820469_INSPECTIONS_20171231

NUH I H LAHULINA
Department of Environmental Qual

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Mer Agency
Facility Number. 820469 Facility Status: Active Permit: AWS820469
Inppection Type: Compliance Inspection Inactive Or Closed Date:
Reason for visit: Routine County: Sampson Region:
Date of Visit: 09123/2016 Entry Time: 01:00 pm Exit Time: 2:00 pm Incident #
Farm Name: Farm 2025 Owner Email:
❑ Denied Access
Fayetteville
Owner: Murphy -Brown LLC.
Phone: [phone]
Mailing Address: PO Box 487
Warsaw NC 26398
Physical Address: 2185 Thompson Ave
Turkey NC 28393
Facility Status: Compliant ❑
Not Compliant Integrator:
Murphy -Brown LLC
Location of Farm:
latitude:
35' 02' Longitude: 78° 10' 35"
On SR 1906. approx_ 112 miles from intersection of SR 1906 and SR 1905, on west side
of road_
Question Areas:
Dischrge 8 Stream Impacts
Waste Col, Stor, 8 Treat
Waste Application
Records and Documents
Other Issues
Certified Operator: Bradley Devone Herring Operator Certification Number: 26545
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Norris Phone
On -site representative Mike Norris Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820469 Owner - Facility : Murphy -Brown LLC Facility Number: 820469
Inspection Elate: 09/23/16 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish 6,966
Total Design Capacity: 6,966
Total SSLW: 940,410
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date freeboard Freeboard
Lagoon
1
19-00
47.00
Lagoon
2526
19.20
page: 2

Permit: AWS820469 Owner -Facility: Murphy -Brown LLC Facility Number: 820469
Inspection Date: 09123/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na Ne
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DV Q)
❑
❑
❑
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)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Coftection. Storage & Treatment
Yes No Na _Ns
4. Is storage capacity less than adequate?
❑
N ❑
❑
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?
❑
N ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (loot applicable
❑
00
❑
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
Yes 'No No No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
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 a 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 AWS820469 Owner- Facility Murphy -Brown LLC Facility Number 820469
Inspection Date: 09I23116 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Wasta Application
Yes
No Na Ne
Crop Type 1
Coastal 8ermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain
overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
ocdia
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Sail 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?
❑
N ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
1B. Is there a lack of property operating waste application equipment?
❑
0 ❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
N ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
❑
❑
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 Tfansfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS820469 Owner - Facility : Murphy -Brown LLC Facility plumber:
$20469
Inspection Elate: 09/23/16 Inppection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yes No Na Ne
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
❑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?
❑
M ❑
❑
Other ISsUes
Yeti No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
M ❑
❑
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,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑M
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile 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?
❑
❑
❑
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: 820469 Facility Status: Active Permit: AWS820469
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Sampson Region:
Date of Visit: 11/05/2015 Entry Time: 09:00 am Exit Time: 10:00 am Incident #
Farm Name: Farm 2026 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
❑ Denied Access
Fayetteville
910-296.1800
Physical Address: 2185 Thompson Ave Turkey NC 28393
Facility Status: Compliant Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 35' 02' Longitude: 78' 10' 35"
On SR 1906. approx. 112 miles from intersection of SR 1 W6 and SR 1905, on west side of road_
Question Areas:
Dischrge 8 Stream Impacts Waste Col, Stor, 8 Treat Waste Application
Records and Documents Other Issues
Certified Operator: Bradley Devone Herring Operator Certification Number: 26545
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Norris Phone:
On -site representative Mike Norris Phone:
Primary inspector: Robert Marble Phone:
Inspector Signature: Dale:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820469 Owner - Facility : Murphy -Brown LLC Facility Number: 820469
Inspection Date: 11/05/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Feeder to Finish 6,966
Total Design Capacity: 6,966
Total SSLW: 940,410
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon i 19.00 49,00
Lagoon 2526 19.20 1 _::=
Page: 2

Permit: AWS820469 Owner - Facility : Murphy -Brown t-i Facility Number: 820469
Inspection Date: 11/05/15 Inssection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na 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? (J yes, notify DWQ)
❑M
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify Ill
❑
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 ❑
❑
Slate other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (l.eJ 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?
❑
M ❑
❑
B. 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
❑
M ❑
❑
maintenance or improvement?
Wash Application
Yos No Na He
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
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. Zr, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820469 Owner - Facility : Murphy -Brown LL_C facility Number: 820469
Inspection Date: 11/05/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes
No NJ N
Crop Type 1
Coastal Bermuda Grass
jHay, Pasture)
Crop Type 2
Smal Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
SPIT Type 1
Op[1a
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
❑
E ❑
❑
Management Pian(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
N ❑
❑
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
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.
WU P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
E ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page:
4

