820611_INSPECTIONS_20171231

Department of Environmental Qual

l 1A —7 1�ri,+v lr
Type of Visit: Q Comp ' nce Inspection U Operation Review U Structure Evaluation Q Technical Assistance
Reason for Visit: Routine 0 Complaint Q Follow-up 0 Referral Q Emermency Q Other O Denied Access
Date of Visit: Arrival Time, •3D Departure Time: ; v County: 9/")% Q t1) Region: ��
Farm Name: 7o- ti ►1 e Owner Entail:
Owner Name: (30.ea A h V-0 Phone:
Mailing Address:
Physical Address:
Facility Contact: r�_vivcW Title: Phone:
Onsite Representative: V Integrator:LM 6 S, w -
Certified Operator: (3eL til4 "A e<Certification Number: f /SIN
Hack -up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pap.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
C7 -c90
I Non -Layer
I
I
Dairy Calf
Feeder to Finish
Farrow to Wean
D . P,oul
Design
Ca aci
Current
P,a
Dairy Heifer
Dry Cow
Non -Dairy
Farrow to Feeder
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Qther Turkey Poults
Other Other
_Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
1 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 &Pira` ❑ NA ❑ NE
❑ Yes
❑ No
�A
❑ NE
❑ Yes
❑ No
[
❑ NE
[:]Yes
❑No
[ -?q
❑ NE
❑ Yes
❑-%o-
❑ NA
❑ NE
❑ Yes
[]'No
❑ NA
❑ NE
Page 1 of 3 21412015 Coniinued

Facility Number: Date of Inspection: uN[
❑ Yes
Er D
❑ NA
❑ NE
r
Waste Collection & Treatment
0 Yes
D -Igo
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
E] Yes
�'
E NO
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[ -b A-
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
identifier:
18. Is there a lack of properly operating waste application equipment?
[] Yes
D-lZo
❑ NA
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3o
5. Are there any immediate threats to the integrity of any of the structures observed?
0 Yes
❑ No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
❑ No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
❑ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[]No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ 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 ❑ Evider
13nce of Wind Drift E] Application Outside of Approved Area
12. Crop Type(s): 'tT 0
13. Soil Type(s): nth
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Er D
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
0 Yes
D -Igo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Eq -Ko-
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
�o �
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
[] Yes
D-lZo
❑ NA
❑ NE
Reauired Records & Documents
19_ Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
9-TTo
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA ❑ NE
the appropriate box.
❑ WUP [--]Checklists ❑ Design ❑ Maps 0 Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Eq -Ko-
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ RainfaIl p Stocking 0 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
❑i'No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 2/412015 Continued

Facili Number: Date of Inspection: Ar -
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-comptiant 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
El�Io
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
E3 - <o
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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:
33 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 23'< ❑ NA ❑ NE
❑ Yes E3<o ❑ NA ❑ NE
❑ Yes ❑`No [DNA ❑ NE
❑ Yes r f.v ❑ NA ❑ NE
[❑ e'Sr.o ❑ NA ❑ NE
❑ Yes []"No ❑ NA ❑ NE
[:]Yes [ -lqo ❑ NA ❑ NE
Comments (referta,yestton:#): Explain any YE$ .aasvFen orany additional recommendations �or:yot6er cotninents. —
Use drawings•M of factltiyfito:tieiter. explain situations:{use _addidonal'pages;:as necessary). _ ,
ii
b
X67,
Reviewer/Inspector Name:
Reviewer/Inspector Signator
Page 3 of 3
Y
Phone: L 0 U
's
Date: �� cJU
21412015

- ivision of Water Resources
Faeii>ity Number � - f j ®Division of Soil and Water Conservation
Milli
® Other Agency
Type of Visit: ompliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: 0-Iffo-utine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: f ' c eparture Time: County: �x e -`Region: {j
Farm Name: _71, -z -a eL >`d✓rrL._
Owner Name:,v GleJ -LE nr1 nl✓
Mailing Address:
Physical Address:
Facility Contact: 45--r 2-Y/ r1loo'-r- Title:
Onsite Representative: 504r__ �
Certified Operator:
Owner Email:
Phone:
�-e_-. Phone:
Integrator:/ •/
Certification Number:�p
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes �io ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes jNo
❑ Yes �No
[]NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued
Design Current
Design
Current
Design Eurrent
Swine g
Capacity Pop
Wet Poultry
Capacity
Pop
Cattle Capacity Pop.
VA, -�
Wean to Finish
La er
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
-:
Design
Current
D Cow
Farrow to Feeder
f
D . Poul
Ca aei
P,o .
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
a
Pullets
Beef Brood Cow
Turkeys
-
()then
Turkey Poults
Other
�
Other
141
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes �io ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes jNo
❑ Yes �No
[]NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Facility Number -4:P117 -
V jDate of Inspection:
Waste Collection & Treatment
4 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [R -No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
[j NA ❑N
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier:
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
KNo
❑ NA
Spillway?:
the appropriate box_
❑ WUP ❑Checklists ❑ Design ❑ Maps [❑ Lease Agreements
❑Other:
Designed Freeboard (in): L ,
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
IR No
[] NA
Observed Freeboard (in): -L-
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
[] Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rainfall Inspections
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
0 No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ESI—N0
❑ NA
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
O'No
❑ NA
[_1 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
f;a No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
KNo
❑ 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
D4�No
❑ NA
❑ NE
maintenance or improvement?
�
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
P No
❑ NA
[] NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ YesPq�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% 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): on 2&j�
13. Soil Type(s): _A:
14. Do the receiving crops differ from those designated in the CAWMP? [] Yes �o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ENo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes allo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes M No ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[�j No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
KNo
❑ 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
IR No
[] NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
[] Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[a No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ESI—N0
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

Facili Number; Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes C&No
t 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ELNo
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 RNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes JR]'No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[] Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/inspector Signatur
Page 3 of 3
❑NA ❑NE
❑ NA ❑ NE
E] NA E] NE
❑NA ❑NE
❑ Yes K No ❑ NA ❑ NE
❑ Yes R No E3NA ❑ NE
❑ Yes IR No ❑ NA ❑ NE
❑ Yes 1�No ❑ NA ❑ NE
❑ Yes ff�No ❑ NA ❑ NE
❑ Yes Cq No ❑ NA ❑ NE
❑ Yes , o [] NA ❑ NE
f
Phone:
Date: Z o ��
21412015

