--�`{T t3 w Title: Phone:
Onsite Representative: Integrator: Y" Q "S
Certified Operator: OC7�G`'1 Certification Number: L&A(
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: Longitude:
Dische es and Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other;
❑ Yes [&10 [] NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No ff-NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No �j(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 YNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [IfINo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes UfNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/412011 Continued
Design Current
Design*Currentr
Design Current
Swine
Capacity Pap. Wet_Poultry -
Gapacityp PapCatt[e
Capacity Pap.
Wean to Finish
Layer Dairy Cow
Wean to Feeder
Non -La er
I I
Dairy Calf
Feeder to Finish
jDairy Heifer
Farrow to Wean
Desi Current �
D Cow
Farrow to Feeder
''�^D P,6ul �
�
�,Ca�o -
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
: .
Other
-
Turkey Poults
Other
Other
Dische es and Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other;
❑ Yes [&10 [] NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No ff-NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No �j(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 YNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [IfINo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes UfNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/412011 Continued

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 EPNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? O Yes ❑/'No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [] Yes E]No ❑ NA [] NE
maintenance or improvement?
Waste Aonlication
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 E No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload 0 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): W 4,XA- J �ff
13. Soil Type(s): w4 d v 4
❑ Yes
[TNo
❑ NA ❑ NE
Faci * Number: jDate of Inspection:
14. Do the receiving crops differ from those designated in the CAWMP?
[:]Yes
U?'No
Waste Collection & Treatment
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
0<0 ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
[:]Yes
❑ No [! NA
❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
7
Identifier:
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ "No
Spillway?:
Designed Freeboard (in): Cs --S r
❑ NE
❑ Yes
Observed Freeboard (in): 5 b 305 S
1 J
;3�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
�6 FINo C-]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
8 -Do ❑ 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 EPNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? O Yes ❑/'No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [] Yes E]No ❑ NA [] NE
maintenance or improvement?
Waste Aonlication
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 E No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload 0 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): W 4,XA- J �ff
13. Soil Type(s): w4 d v 4
❑ Yes
[TNo
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
14. Do the receiving crops differ from those designated in the CAWMP?
[:]Yes
U?'No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[!]rNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[�No
❑ NA
❑ NE
acres determination?
❑ Waste Transfers
❑ Weather Code
❑ Rainfall [] Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
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
ZNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[TNo
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
[+rNo
❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[ 1No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall [] Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
f
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
r
❑ NA ❑ NE
Page 2 of 3
2/4/2014 Continued

Facilif5F Number: jDate of Inspection-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E j Alo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of fust survey indicating non-compliance;
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 4 No ❑ NA 0 NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes E?fNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes []?No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes FL_E No DNA ❑ 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 E�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 [!T 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 P6 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 No ❑ NA ❑ NE
omlgtlents (refer to question Explam•any,YEm
S answers and/or any additional recommendations or any other coments. ; _*
,
Use'drawings of facility to better explain situations (use additional pages as necessary).,:
I-1 Pt
O
Reviewer/Inspector Name: -_t
Reviewer/Inspector Signature:
Page 3 of 3
Phone: .3 `AJ V2
Date: (p
2/4/2011
r 6`�
(�
Reviewer/Inspector Name: -_t
Reviewer/Inspector Signature:
Page 3 of 3
Phone: .3 `AJ V2
Date: (p
2/4/2011

Type of Visit: ®'Compliance inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: GHCoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: ,Arrival Time: �tlb�— Departure Time: County: 311- Region:
Farm Namek-e- Fr_y4A __.., Owner Email:
Owner Name: l tjo 6�Y Phone:
Mailing Address:
Physical Address:
Facility Contact: �� �/� Title:
Onsite Representative: j { ! h'i Qj 'c.� �i U'y'
Certified Operator: L wooirlp-
Back-up Operator:
Location of Farm:
Phone:
Integrator: M I
Certification Number:)
Certification Number:
Latitude: Longitude:
Design Current
-
Design
Current
Design Current
Swine Capacity Pop.
WettPauI,
Capacity
.Pap.
CatHe ULPacit-7VIMEP.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La e
Dairy Calf
Feeder to Finish
""
Farrow to Wean_
Design
Current
—DairyHeifer
Cow
Farrow to Feeder
.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Turke s
Beef Brood Cow
Other '.
Turke Poults
Other
Other
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)? `
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes �o ❑ NA ❑ NE
[:]Yes ❑ No
[:]Yes ❑No
❑ Yes ❑ No
❑ Yes ❑~No
❑ Yes E5 -N -o
[a -MA ❑ NE
ONE
LJ NA ❑ NE
❑ NA ❑ NE
❑ NA [] NE
Page 1 of 3 2/4/2011 Continued

acili Number: 663 - Date of Inspection: .�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
©-fTo—
[] NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No
B AA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Siructure 5
Structure 6
Identifier: % d 10
Spillway?:
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure
to Incorporate Manure/Sludge into
Bare Soil
j�-7
❑ Outside of Acceptable Crop E] Evidence of Wind Drift
❑ Application Outside of Approved Area
nnWindow
12. Crop Type(s): &Lo ) Q _S G-�_->
Designed Freeboard (in):
Observed Freeboard (in): °� 0 f;L- `#-
3o
a
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[5<o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes No
,1 f
❑ NE
l6. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes E5No
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
[D No
❑ NA '
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE r
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [31 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 [DNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes [jNo
❑ 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 E] Evidence of Wind Drift
❑ Application Outside of Approved Area
nnWindow
12. Crop Type(s): &Lo ) Q _S G-�_->
_
13. Soil Type(s): o D
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes C5,No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ NE
l6. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes E5No
❑ 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
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 13<0
❑ Yes [ o
❑ Yes [a1 No
❑ Yes [TNo
❑ Otb er:
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [3No ❑ 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 L ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes dNo ❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facility Number: - Date of Ins ection: r
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [j,'14o ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [3 -Ko ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Nan -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [-]Yes C -No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 6 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?
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)
3I. 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?
5 j C UL3
[:]Yes allo ❑ NA ❑ NE
❑ Yes [!]No D NA ❑ NE
❑ Yes
allo
❑ NA
❑ NE
[:]Yes
C No
❑ NA
❑ NE
[:]Yes
[! No
❑ NA
❑ NE
❑ Yes
EfNo
❑ NA
❑ NE
r?
O e_"r 4' z. j
Reviewer/Inspector Name: 1 `�L) Phone:
Reviewer/Inspector Signature: Date:
Page 3 of 3 2/4/2014

