090208_INSPECTIONS_20171231

NORTH CAROLINA .J
Department of Environmental Qua

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
090208 Facility Status:
Active Permit: AWS090208
❑ Denied Access
Inppection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Bladen Region:
Fayetteville
Date of Visit:
03/22/2017 EntryTlme: 09:00 am
Exit Time: 9:30 am Incident #
Farm Name:
2601-2
Owner Emall:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 7301 NC Hwy 210 W Garland NC 28441
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Fans: Latitude: 34` 49' 12" Longitude: 78' 30' 07"
From Fayetteville, take Hwy 53 to Hwy 210 go to Bladen Co. two miles on right.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Robert T Young Operator Certification Number: 18461
Secondary OIC(s):
On -Site Representativeis): Name Title Phone
24 hour contact name Mike Ammons Phone : [phone]
On -site representative Mike Ammons Phone: [phone]
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspectoris):
Inspection Summary:
page: 1

Permit: AWS090208 Owner - Facility: Murphy -Brown LLC Facility Number: 090208
Inspection Date: 03/22/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Swine
Design Capacity
Current promotions
El Swine - Wean to Feeder 7,104
Total Design Capacity: 7,104
Total SSLW: 213,120
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
#1
19.00
30.00
Lagoon
1
19.00
page: 2

Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number. 090208
Inspection Date: 03/22/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Ye.
No_Na_He
1. Is any discharge observed from any part of the operation?
❑
■ ❑
❑
Discharge originated at
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
1:10
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na No
4. Is storage capacity less than adequate?
❑
■ ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
m ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
m ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
aste AnDlicatio
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 Ibs,?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number: 090208
Inspection Date: 03/22/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes
No Na No
Crop Type 1
Corn, Wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
S0il Type 1
Foreston loamy sand
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
N ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑0
❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
E ❑
❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ E ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number: 090208
Inspection Date: 03/22/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yoe
No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑ ❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑ ❑
(NPDES only)?
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑ ❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑M
❑ ❑
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?
❑
0 ❑ ❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
1101111
Other Issues
Yes
No Na No
28. Did the facility fall to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
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 regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i,e,, discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility?
❑M
❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
El
Other
❑
If Other, please specify
32. Were any additonal problems noted which cause non-compliance of the Permit or
❑
■ ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
❑
0 ❑
❑
34, Does the facility require a follow-up visit by same agency?
❑
M ❑
❑
page: 5

■ Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
090208 Facillty Status:
Inppection Type:
Compliance Inspection
Reason for visit:
Routine
Date of Visit:
09/2312015 Entry Time: 10:00 am
Farm Name:
2601-2
Owner:
Murphy -Brown LLC
Active
Permit: AWS090208 E] Denied Access
Inactive Or Closed Date:
County: Bladen Region: Fayetteville
Exit Time: 11:00 am Incident #
Owner Bmail:
Phone: [phone]
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 7301 NC Hwy 210 W Garland NC 28441
Facility Status: N Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34° 49' 12" Longitude: 78' 30' 07"
From Fayetteville, take Hwy 53 to Hwy 210 go to Bladen Co. two miles on right,
Question Areas:
Dischrge & Stream Impacts Waste Col, Star, & Treat Waste Application
Records and Documents Other Issues
,Certified Operator: Robert T Young Operator Certification Number: 18461
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone: [phone]
On -site representative Mike Ammons Phone: [phone]
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number: 090208
Inspection Date: 09/23/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Wean to Feeder 7,104
Total Design Capacity: 7,104
Total SSLW: 213,120
Waste Struglurgs
Designated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon #1 19.00
Lagoon 1 19.00 37.00
page: 2

l
Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number: 090208
Inspection Date: 09/23/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yal No Nj He
1. Is any discharge observed from any part of the operation?
❑
[]
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
0
a. Was conveyance man-made?
❑
M ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
NO
❑
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)
❑
0 ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Xej
No Na No
4. is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (LeJ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
0
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yea No Na Ne
10, Are there any required buffers, setbacks, or compliance alternatives that need
❑ MOO
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090208
Owner - Facility: Murphy -Brown LLC Facility Number: 090208
Inspection Date: 09/23/15
Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Ng Ne
Crop Type 1
Corn, wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Foreston loamy send
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
■ ❑
❑
Management Plan(CAWMP)?
15, Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑M
❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
❑
❑
Records and Documents
Yes
No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number:
090208
Inspection Date: 09/23/15 inpsection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yea
No No No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
[]
0013
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
N ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
E ❑
❑
25, Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
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 phosphorous loss assessment (PLAT) certification?
[]
E ❑
❑
Other Issues
Yes No_No No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
a ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
1101111
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i,e,, discharge, freeboard problems, aver -application)
31. Do subsurface the drains exist at the facility?
[]
m ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
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 on -site representative?
❑
E ❑
❑
34. Does the facility require a follow-up visit by same agency?
Cl
0 ❑
❑
page: 5

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
090208 Facility Status:
Inpsection Type:
Compliance Inspection
Reason for visit:
Routine
Date of Visit:
08/19/2014 Entry Time: 12:30 pm
Farm Name:
2601-2
Owner:
Murphy -Brown LLC
Active Permit: AWS090208 ❑ Denied Access
Inactive Or Closed Date:
County: Bladen Region: Fayetteville
Exit Time: 1:30 pm Incident #
Owner Email:
Phone: [phone]
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 7301 NC Hwy 210 W Garland NC 28441
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34° 49' 12" Longitude: 78° 30' 07"
From Fayetteville, take Hwy 53 to Hwy 210 go to Bladen Co. two miles on right.
Question Areas:
Dischrge 8 Stream Impacts Waste Cal, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Danny Lee Tyner Operator Certification Number: 28715
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone: [phone]
On -site representative Mike Ammons Phone : [phone]
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
inspection Summary:
page: 1

Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number: 090208
Inspection Date: 08/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Wean to Feeder
Total Design Capacity:
Total SSL.W:
Wasle Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon #1 19,00
Lagoon 1 19,00
page: 2

Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number: 090208
Inspection Date: 08/19/14 Inpsection Type: Compliance Inspection Reason for Visit Routine
Discharges $Stream Impacts
Yea No Na No
1. Is any discharge observed from any part of the operation?
❑
M ❑
Cl
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
0 ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
013
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
■ ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10, Are there any required buffers, setbacks, or compliance alternatives that need
❑
❑
❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑
❑
❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number: 090208
Inspection Date: 08/19/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No No No
Crop Type 1 Corn, Wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1 Foreston loamy sand
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
❑
❑
Management Plan(CAWMP)7
15. Does the receiving crop and/or land application site need improvement?
❑
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
❑
❑
18, Is there a lack of properly operating waste application equipment?
❑
■ ❑
❑
Records and Documents
Yet __
o Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number: 090208
Inspection Date: 08/19/14 1npsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22, Did the facility fail to install and maintain a rain gauge?
❑
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M1113
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
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?
❑
M ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
M ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
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 regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
CAWMP7
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
■ ❑
❑
page: 5

■ Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 090208 Facility Status: Active Permit: AWS090208
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
ReasonforVlsit: Routine County: Bladen
Date of Visit: 10/16/2013 Entry Time: 09:30 am Exit Time: 10:30 am
2601 2
Region:
Incident #
❑ Denied Access
Fayetteville
Farm Name: Owner Email,
Owner: Murphy -Brown LLC Phone: [phone]
Malting Address: PO Box 487 Warsaw NC 28398
Physical Address:. 7301 NC Hwy 210 W Garland NC 28441
Facility Status: 0Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34` 49' 12"
From Fayetteville, take Hwy 53 to Hwy 210 go to Bladen Co. two miles on right.
Longitude: 78° 30' 07"
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Danny Lee Tyner Operator Certification Number: 28715
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone: [phone]
On -site representative Mike Ammons Phone: [phone]
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(a):
Inspection Summary:
page: 1