Permit: AWS820469 Owner - Facility : Murphy -Brown LLC Facility Number:
820469
Inspection Date: 11/05/15 Inppection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yes
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?
❑
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(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 cerlified operator in charge?
❑
M ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
S ❑
❑
Other Issues
Yes No Na Na
28. Did the facility fail to properly dispose of dead animals within 24 hours andlor document
❑
M ❑
❑
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,
❑
m ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility?
❑
❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon I 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?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
M ❑
❑
page: 5

i
Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
820469
Facility Status: Active Permit AWS820469
Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit.
Routine
County: Sampson Region:
Fayetteville
Date of Visit:
12116/2014 Entry Time: 12:15 pm Exit Time: 1:00 pm Incident #
Farm Name:
Palm 2026
gwner Email:
Owner:
Murphy -Brown LLC
Phone:
91D-296.1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
2185 Thompson Ave
Turkey NC 28393
Facility status:
RCompliant El
Not Compliant Integrator: Murphy -Brown LLC
Location of Farm:
Latitude: 35' 02' Longitude:
78' 10' 35"
On SR 1906, approx.
1/2 miles from intersection of SR 19D6 and SR 1905, on west side of road.
Question Areas:
Dischrge 8 Stream Impacts
Waste Col, Stor. & Treat Waste Application
Records and Documents
Other Issues
Certified Operator Bradley Devone Herring Operator Certification Number: 26545
Secondary OIC(s):
On -Site Representative(s):
Name Title Phone
24 hour contact name
Mike Norris Phone:
On -site representative
Mike Norris Phone:
Primary Inspector:
Robert Marble Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820469 Owner - Facility : Murphy -Brown LLC Facility Number: 820469
Inspection Date: 12/16/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
El Swine - Feeder to Finish 6,966
Total Design Capacity: 5,966
Total SSLW: 940,410
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
1
19.00
48.00
Lagoon
2526
19.20
page: 2

Permit: AWS820469 Owner - Facility : Murphy -Brown LLC Facility Number: 82D469
Inspection Date: 12/16/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
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)
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 observable adverse impacts or potential adverse impacts to Waters of the
State other than from a discharge?
Waste Collection, Storage & Treatment
4. Is storage capacity less than adequate?
It yes, is waste level into structural freeboard?
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ 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?
8. Do any of the structures lack adequate markers as required by the permit? (Riot 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
maintenance or improvement?
Waste Application
10, Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
i 1. Is there evidence of incorrect application?
If yes, check the appropriate box below.
Excessive Ponding?
Hydraulic Overload?
Frozen Ground?
Heavy metals (Cu. Zn, etc)?
PAST?
Is PART > 10%I10 lbs.?
Total Phosphorus?
Failure to incorporate manureisludge into bare soil?
Outside of acceptable crop window?
Evidence of wind drift?
Application outside of application area?
Yes No Na No
❑■❑❑
EDEIN ❑
❑ N ❑ ❑
❑■❑❑
Yes No Na Ne
❑ ❑ ❑
❑N ❑ ❑
❑■❑❑
11 ■ ❑ ❑
❑■❑❑
❑■❑❑
Yes No Na No
❑ N ❑ ❑
"Eft
page: 3

Permit: AWS820469 Owner - Facility : Murphy -Brown LLC Facility Number: 820469
Inspection Dale: 12/16/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Ng Na
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Wagram loamy sand, 0 to
5% slopes
Soil Type 2
orna
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(CAVVMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
E ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
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
Yes No Na He
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?
❑ N ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21, Does record keeping need improvement?
❑ N ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS820469 Owner - Facility : Murphy -Brown LLC Facility Number:
820469
Inspection Date: 12/16/14 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yes
No No No
Stocking?
❑
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
❑
❑
❑
(NPDES only)?
24_ Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
[]
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 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?
❑
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
❑
M ❑
❑
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,
❑
M ❑
❑
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 J Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
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?
❑
0 ❑
❑
page: 5

0
M
Division of Water Resources
Ll
Division of Soil and Water Conservation
El
Other Agency
Facility Number.
820459
Facility
Status: Active Permit: AW5820469
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Sampson Region:
Fayetteville
Date of Visit:
1211112013 Entry Time:
10:30 am Exit Time: 11:30 am Incident #
Farm Name:
Farm 2026
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1600
Mailing Address:
PO Box 487
Warsaw NC 28398
Ph ' 1 Add
2185 Thompson Ave
Turke INC 26393
ys�ca ress: Y
Facility Status: Compliant Not Compliant lntogratoc Murphy -Brown LLC
Location of Farm: Latitude: 35' 02'
On SR 1906, approx. 112 miles from intersection of 5R 1905 and SR 1905, on west side of road.
Longitude: 78' 10' 35'
Question Areas:
Dischrge & Stream Impacts
Waste Col, Stor, $ Treat
Waste Application
Records and Documents
Other Issues
Certified Operator:
Operator Cenifica6on Number:
Secondary OIC(s)
On -Site Representative(s):
Name
Title Phone
24 hour contact name
Mike Norris
Phone.
On -site representative
Mike NDrns
Phone -
Primary Inspector: Robert
Matte
Phone:
Inspector Signature:
Date:
Secondary Inspectors}
Inspection Summary:
page: 1