Type of Visit: Q -Co -m fiance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral Q Emergency 0 Other 0 Denied Access
Date of Visit: rn '"y !`j Arrival Time: Departure Time: County: C34W Regio//e-o
Farm Name: "V `' GV IVtQ f/`'tA, Owner Email:
Owner Name: I[70 rPhone:
Mailing Address:
Physical Address:
Facility Contact: "� (L Title: Phone:
Onsite Representative: U integrator: A( S
Certified Operator: ? �/(��0 �!V� Certification Number: 197
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Discharees and Stream Impacts
1. is any discharge observed from any part of the operation'? ❑ Yes &- go— ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No [S~IQA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No NA [DNE
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 0 NE
2. is there evidence of a past discharge from any part of the operation? [:]Yes No E] NA [:] NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes [❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2011 Condnued
Design Current x ^`k a Design Current :., y�R';: Design Current
Swine
�.
Capacity Pop. W,et Poultry . ;:Capacity
.Pop aCattle Capacity Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder
—Layer
Dairy Calf
Feeder to Finishy`
Dairy Heifer
Farrow to Wean
`
DesignCurrent -
Dry Cow
_
Farrow to Feeder
D ;FaultaatvPop.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
g;
Uther
�+ Turkey Poults
s
Other
Other
Discharees and Stream Impacts
1. is any discharge observed from any part of the operation'? ❑ Yes &- go— ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No [S~IQA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No NA [DNE
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 0 NE
2. is there evidence of a past discharge from any part of the operation? [:]Yes No E] NA [:] NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes [❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2011 Condnued

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 Q 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): C&V .0Q,1�nC"0_ucA L9 Q
13. Soil Type(s): a o�
14. Do the receiving crops differ from those designated in the CAWMP? [—]Yes [TI o ❑ 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 ❑ Yes fNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes d No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes E]"'No ❑ NA ❑ NE
Required Records & Documents
14. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [ENo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ErNo 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 [ o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22- Did the facility fail to install and maintain a rain gauge? ❑ Yes � o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes WNo ❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued
[Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus stone storage plus heavy rainfall) less than adequate?
❑ Yes
CgK6__❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No Ej NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
7
Identifier: _ 0 O
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
f 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
❑ 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)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
❑ No ❑ NA
❑ NE
maintenance or improvement?
Waste A2plication
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 Q 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): C&V .0Q,1�nC"0_ucA L9 Q
13. Soil Type(s): a o�
14. Do the receiving crops differ from those designated in the CAWMP? [—]Yes [TI o ❑ 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 ❑ Yes fNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes d No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes E]"'No ❑ NA ❑ NE
Required Records & Documents
14. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [ENo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ErNo 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 [ o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22- Did the facility fail to install and maintain a rain gauge? ❑ Yes � o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes WNo ❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

lFacility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes F�Jxw ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [35S` ❑ 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
0 Yes
No
❑ NA
List structure(s) and date of first survey indicating non-compliance:
permit? (i.e., discharge, freeboard problems, over -application)
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
�
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
Q Mo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
CtNo
❑ NA ❑ NE
and report mortality rates that were higher than normal?
❑ Yes
N
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
I__I No
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
❑ NA
❑ NE
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
0 Yes
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
3 L Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
I__I o
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
N
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
I__I No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
L Ivo
❑ NA
❑ NE
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
21412011

151
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Q_toutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 'qd Arrival Time: /:4d ftfi Departure Timer County: 6Af xff 20H
Farm Name- �£,� ���r.is CQrnpAr• Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ��{ �s g A p� , �.� �� Title:
Onsite Representative: � A M'r
Certified Operator: Aqia LK,t r- A en
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Region: rQG
Integrator: V\ �,.t%Rt,wa�
Certification Number:���
Certification Number:
Longitude:
Discharp-es 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 [2"No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [—]No
[:]Yes
gn C
Desiurrent
❑ Yes
Design
Current
Design Current
"Swine
Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
]Non -Layer
Dai Calf
Feeder to Finish
."lctq 4
Dai Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
Dry P,vulh:
Ca aci_ty
P,o
Non -Daily
Farrow to Finish
La ers
Non -Layers
Beef Stocker
Beef Feeder
Gilts
Boars
Pullets
Beef Brood Cow
Other
Turke Poults
Other
Other
Discharp-es 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 [2"No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [—]No
[:]Yes
❑No
❑ Yes
fffNo
❑ Yes
Q No
2 NA ❑ NE
1. NA ❑ NE
DNA ❑ NE
[DNA ❑ NE
[DNA ❑NE
Page 1 of 3 2/4/1011 Continued