�`_
l�
(Type of Visit: fd'Comp ' nce Inspection U Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine O Complaint 0 Follow-up O Referral 0 Emergency 0 Other O Denied Access Ij
DateofVisit:12= Arrival Time: r'i7TJ Departure Time:. � ,��� County: Region: _rp
Farttr Name: �r,,�Y/ /��ry -
Owner Name: n' -Z:'-�.
Mailing Address:
Physical Address:
Facility Contact:Title:
Onsite Representative:
`Certified Operator: -'o-nn
Back-up Operator:
Location of Farm:
Latitude:
Owner Email:
Phone:
Phone:
Integrator: '1�1.nell�41
Certification Number:
Certification Number:
Longitude:
Design current
❑ Yes
Design
Current
Design Current
c. What is the estimated volume that reached waters of the State (gallons)?
oultry
Cto
Finish
C a er
❑ No
❑ NA
Dai Cow
to Feeder
Non -La er
[a No
❑ NA
Dai Calf
r to Finish
❑ Yes
f.No
❑ NA
Dai Heifer
to Wean
FGilts
Design
Current
D Cow
to Feeder
D . Poal
Ea aci
Po
Non -Dairy
to Finish
La ers
Beef Stocker
Non -La ers
Beef Feeder
'
Pullets
Beef Brood Cow
_
Turke s
Outer , p
Turkey Poults
Other
Other
Discharges and Stream impacts
I . is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes Q No ❑ NA ❑ NE
E] Yes E] No E] NA El NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
[] No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[a No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
f.No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facili Number: - IDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
P.Dio
[JNA
❑ NE
a. I f yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in).
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
JE3-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
12INo
❑ 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
JE�No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
RM No
E] 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 Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
jj4,No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
Wo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus [] Failure to Incorporate Manurc/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): /T /qj t/-� 7-j
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes] No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes KNo D NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑Yes ,Z No ❑NA ❑NE
❑ Yes J�jNo ❑ NA ❑ NE
Reset aired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [:]Yes gNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [-]Yes [allo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design p Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes YK No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis 0 Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes kNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P�No
❑NA ❑NE
❑ Weather Code
[:]Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2141201S Continued

lFacillty Numbe i,rll Date of inspection: j
• 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes allo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check D Yes allo ❑ 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 0 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes KNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
E] Yes
No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
i�
29: At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
VEfNo
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
� No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below.
❑ Yes
151No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage fond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
allo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
E3 No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
� No
❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signatut
Page 3 of 3
Phone: /y 3 D -3—,g
Date:
2/4!2075

3 -S -1k
11
Type of Visit: QCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: -i.r Arrival Time: Departure Time: /J ; j County:" Region: lr-�
Farm Name: Z iel h i.,r Pry%— _ Owner Email:
Owner Name: I c714,� Phone:
Mailing Address:
Physical Address:
Facility Contact: tri s- NCO e -e Title:
Phone:
Onsite Representative: �'� Integrator:
Certified Operator: [yam l Certification Number:J~v�L1 .
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
F� Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
@attle C►apacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder�n VD
Non -La er
Dairy Calf
Feeder to Finish
_
Dairy Heifer
Farrow to Wean
Dr .P■oul
Design
Ca aci
Current
P.o
DEX Cow
Non -Dairy
Farrow to Feeder
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
- Turke s
Poults
Other
Other
Discharges and Stream Impacts
I . is any discharge observed from any part of the operation? ❑ Yes [K No ❑ NA [:]WE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ WE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes ❑ No
❑ Yes ®. No
❑ Yes allo
❑NA ❑NE
[] NA ❑ NE
❑NA ❑NE
Page 1 of 3 2/412014 Continued

Facili Number: Date of Inspection:
-- S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
M-No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 22 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
b. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
allo
❑ 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
[LNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[S No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[R No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[2,No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. [:]Yes FS-d1Vo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs. ❑ Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):- /-
14. Do the receiving crops differ from those designated in the CA WMP? ❑ Yes E2[No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes � No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes "No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes [51 No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ONE
Required Records & Documents
19, Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [g No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [:]Yes allo ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists [—]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [_No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [] Stocking [] Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [—]Yes allo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes allo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA []NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: - (v// Date of Ins Inspection: /
❑ Yes
Jallo
❑ NA
- 24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
❑ NA ❑ NE
the appropriate box(es) below.
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
❑ Failure to complete annual sludge survey []failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
Callo
List structure(s) and date of first survey indicating non-compliance:
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
26. Did the facility fail to provide documentation of an actively certified operator in charge?
[:]Yes
[&No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[!�No
❑ NA ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
Jallo
❑ 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
a 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
Callo
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[:]Yes
C,No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[:]Yes
®. No
❑ 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
[0 No
❑ NA
❑ NE
Comments (refer to question #f) Explain any YES answers and/or any additional recommendations or any other continents
a..
Use drawines,offacility to better_exnlam sihtations (use additional oaees as necessarv).
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 3 of 3
421--e— � J��' - Phone: 7fb—q_33-33ti_Z-)
Date: 1/ —`/�
2/4/2011

Irype of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: e4outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit; G Ho Arrival Time: ; po Departure Time:o' ori County / Region: 10
Farm Name ^rte n r� Fa rrj'%' Owner Email:
Owner Name: r'- V T ,,, ,, ��' Phone:
Mailing Address:
Physical Address:
Facility Contact: r r i'' ii9Dp/`� Title: z1 SSG . Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
Discharzes and Stream Imaacts
1. Is any discharge observed from any part of the operation? ❑ Yes RNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (galIons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes C -No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes g -No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 214/2011 Continued
Design Current
DesignpLt.-urrent
Swine
Capacity Pop.
Wet Poultrypacity
LiDr—e-sifig-
Pop.
Cattle Capacity Pop.
Wean to Finish
I aver
Dai Cow
Wean to Feeder
�`
Non -La er
Dai Calf
Feeder to Finish
}_ ^� ''
D < eP,ou!
_
Design Current
Ca aci $o -
Dai Heifer
D Cow
Non -Dairy
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Turkey Poults
Other
Other
Discharzes and Stream Imaacts
1. Is any discharge observed from any part of the operation? ❑ Yes RNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (galIons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes C -No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes g -No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 214/2011 Continued

Facility Number: - 10 J Date of Ins ection: to
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
D .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: p
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E�SNo
❑ 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)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
FA No
DNA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes
0 No
❑ NA
[] NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes CE� No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus [] Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 3/`M j t.L Al/ re ird - - - -
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑Yes [�No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes Q No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes rUt No ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [Q No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes FO No ❑ NA ❑ NE
the appropriate box.
❑WUP [—]Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other.
21 . Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes allo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes Pq No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued
f

Facility Number: - Date of Inspection: �-- —
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [.No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
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)
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
54 No
❑ NA
❑ NE
❑ Yes
[Z No
❑ NA
❑ NE
❑ Yes
`ice No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
[:]Yes [&No ❑ NA ❑ NE
❑ Yes Ej No ❑ NA ❑ NE
❑ Yes No
❑ Yes No
[:]Yes CgNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer. to question #): Explain any YES answers and/or any additional recommendations or any other. comments _�„
Use drawings of facility to better explain situations (use additional pages as necessary).. , u
-K-r eo f 5 .175e &-, / D —C9-3 'PX / q
cb-t-� t e FPType Gra-63
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
2/412011

Type of Visit: Q<ompllance Inspection 0 Operation Review 10 Structure Evaluation 0 Technical Assistance
Reason for Visit: OW�utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: CountyF'D'* Region:
Farm Name: , a M,4 ear lc:"* Owner Email:
Owner Name: Ca wr '�i�"n Phone:
Mailing Address:
Physical Address:
Facility Contact: 1 /'cry_ ow --c- Title: /' 4p:+G, Phone:
Onsite Representative: ,.�� Integrator:
Certified Operator: �a,,,.7 ��ry�/�rl� Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
DischarEes and Stream Impacts
I . Is any discharge observed from any part of the operation?
❑ Yes
Ng No
DNA
❑ NE
Discharge originated at: ❑ Structure [] Application Field ❑ Other:
Design Current§
Design
Current=
Design Current
Swine
Capacity Pop.
Wet I'aultry
Capacity -Pop.
Cattle - Capacity Pop.
❑ No
D NA
❑ NE
c. What is the estimated volume that reached waters of the State (gal ions)?
La er
Yes
❑ No
Da Cow
Wean to Feeder
Iwo
Layer
ro' No
❑ NA
Da Calf
Feeder to Finish
❑ Yes
[� No
❑ NA
❑ NE
Da' Heifer
Farrow to WeanDesign_
C_ urrent
D Cow
Farrow to Feeder
D , Poul
Cama ifv
. p-lNon-Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
NO
Turkeys
Other
I
Turkey Poults
Other
Other
DischarEes and Stream Impacts
I . Is any discharge observed from any part of the operation?
❑ Yes
Ng No
DNA
❑ NE
Discharge originated at: ❑ Structure [] Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
D NA
❑ NE
c. What is the estimated volume that reached waters of the State (gal ions)?
d. Does the 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
ro' No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[� No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 214/2011 Continued