Permit: AWS820469 Owner - Facility : Murphy -Brown LLC Facility Number: 820469
Inspection Date: 12111/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine Feeder to Finish
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00
Lagoon 2526 19.20
page: 2

Permit: AWS820469 Owner - Facility : Murphy -Brown LLC Facility Number: 820469
Inspection Date: 12/11/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No No No
1_ Is any discharge observed from any part of the operation?
❑
■ ❑
❑
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)
❑
❑ m
❑
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?
❑
N ❑
❑
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
Ygs
No Na_ No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
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
❑
N ❑
❑
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?
❑
■ o
Cl
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
❑
E ❑
❑
maintenance or improvement?
Waste Application
Yes No No Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11, Is there evidence of incorrect application?
❑ E D ❑
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

J
Permit: AWS820469 Owner - Facility Murphy -Brown LLC Facility Number: 820469
Inspection Date: 12/11/13 Inpsection Type Compliance Inspection Reason for Visit Routine
Waste Application Yes No Na Ng
Crop Type 1 Coastal Bermuda Grass
(Nay, Pasture)
Crop Type 2 Small Gram Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Wagram loamy sand, 0 to
6% slopes
Soil Type 2
Ocilla
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 ❑
11
16 Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
M ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M ❑
❑
Records and Documents
Yss
No Ne Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily availaNe?
❑M
❑
❑
20 Does the facility fail to have all components of the CAWMP readily available?
❑
❑
❑
If yes, check the appropriate box below.
WU P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
M ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS820469 Owner - Facility : Murphy -Brown LLC Facility Number: 820469
Inspection Date: 12/11/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
N ❑
❑
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
❑
❑
❑
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 dale of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
❑
Mer Issues
Yes No Na Ns
2& Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑0
❑
❑
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 DWO of emergency situations as required by Permit?
❑
E ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface the 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
❑
❑
❑
CAWMP?
33. Did the Reviewerlinspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 []
❑
page: 5

Type of Visit: 4b Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: e Routine O Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 7 Lp iy Arrival Time: /D, Yma+ Departure Time: /'0 County• _o Region: 9!�' 1
Farm Name: 2 03 73 , _ 2-0 3S3 Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
t
Facility Contact: Ml�e Title: Phone:
Onsite Representative: Ii Integrator: u
Certified Operator: (JQ Certification Number:
Back-up Operator:
Location of .Farm:
Latitude:
Certification Number:
Longitude:
�Rign Current
Swinc 'i = Cap ity Pop.
z-
"'�' Design Current
Wet Poultry Capacity Pop.
Cattle
Design Current
Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
eeder to Finish
Farrow to Wean
Non -Layer
Dairy Calf
1}
Design Current
D , Fault . C_a act P,o ,
Dairy Heifer
Dry Cow
Non -Da'
Farrow to Feeder
Farrow to Finish
Gilts
Layers
Beef Stocker
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Turkeys
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the Stale other than from a discharge?
❑ Yes 1�3 No
Yes [::]No
[:]Yes [::]No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
�NA ONE
jg NA ❑ NE
NA ❑ NE
❑ NA ❑ NE
[]NA ❑NE
Page 1 of 3 2/4/2011 Continued

Facili Number: Datoinspection: .? 7,7
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
0NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: wo-4 !�
Spillway?:
Designed Freeboard (in):
_
Observed Freeboard (in): !' `l
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.)
(E
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes]
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
0 NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 'Q No ❑ NA ❑ NE
❑ Excessive Pondin�g ❑ 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): /Vp y`i-,li�.G�l✓1
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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[�]o No
❑ NA
❑ NE
❑ Yes
Q No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box. 7�
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [P No 0 NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Inspection: 2 7i
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey Q Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No
❑ NA ❑ NE
❑NA []NE
❑ NA ❑ NE
NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[�allo
❑ 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
JZ 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
�Vo
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
7
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
P 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 #) Ezplatn any YES answers:aed/or.-any additional recommendatians.nr any other commenfs.
Use drawins}s of facilit'vr to betferzex6lain situations (use additional naees as necessarvl..
54 vt 5 /2,1 �r 2-
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
7/I31f2,
11
Phone: 1-Y7f �dn
Date:
21412011

i'ype or visit: W Compliance Inspection U Operation Review U Structure Evaluation U 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: ' beck Departure Time: County: Region:
Farm Name: f-&49
C� Owner Email:
Owner Name: � Phone:
Mailing Address:
Physical Address:
Facility Contact: 1ke Lig-m"-s Title: Phone:
Onsite Representative: G Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Design
' Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish I
ILayer
Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
1Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D . foul
Ca ac'
P,o
Non-DaiEZ
Farrow to Finish
Layers
Beef Stocker
Gilts
I
lNon-Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Dther
Turkey Poults
Other
Other
Discharges and Stream lmaacts
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
JN NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
�j NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
[] No
4 NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[P No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
15@ No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21417011 Continued