V�
lFacility Number: - S-Ite Date of Inspection: al
Waste Collection & Treatment Ile
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No �NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: a 3 AL4 � J � 7
Spillway?:
Designed Freeboard (in): 1 S C _ l el 1 q — 1C�
Observed Freeboard (in): L05 IA J `� kAZ 3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �XNo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not property addressed and/or managed through a [:]Yes WNo ❑ 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 �VN
o C] NA E] NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes o [:] NA [:] NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [::]Yes CdNNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [�To ❑ NA ❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes �10 ❑ 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 C]Evidence of Wind Drift E]Application Outside of Approved Area
12. Crop Type(s): _ 3nN 1r1LP >!5k t..]� tnA i7s� 4 QaRn'f Gkmsn {icy (y. N�9AuZ� 1G. G
13. Soil Type(s): 1A A �a�a rr A 1�O v �� Pl d A
14. Do the receiving crops differ from those designated in the CA WMP? [:]Yes Cg'&o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
IT Does the facility lack adequate acreage for land application?
18. Is there a lack of property operating waste application equipment?
Required Records &_Documents
l9. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box.
❑ W UP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes C2'No ❑ NA ❑ NE
[-]Yes [ErNo ❑ NA ❑ NE
❑ Yes [2No ❑ NA ❑ NE
❑ Yes ffNo ❑ NA ❑ NE
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
r,-Y+fo
❑ NA
❑ NE
❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �io
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Yes [j3/No
❑ Yes O No
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?
❑ NA ONE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
F2/NA ❑ NE
Page 2 of 2/412011 Continued

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 [ KNo ❑ NA ❑ NE
❑ Yes ff No ❑ NA ❑ NE
❑ Yes D'No ❑ NA ❑ NE
❑ Yes [�(No ❑ NA ❑ NE
❑ Yes
dNo
❑ NA
❑ NE
Facili Number: jDate of Inspection: (o 1;t
[v"No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[gNo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[gfo
❑ 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
[gNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[—]Yes
❑ No
[g"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 [ KNo ❑ NA ❑ NE
❑ Yes ff No ❑ NA ❑ NE
❑ Yes D'No ❑ NA ❑ NE
❑ Yes [�(No ❑ NA ❑ NE
❑ Yes
dNo
❑ NA
❑ NE
[—]Yes
[v"No
❑ NA
❑ NE
[:]Yes
C> yNo
❑ NA
❑ NE
tceviewevinspector IName: Iz—No .l p7_ F -\A], rn►uuc. Aw .moo —W -
Reviewer/inspector Signature:
Page 3 of 3
Date: 41Z4 --L
11412011

l'ype of visit: t7 Com fiance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason For Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: CGU County -
Farm Name:£, 15LJ 1 Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Region: f=1T��
Facility Contact: 0
art-ul��, Title: Phone:
Onsite Representative:Integrator: WrJ
Certified Operator: ij Certification Number: Ito q ce
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
* � Desig. g ; u_rrentOil"
Swine CapaJcrty, 1'ap..
Wean to Finish
Deslgn C�rre t
Wet•I'�ultry Capaciiv jp_Cattle
La er
DeSigp Cturent
C►apacity Pop.
Daia Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
"'" =
Dairy Heifer
Farrow to Wean
Qesign Cur..T
D Cow
Farrow to Feeder D. , .l'oEiiltry Ca achy _ ,Po
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Ig -<A
Turke s
c. What is the estimated volume that reached waters of the State (gallons)?
QthcrTurke
.,. ._
Poults
Other
Other
❑ Yes
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
19<0
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
�A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[]Yes
❑ No
Ig -<A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes; notify DWQ)
❑ Yes
❑ No
``A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
Eklo
] NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
02r<o
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facili umber: jDate of inspection: Co F
Waste Collection & Treatment /
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ NAA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No V2,16 ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: / � � �
S
❑ Yes
ao
Spillway?:
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E3<o
❑ NA
❑ NE
Designed Freeboard (in):
❑ Yes
Lit j4o
❑ NA
Observed Freeboard (in): 1-3
/2
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
004o ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
[gtlo ❑ NA
❑ NE
waste management or closure plan?
Ga<o
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmentalthreat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
Q 4o ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[goo ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
/
NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes NA ❑ NE
maintenance or improvement? /
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [0� 0 ❑ 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 Appr ved Area +r
12. Crop Type(s): 150L1 6CLI13 S
13. Soil Type(s): D 1 -1N °
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ao
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E3<o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Lit j4o
❑ 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
o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Ga<o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
E '1Go
❑ 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 2<o ❑ 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 [� N VNA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [D Yes [:]No ❑ NE
Page 2 of 3 2/4/2011 Continued

[FaciNty Number: - Date of inspection:
24, Did the facility fail to calibrate waste application equipment as required by the permi . ❑ Yes K: o
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check [] Yes E14 o
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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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)
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
[0 No
❑ NNAA
E]NE
❑ Yes
❑ No
61<A
❑ NE
[:]Yes
io
❑ NA
❑ NE
❑ Yes Io ❑ NA ❑ NE
❑ Yes No [DNA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
2<0
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss revicw/inspection with an on-site representative?
❑ Yes<�
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
E:]lD Yes
o
❑ NA
❑ NE
Comments refer touestion Ea lain any YES answers and/or an additional recommendations of an �coni�men
.
Use drawings of facititv4 better explain,situations (use additional. pages-as.necessary).,
�ther
&Vv-ee px�5
Reviewer/Inspector N,
Reviewer/Inspector Si
Page 3 of 3
Phone: .3lb -4
Date:
2/ /2011

.-
Ins v. lalroj(p
Fatality Nu>fnber
hvisiori`of Way
*Visionof Soil
type of Vlsit O Compliance Inspection Q Operation Review O Structure Evaluation O Technical Assistance
Reason for Vlsit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
OSte of Visit: _II� Arrival Time: Departure Time: � County.: Revion:
Farm \`ame:T�4� S i'nl�ll�_ Q1' Owner Email:
Owner ,Name: �4,�:ti7�P C TrG Phone:
Mailing Address:
Phvsical Address:
Facility Contact: W 0 Title: Phone No: aJ f a 4AI
OnsiteRepresentatives t &_U woom4Integrator: �_— _
Certified Operator: P1 tV1 1Ten Operator Certification Number: } 7
Back-up Operator: Back-up Certification Number:
Location of Farnu Latitude. ❑v =1 ❑y Longitude:=o E73 ❑"
Swine
❑ Wean to Finish_
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feede
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
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?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑ Cow
❑
Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
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 NrNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
tR No
❑ NA
❑ NE
❑ Yes
2 No
❑ NA
❑ NE
12128/04 Continued
".k