Permit: AWS090208 Owner - Facility : Murphy -Brawn LLC Facility Number: 090208
Inspection Date: 10/15/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Wean to Feeder
Total Design Capacity:
Total SSLW:
Waste Structures
Oisignated Observed
Type Identifier Closed Date Start Data Freeboard Freeboard
agoon 91 19,00
agoon 1 19.00
page: 2

Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number: 090208
Inspection Date: 10/15/13 Inpseclion Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Im acts
Yes No No No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
[]
Application Field
❑
Other
❑
a, Was conveyance man-made?
❑
❑0
❑
b, Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑0
❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
ve.
No Ne No
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (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
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yves No No No
10, Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

I
Permit: AWS090208 Owner - Facility : Murphy -Brown LLC Facility Number:
090208
Inspection Date: 10/15/13 Inppection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yes No Ne No
Crop Type 1
Corn, Wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Foreston loamy sand
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14, Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ 0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
[]
❑
Records and Documents
yes 2 No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ E ❑ ❑
20, Does the facility fail to have all components of the CAWMP readily available?
[] ❑ ❑
If yes, check the appropriate box below.
WUP?
Checklists?
El
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
El
Weather code?
Rainfall?
Stocking?
❑
page: 4

I
Permit: AWS090208 Owner -Facility: Murphy -Brown LLC Facility Number:
090208
Inspection Date: 10/15/13 Inpseclion Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yea No No No
Crop yields?
❑
120 Minute inspections?
r]
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
M ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
M []
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
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 phosphorous loss assessment (PLAT) certification?.
❑
0 ❑
❑
Other Issues
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report mortality rates that exceed normal rates?
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 regional DWQ of emergency situations as required by Permit?
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility?
If yes, check the appropriate box below.
Application Field
Lagoon / Storage Pond
Other
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
CAWM P?
33, Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
34. Does the facility require a follow-up visit by same agency?
Xos No o Na No
❑ M ❑ ❑
❑ M ❑ ❑
❑■❑❑
❑ m ❑ ❑
page: 5

cr�,v
Division of Water Quality
„ Facility Number I� - ® 0 Division of Soil and Water Conservation
0 Other Agency 11
Type of Visit: 4rCompliance 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 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: L Region: Y"rC
Farm Name: 26O 12, Owner Email:
Owner Name:Phone:
Mailing Address:
Physical Address:
Facility Contact:
1**41?11 /Y ,OA15 T Title:
Onsite Representative: �l
Certified Operator: Tarn 4 lxaf
Back-up Operator
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number: 2—b o7b
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
/O Non -Layer
Dry Youltr
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes yq No ❑ NA ❑ NE
❑Yes ❑No NA ❑NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[]No
IP 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 1 of 3 2/4a011 Continued

r.. , .y . 4,,,� - M r `ems, - ' 4� , ..�iit'M1" ''r�yl4.+ ;.i4.lTM', r �: ♦, C` 33i.. . j ., - ,
W Division of Water Quality
.y Fiity Number - ® O Division of Soil and Water Conservation
- .. . , Q Other Agency
Type of visit: % Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: 0 Routine 0 Complaint Q Follow-up Q Referral Q Emergency 0 Other 0 Denied Access
Date, of Visit: 15 J "rrival Time: Departure Time: -W, -1ACounty: e L.A1r#-*14 Region:
Farm Name: 7,6 ` - Owner Email:
Owner Name:^�y�
Mailing Address:
Physical Address:
y
Phone:
Facility Contact: Title: Phone:
Onsite Representative: r� Integrator: LUW
Certified Operator: L( NQ-ye
Back-up Operator: i C� � V" 9
Location of Farm:
�z
Design Current
Swine 'Capacity._, Pop.
Wean to Finish•
Wean to Feeder /O
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other,
Certification Number:
Certification Number: 2—too-746
Latitude:
Design Current
Wet'Poultry Capacity Pop.
Layer
- Non -Layer I^
lets
Poults
Design Current
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharees and Stream Impacts
;•, I.'.Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑'Structure ❑ Application Field ❑ Other:
..,, a. Was the conveyance man-made?
❑ Yes
❑ No
rv7 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
a._�_ _mot__ �L__ r__.Y _ �:__L____n
❑ YesEP
No
, ❑ NA
❑- NE
Page 1 of 3 21412011 Continuer!
,.,
i
� 1 �a Y r A 1k d�.- - 1.,- � * !1 •� � � E. y Y F 1 � i �' i �. ,.. ; '-v s.+
I
r t.

Facility Number: Date of inspection: Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No V) 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 5E 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 [P 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 [�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 E�b No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 1p No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes P{,No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc..))
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): arvl t wLl ,
13. Soil Type(s): FZ)rP!94 h --gyp _
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [;g No ❑ NA 0 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 Iack adequate acreage for land application?
❑ Yes
fp No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
TT
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
1�5 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
0 No
❑ NA
❑ NE
the appropriate box.
❑WUP El Checklists ❑ Design ❑ Maps [] Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 5@ 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 0 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 21412011 Continued

Facili Number: jDate of Inspection: Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
❑ NA ❑ NE
NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
„w Spillway?:
L
Designed Freeboard (in):
Observed Freeboard (in): �t!
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Z 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 [5g 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 RM RM 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'-o(the waste management system other than the waste structures require ❑ Yes E�bNo
❑ NA
❑ NE
maintenance or i provement?
Waste Application
10. Are there any required buffers,, setbacks, or compliance alternatives that need ❑ Yes No:❑
�
NA
❑ NE
Tom'
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes PP)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): L Kq t LVLL Ai'�
U.-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 [0 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
MV No
❑ NA
❑ NE
there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Required Records & Documents
T�
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
�@ No r
[DNA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ RainfalI ❑ 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
�g No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes n No ❑ NA ❑ NE
Page 2 of 3 214/2011 Continued
J. _ ,-... A:Z._... .. 7, _ ..Y f.__ ` .'i .�k7.-. .+ _i. .. .r .. . ... •4• i. .. . �.,• . ...

Facilit Number: - Date of Inspection:
24. Did tli6 facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [P No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ;M No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other lssues
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?
24. 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
No
❑ NA
❑ NE
❑ Yes
JR No
❑ NA
❑ NE
❑ Yes
§2 No
❑ NA
❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes F No ❑ NA ❑ NE
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
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or:any e.tlie_r comm-ents'':C
Use drawings of facility to better explain situations.(useadditional pages as.neeesssry)
;; „ ..
s r''l
T49_ds r-evt% " rtr 6I 1-L+
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Phone: 9 tc-41P3 -33�v
Date: 9'1 Kr1 Z
Page 3 of 3 21412011

,,]Facility Number: - Date of Inspection:Z.-
24. Did ih facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[V No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
P No
[DNA ❑ NE
the appropriate box(es) below.
y.
❑ 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?
[3 Yes
N] No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
0 No
❑ NA ❑ NE
4
Other Issues
28, Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA ❑ NE
,and report mortality rates that were higher than normal?
' 29, At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[� No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facilityfail to notify the Regional Office of emergency situations as required by the
❑ Yes
4M 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
® No
s
❑ NA ❑ NE
PC
❑ 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 P No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional::recommendatlons or.:anylother-.fcaritmentsf;
Use drawings•of facility to better ex lain situations (use additional'. ages as necessary).
r4o'emj S-11div
v vn, `ems S 2�
�7
w,F �
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
1�
Phone: 910 -k.".3 _3?4
Date:
21412011 ti