Facilitv�Number: - Date of Inspection: 7"
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 1`01 NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?.
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
> No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
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
NfN 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, andfor wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Aig No ❑ NA
❑ 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): P6Q%U U A &Izwr �.�,T401W )1 �/ . &*� ,
13. Soil Type(s): JjuC,U-0,4%,, U
❑ NE
14_ Do the receiving croMdifter 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
M No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Re uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Jo No
TT�]
❑ 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 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
Page 2 of 3
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA [] NE
❑ NA ❑ NE
21412011 Continued

Facili Number: - Date of Inspection: ? 11,1
j 7/
24_ Did the facility fail to calibrate waste application equipment as required by the permit?
Yes No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
Yes No
NA NE
the appropriate box(es) below.
Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
Non -compliant sludge Ievels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
Yes No
❑ NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Yes No
NA NE
T
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
Yes j 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 facility fail to notify the Regional Office of emergency situations as required by the
Q Yes �j No
0 NA NE
permit? (i.e., discharge, freeboard problems, over -application)
3I. 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:
r
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 ff): Explain any YES answers and/or any additional.recommendations-ar'anN',lother'c fneats.
r
Use drawings of facility to better explain situations (use additional pates as necessary).
,., ¢ems
t_, W.__.
Pres re,/i`e�,r� 71 r 3 j r 2,
5r4e Ili S' 12-14C
-
Slu �
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: Ple" -1 31M
Date: L- b Z
21412011

Type of Visit: 0 Compliance Inspection Q Operation Review O Structure Evaluation U Technical Assistance
Reason for Visit: l] Routine O Complaint 0 Follow-up O Referral Q Emergency O Other p Denied Access
Date of Visit: Arrival Time: Departure Timer County:S 1 j(Jy Region:
Farm Name: ,Zoz 43 Owner Email:
Owner Name: I I A C4) Phone:
Mailing Address:
Physical Address:
Facility Contact: �t 1116�f T 1 Title: Phone:
Onsite Representative: u Integrator:^7�?LJt"`--
Certified Operator: Certification number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
+ Design
Current
µ�"� D s gn Curret►t
Design Current
Swine' Ca aci
Pa
Wet Poult r. Ca a ttyPo
Cattle Ca aci Po .
Wean to Finish
Wean to Feeder
Non -Layer
aia Cow
aily Calf
Feeder to Finish
SIP
Dairy Heifer
Farrow to Wean
acrty' A
Dry Cow
Farrow to Feeder
D . P,ault�Ca` P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Beef Brood Cow
Boars Pullets
Turkeys
-
Qther10 1111
Turkey Poults
Otherr i Other
Discharges and -Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b- Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
NA ❑ NE
NA ❑ NE
NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Faaili Number: - Ds ection: p
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P2
No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No P NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
`� No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
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
F9 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
W No
❑ NA
❑ NE
maintenance or improvement?
Waste Anolieation
10. Are there any required buffers, setbacks, or compliance alternatives that need [] Yes ® No ❑ NA ❑ NE
maintenance or improvement? TT
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): C_�OV
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [)9 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
T 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 T sfers
❑ 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 CP
No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes fV No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: Date of Inspection: JOIL4111
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [� No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below. f
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29_ At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30_ Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes ;A No
❑ Yes 5DNo
❑ NA ❑ NE
❑ NA [] NE
❑ Yes
� No
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE
[:)Yes
[_P No
❑ NA
❑ NE
❑ Yes
CITNo
❑ NA
❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes q9 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-answert and/or any additional reeo'M endations or anti , otheir comments:
Use drawings of facility to better explain stuahons;(use additional pages as necessary). ;.
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: *V .33-3 1D
Date: D
17-ell
21412011

Type of Visit Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up Q Referral O Emergency O Other ❑Denied Access
Date of Visit: Q Arrival Time, i / Departure Time: County: Region:
�=660
o
Farm Name: ��� �;14 Owner Email:
Owner Name: �� �1-L Phone:
Mailing Address:
Physical Address:
Facility Contact: Girr Title:
Onsite Representative;
Certified Operator:fX
Back-up Operator:
Phone No:
integrator: MU,`AVW LLC—
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = [= Longitude: a ° =1 0 u
,.:fir
Design Current*y Design Current
Design Current
Swine
Capacity Population «'et Pottltry Cap P�tiptlat'on
Cattle Capacity POpniation
❑ Wean to Finish ❑ La er
❑Dai Cow
❑ Wean to Feeder I JE1 Non -Layer I
lf
15OFeeder to Finish
❑ Dairy Heifer
El Farrow to Wean it
Dry Poary '
El Farrow to Feeder �
El Dry Cow
❑ Non-Dai ry
❑ Farrow to Finish ❑ La ers
❑ Beef Stocker
Gilts Non -La ersPullets
Q Beef Feeder
EBoars
❑ Beef Brood Cow
❑ Turkeys
Other ❑ Turkey Poults
❑ Other ❑ Other
Number of Structures:
Discharges & Stream lm acts
1, Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
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 TNo ❑NA [I NE
❑ Yes ❑ No T NA
1
❑ NE
El Yes El No NA
❑ NE
❑ Yes ❑ No [INA
❑ Nl*
❑ Yes No ❑ NA
❑ NE
❑ Yes No ❑ NA
❑ NE
Page I of 3 12128104 Continued