Facility Number:16), — 2
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes PNo ❑ 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: 1-7
Spillway?:
Designed Freeboard (in): q- �� 1q q
Observed Freeboard (in): al T f L10 3
5_ Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes C3No [--INA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes tRNo ❑ 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? JSYes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes "� No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 10 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes 15�1Vo ❑ 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 (litter from triose designated in the C;AWMF''!
U Yes 25No U NA UNE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [S No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes [9 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes EjNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes R No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers andlor any recommendations or any other comments.
Use drawings of facility to better explain situations. {use additional pages as necessary,):
Reviewer/Inspector Namei?*� I G . O ,, ,� Phon 33--x333
Reviewer/Inspector Signature: Date: Dec 7
,.rU 12/28/04 Condnaed

Facility Number: ,— 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 El Maps ❑Other
❑ Yes
IRNo
❑ NA
❑ NE
❑ Yes
9 No
❑ NA
❑ NE
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes UNo [INA ❑ 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 CTlo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [�JNA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes fR No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
10 -No
[:INA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
CgNoNA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? dr
❑ Yes
WNo�NA
❑ NE
Other Issues Wlolto l
r-e�c�.
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
VNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
CBNo
❑ 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
MrNo
❑ 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
RNo
❑ 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
1UNo
❑ NA
❑ NE
33_ Does facility require a follow-up visit by same agency? ❑ Yes ONo ❑ NA ❑ NE
Additional Comments and/or Drawin>_s:
Yvak a) bv-,e �n �r,�� s lo of [-il l -7aj6. mo Y �tiet od Lhj
to . Ld o is 1 t0 k1� ooq�. I m ewe er .
as. Si u T s.r e -NOL vva-40"sf 0(olle do } n uM 4 f no's )1t,&'k4 Urielf. `
p fo baa b l
7 Se
U jans I, �� 0,3 rld- Wn VieL C orl.a,1f1 bv-- a -,e- moi_�64,
10 �) AW -i in v)e- -lye- i' wW_ @OBQ
y
�
- I Is -f rad teded H- wee I' ,
r-e�c�.
Page 3 of 3 12128/04

Facility No.ebD-` _) Farm Name
Permit -,"' COC
Pop. Design Current
Type
Date
v�
OIC NPDES (Rainbreaker PLAT Annual Cert )
Ftp
Drops
Lagoon
1 2 3
Spillway
Design freeboard
Observed freeboard in
Sludge Survey Date
51ud a Depth ft
;),-7 a.
Liquid Trt_ Zone ft
;L57 3 f �
Ratio Sludge to Treatment Volume
Calibration- -fc7©�Fi«�
MOM
Soil Test Date �6 Wettable Acres RAIN GAUGE
pH Fields WUP Dead box or incinerator
Lime Needed Weekly Freeboard Mortality Records
Lime Applied3111 Q'i dh 1 in Inspections
Cu -I Zn -I j 1CV0 120 min Insp.
Needs P Weather Codes
Crnn Yield Transfer Sheets
r
L1__7
. - ��
IM—A
�
r-ty p4� 1101410
Verify PHONE NUMBERS and affiliations
Date last WUP FRO 651c� Date last WUP at farm V IP -5 App, Hardware
FRO or Farm Records 7 ]A ,Sri -6, � � D IOD
r
rw
Lagoon # �t yg Sf 4'4- 116 ! f CO
Top Dike
Stop Pump
Start Pump
Conversion- Cu -I 3000= 108 Ib/ac; Zn -I 3000= 213 lb/ac
i
a`
ul
YY

Corn - USaal� I -a S -q q C� P3�
I a p
y y
� h�- - f ly -70 b6'�ftdS7 �5a (b,1038-
C�r,-whe+l -4�) `t New
S -pp

`y
13 1w,
Type of Visit UCompliance Inspection Q Operation Review O Structure Evaluation {7 Technical Assistance
Reason for Visit Q Routine O Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: c� ^ County: '3041402h Region: fry
Farm Name: ` Sjy lA j� n t Owner Email:
Owner Name: , W iv i_? �� -Ayt C_ Phone:
Mailing Address: o P 4 he'n is rd
_f
Physical Address:
Facility Contact: P I ►V00461 Title: n Phone No:
Onsite Representative: Integrator:
Certified Operator: +►�` :� t vtE�1i� Operator Certification Number:' 77 f
l
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: o =' ="
Longitude: = ° = ` = U
Design . Current
De1 mill sign Current
Design Current
Srdine , Capacity ._Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
'on -Layer
❑ Daiiy Calf
Feeder to Finish
❑ NA
❑ Dairy Heifer
❑ Farrow to Wean
D . Poultry
❑ Dry Cow
❑ Farrow to Feeder I 6A0
❑ NE
Non -Dairy
❑ La ers
El Stocker
❑ Gilts
❑Non -La ers
❑ Beef Feeder
❑ Boars
❑Pullets
❑ Beef Brood Cowl
-
❑ Turkeys
IRNo
Other '•
❑ Turkey Poults
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Other
❑ Other
Number of Structures:
❑ NE
other than from a discharge?
Discharges & Stream Impacts
L Is any discharge observed from any part of the operation?
❑ Yes
EJNo
❑ 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? (I f 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
❑ NA
❑ NE
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
IRNo
❑ NA
❑ NE
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
B•NO
❑ NA
❑ NE
other than from a discharge?
12/28104
Continued