C)0
Facili Number: Date of Inspection:
Waste Collection & Treatment
4 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ej§�No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(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
EC 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
5No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
§?INo
❑ 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
ENo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[,�allo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [—]Yes 5?[No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): / �U,ci-S�rd1
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Z No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 0 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes C&No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes allo ❑ NA ❑ NE
❑ Yes L5 No ❑ NA ❑ NE
Re4uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [. No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes U. No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes D4 No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ONE
Page 2 of 3 2/4/2011 Continued

C9
FacHity Number: -to Date of lns ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ®.No ❑ NA ❑ NE
t 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes C&No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ® Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 0 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [Z No ❑ 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:
❑ Yes [3j No ❑ NA ❑ NE
❑ Yes �&No ❑ NA ❑ NE
❑ Yes rV No [:]NA ❑ NE
❑ Yes CR No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
[S No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes
Q4 No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
C?Mo
❑ NA
❑ NE
Comments (refer to.question # ): Explain any YES answers and/or any additional recommendations or;any other comments.w.
Use drawings of facility to better explain situations (use additional pages as necessar_y).� .
Reviewer/Inspector Name: Phone: 2�IA2— jda3:�M
Reviewer/Inspector Signature: Date:
Page 3 of 3 2/412011

" ivis`ion of Water Quality �� _/� �� �Tly
Facility Number ® / f O
O Division of So
lndWonia
AgeOtheny
typeofVisit;
Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
lesson for Visit: (alkoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 1 =/ Arrival Time: p p Departure Time:,t a County: zap
Farm Name: ']�� r1 z -r' 14/`/92 Owner Email:
Owner Name: 4!r-xr 1rz h!l..r,"- Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: -� R
Certified Operator: t/ `Yd r,k vi- -
Phone:
Integrator: I kEOI
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Region: 1!_� [L
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[-]Yes
RNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
Design Currept ..
Design
Current
Design Current
Swine
Ca aci Poli: - .
P ty P� -..
Wet Poult ,
ry
Ca aci
P h
Po P•
Eattle Ca aci POID
P tY P
Wean to Finish
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
Layer
Da' Cow
Wean to Feeder
d pp
❑ NA
Non -La er
2. Is there evidence of a past discharge from any part of the operation?
[:]Yes
No
Da' Calf
Feeder to Finish
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[:)Yes
No
[] NA
-
Da" Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
D . l;oalt .
Ca achy
P,p
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
(7ther
Turke Points
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[-]Yes
RNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[] No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
[:]Yes
[] No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
[:]Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[:)Yes
No
[] NA
❑ NE
of the State other than from a discharge?
Page l of 3 2/4/2011 Continued

Facility Number: - Date of Inspection.-
ns ection.-
❑ Yes
® No
❑ NA
❑ NE
Waste
Waste Collection & Treatment
❑ Yes
® No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
R'No
[DNA
❑ 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
❑ NA
Identifier=
the appropriate box.
Spillway?:
Designed Freeboard (in):� 1
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
fD 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
Eq No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Apolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding [] Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift p Application Outside of Approved Area
12. Crop Type(s):'1"t�f •ec Y is
I3. Soil Type(s): I _
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ® No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[g No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [0 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge'? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facility Number: - } t Date of Ins ection: — 0 —,;zo
24. Did the facility fail to calibrate waste application equipment as required by the permit? C]Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of fust survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes P,No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ®, No
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?
❑ NA ❑ NE
❑ NA ❑ NE
0 N 0 N
❑ NA ❑ NE
❑ Yes � No [:]NA [—]NE
❑ Yes [a No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes No
[:]Yes ® No
❑ Yes No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer;to,gnestion ff): Explain any YES aEtswers:and/orryany additional recommendations or:any other comments.
Use drawir>gs of fsicility'to better explain situations;(use.addrtionaI pages as necessary):
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: %O
21417011

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Beason for Visit: tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ILLI
Design Current
Arrival Time: 'p
Departure Time: 1 : j0 County Region: %� Q
Farm Name-
,.t +4r.I�
tQi,rVv
Owner Email:
Pop.
Cattle Capacity Pa_:o
Owner Name:
ere
Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: Integrator:
Certified Operator: &ae y Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes RL No 0 NA ❑ NE
❑ Yes ❑ No
❑ Yes [:]No
❑ NA ❑ NE
❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes ® No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:)Yes FM -No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued
Design Current
Design
Current
Design C►urrent
Capacity Pap.
Wet PoultryCapacity
Pop.
Cattle Capacity Pa_:o
Finish
L.a er
Dai Cow
o Feeder
Non -La er
Dai Calf
to Finish
roGilts
O
-� .yJ "•
Dai Heifer
to Wean
:_ Design
Dry Poult`�Ca� aci
Current
P,o
Cow
to Feeder
Non -Dairy
to Finish
La ers
Beef Stocker
Non -Layers
Beef Feeder
Boars
Pullets
Beef Broad Cow
�......
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ 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)?
❑ Yes RL No 0 NA ❑ NE
❑ Yes ❑ No
❑ Yes [:]No
❑ NA ❑ NE
❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes ® No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:)Yes FM -No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facili Number: - Date of Inspection: 0-73-
❑ Yes
1@ No
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
CS No
❑ NA
❑ NE
i 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
1
❑ Yes
fo No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
® No
Identifier:
❑ NE
the appropriate box.
Spillway?:
Designed Freeboard (in): 19-_
Observed Freeboard (in): 3S__ Af
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
5gNo
❑ 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
T Do any of the structures need maintenance or improvement?
❑ Yes
0 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[g No.
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
R[ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
5d No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] Yes 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 6
13. Soil Type(s): lJ�u,
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ® No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [g No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
1@ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
CS No
❑ NA
❑ NE
Rgquired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements []Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes allo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ® No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes CR No ❑ NA ❑ NE
Page 2 of 3 2/412011 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes &No ❑ NA ❑ NE
f
1 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes RLNo ❑ NA ❑ NF,
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)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
5a No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
a No
❑ NA
❑ NE
[:]Yes RNo ❑ NA ❑ NE
[]Yes ® No ❑ NA ❑ NE
❑ Yes C.No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
Ea No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes
(2 No
❑ NA
❑ WE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
tC=0,J1 No
❑ NA
❑ NE
Usemeatsdrawings (refer
o question #;): Explain any YES answers and/or any additional recammendations oraanyiother eOmmb-11i
Comments e er to
to .better explain situations(use, additional pages as necessary)
w .
-Work-- ,T,-
Reviewer/inspector Name:
Phone:
Reviewer/Inspector Signature: Date: fQ—/—T r • it
Page 3 of 3 2/4/2011