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 0 Denied Access
Date of Visit: ❑j Arrival Time: L R IX Departure Time: t County: SIADEJJ
Farm Name: 260 1 ;)- Owner Email:
Owner Name: '" 1 lA irk h.V—eYDa,J , Phone:
Mailing Address:
Physical Address:
Region: T
Facility Contact: Mt �— fir,-'Imorns Title: Phone:
Onsite Representative: Integrator: M Ll.✓' 2kq 7-b> L�C
Certified Operator: h} Certification Number: ZU 7/57—
Back-up Operator: V 1 C4-ir _5tA,6pj Certification Number: 2-bp71:;�
Location of Farm:
Latitude:
Longitude:
Design
Current
Design
Current
Design Current
Swine Capacity
Pap.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
I) , P■aultr,
Ca acit
P,o P.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turke Poults
Other
Other
Discharees and Stream Impacts
1 • Is any discharge observed from any part of the operation?
❑ Yes
f9 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
W NA
❑ NE
b, Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
P 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
M 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
10 No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

4
Facility Number: ZI Date of Inspection:
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 ERNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 1 �T
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
�D No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
W No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
C9 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
a] 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?
1 l . Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
Area
12. Crop Type(s):
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
.® 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
0 NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ? No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes 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 21412011 Continued

liacili Number: Date of Inspection:117
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
IF No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
[:]Yes
MU No
❑ NA ❑ NE
the appropriate box(es) below.
VM
❑ 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
(K 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
Co No
[DNA ❑ NE
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
Z 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
[P No
[DNA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[ No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[� No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�] No
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments
Use drawings -of facility to better explain situations (use additional panes as necessary)
condur4j 6-11411,
?e cey-43 rew i q /I I'l/ ,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 910"—I 33 '3300
Date: I Bill
21412011

w ,J
- -- 0 Division of Water Quality
EL=:Nber _ Division of Soil and Water Conservation
---- 0JEffiQtErZA_`ffCn:c�yj
Type of Visit IP Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other �❑ Denied Access
Date of Visit: Arrival Time: +� Departure Time: dt� County: �" Region: FPZ
Farm Name: _____- - _ 2_�pt7(Z Owner Email:
Owner Name: LCC Phone:
Mailing Address:
Physical Address:
r
Facility Contact: 1 1 `11kov-S Title:
Q
Onsite Representative:
Certified Operator: hn
Back-up Operator: _. �)I
' (10.W► r`
Phone No:
Integrator: / "! LLB �rJ��c3h uc
Operator Certification Number: .097/_S�'
Back-up Certification Number: . _?�o
Location of Farm: Latitude: ❑ e =' = Longitude: = ° ❑ ' =
Desi�n@u;rent
ulation
Wet Poultry
DesignCurrent
Capacity Population
n Current
Cattlety Population
w(esenall
❑ an to Finish
❑ La er
on -Layer
❑ Dairy Cow
Wean to Feeder
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
El Beef Stocker
❑ Beef Feeder
❑Beef Brood Cow
Number of Structures:
Feeder to Finish
❑ Farrow to Wean Ury Poultry
❑ Farrow to Feeder
❑ Farrow to Finish ❑ La ers
❑ Gilts ❑Non -La ers
❑ Boars ❑Pullets
❑ Turke s
Other ❑ Turke Poults
❑ Other ❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
F, 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
N No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
tRNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: 1-1
Date of Inspection l III JIQ_J
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?
St tore 1 Structure 2 Structure 3 Structure 4
Identifier.
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 7No ❑ NA ❑ NE
❑ Yes ❑ No 9bNA ❑ NE
Structure 5 Structure 6
❑ Yes %No ❑ NA ❑ NE
❑ Yes [�No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes YNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [�No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [�tNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Lka
prNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [F)No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) et--rrh
13. Soil type(s) Q
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
rN
o ❑NA ❑NE
o ❑ NA ❑ NE
No ❑ NA ❑ NE
®No ❑ NA ❑ NE
91No El NA El NE
Comments (refer to question #): Explain any: YES. answers and/or any. recommendations or any other comments 1 a
Use drawings of facility to better explain situations. (use additional pages. as necessary):;
Reviewerllnspector Name I I Phone: Q�
Reviewer/Inspector Signature: Date: 2 D
Pace 2 of 12/2k104 Continued

+ Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes FNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ElNA ElNE
the appropriate box. ❑ WUP ElChecklists [IDesign El maps ElOther
21. Does record keeping need improvement? If yes, check the appropriate box below, ❑ Yes ONo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 ° Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
29.
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
rPO
/P9 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
F-' 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
PiNo
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
M No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
E*No
❑ NA
❑ NE
Additional Comments end/or Drawings:
Page 3 of 3 12128104

�4
O Division of Water Quality
Facility NumbcrE:T��� Q Division of Soil and Water Conservation
O Other Agency
Type of Visit 46 Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit *Routine O Complalnt O Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: r Departure Time: County; BLA0�—rV
Farm Name: 2� Po ! ;'- Owner Email:
Owner Name: Muy qL 4nDizvI , LPhone-
Mailing Address:
Physical Address:
Facility Contact: M le Amr^oyl S Title:
Onsite Representative: ti
Certified Operator: r\ I QV'
Back-up Operator: W i 11 I"O'\ .ScC'f-6
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
V/
Region:
Phone No:
Integrator:�✓%� ►�-�1 `i�rt7u3rl t `��C
Operator Certification Number: Arr
Back-up Certification Number: uo*z6
Latitude: = e = i = f{ Longitude: = ° = I = "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
n ❑ La er
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turke 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)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ro ❑ NA ❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
J NA
❑ NE
El Yes
I<No
❑ NA
❑ NE
❑ Yes
4iNo
❑ NA
❑ NE
Page I of 3 12128104 Continued

r�L
Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes PoNo ❑ NA [INE
a. if yes, is waste level into the structural freeboard? ElYes ❑ No NA El NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Ptnuct
ure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 33
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[No
[INA
ElNE
(ie/ Iarge trees, severe erosion, seepage, etc.)
11"'
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
[INA
ElNE
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
P9No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[ No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
I
9. Does any part of the waste management system other than the waste structures require
❑yes
�No
[I NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes (#No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Ccwvi . Wkoa,+. Ste, i tam S
13. Soil type(s) F-per
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ZNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes If No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes 23 No ❑ NA ❑ NE
❑ Yes MNo ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/InspectorName Phone:
ReviewerlInspector Signature: Date:
.12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes j No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes PNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes (P No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
E9 No
[]NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
S No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
El Yes
W No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
bNo
❑ 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
n 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
�D 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
�i No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
nat Comments and/or Drawings:
12128104