Facility Number -
Date of Inspection f a n�1�
Waste Collection &'Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Wo ❑ 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 S Structure 6
Identifier: #-7
Spillway?:
Designed Freeboard m
Observed Freeboard (in): LI -7
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 13No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
r
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
RNo ❑ 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?
aYes
❑ No ❑ NA
❑ NE
8- Do any of the stuctures lack adequate markers as required by the permit?
(RY'es
❑ No ❑ NA
[:INE
(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
RNo ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
f3 No ❑ NA
❑ NE
maintenaneelimprovement?
1. 1s there evidence of incorrect application? If yes, check the appropriate box below.
ElYes
�
;jNo ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ 'PAN> I0% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge into Bare Soil
❑ Outside of Ac _ptabie Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Area
12. Crop type(s) �1� �n . )Vh � `r �ru� r. ',' ��1 . �t r�i"1!�;t'
.• ,,n r ' �.11C%. Cf .1 ' 7 ` iiy
`� ���t
13. Soil typc(s) Ahi �v . � 'f11 �+ , -- l� '/' �] �'
WAg/ "s
1-01hr
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
RNo El NA [:1 NE
P�No ❑ NA ❑ NE
P No ❑ NA ❑ NE
® No ❑ NA ❑ NE
CRNo ❑ NA ❑ NE
Comments{refer to question`'#}.' Explain'in* YEapswers and/or any recomen datitinstni'• a�nyoWhoerconm"Wm"e"=sUse drawings of facility.to better explain situationst{use additionalpages as necessary) '`�tee
r
7
Reviewer/Inspector Name C Fl :' Phone I (} y�i-'3300X3
Reviewer/Inspector Signature: Date:�C+
U 12128104 Continued

Facility Number: �Z 2L — ,�)(, Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes P No ❑ NA ❑ NE
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 19 No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P -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
N NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
J�FNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
UNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
JRNo
❑ 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
19 No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
Yes
VNo
❑ 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
nNo
❑ 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
ONo
❑ 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
Z[No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?❑
Yes
JgNo
❑ NA
❑ NE
Additional Coznruents andlor Bra+virigs:
FG m i S j t 1 ra ns i'�`a11, �'e0 or G t>!--~� o �� l�h - -own � -to `� 1' h , A o*
rvoA � �� � b,in buy Id r'n� 4o 4uf fA _ 13fow,, Riaicic�ds,
New wt� PiA D�Ga�,`re
�' y
7. ta ccns SL�rr�. ��� s/
9 1 � A, �Qy � n -e-ed.s -to b e— c L~� ba,
aae d�e bE* 4� aY�c� 0 1� �-, 4 d om 4o sia-lp ,
!rn 01 �r G� h � ll 4i
i5 orate
rn o�lrka�-�, iq-fe6() bV+ ivfre IS F ('a 64k 3 +rmJ
-F a
��l 9 y� GOn `I AA �tu�~ S.Sa✓ OG09Q'Ve"S 6&'Ie
©!1 't -Q I'�1} s'rJ �%qp Jo,
f i� Ll y�
f g C! �J Y%�
A • J T"WJ4 .N, d 6 e T d �1�' le
J l y.
a�dL Ca �-�
�cla _ tUr wh�esl�d ,e v�ur s ��d�� Fo; - ,r1.si: l' r,
is'� l �l DLJ
V1 -f- 0 W S 1 1 ns lrn� Gtr i u� � sp-00 D�'Pn ti
hL 1^�f
%v s✓1
IW8104

T Facility No.�_Farm Name 0 Sv n Date _j o tal o q _ __
Permit ---� COC OIC_ NPDES {Rainbreaker PLAT Annual Cert )
Pop.Type Design Current FB Drops Sol
#bserved freeboard (in)
Calibration Date
`�
0 -
-•®�■�s��
Soil Test Date q*
NM
Weather Codes
pH Fields
WUP
Transfer Sheets
Lime Needed Q�
10GO-
Fwaste—Analy-sis- Date
POR Nan.& . A, &Q tJo% ` ` C ien&@a'.rn .Sa-,P,t1, -' ' die SvM1,4s-}vh+4����l�it�ePhn�
. ��
`�
;may
Soil Test Date q*
Wettable Acres
T�
Weather Codes
pH Fields
WUP
Transfer Sheets
Lime Needed Q�
10GO-
Weekly Freeboard
RAIN GAUGE
Lime Applied
Rainfall >1"
Dead box or incinerator
Cu a ZnnrelU00-13010
1 in Inspections
Mortality Records
Needs P
120 min Inspections
_�
Crop Yield_'-it1rdcef
Fwaste—Analy-sis- Date
POR Nan.& . A, &Q tJo% ` ` C ien&@a'.rn .Sa-,P,t1, -' ' die SvM1,4s-}vh+4����l�it�ePhn�
. ��
..
;may
_ araJp 19
�, •.�. iii `
M, "Imm
Verify PHONE NUMBERS and affiliations
Date last WUP FRO Date last WUP at farm
FRO or Farm Records
Lagoon #
Top Dike l
Stop Pump
Start Pump
Conversion- Cu -I 3000= 108 lb/ac; Zn -I 3000= 213 lb/ac
Pq() dfr %EK63 I 167q4 FW -M07!
�vv4'1h
Ir9
App. Hardware
5 rdel9e q Dobai &o e0 001 Pk
►�
15 Of -6) Sofscl°o
yep _S t�fTo�arcD�ie��/