t
type of Visit (Mompliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason far Visit outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: / 3a-/57 1 Arrival Time: ;3 ti Departure Time: r ; County;toe��� _ Region:
Farm Name: Ta rt n Pf"` Fa✓ 2n= Owner Email:
Owner Name: _ _ Ta..i1t. e r k* R_ Phone:
Mailing Address:
Physical Address:
Facility Contact: Q-" 41—L-: Title: Z21b2rr Phone No:
Onsite Representative: t�."r_ �.� /i%^- _ Integrator: /"Ae E'A
Certified Operator: �1?�r c �'`-� Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 =I ="
Longitude: =0=6
°=6 =
Design Current
Swine Capacity Population
Wet Pouitry
DesignCurrent
(sapscity Population
Design Current
Cattle Capacity Papulation
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
[Wean to Feeder '-Paye 1110
Non -Layer
❑ Dairy Calf
❑ Feeder to Finish
❑ No
❑ Dairy Heifer
❑ Farrow to Wean
Dry Foultry
❑ Dry Cow
❑ Farrow to Feeder
❑ NA
❑ Non -Dairy
El Farrow to Finish
ElLayurs
❑ Beef Stocker
Gilts
❑on -La urs
❑ Beef Feeder
Boars
HElTurku
El
❑ Beef Brood Co
❑ NE
El s
❑ Yes
(tither
❑ Turkey Poults
❑ NE
❑ Other
JE1 Other
Number of Structures:
Discharges & Stream Imuacts
1. Is any discharge observed from any part of the operation?
❑ Yes
QJ�14o
❑ 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? (Ifyes, 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 a past discharge from any part of the operation?
❑ Yes
&No
❑ NA
❑ NE
3, Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Q�Wo
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Facility Number: 8;L— / f Date of Inspection
S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
0 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3(,
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[3 No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
E@ 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
9 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[4 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
9No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
mai ntenancelimprovement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes BNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes MNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes E.No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ®, No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
fr-3a--1b
❑ Yes ®.No ❑ NA ❑ NE
❑ Yes Flo ❑ NA ❑ NE
Reviewer/inspector Name �� /� Phone: p 3 -:13VV
Reviewer/Inspector Signature: Date: -5v—'RV'Z>
Page 2 of 3 12/28/04 Continued

Facility Nurnber: Date of Inspection F 1� D
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [H No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [;&No ❑ NA EINE
the appropriate box. ❑ WDP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes RNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 124 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[&No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
allo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
]RNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
®No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
CR No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[.No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
RNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
ZLNo
❑ 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
KNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
D.No
❑ NA
❑ NE
Mddttiments andJor Dt aiviags i --
Page 3 of 3 12128104
Page 3 of 3 12128104

S ays
a H(0I
Type of Visit OPCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I M Arrival Time: E=j_'_t__1 Departure Time: , jS_ACounty: !!�1" tRegion:
1
Farts Name: d W /? V/S s -&V 4a Owner Email:
Har
Owner Name: f'"iar k k1 rl Phone: 37q—Vqd���
Mailing Address: Rd!� e Fd __ _ v ag�
Physical Address:
Facility Contact: Title:
Onsite Representative: , � 2 lvl1
Certified Operator: H& k — (904l i
Back-up Operator: lorCod ivl�
Phone No: 374—<a1QQ
Integrator:
Operator Certification Number: �W r 83 2y
Back-up Certification Number: AkA 1$379
Location of Farm: Latitude: =0 =I ="
Longitude: =0=6
°=6 = 'i
urrent
Swine 1121PS-1�0YPOCY.1-0-1ation
Design Current
Wet Poultry Capacity Population
Design C*urrent
Cattle Capacity Population
to Finish
❑ La er
❑ Dai Cow
to Feeder
❑Non -La er
❑Dai CalfEr
to Finish -3t! (v
a. Was the conveyance man-made?
❑ Dai heifer
to Wean
❑ NA
❑ D Cow
to Feeder
❑ Yes
Non-Dairyw
to Finish
FEI
La ers
❑ Beef Stocker
Non -La ers❑
Seef Feeder
Pullets❑
Broad Coj__
❑ No
Turke s❑Beef
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Turke Poults ❑ Other
Number of Structures:
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
IRNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a 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
&No
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Facility Number.q —(04 Date of inspection 0
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
[]Yes CRNo ❑ NA CINE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
Identifier:
a
Spillway?:
t
Reviewer/Ins ector Name ._
p S _
IIQ
Designed Freeboard (in):
Reviewer/Inspector Signature:
Date: v
Observed Freeboard (in): 3�
5_ Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
CjkNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
t9 -No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
Yes
❑ No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
allo
❑ 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
[RNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
1,;4No
❑ NA ❑ NE
mai ntenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
MNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN> 10% or t0lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window Evidence of Wind Drift ❑ Application Outside of
Area
�j❑,
12. Crop type(s) cbal-fa I BL/4/& 'Q„ smo _Cg/ DS
13. Soil type(s) Ay L
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
RNo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
10 Yes
❑ No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
'fg No
❑ NA ❑ NE
IT Does the facility lack adequate acreage for land application?
❑ Yes
RNo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
lia No
❑ NA ❑ NE
.
Cammeitts (refer to questiop;#) Explain any YES answers4nd/or any reevmmi:pdations or'any other,.eomments-TL
.Use drawtng"f faciliq-to'lierter.explain situations. (use additional pages as-neessary):
a
t
Reviewer/Ins ector Name ._
p S _
Phone
Reviewer/Inspector Signature:
Date: v
V 12/28104 Continued

•I Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 15allo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [Q -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 &-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 5'NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
tallo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[:]No
SNA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
W No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
UNA
❑ NE
Other Issues
2$. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
I No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
allo
❑ 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
�FNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 t. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
ti -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
CTNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
[I Yes
KNo
❑ NA
❑ NE
A°dd hong! Comments and/or Drawings:
7, Pleibe C.L-�-W04'Veewl -0-o,1., i d2. balk Ld ocn
Bares bf-in l Pim�{0. ReU �% �o s ra r
ul a . Nva.r S i ,a co 'l� �o i`e[Oa1��lc�a7�4�
� 9
�rQ� 01 l�al (a rayo b*d "d n
U`me.. w©.3 Go � 9 �i r ofi coo `fro we((,
t �c- JV'1e- a on, aecorIlhq "�9 �oJ�'SOi � '�Py�•
dye svrve tact �fiii Ln hrl aJora !
oed-100 �1�1 -(:4rm 4
11128104