Facilitj,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
`DNA
[I NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Slitructure 6
Identifier: 1
Spillway?:
Designed Freeboard (in):
IV
Observed Freeboard (in): S
5. Are there any immediate threats to the integrity of any of the structures observed`?
❑ Yes [ No
ElNA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
i
6. Are there structures on -site which are not properly addressed and/or managed
❑Yes No
El NA
El 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 ❑ 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 T No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ rota] Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Sail
❑ Outside of Acceptable Crop
� Window ❑ Evidence of Wind Drift ❑l Application Outside of Area
12. CroP h'Pe(s) 1 t leX� 1rCe�/ l fT�-t . �QSI- .� J . �M r u�1-
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
EjLNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Ir No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
1� No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
F�-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
1
El NA
El NE
Comments (refer to question #): Explain any YES answers and/or any recommendations o - any other comments !:1<�
,}
Use drawings of facility to better explain situations. (axe additional pages as necessary): �� �- � Al
p j
' � {,e�.•P S I�L,,I t`C,c�li.�4i / E��iO r
�
T
Reviewer/Inspector Name A 1011 Phone:
/ -3300
ReviewerlInspector Signature: Date:
#D
12128104 Continued

Facility, Number: Date of Inspection D
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes EyNo ❑ 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
2t. 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
No
❑ NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
'nNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
ElNE
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
i4No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[)�No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�No
❑ NA
❑ NE
Additional Comiiie L'andla'r Drawings F.
a
Page 3 of _3 J2128104

Type of Visit O Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 9 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 0 2 Arrival Time: 3% Departure Time:
Farm Name: m .2Q2 6 3 Own
An 0-
County: SR+"'PSOA) Region: •X0
er Email:
Owner Name: „ �!14r- LtAA) \ Phone:
Mailing Address:
Physical Address: Facility Contact: Greo� Title:
Onsite Representative:
-' t
I
Certified Operator: ^5
Phone No.
Integrator:
Operator Certification Number: 919
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = e = 6 = Longitude: = o = 1 0 «
Design Current Design Current
Swine Capacity Population Wet Poultry CapCitV Population
Design Current
Cattle Capacity Population
❑ an to Finish
❑ La er
❑ Dairy Cow
❑ an to Feeder
❑Non -La er
❑ Dairy Calf
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
%i
Dry Poultry
❑ Dairy Heifer
❑ Dry Cow
❑ Non
❑ La ers
-Dairy
❑ Farrow to Finish
❑ Beef Stocker
❑ Non -La ers
❑ Gilts
❑Beef Feeder
❑ Pullets
❑ Boars
❑ Beef Brood Co
Other
❑ Turkeys
❑ Turkey Pouets
❑ Other
Hummer of Structures:
, ED
❑ Other I
Discharges & Stream 1 invacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Wo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
ONA
❑ 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
1P NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
❑ Yes
Wo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
MNo
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: f
Date of Inspection
Waste Collection. & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Wo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No q#A ❑ NE
S"Twre 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes PNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes P 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
T Do any of the structures need maintenance or improvement? ❑ Yes Q4 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 6Io ❑ 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 (P No ❑ NA ❑ NE
maintenance or improvement?
Waste ADDlicatiOn
10, Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No [INA ❑ NE
maintenance/improvement?
11, Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes sa 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 ❑ Evid nce of W ind Drift ❑ Application Outside of Area
12. Crop tys) q,�¢��vt ow" pe
13. Soil type(s)Jlrip
14, Do the receiving crops differ frZFm 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
P No ❑ NA ❑ NE
[)No ❑ NA ❑ NE
P No ❑ NA ❑ NE
IPNo ❑NA El NE
No ❑ NA ❑ NE
Comments (refer.to question #) �,Egplain any. YESanswerantiLor any recommendations or anyiother comments.
Use drawings pf facility to better explain situateoos(use additia©al pages as necessa):
ReviewerllnspectorName Q . �, ';����� ;. Phone: la
Reviewer/Inspector Signature Date:
121.2.9104 Continued

r
Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [334o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWIVIP readily available? If yes, check ❑ Yes n No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes {%No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes .) No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
.EPNA
❑ 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
9No
❑ NA
❑ NE
26, Did the facility fail to have an actively certified operator in charge?
❑ Yes
(2 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 CA W W?
❑ Yes
P No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
NbNo
❑ 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
b 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
OhNo
❑ NA
❑ NE
General Permit? (ie( discharge, freeboard problems, over application)
32. Did Reviewer/Impector fail to discuss review/inspection with an on -site representative?
❑ Yes
P No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
fgNo
❑ NA
ElNE
I Z128✓04