I
Division of Water Quality
Facility Number Q O Division of Soil and Water Conservation
O Other Agency
Type of Visit � Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit qn Routine O Complaint O Fallow up O Referral O Emergency O Other El Denied Accessrr
Date of Visit: Arrival Time: —� Departure Time: � County: Region: Y jeo
Farm Name: "I Owner Email:
Owner Name: rD IS FOO ?1Y h C, Phone:
Mailing Address:
Physical Address: 7T
Facility Contact: ►_j
Onsite Representative:
Certified Operator:
l
Back-up Operator: _
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Title: /./ V , ` [ Phone No:
Integrator:
Operator Certification Number:
1J Back-up Certification Number:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
0q3 a er
❑Non -La eY
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made`?
Longitude:
000L 01i
Design Current:
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dal
❑ Beef Stockee
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: �;
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ANo ❑ NA ❑ NE
❑ Yes
❑ No
P NA
❑ NE
❑ Yes
❑ No
� NA
❑ NE
JkNA
❑ NE
❑ Yes
❑ No
❑ Yes
?a No
❑ NA
❑ NE
[:]Yes
SINo
ElNA
[INE
12128104 Continued

IFacility Number:6 Date of Inspection
Required Records & Documents
19, Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes'�?No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA [INE
the appropirate box. ElWUP ElChecklists ❑ Design [I Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes )�Pqo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes *�Vo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
kNA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
&No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
RjNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
XNA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ;k�No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[:]Yes
ZNo
❑ 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
/E,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
gNo
❑ NA ❑ NE
General Permit? (ic/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes]
No
/`
❑ NA El NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA ❑ NE
Comments and/or Drawings:
12128104

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes {�` No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: &O/ " Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes RI 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 N No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No [:INA ❑ NE
maintenance or improvement?
Waste_ Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ yes F] No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) C �j S
13. Soil type(s)O r
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
VI No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
El
[I NE
17. Does the facility lack adequate acreage for land application?
El YesPNO
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
rVNo
[INA
[INE
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): 7sw
RVVVt,V u O
Reviewer/Inspector Name E_ NTt7Aj 04 1 Phone: !(, ~�0
Reviewer/Inspector Signature: _ _ Date: t .�rxo&
Page 2 of 3 y v 12128104) Continued

In
Division of Water Quality
Facility Number Division of Soil and Water Conservation ,
Agency
O Other A
_ � y
Type of Visit ompliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Vlsit"q Routine Q Complaint O Follow up O Referral O Emergency O Other (:1 Denied Access
r
Date of Visit: Arrival 'rime: ® Departure Time: County:
Farm Name:. �e c)— __ _ Owner Email:
Owner Name: Phone: _
Mailing Address:
Physical Address:
Region:
Facility Contact: �l► �Vv`VV oY- Title: Phone No:
Onsite Representative: Integrator:
y OCertified Operator: Operator Certification Num r:
Back-up Operator: Back-up Certification Number: Ly
Location of Farm: Latitude: = ° Longitude: °
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
Layers
Non -Layers
Pullets
Turku
Turkey Foults
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)
Cattle
Design Current'
Capacity : Population .
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifei
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:.
E
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 ?fo ❑ NA ❑ NE
❑ Yes
❑ No
A
ElNE
ElYes
ElNoNA
❑ NE
[]Yes
❑ No
)RNA
❑ NE
❑ Yes
T36o
❑ NA
❑ NE
❑ Yes
kNo
❑ NA
❑ NE
12128104
Continued

J I Facif ty Number: am
Date of 1 nspection `I b
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes O.No ❑ NA ❑ NE
❑ Yes ❑ No PAPA [I NE
Structure 5 Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes allo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement'? ❑ Yes NNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes o ❑ NA ElNE
(Not applicable to roofed pits, dry stacks and/or wet stacks) PV
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 *0No ❑ NA ❑ NE
maintenance/improvement?
H . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes IT No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs []Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop 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 kNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes VNo
❑ 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 YIDS answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
A.
Reviewer/Inspector Name Phone:
Reviewer/inspector Signature: Date:
12128104 Continued

Facility Numbe Date of Inspection
Required Records & Documents_
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes IQ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26, Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
nal Comments and/or Drawings:
❑ Yes %No ❑ NA ❑ NE
❑ Yes ❑ No°NA [I NE
ElYes SkNo ✓✓❑miNA ❑ NE
❑ Yes �'RNo ❑ NA ❑ NE
❑ Yes IK.No ❑ NA ❑ NE
❑ Yes ❑ No �IA ❑ NE
f
❑ Yes ;KNo ElNA ElNE
ElYes C'No ❑ NA ❑ NE
❑ Yes
(&No
❑ NA
❑ NE
❑ Yes
�3 No
❑ NA
❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes X)No ❑ NA ❑ NE
12128104

Facility No. ���� rr Time In Time Out Date
Farm Name ^Q LUl_1 t y _ _ Integrator _
Owner Site Rep
Operator w No.
Back-up No.
COC Ci ner or NPDES
Design
Current
Design
Current
can = Feed
Farrow — Feed
We ish
Farrow — Finish
Feed, Finish
Gilts 1 Boars
Farrow —Wean
Others
FREEBOARD: Design
Sludga Survey
Crop Yield
Rain Gauge
Soil Test
Weekly Freeboard 1/
Spray/Freeboard Drop
PLAT'
Observed
Calibration/GPM I
Waste Transfers
Rain Breaker
Wettable Acres
Daily Rainfall 1-in Inspections L.—
Weather Codes 120 min Inspections
Waste Analysis:
Date Nitrogen (N) Date Nitrogen (N)

Type of Visit (Ertompliance 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: Arrival Time: 0 D 1 Departure Time: 13 ; 0 —0-1 County: .,._
Farm Name: f7�?, Owner Email:
Owner Name: Co N /^D // Ls�i�/.i 4 �n G- Phone:
Mailing Address:
Physical Address:
Facility Contact: YOU,*UL Title:
Onsite Representative: Certified Operator: Operator: jj �Z�11cs�/��,_...
Back-up Operator:
Location of Farm: Latitude: F7
0
Region:
Phone No:
Integrator: r 1xrD�1
Operator Certification Number:S�/ D
Back-up Certification Number: ,ZI!
❑ Longitude: = ° ❑ ' ❑
Design Current
Swine Capacity Population
Design Current
Wet Poultry C►apacity Population
Design
C•att[e Capacity
C►urrent
Population
❑ Wean to Finish I I
I ❑ La er I
❑ Dairy Cow
CA Wean to Feeder ZZ49q 17/p
❑ Non -Layer I
I
❑ Dairy Calf
❑ Feeder to Finish I
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
El❑ La ers
El Dry Cow
El Non -Dairy
❑ Beef Stocker
Farrow to Feeder
El Farrow to Finish
❑Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
Other
❑ Beef Feeder
El Beef Brood Cow
Number of Structures:
❑ Gilts
❑ Boars
Other
❑ Other I
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at; ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes
N No
❑ NA
❑ NE
❑ Yes
4 No
❑ NA
❑ NE
❑Yes
®No
❑NA
[I NE
❑ NA
[:]NE
[:]Yes
[KNo
❑ Yes 4 No
❑ Yes jallo
Page I of 3 12128104
[I NA ❑NE
El NA ❑NE
Continuer

1
IFacility Number: Cf Date of Inspection �o
t Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 9SNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [NNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): p7 D
Observed Freeboard (in): 6—
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
EgNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
ZI 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
[KNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
0 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
dNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
0 No
❑ NA ❑ NE
maintenance/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 t0 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)YZ/_�/-�-��
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
L9 No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
XNo
❑ NA
❑ NE
18.
is there a lack of properly operating waste application equipment?
❑ Yes
KNo
❑ NA
❑ NE
v t.-,. J -r 4 �r Fk�r �•
Comments (refer to question #):. Explain any YESanswers and/or: any, recommenilatlons or any other"comments
.Use drawings of facility to better explain situations. (use additional pagesas necessary}: ' ry
w
Reviewer/Inspector Name
Phone: 9-/y_��po
Reviewer/Inspector Signature:
Date: 49 /19-, A
Page 2 of-3 - 12128104 Continued