_Date �o�1
Facility No.����Farm Name rr
� 'Vl}$ I
Permit � COC .�� OIC NPDES (Rainbreaker PLAT Annual Cert )
Pop- Design Current FB
Type Drops
Lagoon 1 2 3 4 5 6 7
-Spillway
35} 3S
--Design freeboard
Observed freeboard in 3 3
Sludge Survey Date
Sludge Depth ft ,3
Liquid Trt. Zone ft
Ratio Sludge to Treatment Volume
Calibration Date
1 2 3 4 5 6 7 8
Design Flow
IS
Actual Flow
l
Design Width
a)
Actual Width
a5�
Soil Test Date I j;Zk(QqWettable Acres RAIN GAUGE
pH Fields WUP ✓ Dead box or incinerator
Lime Needed Weekly FreeboarcA` Mortality Records
Lime Applied ktK7WOS 1015 1 in Inspections
Cu -1 %-�n-I 120 min Insp.
Needs P {-f0 Weather Codes -�
Crop Yield Transfer Sheets
M.
kAm:t EN1 000 Gal)
Pull/Field Soil
Crop Acres PAN Window Max Rate Max Amt
Verify PHONE NUMBERS and affiliations
Date last WUP FRO 11301Oj
Date last WUP at farm
S� o
FRO or Farm Records
Lagoon #
Top Dike {
3 0
Stop Pump Q'S'lw
Start Pump qT-7 4 $
4
I �` $��•�
Conversion- Cu -I 3000= 108 Ib/ac; Zn -I 3000= 213 Wall;
I_}qf
4�jlIIQT-
App. Hardware
(5UA Wbw) 100
Verify PHONE NUMBERS and affiliations
Date last WUP FRO 11301Oj
Date last WUP at farm
RO 31asbq
FRO or Farm Records
Lagoon #
Top Dike {
3 0
Stop Pump Q'S'lw
Start Pump qT-7 4 $
4
I �` $��•�
Conversion- Cu -I 3000= 108 Ib/ac; Zn -I 3000= 213 Wall;
I_}qf
4�jlIIQT-
App. Hardware
(5UA Wbw) 100

�,/)gnsv au 34
f[itJ �1C_f
Q-71 -0

ll.
151Ms 1011716T Jv1
Division of Water Qnatity
IFacffi Numbt'r $ of tp j 1 110
ivision of soil and Water Conservation
I
--- -- — – - ther Agency
Type of Visit JSk Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit a Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 04' 00 a Departure Time: County: sawasoRegion:
Farm Name: C7� &Lya:P/j I Owner Email:
Owner Name:.' IOtk T _ _.._ _ cro Wln - Phone:
Mailing Address: I1 -."7 e I/ 4P 0i NItUl kfavp D8361
Physical Address:
Facility Contact: Mask 60X hC6 Title: Nher' Phone No: T _!–g:y? Lt�
Onsite Representative:
Certified Operator: M4+_ h'ri
Back-up Operator: LAId-
Integrator:
Operator Certification Number: AWA )? 37?
Back-up Certification Number: A!!A- 1937$
Location of Farm: Latitude: = e =I = u Longitude: = n = I = u
Design CurrentmS*Design
Capacity Populatton
❑ Wean to Finish
Wean to FeederIIE]Non-Layer_
. Current
Wedpactypulation
❑ Layer I I
I
gn CurrenSwine
Cattle Capacity Population
Dairy Cow
Dairy Calf
❑ NA
❑ NE
❑ Feeder to Finish
°*
Dairy Heifer
❑ Farrow to Wean
Dry Poultry -
❑ Dry Cow
❑ Farrow to Feeder
❑ No
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Puliets
❑ Beef Brood Co
-: - -
❑ Turkeys
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
Other
❑ Other
❑ Turkey Poults
❑ Other
Num_ ber of SVuctures:
EINE
2. Is there evidence of a past discharge from any part of the operation`?
❑ Yes
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes
Cj�No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
EINE
2. Is there evidence of a past discharge from any part of the operation`?
❑ Yes
NNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
RNo
❑ NA
❑ NE
other than from a discharge'?
Page 1 of 3
12/28/04
Continued

r
Facility Number: $a,— (p I I I Date of Inspection u yr 7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes QNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): � �9 I, a3
Observed Freeboard (in): 43 41
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E�No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc,)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
5JNo
❑ 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
5JNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
RNo
❑ 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
ballo
[INA ❑NE
maintenance or improvement?
Waste Analication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
C`No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
Wo
❑ 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 D Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) COAL-tal Bfl' ?-4& —HA .,'56 67S
_
13. Soil type(s) t
14. Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
52 -No
[INA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Wo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
�5No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
Wo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
RNo
❑ NA ❑ NE
Reviewer/Inspector Name �� . SG44u.E f F rt a =Phone: QED -4'. 33tA0 X . k33
Reviewer/Inspector Signature: �— — Date: 11011b

Facility Number: % a - 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 appropirate box. El WUp [❑ Checklists ❑ Design [3 Maps [I Other
❑ Yes
%No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes C,5kNo ❑ 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?
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26, Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
S 'No
❑ NA
❑ NE
❑ Yes
❑ No
(,qNA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
❑ Yes
CRNo
❑ NA
❑ NE
❑ Yes
❑ No
5iNA
❑ NE
❑ Yes
C'No
❑ NA
❑ NE
❑ Yes
JR -No
❑ NA
❑ NE
❑ Yes
5 'No
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
&.No
❑ NA
❑ NE
❑ Yes
9 No
❑ NA
❑ NE
�dd'rtioQal Comments and/.Or Drawings:
s. Ex 1 al.rl �e Sw woe fio� a ooh.
P1eile_ wvo/k pnVM b�f-ar aO 08
Ufa of,-yft
/JIA,
1A'1uwar a
i, aooasoil - �n ea ho
Sm011yran % be dli Jfirau(y�
Merl rnM*h6bt'C/n7 4 recofz&,
Page 3 of 3 12/28/04

Facility No. %-61 j Farm Name 6411114) 1v Nr Date
Permit �V"- COC _ ►% OIC_ NPDES (Rainbreaker
PLAT Annual Cert )
Pop- T e Design Current FB Dro s
JA _ no 'r1 irl-C&-Wk
....�:'�i©d0
soil Crop RYE OANI Window
Spillway
a J7S
Design freeboard
•
fibserved freeboard (in)
�r c
Sludge Survey Fate ?I Liquid (ft)
r
Sludge Depth (ft)
.... MMMIK- MiM1,
soil Crop RYE OANI Window
a J7S
•
Actual
©I� 14' IJ �fW 4 v Vj
SoillestTat�_111P ' .- 1 in Inspections
pH Fields Crop Yield X406431007 ✓ 120 min Inspections
Wettable Acres
Lime Needed Weather Codes
Lime Applied �h 0M WNP _ Transfer Sheets
Cu Zn Weekly Freeboard RAIN GAUGE
Needs P Rainfall > 1"
N Amt / 1 1 • 1 �i�i�i�
1 0'y ,/ ti
Date of last WUP FRO �o Date of last WUP at farm App_ Hardware a*1 Max RateA Max Amt Os k0
Pull/Field
soil Crop RYE OANI Window
a J7S
S6 �D SP
�r c
r
JG b
Verify phone numbers and affiliations
ot-%e
-To=- qq 104:1
55f- q- j'&-4q'4q j.0 'd4`f, �
'W*%j )D b, & 6),

® Division of Water Quality
Facility Number I �p 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit I* Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 3 C"7 Arrival Time: q Os; Departure Time: County: ` Region: LP_
Farm Name: CV&Oii7 k�JSff!w '�C� 4 1 j Z Owner Email:
Owner Name:. MW � � (Y U - 1 .' _� I,-- Phone:
Mailing Address:
Phvsical Address:
Facility Contact: r ' _ LJ C �1 � �^ __ Title: 0 Phone No:
Onsite Representative: �i 0- O integrator:
f ' `_
Certified Operator: : �- Ir
i o l�J. YO. O erator Certification Number: Y` t
Back-up Operator: �1T Q`- y �sJ�� Back-up Certification Number: �U S_�
Location of Farm: Latitude: =0
=N
❑ « Longitude: =0=1 ❑ u
Design ,;. Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
can to Feeder 007
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La et
❑ Non -La yer
Dry Poultry
❑ Lavers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge; observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made`?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Dairy Cow
❑ Dairy Calif
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood CoAi
Number of Structures:''` ;
c. What is the estimated volume that reached waters of the State (gallons)?
Design Current;'
Capacity, Population
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 0 No ❑ NA ❑ NE
Yes
❑ No
;9 NA
❑ NE
❑ Yes
❑ No
I�INA
❑ NE
❑ Yes
❑ No f NA
❑ NE
[:]Yes
,Ej�Vo
[]NA
❑ NE
❑ Yes
❑ No
hNA
❑ NE
12/28/04 Continued