wft-�
arr
6a A-
M
M
�jb�rJ, acc�lbSl�ove rA�
_5.000

f !MS it ll, 0oy 09
Type of Visit &Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit V Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: a Arrival Time-
Departure Time:
County: Sl
Region: Fftt
Farm Name: a- SHe- CO3 3;1a.
Wet Poul#ry
Owner Email:
❑ Wean to Finish
Owner Name: m t slr 1� t? CO -rrV�
❑ Layer
Phone:
❑ Wean to Feeder
Mailing Address: IQa_._t)
❑ Non La er
❑ Dairy Calf
pl
Physical Address:
`''
.,,: ,
y Dai Heifer
ElFarrowFarrow to Wean
Facility Contact: RIC4 1V®0k11
nn
Title: rJ Wn
Phone No:
El Farrow to Feeder
❑ Yes
„
Onsite Representative: tClet,
Vvy*n
Integrator:_ld�'�
❑ Layers
Certified Operator: I
❑ Gilts
Operator Certification Number: AwA Mom
Back-up Operator:
❑ Beef Feeder
Back-up Certification Number:
(INA
❑ Pullets
❑Beef Brood Co
Location of Farm:
Latitude: Q
=, = « Longitude: =0=1
= G
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'?
Design Current
`Design Current , Design Current
Swine
Capacity Population
Wet Poul#ry
Capacity PopUla tton Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
❑ No
❑ Non La er
❑ Dairy Calf
Feeder to Finish
❑ Yes
`''
.,,: ,
y Dai Heifer
ElFarrowFarrow to Wean
c. What is the estimated volume that reached waters of the State (gallons)?
s
Dry Poltry
�,�
❑ D Cow
El Farrow to Feeder
❑ Yes
„
`� ❑Non -Dai
RFarrow to Finish
1600
❑ Layers
9 ❑ Beef Stocker
❑ Gilts
❑ NE
❑ Non -Layers
❑ Beef Feeder
❑ Boars
(INA
❑ Pullets
❑Beef Brood Co
[ITurkeys
�- -
Other .`
12/28/04
❑Turkey Poults
K�
❑ Other
[] Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'?
ffyes
❑ No
❑ NA
❑ NE
Discharge originated at: ® Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
CR Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
ONo
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
n
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
$?No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
JRNo
[:INA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
[]Yes
INNo
(INA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

Facility Number:ga —3
Date of Inspection 11 1 e�. fps
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [RNo ❑ 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 S cture 6
Identifier: a� 3 5 9u 7
Spillway?:
Designed Freeboard (in): I qIg� 13
Observed Freeboard (in): 3 („9 �- _ 3 3 3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes IRNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes C"No [INA ❑ 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? WYes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ® No ❑ NA Cl 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 tR 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 ONo [INA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > l0% or 14 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 CA WMP?
❑ Yes
W No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ER 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
10 No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
RNo
❑ NA ❑ NF
�A 7f :,..i��*�+�,mtmen{refer #o'quesfion #) Eitplatn an3ES.ag
Ilkse
�" �drawtns *of facrll Y to better*exy Iain sitaahons. ase addrhop P
i 1
Reviewer/Inspector Name
ReviewerlInspector Signature:
Page 2 of 3
Phone: 110 4,33-33W X �
Date: 1VW I1. ad311k
12/28104 Continued

Facility Number: %a S7 Date of Inspection U I Ira 103
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes N[No [INA ❑NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes C? -No ❑ NA ❑ NE
the appropirate box.
❑ WUP [3 Checklists [:1 Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes R No ❑ NA EINE
❑ 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
U] No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
RNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
1;�l No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
2b.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
NNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
P NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
JWNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
15? 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
C'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
JRNo
❑ 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
R[No
❑ NA
❑ NE
Additions "Comments and/or Drawings
I,S Iillor
s�; i)Rlpy_il�Q�m'aJel� ; !vi+� , reelace�r^f )et�.� ho upj aid Le 0a, -7 ,
o;�c �bt n�br xeq U �9
�Immoved_
Has c&o&- erg sQ,,,¢Q )a vis. S J I a -�'�w br?�s�Bfr Dn lO9obr Q 7.
P le i r tie`s c+� a f Jtle_�+ aid mow a ! iffle, rn ore e_ .baclal -e
r SJd� sw�e 5 s of ai� -e& Q cm at4t avor ,
not � ►"cf,ed .
y
�
9+ rye-, ,fit
Cood.sdC y , 9�? 'y
l&� TQ arscr�► 2s
m eddy ara. in cowfd�e sit l Lam Y,
cw Are- moved. 64o n-erye_-A_ejds,
` [p Ems, j y � 1 �►�'c� F- 4c�� i� aaj ri D'�P, >l off' a+'�p'nr � t o��
Page 3 of 3 12128104

Facility No.' --"S7 Farm Name -04wS�VAe- Date 111ta leg
Permit COC L,.--, OIC— NPDES (Rainbreaker PLAT Annual Cert)
FB Drops
a-ao-oz 1
Calibratio6 Date
Actual Flow
—Design Width
Actual Width
YAVc-
f sTr�e�
& lr
Soil Test Date
! l.a6yr<a' l lawn
j f [
-
1 in Inspections
Design freeboard
Observed freeboard (in) R7
Sludge Survey 11!ate Perm Lkiqukid
A
kid 3P-01 Sludge Depth (ft) rm7 MMK�E�Fmml
6=
a-ao-oz 1
Calibratio6 Date
Actual Flow
—Design Width
Actual Width
YAVc-
f sTr�e�
& lr
Soil Test Date
! l.a6yr<a' l lawn
j f [
-
1 in Inspections
Crop Yield ,�
pH Fields
Lime Needed
A
Wettable Acres
120 min Inspections ✓
Weather Codes
Lime Applied
�-
e6.7elft
WUP
Transfer Sheets tI X(*
Cu
Zn
Weekly Freeboard
RAIN -GAUGE
Needs P
_ p
Rainfall >1"
.i .-
.0 r.
Pull/Field Soil Crop RYE PAN Window
r
w
Verify PHONE NUMBERS and affiliations
Date last WUP FRO Date last WUP at farm
Top Dike
Stop Pump
Start Pump
s
Czh ha,4 ow Sl��P,
App. Hardware Max Rate in/hr Max Amt in.
Acwdl,j fofa- ., ,t *pr at(Ddr fD
S /f
`��� 1nS'h�1rj bsf'J ���✓�d d.e � � �

f
SF Division of Water Quality
Facility Number $ a S O Division of Soil and Water Conservation
- O Other Agency
Type of Visit 19Compliance Inspection O Operation Review O Structure Evaluation C) Technical Assistance
Reason for Visit 91 Routine Q Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of visit: �y� Arrival Time: ['G, <{ "� Departure lime: County: +- �'1 Region: ��Q
Farm Name: -jq ly SIvAl2 %DInr_ _ Owner Email:
Owner Name: „211V SWIAP COTnC. Phone: {
Mailing Address: P30 MkfiQ ChUX-Ch U_ j)Vgn Ne a7— 233
kJ
Physical Address:
Facility Contact: Dickwivv Title: 5HK MTOA'— 6"VA#'_ Phone No: 910 '1`:
Onsite Representative: iv Integrator:
Certified Operator: c4C WoBi Operator Certification Number: & V 1,
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: [=O = =61 Longitude: =0=6
0=6 0 «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer e
❑ Non -La et
Dry Poultry
❑ Layers
❑
Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance than -made?
h. Did the discharge reach waters of the State'? (If yes, notify DWQ)
Design Current:
Cattle. Capacity Papulation7%''
❑ Dairy Cow
❑ Daia Calf
❑ Daia Heifei
❑ Dry Cow
❑ Non -Dairy
r
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cowl I
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: 1 V :I
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 KNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes 1Z No ❑ NA ❑ NE
❑ Yes JffNo ❑ NA ❑ NE
12/28/04 Continued

acility Number a: -Sl
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 I Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes g No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
�r 3
Spillway?:
Desigmed Freeboard (in):
Observed Freeboard (in): 3 3 a57 _ _ 3,3 i4Q 3
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 b?No ❑ NA ❑ NE
❑ Yes P 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 9No ❑ NA ❑ NE
8. Du any of the stuctures lack adequate markers as required by the permit? ❑ Yes 9No ❑ 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 ERNo ❑ NA Cl NE
maintenance/improvement?
0
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [9No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 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) C..Q ►Ill t, nval ' S Aywai
13. Soil type(s) (7 Ar A,
-e4
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 [9No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[--] Yes
ER No
❑ NA
❑ NE
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
PTNo
❑ NA
❑ NE
Comments (refer to question ft 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 Dame chnem[' Phone: glo- 433-x,33
Reviewer/Inspector Signature: Date:
V 12/28/04 Continued

Facility Number: 001 S'j Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Pennit readily available? ❑ Yes 5Z&o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes MNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes U No ❑ NA ❑ NE
Cl Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22_ Did the facility fail to install and maintain a rain gauge?
❑ Yes
5'No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
IN NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
1p No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
5d No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
51 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
CRNA
❑ NE
Otherlssues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
®iNo
❑ 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
WNo
❑ 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
�TNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss reviewlinspection with an on-site representative?
❑ Yes
MNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
EJ'No
❑ NA
❑ NE
Additional Comments and/or Drawings:
7. s Bed old n 6kh bre spar on I a`a oonj eseec t e hi r,^�� wal e 1 � s�';�,
$fegie. f2 mwe_ -"rah-ra,.,t i ajoths
asp ao� Slyd�es�vcr c�a�e� y��da� ��a laolo��, �a�rak n� 6�►E� y,�
wore911,6e- Swvelr rv#J otl7e—
R e- &ocd s%cl. , yvhea LJ+ plalf smybea s harvP,� end D NoLev"h '-.
� i�
12/28/04

r
.
DK- R -2-
Access
Date of Visit: Arrival Time: Departure Time: � � 3� � County: L4_Aj0:PPZ&- Region:
Farm Name: — �" S t�1 J N 0" Owner Email:
Owner Name: — I C kt,. Wn Q -c Phone:
Mailing Address:
Physical Address:
Facility Contort: - -, W 0C4<,-tj Title: D kiV'j Phone No:
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: ED o Q ' =" Longitude: =° =' E=1 «
❑
❑Farrow to Wean
❑ Farrow to Feeder
S
Gilts
❑ Boars
Discharges & Stream Impacts
_ 1. Is any discharge observed from any part of the operation?
Discharge originated at. El Structure ❑Application Field El 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?
Page 1 of 3
❑ Yes 0
No ❑ NA ❑ NE
[I Yes �No [INA ONE
❑ Yes 'V' No ❑ NA ❑ NE
❑ Yes (1W No [:1NA ❑ NE
❑ Yes W No ❑ NA ❑ NE
❑ Yes W
Design Cnrrent
Design C*u—Frent
Design Current
Swine
Capacity Population
Wet Poultry Capacity Population
Cattle CapacityPopulation
❑ Wean to Finish
❑ Layer
El Dairy Cow
❑ Wean to Feeder
❑ Non -La er I
Dairy Calf
Feeder to Finish
❑ Dairy Heifer
No
D . Paul €
tryz�._
❑ D Cow
_
❑ Non -Da'
Farrow to Finish
Di7
❑ La ers
❑ Non -La ers
El Beef Stocker
❑ Pullets
El Beef Feeder
ElTurkeys
❑ Beef Brood Co"
Other
❑ Turke Poults
❑ Other
El Other
Number of Structures:
❑
❑Farrow to Wean
❑ Farrow to Feeder
S
Gilts
❑ Boars
Discharges & Stream Impacts
_ 1. Is any discharge observed from any part of the operation?
Discharge originated at. El Structure ❑Application Field El 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?
Page 1 of 3
❑ Yes 0
No ❑ NA ❑ NE
[I Yes �No [INA ONE
❑ Yes 'V' No ❑ NA ❑ NE
❑ Yes (1W No [:1NA ❑ NE
❑ Yes W No ❑ NA ❑ NE
❑ Yes W
12/28104 Continued
Type of Visit V Compliance inspection Q Operatipn Review (] Structure Evaluation (,} Technical Assistance
Reason for Visit ®Routine Q Complaint Q Faflpw up Q Referral Q Emergency Q Qther ❑ Denied
No
❑ NA
❑ NE
12/28104 Continued
Type of Visit V Compliance inspection Q Operatipn Review (] Structure Evaluation (,} Technical Assistance
Reason for Visit ®Routine Q Complaint Q Faflpw up Q Referral Q Emergency Q Qther ❑ Denied