At
Type of Visit 4P Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: I J1 17 (109 Arrival Time- Departure Time: County: Region:
Farm Name: Owner Email://f
Owner Name: I ' +ulrvi ✓� r�%D UC_ _ Phone:
Mailing Address:
Physical Address:
FacilityContact e Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
�� Phone No.: Q
Integrator: /�IA.Ii+�LL.r.� f uifiGt)�?y� L--C
Operator Certification Number: )4 s PL _
Back-up Certification Number:
Location of Farm: Latitude: = e 0 I = " Longitude: 0 ° 0 + = "
Design.
Current
DestgnCitrrent
I'llDesign Current
Swine Cap
Population
Wit Poulin'
C�pacryPopulation
C►attle Capacity Population
El
Wean to Finish
Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
El Farrow to Feeder
❑ Farrow to Finish
El Gilts
❑ Boars
Discharges &Stream Impacts
1.
Is any discharge observed from any part of the operation?
Discharges &Stream Impacts
1.
Is any discharge observed from any part of the operation?
[]Yes
ga No
❑ NA
❑ NE
Discharge originated at: ❑Structure El Application Field [I Other
a. Was the conveyance man-made?
❑Yes
❑ No
QFNA
tt5
[I NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑Yes
❑ Na
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
��--I
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑Yes
❑ No
�§NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑Yes
�No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
� No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128/04
Continued

FacilityNumber: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes P9 No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
O NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): k
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes X No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No
ElNA ElNE
through a waste management or closure plan?
IQ
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 WNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes �5No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes .&No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
1 U. 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 > I0% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/SIudge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s) �� s_ i
F ,(" (PaLA4rej4 , give,
13. Soil type(s) LonM11YA—Dr
f/ _j r
14. Do the receiving crops differ from those designs ed in the CA WMP?
❑ Yes
fia No
❑ NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
El 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 tolques6ronx#)Explsin.anyx4tES answers and/oryommendations or any other emments.
«� pE
Use drawings of factli�o bettetexplatn;-situations. (use additional pages4as n_ ecessary):
f
Reviewer/Inspector Name 1 Phone:
Reviewer/Inspector Signature: Date: [ f
r4gC L Gj .7 lL/La UV L.Ufj lre uef/

Facility Number: — Date of Inspection t
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ CheckIists ❑ Desig
n El Maps El Other
❑ Yes
,0 No
❑ NA
❑ NE
❑ Yes
IgNo
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ,8No ❑ NA ❑ N E
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
JDNo
❑ NA
❑ NE
❑ Yes
&No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
Ili No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
[RNo
❑ NA
❑ NE
[:]Yes
W No
❑ NA
❑ NE
Additional Comments aodloraDra�vrn
1
7
Page 3 of 3 12128104

i
0 Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 4D Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit a Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: `3 Arrival Time: lTrTQ Departure Time: County: Region: FA0
Farm Name: d�[Jo? _ ._._ Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: 2 L4w-r Title: Phone No:
j
Onsite Representative: U Integrator: IVWRA41 & v f.%
Certified Operator: :1z& Ili Operator Certification Number: a 6b
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = 1 0 « Longitude: = ° = 4 0 «
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 ei
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Cattle
Design.. CdrrenV
Capacity Population
i
❑ Dairy Cow
❑ Daia Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non-Dai
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures: 1
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 PNo ❑ NA ❑ NE
❑ Yes
❑ No
[9 NA
❑ NE
❑ Yes
❑ No
�9 NA
❑ NE
�9 NA
❑ NE
❑ Yes
❑ No
❑ Yes
[►No
❑ NA
❑ NE
❑ Yes
TB No
❑ NA
❑ NE
12128104 Continued

t
•
Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
$0 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
P NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): S
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
V 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
V 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 13 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Po No ❑ NA ❑ NE
(Not applicable to too fed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 'El No ❑ NA ❑ NE
maintenance ar improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes P No ❑ NA ❑ NE
mai ntenancc/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 50 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ 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) I Abp � , D
v
14. Do the receiving crops differ from those designate m the GAWMP? ❑Yes No ❑ NA [:1 NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
R] 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
to No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
A No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
T
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: V.1 P4 Date: 3 7
12128104 " Continued

Facility Number: TU — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 13 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 appropiiate box.
❑ WUP ❑Checklists ❑Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes f] No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ;W No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
USNo
❑ 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.
ja No
❑ NA
❑ NE
27_
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
51 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CA WMP?
❑ Yes
15 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
JM 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
09 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
W 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
19 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑Yes
�No
[I NA
❑ NE
Comments and/or Drawings:
12128104