Facility Number: Z— hate of Inspection 2 0
Waste Collection & Treatment
4*' Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes)4LNo
❑ NA ElNE
Structure 1 St cture 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 23 1
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
0 No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
� No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
[INA ❑ 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 N 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 El Application Outside of Area
12. Crop type(s) 4A . arn C, r N
13. Soil type(s) t l 6 G
14. Do the receiving crops differ from those designated in the CA WMP? ❑ Yes �iNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [5(No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes � No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment`? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name ( U) N [ N Phone: ISO ���
Reviewer/InspectorSignature: C _ �� /�,,� Date: L1c 3. �oD"7
12128104 Continued

Facilit)kNlumber:ZOLi Date of Inspection a
HiRuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
V9 No
❑ NA
❑ NE
the appropirate box.
❑ WUP ❑Checklists ❑Design [l Maps ❑Other
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes]
21.
Does record keeping need improvement? If yes, check the appropriate box below_
❑ Yes
0 No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Yes
❑ 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
kNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
0 NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
W No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
go No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
JX NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes (0 No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NF
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes]
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
�gNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
Na W:n�6r Crop �p It ,
v tii Y V
"Oda � V
�Q � +'�.li+ � tJVl
12/28/04

Facility No.� ` Time In c� C) Time Out Date Z 3 a
Farm Name S Integrators
Owner J dy x �! 'U - �^ Site Rep p
Operator � _ � L No. Vol
l
Back-up SGL No.
GOC Circle: (Generat3�or NPDES
NO
Design --Current Design Current
Farrow —Feed
Wean —Finish Farrow — Finish
Feed — Finish Gilts 1 Boars
Farrow — Wean Others
FREEBOARD; Design
Sludge Survey b Cr
Crop Yield l�
Rain Gauge � i
Soil Test j` Wettable Acres G/
Weekly Freeboard Daily Rainfall
Spray/Freeboard Drop V
Weather Codes 124 min Inspections
Waste Analysis:
Date Nitrogen (N)
Observed
Calibration/GPM o�1 �l b
Waste Transfers
Rain Breaker _—
PLAT
1 -in Inspections
Date Nitrogen (N)
Pull/Field Soil Crop Pan Window
t< -2 7 a r,

e
Type of Visit ® Compliance Inspection 0 Operation Review 0 Stricture Evaluation O Technical Assistance
Reason for Visit Routine Q Complaint 0 Follow up 0 Referral 0 Emergency Q Other ❑ Denied Access
Date of Visit:(lta Arrival Time: JI � � Departure Time, County: !I Region: re_
Farm Name: ` tV i1J$Qi S�J_r Owner Email:
Owner Name:.- 01Z I C a C�9fryC<t �7i r\ Phone:
Mailing Address:
Physical Address:
Facility Contact: Plar L Title: n C art s Phone No:
Onsite Representative: Integrator: -m-L �
Certified Operator: ffbkrV, QWD n - Operator Certification Number: `
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [=O
=I
[=
Longitude: = o =, 0
MMDesign Current
Design Current
Design Current
Swine Capacity Population
Wet Poultry
Capaci#y Popes tion
CattleMLapacitvmr opU11ti n
❑ Wean to Finish
F13—Layer
❑ Da Cow
Wean to Feeder Z
❑ Non -Layer
❑ Da Calf
❑ Feeder to Finish
``
❑ Da'uy Heifer
❑ Farrow to Wean--
-- - "'-
El Dry Cow
❑ Farrow to Feeder
L1Non-Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -La ers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef F3rood Co
❑ Turke s
-
the
El ❑ Turke Poults
❑ Other
❑ Other
r Number of Structures:
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation'? ❑ Yes NNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made? ❑ Yes ❑ No 0 NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No 0""NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ) ❑ Yes ❑ No ONA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes No 11 NA ❑ NC
other than from a discharge?
Page 1 of 3 12128/04 Continued

Facility Num—01Date of Inspection
Waste Collet"tion & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes WNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No SNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: r�
Spillway?:
Designed Freeboard (in): 9
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes JkNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes DqNo ❑ 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 jo No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ YesNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) 10
9. Does any pan of the waste management system other than the waste structures require ❑ Yes)�j&o ❑ NA ❑ NE
maintenance or improvement?
Waste Aonlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 9No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? 1f yes, check the appropriate box below. ❑ Yes A No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metais (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14_ Do the receiving crops differ from those designated in the CAWMP?
❑ Yes "io
El NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
El NA
El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
El Yes4�No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
igNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
9No
❑ NA
❑ NE
Reviewer/Inspector Name►iWO r�-1� Phone: J3 .S
Reviewer/Inspector Signature: Date:1 23
✓ Cp��
Page 2 of 3 12/28/04 Continued

Facility Nuinher. — U ` Date of Inspection I I 4L
Re aired 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 [RNo ❑ 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 1" Rain Inspections ❑ Wcather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
ANo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
ANA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
1;R[No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
j5d No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
�No
El NA
E:1 NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
20NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
$No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P§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
;S�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
ANo
❑ 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
PfrNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
D!�No
❑ NA
❑ NE
Additional Comments and/or
- �►c �d 2 r p-�� X02- . ��II �r vesk�al-4 X 4- a (2f*rcfa sa e,
•
— i tie. re <y, �trt W � 1�e rmu of n �r;r, �. NO O�xStce�
4L",f> tAS')1 'f -to pe' -O Pai*e.. Ar
H
Page 3 of 3 12/28/04

Facility No. Time In 355 Time Out Date I
Faun Narrle 11 A UD f Z Integrator
OwnerI0- (sz+� � Site Rep c
Operator 4 Ic J _ No.
Back-up No.
COC Circle: General or NPDES
141
Design Current
Design Current
can — Feed
Farrow — Feed
Wean — i
Farrow — Finish
Feed — Finish
Gilts 1 Boars
Farrow —Wean
Others
FREEBOARD: Deign Observed
Sludge Survey V Calibration/GPM 1
Crop Yield Waste Transfers
Rain Gauge Rain Breaker '
Soil Test PLAT Wettable Acres V
Weekly Freeboard
Spray/Freeboard Drop
Weather Codes
Waste Analysis:
Date
Daily Rainfall ✓ 1 -in Inspections
120 min Inspections IQ
Nitrogen (N) Date Nitrogen (N) b

t
Division of Water Quality`,.
r
facility,Nuulber ga O Division of Soil and Water Conservation- ti
0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: l%'8-0 Arrival Time: Departure Time:: County: _ 54p Region:
Farm Name: Go .��_Q/stt[Pc�-3_C..%,% At- I a J 2_ Owner Email:
Owner Name: -�-=er—q Phone:
Mailing Address: _11 %% FldiJSe I_UI✓e Jan Gr_AlL /V__ -29366
Physical Address:
Faciliq Contact Title:
Phone No:
Onsite Representative: _/_Ylar_k( �cdw,'y Integrator: _/t�'tr_r �r___�,.•�
Certified Operator: Mask _ ,�7 Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Other
❑ Other
Back-up Certification Number:
Latitude: =o =, 1 Longitude: =o =, =„
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
mann 000 10 Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & 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?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy lieifet
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: 2�
b. Did the discharee reach waters ofthe State? (Il'yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (Ifves. 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 04o ❑ NA ONE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ NA
❑ NE
Yes
[:1Lld
,❑�
"No
❑ NA
❑ NE
12128/04 Continued