1
L
I -Facility Number: pate of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes � No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �<No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 5LNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EkNo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
M No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
R[No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
J,No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
0 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
MNo
❑ 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
*o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
J'No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
ZNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Type of Visit compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: / Arrival Time: C7 Departure Time: 0i 1 County: Region:
Farm Name: ' i (O 0 /`, �____ _ _ _ _ _ Owner Email:
Owner Name: %� yL^f�IJ w''� Phone:
Mailing Address: �� DX ,ZZ2 �?'' LI N�'
Physical Address:
Facility Contact: ��7' Title:
Onsite Representative:
Certified Operator: A_Al t }—
Phone No:
Integrator: —
Operator Certification Number �d l
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: 0 e = f =15 Longitude: ❑ 0 0 I = 11
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
7lpr.� 1I JE3 Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dair Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non-DaijX
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: H:1I
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 JXNo ❑ NA ❑ NE
❑ Yes
VLNo
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
12128104 Continued

J 1�
Facility Number: e9,0 0Qp
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ANo
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
PlNo
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 19
Observed Freeboard (in): 3,9"'
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
C-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
ANo
❑ 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
RNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
J.No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
[K_No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
0 No
❑ NA ❑ NE
maintenance/improvement'?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
El Yes
mNo
❑ 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) � �//�s / r.,,21— / e Dr'n.
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
9No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
gZNo
[I NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,
] Yes
XNo
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
U(No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
606fNo
❑ NA
❑ NE
Reviewer/inspector Name��, ' '[js ' �� .^- ; .1 Phone:
Reviewer/Inspector Signature: Date: O
1L/1CO/Uy [.Pntrnueu

Facility Number: Date of Inspection —D
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes XNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes P(No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [%No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
C.No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
R No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[% No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
9No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ONo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
VZNo
❑ 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
W,No
❑ NA
El NE
i�d�di`t u a1�C mm nt^s��nd/a ,Drawl gs:,
�Gtdy'�''" fT�rC�7�o'S �/ �r� � �oa1•
12128104

f
Facility Number d hate o1' Visit: Time:
10 Nut O e t' al Below eshald
Permitted M Certified © Conditionally Certified [] Registered Date Last Operated or Above Thresbold:
Farm Name: I _a rra l� s _-) (_ o i :� County: a I a�tw`,_ rk0
Owner Name:
Phone No:
Mailing Address:
Facility Contact: M P i ZO C.. _ Title: Phone No:
Onsite Representative: z8 es r-r V0 U--! t Integrator: LAr,n1� �* — Yn ca Aj -
Certified Operator: &)a Ile-j Al. /e S Operator Certification Number: ASS d
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' • u Longitude * �
-Swine Design .'a Current Design CurrentDesign Current
Ca acitvl Po ulat�an Poult : 3' Ca achy , Po' utatia n , ;, Cattle , Ca achy. . Population
Wean to Feeder d Layer Dairy
�] Feeder to Finish ❑ -Non-Layer JE1 Non-Dai
❑ Farrow to Wean
Farrow to Feeder p E ❑Other j
E; Farrow to Finish I Total Design Capacity
❑ Gilts i #
!` ❑ Boars Total'SSLW, i
''Number of Lagoons i' _ j ❑ Subsurface Drains Present ❑ La oon Area S rav Field Area
i -
Halding'Ponds f Solid .Traps; ; �� ❑ No Liquid Waste Management Svstem' '
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes W No
Discharge originated at: ❑ Lagoon ❑ Sprav Field ❑ Other
a. ff discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min? /V /A
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® 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 Collectio & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes allo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
05103101 Continued

45acility Number: 9
Date of Inspection o oS o5/
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
I I - Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type C O fC�_' o (gr.'Ltj Os
13. Do the receiving crops differ with those &signated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes No
❑ Yes No
® Yes ❑ No
❑ Yes ® No
❑ Yes No
❑ Yes ® No
❑ Yes No
❑ Yes CM No
❑ Yes �0 No
❑ Yes ® No
❑ Yes ® No
❑ Yes P No
❑ Yes ® No
❑ Yes 131No
❑ Yes ® No
❑ Yes •[ No
❑ Yes 0 No
°wse,arawiags or;mctncy to, ure piatn�stwatrona. t e�aaattea at pig as ry)s field COPY ❑Final Notes
!ii`�Hf�.1���4i�:[�������. �6itGe�.�.�1?i .. ?�� . � � s�� :-:ak- �•,�: .,._. �a_ �::. xu
al.7, 2.1, 2.3 n --
7- 8,e ee,+j OncArenGQ o t- iapoo� • �Pl�cur -i-o �� Ca4
WOvL- +0 es+"a '4k .1rass "K
t-1..� avcn.
Mt. yoH+�q S�o{cs CrAwVNIf r_o Ve 4r �'tiow� C0aoF
CY bias i-'1 s Cow. �q �C-ar.
Reviewedlnspector Name j
Reviewer/Inspector Signature:
Date: /4
J2112103
Continued

i rFaUlty Number: V - .;kqP I Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
3I . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes I$ No
❑ Yes [2 No
❑ Yes IJ No
❑ Yes 10 No
❑ Yes CO No
❑ Yes No
❑ Yes No
❑ Yes allo
❑ Yes ® No
❑ Yes dNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
12112103

Facility Number Q r% �� Date of Visit: 1S•-??- 43 Time: 1 7,07 5FT
Not Operational 0 Below Threshold
[i Permitted 0 Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Dame: C' a�fv T -_
arl—��1 o � '-n2 . County:
Owner ?dame:
Mailing Address:
Phone No:
Facility Contact- J7� hN ZTitle: Phone No:
Onsite Representative: �o.��-� Integrator:
Certified Operator: l- 1;0e r_ / Oar Operator Certification Number: aS-.f � O
Location of Farm:
❑ Swine ❑ poultry ❑ Cattle ❑ Horse Latitude a & a Longitude • 01 u
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
Wean to Feeder 'y/ Oq 1E] Layer I ❑ Dai
❑ Feeder to Finish 10 Non -La et I 1 10 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder . ❑ Other
❑ Farrow to Finish Total Design Capacity 7/ 0 y
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons
E
P ",Dolding Ponds I Solid Traps .
Discharges & Stream Impacts
1. 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 Water of the State? (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)
2, is there evidence of past discharge from any part of the operation?
"Area }Q Sprav F:eld Area
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes 4No
Structure 6
Condnued

Wk
Facility Number: i
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes [ j No
❑ Yes 1� No
❑ Yes [� No
❑ Yes No
❑ Yes No
❑ Yes IT No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes No
12, Crop type C�Prr�aecPa. r� l t ►�a. nJ —
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
M. a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? ❑ Yes No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
(O No
Reoulred
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
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
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ic/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
[;9 No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
14 No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (iefer to question#): Explain any YES answers any recommendations�or ahn other'coEnments -
Use,sdrawi ys of facility to /letter explain situations '(use adiiitlonal pages-as.""'pees'si3ry).. ❑Field Copv ❑Final Notes
All
/'f Cr+�v e w e e aE�-�',�o,►. �a yoa.►. � a u � .
prates SOa.afg- ! S'f4A a.e/a� o-�'
r6�►rG
Ftelf� % icdfG�Q CtrG �i'���— U'tJG'CQ+- �7 fP►ai9aTlO�v Bq.,:�arwtn"�` GaAs
mr' y6K021 kdj Coil+4c4ece Ra Ciei
L►Oe ne-f reGeit/'a_
7
Reviewer/Inspector Name
Reviewer/inspector Signature: Date:
05103101 Continued