Type of Visit V Compliance Inspection Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit • Routine O Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: �( s� Arrival Tune: : ot? Aty Departure Time: 00 County: c Region:
iiiiJill—
Farm Name: , � 2 b LCQ-0)Owner Email:
Owner Name: r'N Phone:
Mailing Address:
Physical Address:
Facility Contact: Title-,
if
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator:. Cll'l7J
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: ❑ o = I = 11
Longitude: 0 0 = I ❑ "
Design Current
Swine -
Poultry
Design Current
Design Current
Carile
Capacity Population
Wet
capacity Population
C*apacity Population
❑ Wean to Finish
❑ Layer
airy Cow
❑ Wean to Feeder
❑ Non -La er
airy Calf
Feeder to Finish
�� =
El Dairy Heifer
❑ Farrow to Wean
©rysPotiltry
�r
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑Lavers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pul leis
❑ Beef Brood Co
;, .:,;
ElTurkeys
_
Other F
❑ Turkey Poults
❑ Other
❑Other
Number of5tructures:
Discharges & Stream Impacts
. Is any discharge observed from any part of the operation?
❑ Yes
P No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
0 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
[n NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
'ONA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
Q9 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
�9 No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: Date of Inspection?
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
ER No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
' No ❑ NA ❑ NE
LP
(ie/ large trees, severe erosion, seepage, etc.)
6_ Are there structures on -site which are not properly addressed and/or managed
❑ Yes
P 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
Q5 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[� No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
(9 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[,�iNo ❑ 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)
13. Soil type(s) jV p
14. Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
;DNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement`?
❑ Yes
EJ 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
P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment'?
❑ Yes
9No
❑ NA
❑ NE
Comments (refer to question ff): 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): u_
Reviewer/Inspector Name Phone:33�
Reviewer/Inspector Signature: Date: per; -06
page 2 of 1 12128104 Continued

Facility Number: 92= Date of Inspection ro
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes W No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? Ifyes, check ❑ Yes [4 No ❑ NA ❑ NE
the appropriate box.
❑ WUP El 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
CH No
❑ NA
❑ NE
23,
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
WNo
❑ 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
0 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
0 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
X 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
W No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
JSNo
❑ NA
❑ NE
Page 3 of 3 12128104

Type of Visit ®-Compliance inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: 2Q Arrival Time- j Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: __ _ 44 LnCQ Phone:
Mailing Address:
Phvsical Address:
Facility Contact: [ Title:
Onsite Representative: �s
Certified Operator.
Back-up Operator:
Location of Farm:
Swine
I. -Other
Phone No:
Integrator: _ 1 i,
Operator CerttCcadon Number: �1 �
Back-up Certification Number:
Latitude: [= o = = Longitude: = ° =1 = "
DesignCurrent Design Current
Capacity Population Wet Poultry Capacity Population
Finish ❑ La er
Feeder f JEI Non -La ei
Fine e-? In%n t i -3- - -- - -- - -
Dry Poultry
❑ Layers
❑ Non -Layers j
❑ Pullets
❑ Turkeys
t
❑ Turkey Pouets !
❑ Other_
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Daia Heifei
❑ Da Cow
❑ Non -Dairy
❑ Beef Stocket
Cl Beef Feeder
❑ Beef Brood CovA
Number of Structures: FTI
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 �q No ❑ NA ❑ NE
❑ Yes
❑ No
P NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
1Z NA
❑ NE
❑ Yes
[--]No
❑ Yes
( No
❑ NA
❑ NE
❑ Yes
[ No
❑ NA
❑ NE
12128104
Continued

,racility Number:
Date of Inspection Lily 4'
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[--]Yes
$dNo
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
KNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: !(
Spillway?: to 0
Designed Freeboard (in): ^ 1
Observed Freeboard (in): _
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
WNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
Oat 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
V(No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
Z 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
rr"No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
)allo
❑ NA ❑ NE
maintenance/improvement?
1 I . Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
ELNo
❑ 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 0 Application Outside
of Area
12. Crop type(s) �' A+ ! - y r; s" -
13. Soil type(s) i 6LAAA
14. Do the receiving crops differ from those designated in the CAWMP? V
❑ Yes
P'No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Pq No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[:]
Yes
•KNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
J� No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
&No
❑ NA
❑ NE
Comments refer to yiieshon #} Eicpfam any 1GFS answer"strand/or an'lybr comment ons or arty otfter comments.
Use dra;'i�ngs ofAfacility'to4tietter e�plsrmxsitziahoas:_ (use ai3iltiional pagesasnecessry}:
Is
Reviewer/inspector Name ' ' Phone:
r- � �,�� _
Reviewer/inspector Signature: , Date: ,0
12128104 Continued

y'Eacility Number: �}� — r f�c1 Date of Inspection �-5F4
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes KNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ANo ❑ NA ❑ NE
the appropirate box.
❑ Wl3P El Checklists ❑Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ktNo ❑ 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
QNo
❑ NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
J 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
JK No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
KNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
Pj 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
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
{No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
ONo
El NA
El NE
Additional}CoutmenN and/6r Drawings:
12128104