11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 21N�o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ Application Outside of Area
_::, 7s` lad
12. Crop type(s) 13Prnd�ir �(/ X'.
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes D<o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes D- o ❑ NA E
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'❑ Yes ❑ No ❑ NA 0-9E
17. Does the facility lack adequate acreage for land application? ❑ Yes ❑ No ❑ NA ED -KE
18. Is there a lack of properly operating waste application equipment? ❑ Yes &N"o' ❑ NA ❑ NE
:n Ex�3oReviewer/inspector Name hone:
Jliti �� P
Reviewer/Inspector Signature: %VZ" /•f.tir1„ ., Date: 7-9-o!;—
12/28/04 Continued
Facility Number: 02 `G�/� Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ED.No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: -9-
Spillway?:
Spillway?: itrz_ r►[L�
Designed Freeboard (in): / q, " J Cf '' R
Observed Freeboard (in): !f2
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
L -<o"
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
�,/
L7 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
❑-14
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
D<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
El Yes
!!
2 o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ iqo
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 21N�o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ Application Outside of Area
_::, 7s` lad
12. Crop type(s) 13Prnd�ir �(/ X'.
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes D<o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes D- o ❑ NA E
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'❑ Yes ❑ No ❑ NA 0-9E
17. Does the facility lack adequate acreage for land application? ❑ Yes ❑ No ❑ NA ED -KE
18. Is there a lack of properly operating waste application equipment? ❑ Yes &N"o' ❑ NA ❑ NE
:n Ex�3oReviewer/inspector Name hone:
Jliti �� P
Reviewer/Inspector Signature: %VZ" /•f.tir1„ ., Date: 7-9-o!;—
12/28/04 Continued

Facility Number: g] —(� Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 -M -o' ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes ❑K-, ❑ NA ❑ NE
the appropirate box. ❑� ❑ Ch fists ❑ T ❑ r�4❑ 9er--
21. Does record keeping need improvement? If yes, check the appro nate box below. ales ❑ No ❑ NA ❑ NE
El W�App�iee�ie�--['Weekly Freeboard ❑ ❑ Wmtc
Via*--Ei*wckin- ❑ Gpar-� 1:11 s ❑ ❑ w C�
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26_ Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31 . Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
Izd'tvo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
QWE
❑ Yes
❑ No
❑ NA
Q'I<IE
❑ Yes
❑ No
❑ NA
❑"&E
❑ Yes
Uw6
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
D -KE
❑ Yes
Lido
❑ NA
❑ NE
❑ Yes
2No
❑ NA
❑ NE
❑ Yes
[�10
❑ NA
❑ NE
❑ Yes
["No
❑ NA
❑ NE
❑ Yes
D -No
❑ NA
❑ NE
❑ Yes 9'Ko ❑ NA ❑ NE
Additional Cottiimeuts aud/dr,,Dratttuigs *i�•.
ke /
ac Wee �lY-C-ee_4,j t{cord Zv� ,'A s >ro/-
Ori
Tvrms,�i/ 'pas e. lePtf, I SCO+ [!S o R
PF dbyr I
12128104

Facilin• Numberi Date of Visit: Timc: E�
�/ t( Aot O erational Below Threshold
Permitted 01 Certified 0 Con ditio naliv Certified [3 Registered Date Last Operated or Above Threshold:
Farin lame: r. 9 aG Count'v: S!_ Jkbn
r
Owner lame: AprX Qa,41 Phone No: 594 A _
N12ilina Address: 117-7 Va�;J'z 10 We aY3G6
Facility Contact: Eric 0jW164 Title: V&PytePhone \o:
Onsite Representative: M�d tN integrator: &K -4M
Certified Operator: /17,0r 1U.'a, Operator Certification Number.
Location of Farm:
wine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 - Longitude '
Design Current
Swipe Caparih' Poptilation
Wean to Feeder o0 3 too
❑ Feeder to Finish
❑ Farrow to vl`ean i
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Po aiation Cattle Ca acitV Po elation
❑ Laver I I ==]Dairy
❑ Non -Laver I I ain°
❑ Other
Total Design Capacity q�
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ La9001, Area S vas Field Area
Holding Ponds / Solid Traps FE—)No Li uid W=e Management System
Discharges _ Stream Imnactx
1. Is anv discharge observed from any pan of the operation?❑"es —1No
Discharge originated at: ❑ Lazoon ❑ Sprav Field ❑ Other
a. If discharge is observed, was t} a conveyance man-made"
El Yes ❑ No
b. If discharge is observed, did it reach «Vater of the State? (If yes. notify DWQ) ❑ yes ❑ No
c. If discharge is observed. what is the estimated flow in Qal/min?
d. Does discharge bypass a lagoon system? (If ves. noti& DWO) ❑ Yes ❑ No
2. Is there evidence of past discharge from any pan of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste GolLeStign 8: Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure S Structure 6
IdentificT:
Freeboard (inches): 42 ale
05/03/01 Condnued

Facility Number; -9A— 611 1 Date of inspection 6 S O
5. Arc there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ yes ER<o
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a wase management or ,,_,
closure plan? ❑ Yes R
(If any of questions Qui was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ) ,��,,//
7. Do any of the structures need maintenance/improvement? ❑ Yes ,l ifNo
8. Does any pari of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ET INio
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes M'<-
Waste
oWaste An ll� n Cation
10. Are there any buffers that need maintenance/improvement? ❑ Yes �o
11. Is there evidence of over application? ElExcessive Ponding ElPAN ❑ Hydraulic Overload ElM Yes o
12. Crop type (:.AkOht_ br:F~n A. Sm
13. Do the receiving crops differ with those designated Ae Certified Animal Waste Management Plan (CAWMP)? ❑ Yes W<o
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
[Wo
b) Does the facility need a wettable acre determination?
❑ Yes
o
c) This facility is pended for a wettable acre determination?
❑ Yes
,I_�g,
4
L1J'
15.
Does the receiving crop need improvement?
es
❑ No
16.
is there a lack of adequate waste application equipment?
❑ Yes
a<o
Reguired
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
1910
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available'?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
W<o
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
©Ko
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
QK'
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
&K
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
w
23.
Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
ElL` Yes
,,I�
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
[t-}N'o
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ELWO
Q
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Copy ❑ Final Notes
" �'t ir�ie� ��S`t �JO�s�o +�aek,, �o�� S�Gc inn �ro��ssit s7 �C. j `lti�t.. • �•wtf� 4r<N) �AU� Clvr.Coq�d
Use 4-fft,-,4} /hr. Sea „.e Soy [ A.td wiltit ��cd +wd sY[Fy J F[k t MtiS �` re`�+
�tCah� :N �psd ?✓/
Reviewer/Inspector Name j
Reviewer/Inspector Signature:
05103101
Date: G
Continued