Type of Visit P Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit: t' 0 Time:
rO Not Operational Below Thre, hold
LPL Permitted 0Certified [3Conditionally Certified [3Registered Date Last Operated
,1 or Above Threshold:
Farm Name: (go 1 a County:
Owner Name: ce'r 'o mc" oq'ueX Phone No:
Mailing Address:
Facility Contact: 'Dams• ", n Title:
Onsite Representative: k 0, a r-;-#— / fJ
Certified Operator: -Ss
Location of Farm:
Phone
No:
Integrator:
Operator Certification Number:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 6 14 Longitude 0 4 «
Wean to Feeder
Feeder to Finish
U Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
s Present
Da i
Discharges &i Stream Impacts
1. 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 Water of the State? (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)
2. Is there evidence of past discharge from any part of the operation?
Area IU Spray Field Area
❑ Yes 0No
El Yes l No
❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Collection & Ireatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spiilwav
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier,
Freeboard (inches):
05103101
❑ Yes ❑ No
❑ Yes %No
❑ Yes 0 No
❑ Yes N No
Structure 6
Continued

Facility Number: — Date of inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Wgge Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes No
❑ Yes No
❑ Yes *o
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes j No
12. Crop hype L* Mr e. Iff/ 1 5/►aff 6,re,.i, 45
13.
...
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14.
a) Does the facility lack adequate acreage for land application?
El Yes
No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
No
16.
is there a lack of adequate waste application equipment?
❑ Yes
No
Raguired
17.
Records & Documents
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
No
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
[ No
19,
Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes]
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ic/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #) Explain any YES answersjandlor city recomm n is ons#or;anyao�ther eommcn sVIVI
.nal.pages.
Use drawings of facility to better explain situations. (use additioas necessary ,.._ ❑Field Copv ❑Final =s-
Reviewer/inspector Name��
Reviewer/inspector Signature: Date: l L47�
05103101 Continued

Facility Number:? Date of Inspection �t /
QAU Lssues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes [No
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.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional Comments and/or Drawings:
a
05103101

Division of Water Quality
Q Division of Soil and Water Conservation
" 0. Other Agency
„
Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit a Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Dale of Visit: is of Throe: : � Printed on: 7/21/2000
Facility Number ,ZO Q Not Operational C Below Threshold
IN Permitted ® Certified ❑ Conditionally Certified © Registered Date Last Operated or Above Threshold: .........................
r
Farm Name: _ ...............................................................
.............f,Eil�R!--....r 6......Z........................................................ County:..............1.�".....x:ej
Owner Name:....... !�,ra 1/� ......L. 0,47.�%:-'. C. Phone Nn:. (l..l��...........1.......:.................
Phone No:
Facility Contact: ............:......��...,. ........................Title:...................................................................................................................
MailingAddress:..........,:..0.'...........�.......A--��!...,lf...C.....1?.....l.t........................................ ..........................
Onsite Representative:....... ....... ��/.............................. .... Integrator:....�r,f�,¢ (�1 i�lr�.r�✓ . -
Certified Operator:.......,,��.. ...... rd.- Operator Certification Number:
Location 'of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • i �44 Longitude • 4 at
El Wean to Feeder
0 Feeder to Finish
Farrow to Wean
` Farrow to Feeder
El Farrow to Finish
Design Current Design . Current Design. Current
4
'apacity Population Poultry Capacity Population Cattle Capacity_Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑Non -Dairy
❑ Other
Total Design Capacity
`3� ` Boars Total . SSL W
r ,rF' } Npm_ ber o[ Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area Spray Field Area
eE I
tioidiiagPonds I Solid Tralts❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
R No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made`?
❑ Yes
R No
b. If discharge is observed. did it reach Water of the State'? (If yes, notify DWQ)
❑ Yes
a No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ)
❑ Yes
J& No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
&3 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
;KNo
Waste Collection & rreatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
�TT10
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: ....:...........1�............................................................................................
Freeboard (inches):
5100
Continued
on back

Facility Number: B — Z og Date of Inspection Printed on.• 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? Oe/ trees, severe erosion, ❑ Yes *0
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ,KNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes N No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes tffNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes j�kNo
Waste Application
10, Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes No
12. Crop type .►�u.e�,r� �S n}
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ;V'No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes Wo
b) Does the facility need a wettable acre determination? ❑ Yes RNo
c) This facility is pended for a wettable acre determination? ❑ Yes 9T10
15. Does the receiving crop need improvement? ❑ Yes X No
16. Is there a lack of adequate waste application equipment?
Required Records & Doenments
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP checklists, design, maps etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
iQ yipl trigtis:o� �>ficiencies ry t•e �pte�1 ot<whig ihis:visit; Yot�t wiiitee lye jfl fmrth0f -
corres;poriden& abotik this :visit. .. • - - - -
❑ Yes RNo
❑ Yes 5fNo
❑ Yes ,® No
❑ Yes OkNo
❑ Yes ArNo
❑ Yes J4 No
❑ Yes PrNo
❑ Yes &'No
❑ Yes No
❑ Yes AYo
Comments (refer toquestton'�#) Explain; any YES answers and/or any recommendations or!any other comments. x.
U3sei� 4 n"gs of facilitystg better explain situations. (use additional pages as'necessary)
Ir
Reviewer/Inspector Name
Reviewer/Inspector Signature: .. 5i- � _,, Date: _S%le"U/ S/00

Facility Number: 0C-- Date of Inspection O Printed on: 10/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
IQ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
RNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
RNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
RNo
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.)
❑ Yes
[R No
31. Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
RLNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
r[�No
[Additional omment&an or Drawings:
a1
o�
J
5/00

4, Division of Water Quality ,
O Division of Sdil and Water,Congervation
,0,0tI1CC'AgeRCy '.f ,cr - .. r l
Type of Visit RCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ORoutine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number O bale of Z-C1Z1 visit: Time: Printed (in: 7/21/2000
0 Not C} erational 0 Below Threshold
#Permitted [] Certified (/] Conditionally Certified [3 Registered Date Last Operated
or above Threshold: .........................
Farm Name: ,l /S 2 601 _' Z County:........ a/ �qG���..f�.........................................
�-r..o...... ...................... .................
r..l.... f... CL
Owner.Natne: Q.r"T.i}..al...�.�. a�> S Ca,. .... Phone No � ...� .T..Ij'/
.. ............. .. � ..............., ......... ........,7`...............................
Facility Contact: ... L./a1.1,.... l.V orrIp.t.,.... ......Fille: L ca-� ......�l��L.......... I...... Phone No: ............`,.....�� ,T.................
[ailing Address: ..,..1....,4�...1J. ...,..1f..1. r .r�s! t��...'..�!.. ................ 4. :.
Onsite Representative:..... z..4.i:.ve..... k.G. `Q 1.............................................. integrator:....,........................................................
Certified Operator:.. .C.... .L16.....0t ............-....... Operator Certification Number: ..........................................
Location '(4 Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 �` �`` Longitude �• �i 0«
Design Current
awrne Capacity Population
Wean to Feeder / p
(-]'Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current
Poultry Capacity Population
❑ Layer
❑ Non -Layer I I Ed
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Total Design Capacity %/ p
Total SSL W
Number of Lagoons ❑ Subsurface Drains 11'resentlill Lawton Area 10 Spray Field Arest
Holding Ponds / Solid Traps 10 No Liquid Waste klanagement System
Discharaes & Stream Im.___ lyacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If disthurgc is observed, was thr convcyancc man-made?
b. If discharge is ohserved. did it reach Water of the State'? ([[yes, notify DWQ)
c, is ohscrvcd, what is tltc cstirrIMCd flow in gal/[Hill?
d. Does discharge bypass a lagoon system" (If yes, notify DWQ)
2. Is there evidence of 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?
Waste Collection & Treatment
4. Is storage capacity (freehoard plus storm storage) less than adequate? ❑ Spillway
Structmv I Su•ticture 2 Structure ; Structure 4
❑ Yes No
❑ Yes o
❑ Yes No
❑ Yes No
❑ Yes a
❑ Yes No
❑ Yes .
Structure 5 Structure 6
Identifier:.......................................................................................................................................................................................................................
Freeboard (inches): ;2
5100 Continued on back