i
y Facility Number:
Date of Inspection 6-b/-0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes RNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [9 No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 StructuretX S
Identifier:
Spillway?:
Designed Freeboard (in): 7
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes CKNo ❑ NA EINE
(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 I$No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes P0 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [] Yes [$No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes] No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes [ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ 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) �rN S N+�a/f, G�h e A, lri(` f�lvxttX . Sum.••w.4fc9�trc1/rt3�f.+r�ale+�vs�1
Q�
I3.
Soil type(s) i4 &7A, AloE Agkw-
14.
Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
M No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
PNo
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ yes
q No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
KNo
❑ 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 r_� _ i______. PhonecLP �Q/27J%&
Reviewerlinspector Signature: A Date: -J rr OI ZOO
1 0- � __j
Page 2 of 3 12/28/04 Continued

r
Facility Number: gZ — 7 Date of Inspection)
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [9 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes fit] No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design g 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 ❑ Crop Yield ❑ I20 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[KNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
MNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
q No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
0 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
CA No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
1� 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
O 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
[;4No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
P No
❑ NA
❑ NE
Page 3 of 3 12/28/04

IType of Visit compliance Inspection Q Operation Review O Lagoon Evaluation �
for Visit O'Routine Q Complaint O Follow up Q Emergency Notification Q Other ❑ Denied Access
Facility Number Date of visit: 3 a Time: : 0 0
O =Not Operational O Below Threshold
'Permitted [3 Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: -- •—
Farm Name: ........7 . L`� . 5'`)'nG •--.. .:....k&. ..... -... ...................... County: _ �SDn
Owner Name:.........:... ` Phone No: �O ^(�?' a 5
°p.......................WW .. �........................ .. �........... .... ................
Mailing Address:.-- 9 v�._._ 2 ��
.__.........
Facility Contact-
Title- _ Phone No:
Onsite Representative: - ..--- DO` "� ...................... Integrator....... �,c�f, � ^. �, ....... _... _
Certified Operator: ` .......---•. Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 41 Longitude 4 "
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑
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 gallmin?
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 L-i'No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes aNba
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Sic -t"
identifier:........... ..... ........ .............. ...--................................ ............... ............... -- - - ... .....---.................._�. -
3 q-
Frechoard (inches): Z; 6 L 34 3.
12112/03 Continued

Facility Number: ,2 — Date of Inspection 3 0
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [9-K6-"
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or [] Yes �o _
closure plan?
(If any of questions 46 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ) �
7. Do any of the structures need maintenancelimprovement? ❑ Yes E tvo-
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes [�No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes 3-1110
elevation markings?
Waste Application
I t 1 .L
Far., 4,5 7,j rs co ('aS C.w O eam '11 /tea T .
10. Are there any buffers that need maintenanceltmprovement?
❑ Yes
Dad
1 l . Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
�ONoor
L o
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
�y
12. Crop type P,�.a �r�e el{ rn i►� v vrrsrc� / t4 `� m L: ooy,
13. Do the receiving crops diffe ith those designated in the Certified Animal Waste Managemen Ian (CAWMP)?
❑ Yes_
14. a) Does the faLility lack adequate acreage for land application?
❑ Yes
b) Does the facility need a wettable acre determination?
❑ Yes
io
c) This facility is pended for a wettable acre determination?
❑ Yes
leo
15. Does the receiving crop need improvement?
❑ Yes
L` 4q_o
16. Is there a lack of adequate waste application equipment?
❑ Yes
c l b+
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑'ivo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
11Na�
19. is there any evidence of wind drift during land application? (i -e. residue on neighboring vegetation, asphalt,
❑ Yes
Dwo
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
0 Yes
ErNo
Air Quality representative immediately.
s w i...,.`. as - ti x -
:Cotnme�nts (refer to c}uestion ) Eipla�n any YEfi at�wc�s and/or aYry, recamtDetadatio� or any ootmments. ` te --
:Use drawings of facYltty to better expla>kn situations. {arse atidrU6' pages as necessatry) field Copy ❑Final Notes
I t 1 .L
Far., 4,5 7,j rs co ('aS C.w O eam '11 /tea T .
a
Dad
tvpS
ReviewerlLnspector Name Y-,
Reviewer/inspector Signature:
Date:
o
12112103 �/� Continued

YI Facility Number: 2 _ �j Date of Inspection 3 0
Renuired 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?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
28. 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
34. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
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 ❑ Crap Yield Form ❑ Rainfall ❑ Inspection After V Rain
_PA20 Minute Inspections ❑ Annual Certification Form
❑ Yes 8qqo-�
❑ Yes [}#6-__�
❑ Yes ❑_90
❑ Yes [moo
❑ Yes [9w[5 --
Yes
w[5 --
Yes 9'qO_1__
❑ Yes ❑lfo--_
[:]Yes 9 -go—
❑ Yes QNo
❑ Yes Leo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
;�
dditional Comments and/or•Drawings - = � .. �- - -7.
12112103