Facility Number: 8a - Gi Date of Inspection o �
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc_)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanentltemporary cover?
❑ Yes UMNo
❑ Yes [-leo
❑ Yes No
❑ Yes ❑ No
❑ Yes L7No
❑ Yes ,&Aln'
❑ Yes L
"A.. ibotiiii�Camiiients�andJ,oi`jDri?iRings.�,�: � <..:- , ,: a•� ,;F : � : � ,' . �`.�. �+�, �..,„��„s�,;
Ak
05/03!0}

Site Requires Immediate Attention: 1V0
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
AND AL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 4-5-.S1 2 1995
Time: ;-Z"09
Farm Name/Owner: 10 w► �,,..,, !� a;
Mailing Address: R,�- z c o r S9
/ 0,&q m
At A1o4- /i s4ecl
County:---
-Integraator: M�r�t�u Fa �•; �.,.,� _ Phone:
On Site Representatives Fa•'�c! Phone: t 9Iaj 5.3/ - 4/90
Physical Address/Location: S4 17-5(o
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: z 600 /'Furst, Number of Animals on Site: , 2zbao
DEM Certification Number: AC DEM Certification Number: ACNEW
Latitude: Longitude:— " '
Circle Yes or No
Does the Animal Waste Lagoon h
(approximately l Foot + 7 inches) (
Was any seepage observed from the
Is adequate land available for spray?
Crop(s) being utilized: aosfa!
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin s) e ar No
100 Feet from Wells? or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes ok
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes orQjo-)
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes odD If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? � or No
Additional Comments: 11kw r ."OL
sufficient freeboard of I Foot + 25 year 24 hour storm event
DT No Actual Freeboard: 7 Ft. D inches
an(s)? Yes or(S) Was any erosion observed? Yes or®
Oor No Is the cover crop adequate?le�or No
/arc k"G(S
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

10 Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number
Dale of Inspection 3�7
2
Time of Inspection 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: [RRegistered [I Applied for Permit (ex:1.25 for I hr 15 min)) Spent on Review
❑ Certified ❑ Permitted or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated: W. ... _ ....._ .... r .... . , _ .. ........_ ....._..... _ ....
Farm Name:...._»..�L%�-. —. �.. .. _. Connty: _ Jf��'3D�_.. _. ... ,..
Land Owner Name:.. _.... �}Lt'�faC�u Phone No:
Facility Conctact:...__._.._.[:!.. _/`�1g1 Title: Phone No:..
Mailing Address: _....�c.._11.r .1. .�....�/•/f- t r�.�.c .... /7`111�.� .lC,�._ ..'4Q..T ci.............r..�.......�...�,,1
�!Integrator: - 4AOnsite Representative: -,
Certified Operator:._.. .. . . ........... I�. NE"�h .. _ .... _.. Operator Certification Number:
Location of Farm:
Latitude �• �` a Longitude
Type of Operation and Design Capacity
a' tx "•. § r., ,,q.`^"`z5. �,x.s. - - .�. - r^ety ,y,. s �v Asa » ?,'a`xd "b.�
I[+a ;¢ yF Design CurrentUn Des1gR CI1ITeElt DeSlgni xCUiYent
h:winer Ca act Po elation ; Pp!�i y G acrty fPo ulatlbwo; ; aftle . Ca act e Pa nlanon
Nb�
Wean to Feeder ❑ er rt
❑ Feeder to Finish 10 Non- Dairy
� FarroW [O Wean
Farrow to Feeder 6Dt� ;"Total Design Capacity �
Farrow to Finish.
w e r c UWt w a
aToval..�1� -
Other
� Nnwb16
er'of Lago0054/ Ho1d=ng Ponds / ❑ Subsurface Drains Present
❑ Lagoon Area x ❑ Spray Field Area
Cfflneral
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4130197 maintenance/improvement?
❑ Yes go No
❑ Yes UNo
❑ Yes No
❑ Yes No
❑ Yes
0
❑ Yes
[KNo
Latitude �• �` a Longitude
Type of Operation and Design Capacity
a' tx "•. § r., ,,q.`^"`z5. �,x.s. - - .�. - r^ety ,y,. s �v Asa » ?,'a`xd "b.�
I[+a ;¢ yF Design CurrentUn Des1gR CI1ITeElt DeSlgni xCUiYent
h:winer Ca act Po elation ; Pp!�i y G acrty fPo ulatlbwo; ; aftle . Ca act e Pa nlanon
Nb�
Wean to Feeder ❑ er rt
❑ Feeder to Finish 10 Non- Dairy
� FarroW [O Wean
Farrow to Feeder 6Dt� ;"Total Design Capacity �
Farrow to Finish.
w e r c UWt w a
aToval..�1� -
Other
� Nnwb16
er'of Lago0054/ Ho1d=ng Ponds / ❑ Subsurface Drains Present
❑ Lagoon Area x ❑ Spray Field Area
Cfflneral
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4130197 maintenance/improvement?
❑ Yes go No
❑ Yes UNo
❑ Yes No
❑ Yes No
❑ Yes
9No
❑ Yes
[KNo
❑ Yes
UNo
❑ Yes
® No
Continued
on back

Facility Number. -Aa- k
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
S. Are there lagoons or storage ponds on site which need to be properly closed?
Structs reE_(_.agoons andlarJlfllding Po�u2
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure 1 Structure 2 Structure 3
12.`1
79 ..�.._ _._..._ _.... __.....,._
10. Is seepage observed from any of the structures?
Structure 4
1 I _ Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste ADDllcati
❑ Yes ® No
❑ Yes CKNo
❑ Yes LUNO
❑ Yes X No
Structure 5 Structure 6
❑ Yes ® No
❑ Yes 9[No
❑ Yes )j No
❑ Yes M1 No
14_ Is there physical evidence of over application? ❑ Yes tWNo
Of in excess of WpMP, or runoffentering w!-aters of the State, notify DWQ)
15. Crop type _.�F�&�f..r?Tl/! _. .. _ — ..-... _�......... , ... ,........ ... _ ._.
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes $6No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes ® No��)
18. Does the receiving crop need improvement? Yes ❑ No
19. Is there a lack of available waste application equipment? ❑ Yes M No
20. Does facility require a follow-up visit by same agency? ❑ Yes 15 No
21. Did Reviewer/Inspector fail to discuss reviewlinspection with on-site representative? ❑ Yes No
For Cert ied Facili 'es Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes ❑ No
23. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
24. Does record keeping need improvement? ❑ Yes ❑ No
Comments.,{refer to girestron #} Ezplam anyYFS answers andlar any recommendations'or a'y'other eomments:�
Use drawings of facility to better explain situations: {use additional pages its necessary}r v.,i .<r^ a 6. ,�. ,e.,,
,e„! c-•-� _ a.e/ :.n;.
/'j%� y �. �"'t�
J j /'`"/`
/tl� � / /lf�i�I�Y'f� J'J�f■-i�f/ f'`� �/rC•i�S� O� `.�- /n�Ci[1�.f G�/ G� -
/itGr ZK /v_Sf
Reviewer/Inspector Name rr z.a ,;.:� ..
Reviewer/Inspector Signature: Date: ?
cc. Division of Water Qualit); Water Quality Section, Facility Assessment Unit 4/30/97