Facility Number: Q� -,�j Date of Inspection � Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, 0 Yes �] No
seepage, eta.) /
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes 9No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? 9-Yes ❑ No
8. Does any part of the waste management system other than waste structures require taintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and mitiimum liquid level
elevation markings? ❑ Yes No
Waste Application
10. Are there any buffers that need maintenance/improvement`? ❑ Yes ® No
11. Is there evidence over applicatyn? ❑ Exces�ive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes �ONO
12. Crop type
13. Do the receiving crops differ with those dc_1 sated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crap need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Docriments
17, fail to have Cerlilicate of Coverage & General Permit readily available?
18, Does the I'acility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design. maps, etc.)
19, Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
2l. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of ernergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23, Did Reviewer/inspector fail to discuss review/inspection with on -site representative'?
24. Docs facility require a follow-up visit by same agency?
25, Were any additional problems noted which cause noncompliance of the Certified AWMP?
�'Va viola�gris;oT iieficie'ncies were noted dt�ritig �his;visit; Yoh wiii•teceiye trio further; ;
corres�aridence: shout. t>tis .visit.
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):
_IP-7. Ga�ov,,_ ko-45 0oil
D va.-a.l J 4WU,1 104S 5,&Vr�,
❑ Yes No
❑ Yes No
❑ Yes g No
❑ Yes No
❑ Yes ® No
Cl Yes /�` No
❑ Yes 0 No
❑ Yes kNo
❑ Yes No
❑ Yes No
❑ Yes P No
❑ Yes No
❑ Yes No
❑ Yes P] No
❑ Yes RiN0
AL
E
r/Inspector Name
r/Inspector Signature: Date: Z 5100

Facility Number:Oc7 -2 Date of litspecdon Zi
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ®No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
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.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes o
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
+I

[3. Division of Soil and Water Conseiwativn Ope�ation.Review
4, '1 ` 13 Division of:Soil and. Water Conservation Compliance Inspection
a(Division of#.
er
� � �, �k.?�'. Other Agen
cy, atOp�rahton R'evtnWliance Inspeeaon
ty
�i
0 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Fallow -up of DSWC review 0 Other
Facility Number Date of inspection EIRED
Time of Inspection � 24 hr. (hh:mm)
13 Permitted Xcertified [3 Conditionally Certified 0 Registered 10 Not Operational Date Last Operated:
/
FarmNitme:........................^fO/Ir ..........................,.,...............-...-................................. County: ......�,4n...... ....................
Owner Name:.............. all .,.. .r........................... Phone No:... 9109
...�... ��9 ..'`...... s?..T...... �....
ll
FacilityContact: ......6k4.!.. ............... Title: ..........................................-.. Phone No:...................................................
,Mailing Address: ............Li...:.......Of..........tO f(CiF? !✓�.....,fV G� ................... g.l.
A 5..............................
.. ..Onsite Representative:........................................'6............
Certified Operator: ............... ......�Y1<
Location of Farm:
.................. Integrator :............C4..(!-.Q.�iE. .....
................. Operator Certification Number:..........................................
y
.......................................................... ............. ............................. ... ... .......... ... 1
Latitude 0 4 '& Longitude • 4 64
1
1
Design Current it,4 Design -Current Design Current
�SvvI ,4� „' t t� E ���Ca acit Po ulation Poultry , �, � ,Ca aclt � Po' ulation ' Cattle Capacity Po pill
Wean to Feeder
7 Q
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
1 ;e.
❑Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity /0
Total SSLW '
Number of L!ag' oohs; ❑Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
g p ❑ No Liquid Waste Management System
Holdanf PondsSol Traps , :a
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: [ILagoon [3Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made`?
h. If discharge is observed, did it reach Water of the State? (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 ycs, notify DWQ)
2. Is there evidence of 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?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: f//
Freeboard(inches): .........j��......................... ................. ......... .......... ....."...... ................................................ ........ I....................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes A No
❑ Yes No
❑ Yes [ No
❑ Yes No
❑ Yes No
❑ Yes (yJ No
❑ Yes No
Structure 6
...................................
❑ Yes k No
Continued on back

Facility Number: Qj — Jog Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need,maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10, Are there any buffers that need maintenance/improvement?
11. Is there evidence of over applicatio ❑ Excessive Ponding ❑ PAC
12. Crop type Of
13. Do the receiving crops differ with those designated in the Certified Animal
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Management Plan (CAWMP)?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21, Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
23. Did Rev iewer/lnspector fail to discuss review/inspection with on -site representative?
24, Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes 9�Io
[]Yes XNo
❑ Yes A No
❑ Yes �f No
❑ Yes [KN0
❑ Yes X No
❑ Yes VNo
❑ Yes Wf No
❑ Yes [ No
❑ Yes Z No
❑ Yes No
❑ Yes TNo
❑ Yes Po
❑ Yes 9No
Xr es ❑ No
❑ Yes rV No
❑ Yes 0 No
❑ Yes 0 No
❑ Yes [XNo
❑ Yes [Z No
❑ Yes A No
violMIOns 0 O'rici"' , i. ra howo ooiog this;visit;• ;Y;oo ;wi�1•teoeiye fio; fu tii r, '
....... .........
correspondence. abauk this visit. ...
Comments refer to; uestign # Ex lain an YES answers and/or Ean; recommendations or any other comments. "
t �q p any YES y
V.
Vse,drawtngs of facility, to better explain situations (use additional pages as necessary) i. , t
r.'.'�T, €�� n V . E`e @`, ��� ,. ! ! . "'_
Rawl ri►, ,�,� A14J _11� kup a -
e
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
3/23/99

Facility Number: 0 — ap Date (if Inspection SFr
Odor .ISSUes
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ��No
liquid level of lagoon or storage pond with no agitation?
27,
Are there any dead animals not disposed oi' properly within 24 hours?
❑ Yes
No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
No
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.)
❑ Yes
No
31,
Do the animals feed storage bins fail to have appropriate cover?
ClYes
No
/❑
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
No
Additional Comments and/or, Drawi : 1 2, 1..' • ' " ' ' ' ; a , •
A
A" :
x ten #M SIAVej
dok,10 Ao lv" ;eJ Al. WfA u•e"v Ozq-F' .
3/23/99