0
Type of Visit a Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit ® Routine Q Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: GI'� d Tune: %.' /.S`
F_ Facility Number Sr o't � �
Q Not Operationall Q Below Threshold
EaTermitted Mertilited 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ..... _.
Farm Name: ..........._ ..... t2 .. ................ M. ..-_-
��S C .,,.� County:
Owner Name: ---------------- - - ----------- --- --- --- --- Phone No:
Mailing Address: _.__.,,...._..._ ............................
Facility Contact:
Title:
Phone No:
Onsite Representative:.. o .. Integrator:
Certified Operator:----.._.��f..................._.........�5.�...... ------------- Operator Certification Number:.
'd a89y�
Location of Farm:
Swine ❑ Poultry 0 Cattle 0 Horse Latitude 0 ` " Longitude • 4 44
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in galirnin? Alle
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 PO No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes )M'No
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [X No
Structure 1 Strucwre 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier= .......... r.................. ................. ........... ...
Freeboard (inches):
12112103 Continued
I

Facility Number: Y.2 -- �/(o� Date of Inspection
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes qNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes [ No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level [] Yes No
elevation markings?
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
N No
l 1.
Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
[)(No
[:)Excessive Ponddiing ❑ PAN ❑'
❑/ Frozen Ground ❑ Copper and/or Zinc
12.
�Overload
/Hydraulic
�f
Crop type GSGrI►�e1GL����Co r�C f Sis7_a�f cz i tJ
13_
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
j No
14.
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 9 No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes [4 No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes IV No
19. 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)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes No
Air Quality representative immediately.

Fac fiV Number: $ — Y69 Date of Inspection / a
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?
Oe/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31 _ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes O No
❑ Yes 0 No
❑ Yes ft No
❑ Yes 09 No
❑ Yes [I No
❑ Yes ID No
❑ Yes W.No
❑ Yes M No
❑ Yes 5n No
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
12112103

Site Requires Immediate Attention:
Facility No. r
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 7 , 1995
Time: C)a
Farm Name/Owner:
Mailing Address:, P15, -5-4, 4,1�--
County: campmn
Integrator: Carroll Foods Phone:
On Site Representative: Don LaCoe Phone:
Physical Address/Location: ?
Type of Operation: Swine Poultry Cattle
Design Capacity: Number of Animals on Site: 1
DEM Certification Number: ACE DEM Certification N mu ber: ACNEW
Latitude: 0Longitude: or
Circle Yes or No
Does the Animal Waste Lagoon hFaggoon(s)?
sufficie
(approximately 1 Foot + 7 inches)or No
Was any seepage observed from the
Is adequate land available for spray? ue_ � or No
Crop(s) being utilized:
nt freeboard of 1 Foot + 5 year 24 hour storm event
Actual Freeboard: Ft. Inches
Yes orgTo Was any erosion o�b cved? Yes oa�
Is the-gover crop adequate? CY-i�s or No
(-6 -50-1 14C-'eii cC P+-
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? ) ge or No
100 Feet from Wells? �3eor
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or96
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or(* If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Des or No
Additional Comments:
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

e
JUL 14 195 11 : 46A~I
a
{
NORTE CARMMgA DEPAR== OF WnMOPi?=, HEALTH b NXTQRAL RPSOORCKS
DIVISION OF ENVMONME+ M KANAGEKENT
Fayetteville Regional Office
Animal operation Compliance Inspection Form
CAEe0LLS 4aoD? Sic.
-r
,shsE'�?S]h7�Tl+iG'�RDDRB'aS�.•,IL�z -�•:•.
=��'.'=•�`�gACIL=gPL�HCENS�ai[i?SH
624
All. questions answered negatively will be discussed in sufficient detail in
the Comments Section to enable the deemed Permittee to perform the appropriate
corrections:
SECTION I
Animal D eration T '
Horses, cattle, suia poult_-y, or Sheep
5rCrION II
1. Does the number and type of animal meet or exceed
the (.0217) criteria? (Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
poultry (30,000 birds with liquid waste
system)] •
2. Does this facility meet criteria for
Animal Operation REGISTRATIW.
3. Are animals confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a � r►N2ML
WMM NAMGMCMT PI.Mr.
5. Does this facility maintain waste management
records (Volumes of manure, land applied,
spray irrigated on specific acreage With
specific cover crop)?
S. Does this facility meet the 5CS minimum
setback criteria for neighboring houses,
Wells, etc?
M

lu- cu cJu uca•u jUL 14 'S 1i:4G�l
�rcrzo:� zrz
i .
Y N MK---Eh.,S
: Field Site Manaaem znt
4. Is animal waste stockpiled or lagoon
construction within 100 ft. of a USGS
Map Blue Line Stream?
2. is animal waste land applied or spray
irrigated within 25.ft. of a USGS Map
Blue Line Stream?
3. Does this facility have adequate acreage
on which to apply the waste?
4. Does the land application'site have a
cover crop in accordance with the
C$3TIFTCATIDH FIAN?
S. Is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar mar, -made devices?
5. Does tie animal waste management at this
farm adhere to Best Management Practices
(B;ml of the approved I
7. Does animal Waste lagoon have sufficient
freeboard? How much? (Approximately l
8- Is the general condition of this CAF'O facility,
including management and operation,
satisfactory?
SECTION IV
Commen-ts