- _z, .. 777ME7 -....,m,,,.«..,,..:.«..;....:.:.....-.:.:.
Fix °� Division of Sail and Water Conservation 0 Other Agency
` ;Division of Water Quality
O Routine 0 Complaint O Follow-up of DW(2 ins ection O Follow-up of DSWC review 0 Other
Date of Inspection
Facility Number b 20
Time of Inspection �Qb 24 hr. (hh:mm)
0 Registered 13 Certified [3 Applied for Permit E3 Permitted 10 Not Operational, Date Last Operated:
Farm Name: -2 ��.z County: ........................................
.,... .l .........................................,.........,..................,......,............. Count
OwnerName :...... G.r..Rx-.AL.1..................r'�7.�,.,,�.e.✓..C,.�....................... .......... Phone Na:......... ............. �1.........................�,. .(..................
FacilityContact:...... .......,c�."r?. tr ?................ Title:................................................................ Phone No:...,.................................,.............
Mailing Address:.......... . r......(t' ./ .�r........t4l/..T.P ......................
Onsite Representative:......... ............ r�'�V Integrator:....:G AzI.I. �11 .... � y�".`_-'
k! ....................
Certified Operator,....,Y,.!�.�,/.Y,�:...............�ftjsr!� ...,..,..,. Operator Certification Number .,......
Location of Farm:
A
...................................................... ..
�............................................................................................................... ............................................................................................... .,.........
,�..
Latitude =r1 « Longitude • f "
'Swine
ulation Poultry
Wean to Feeder
-7O
'1O
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
La
Design ,
Cattle,,,Capsetty Popp
T ❑ Dairy
Subsurface Drains Present
No Liuuid Waste
S
Area I❑ Spray Field Area
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ITNo
2. Is any discharge observed from any part of the operation? ❑ Yes 1%No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes PCNo
V-
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes VNo
c. If discharge is observed, what is the estimated flow in gaUmin?
A. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes QkNo
3. is there evidence of past discharge from any part of the operation? ❑ Yes No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes VNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes Q No
W maintenance/improvement?
6. Is facility not in compliance with any applicable Setback criteria in effect at the time of design? ❑ Yes RNo
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes �ILNo
7/25/97 Continued on back

Facility Number: &f -- �Og
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes KNo
Structures (Lagoons,11oldina Ponds, Flush Pits, etc.)
9. Is storage capacity (Freeboard plus storm storage) less than adequate? 'Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 0
Identifier: 1�
Freeboard(ft): ...............f......f/..................... ................. ................................. ................... ................... .................................... ....................... I............
10. Is seepage observed from any of the structures? ❑ Yes XNo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes KNo
12. Do any of the structures need maintenance/improvement? ❑ Yes &No
(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? ❑ Yes AINo
Waste Application
14. Is there physical evidence of over application? ❑ Yes X No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type r ......7GP.................................
I6. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes PtNNo
IT Does the facility have a lack of adequate acreage for land application? ❑ Yes ❑ No
18.
Does the receiving crop need improvement?
XYes
❑ No
t9.
Is there a lack of available waste application equipment?
❑ Yes
NrNo
20.
Does facility require a follow-up visit by same agency?
❑ Yes
XNo
21.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
XNo
22.
Does record keeping need improvement?
❑ Yes
A No
For
Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
A No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
A No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
bio
0- No.violations•or deficiencies. were, note'd, during' this. visit.: You.will receive.no•ftirther, ::
6eresponden0 ah'out -this:visif.: :: . . :: : ; . ... ::::.: .
y. 1/XAOV1 k / s r. /$yam 0 � ,.M.,AA/iG coo
,�S �v.✓.¢.r Gv�
�X��o'.t...r� �� �GI�O' � lJf/�_ s��/. %%Io.✓/�'�C �J�"lki� l��f`J' �:r.�r���
Reviewer/Inspector Name ? ,
x '-*
7,� ,..« V
Reviewer/inspector Sigmkture: Date:

t
® Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection
Facility Number d Time of Inspection 13 _Ful 24 hr. (hh:mrn)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ 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: .........................................................................Q..........,..._../.......
.................................................
FarmName: ................PZ. r%, .............................................................................. County:.........t4?1�XC( l`.................................................
Land Owner Name:....5...,eofJU5A?z�,lf� .......................... Phone No:... 7.� 1 ......., .: .. T..........
FacilityConctact:....... ..tf.4a- �.#......................... Title:................................................ Phone No:..........................................................
Mailing Address: <:.,...��:. .P.at✓ ..... �r yr.....Kfri�! ..5 (i� ...�11..�...... 1...................................................
Onsite Representative:......yes.....r+ .lF o............................................. Integrator:.....r...C�!�'.�C.. ,
/ f
Certified Operator:......�r�r ..tr ..................... .9..C.2a. ............ Operator Certification Number: .......
%...7�d.�.....
Lee -#ion ofParm•
'/ / f�f//nk /�
.^-..,fr.......,lc�(� ....1-....rl. �:fry............Q...,7..,3r".rP..r
Latitude Longltude� it
Type of Operation and Design Capacity
rep! Desig> Current > Design Current
Swittie ., wµ.{ .>• k
y",, Ca aci Po' elation pot►ltryr Ca aci Po elation Caf#le,
i it
Ca aci `Po ul tion.
Wean to. Feeder p h ❑ Layer + ❑ Dairy,
❑Feeder to Finish Non -La er`' Non -Da
El
Farrow to Wean 4 r
Farrow to Feeder :TotalDesign-Capaclly r�
Farrow t0 Finish �'I Z ,#V'
�.�, ta1 sS11JW
❑Other sx �a
s
'a'°�?+"3"" ,...-:,,Y'„e,.n �'tYCve7.y_....... ,ax...�rP-x� �,_..«a�<x� T q * .. ..., oE��E.: �.s ... ,;'" �'? .S•t f w� � �`�-:s ,.� �.,x ?�
Number, of Lagoons "/ ° WdingnPontls ��— % ❑Subsurface Drains Present
. !�4 tR ❑ Lagoon Area ❑Spray Field Area
-General
1. Are there any buffers that need maintenance/improvement? ❑ Yes o
2. Is any discharge observed from any part of the operation? ❑ Yes o
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes XNo
b, if discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes o
e. If discharge is observed, what is the estimated flow in gal/min? #
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes 0
3. Is there evidence of past discharge from any part of the operation? ElYes XNo
4. Were there any adverse impacts to the waters of the State other than from a discharge? Cl Yes &No
1- 5. Does any part of the waste management system (other than lagoonsiholding ponds) require ❑ Yes 10
maintenance/improvement?
4/30/97 Corrdrriued on back

Facility Number:
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?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (1,agoons and/or holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure 1 Structure 2 Structure 3
Ava.:.'Z.�..... ............................ ............................
I0. Is seepage observed from any of the structures?
Structure 4
11. 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?
❑ Yes *
' ❑ Yes XNo
❑ Yes g'kNo
❑ Yes ekN0
Structure 5 Structure 6
Wassig Applicatiou
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop typeiQf,F.. g�11�,I/...................................................................
16, Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
. 19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
FQr Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
; (refer to question'# Explain°aand ny YES answers'/or.arny recommendatEans or any other
❑ Yes g)�CNo
❑ Yes ' kNo
❑ Yes/%Ua.—No
❑ Yes *o
❑ Yes KNo
❑ Yes 'No
• j i „h �
Yes No�
❑ Yes XNo
❑ Yes *0
❑Yes�No �,_
❑ Yes Aqo
❑ YesArNo
Yes ❑ No
(( es [I No
invents: P `'�
i�vp�O1�,El/ �r�i�,� �i� �� ���iwq.�✓� �i9.fJ yr � �Ja � �j�
Reviewer/]nspector Name
Reviewer/Inspector Signature: Date:
cc: Division of Water Quality; Water Quality Section, Facility Assessment Unit 4/30/97