820465_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 820465 Facility Status: Active Permit: AWS820465 Denied Access
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Sampson
Date of Visit: 09/22/2016 Entry Time: 02:00 pm Exit Time: 3:00 pm
Farm Name: Farm 2D39
Owner: Murphy -Brown LLC
Fayetteville
910-296-1800
(Nailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 478 Junious Lucas Rd Faison NC 28341
Facility Status: Compliant Not Compliant Integrator: Murphy -Brawn LLC
Location of Farm: Latitude: 35' 04' Longitude: 78' 12' 55"
SR 1901 112 mile from intersection with SR 1740. 1 112 mites from Hatcher on SR 1901 _MS # 2039.
Question Areas:
Dischrge 8 Stream Impacts
Records and Documents
Region:
Incident #
Owner Email:
Phone:
Waste Col. Stor, & Treat Waste Application
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($):
Inspection Summary:
page: 1

Permit: AWS82D465 Dwner- Facility : Murphy -Brown LLC Facility Number: 820465
inspection Date: 09122/16 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish 10.496
Total Design Capacity: 10.496
Total SSLW: 1,416,960
Waste Strugturys
Observed
Disignated
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
2039
19.81
90.00
Lagoon
A
05/11/07
19.00
Lagoon
6
05111107
page: 2

Permit: AWS820465 Owner - Facility : Murphy -Brown LLC Facility Number: 820465
Inspection Date: 09/22/16 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No o Nam
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)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWO)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na Ne2
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Led large
❑
0 ❑
❑
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?
❑
■ a
a
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
❑
X ❑
❑
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?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%l10 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: AWS820465 Owner - Facifity Murphy -Brown LLC Facility Number:
820465
Inspection Date: 09/22/16 Inpsection Type: Compliance Inspection Reason for Visit,
Routine
Waste Application
rah No Na No
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
Goldsboro loamy sand. 0 to
2% slopes
Soil Type 2
Norfolk loamy sand,
0 to 2%
Slopes
Soil Type 3
Wadesborc
Soil Type 4
ordla
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ E ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or (arid application site need improvement?
❑ E ❑
❑
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?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑
❑
Records and Documents
Yes No Na Nr<
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑
❑
20. noes the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑
❑
If yes, check the appropriate box below.
VVU P?
❑
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 Analysts?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS820465 Owner- Facility : Murphy -Brown LLC Facility Number: 820465
Inspection Date: 09/22/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No NA Ne
Rainfall?
[]
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?
❑
E ❑
❑
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?
❑
E ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
00
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27, Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
M ❑
❑
Other Issues
Yes
No No Me
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
E ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
N ❑
❑
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
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer!lnspector fail to discuss review/inspection with on -site representative?
❑
0 Cl
❑
34. Does the facility require a follow-up visit by same agency?
❑
E []
❑
page: 5

E
1
■ Division of Water Resources
❑
Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
820465 Facility Status:
Active Permit: AWS820465
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County: Sampson Region:
Fayetteville
Date of Visit:
11/05/2015 Entry Time: 10:00 am
Exit Time: 11:00 am Incident #
Farm Name:
Farm 2039
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 26398
Physical Address:
478 Junious Lucas Rd
Faison NC 28341
Facility Status:
0Compliant ❑ Not Compliant
Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 35' 04'
SR 1901 112 mile from intersection with SR 1740- 1 112 miles from Hatcher on SR 1901-MB # 2039.
Question Areas:
Dischrge & Stream impacts
■ Records and Documents
Longitude: 78' 12' 55"
Waste Col, Stor, & Treat Waste Application
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:
Inspector Signature:
Secondary Inspector(%):
Inspection Summary:
Robert Marble
Phone:
Date_
page: 1
1

Permit: AWS820465 Owner - Facility : Murphy -Brown LLC Facility Number: 820465
Inspection Date: 11105115 Inssection Type: Compliance Inspection Reason for VisW Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish 10.496
Total Design Capacity: 10,496
Total SSLW: 1.415,960
Waste stmctures Observed
Disignated
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
2039
19.81
74,00
Lagoon
A
051i 1107
19.00
Lagoon
B
05/11107
page: 2

Permit. AWS820465 Owner - Facility : Murphy -Brown LLC Facility Number: 820465
Inspection Date: 11/05/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No No We
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
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)
❑
0 ❑
❑
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?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yas No No Me
4_ Is storage capacity less than adequate?
❑
0011
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le.l 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?
❑
M 0
[]
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No No No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ []
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 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: AWS820465 Owner - Facility : Murphy -Brown LLC Facility Number: 820465
Inspection Date: 11/05/15 1npsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No No
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
Goldsboro loamy sand, o to
2% slopes
Soil Type 2
Norfolk loamy Sand, 0 W 2%
slopes
Soil Type 3
wadesboro
Soil Type 4
Ocilla
Soil Type 5
Soil Type 5
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
E ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
E ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
00
❑
18. Is there a lack of properly operafing waste application equipment?
❑
0 0
❑
Records and Documents
Yes No No 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?
❑
00
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS820465 Owner - Facility : Murphy -Brown LLC Facility Number: 820465
Inspection Date: 11/05115 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yvs
No Na Dle
Rainfall?
❑
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?
❑
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?
❑
NoD
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
s ❑
❑
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
Yes
No Na
28. 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,
❑
0 ❑
❑
contact a regional Air Quality representative immediately,
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(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 ❑ ■ ❑ ❑
CAWMP7
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with on -site representative? ❑ E ❑ ❑
34. Does the facility require a follow-up visit by same agency? [] 0 ❑ ❑
page: 5

f
Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
820465 Facility Status:
Active Pennit: AWS820465
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County: Sampson Region:
Fayetteville
Date of Visit:
12/16/2014 Entry Time: 11:30 am
Exit Time: 12:15 pm Incident #
Farm Name:
Farm 2039
Owner Email:
Owner.
Murphy -Brown LLC
Phone:
910-2W11800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 478 Junious Lucas Rd Faison NC 28341
Facility Status: NCompliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 35' 04'
SR 1901 112 mile from interseclion with SR 1740. 1 112 mites from Hatcher on SR 1901 _MB * 2039.
Longitude: 78' 12' 55"
Question Areas:
Dischrge & Stream Impacts Waste Col, Star, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Ronald James Taylor Operator Certification Number: 27466
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: AWS820465 Owner - Facility : Murphy -Brown LLG Facility Number: 820465
inspection Date: 12/16114 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regutated Operations Design Capacity Current promotions
Swine
[� Swine - Feeder to Finish 10,496
Total Design Capacity: 10,496
Total SSLW: 1,416,960
Waste §Iructures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
2039
19.81
78.00
Lagoon
A
05111107
19.00
Lagoon
B
05111f07
page: 2

Permit: AWS820465 Owner - Facility : Murphy -Brown LLC Facility Number: 820465
Inspection Date: 12/16/14 1npsection 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?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the Stale (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?
❑
■ ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No No No
4. Is storage capacity less than adequate?
❑
m ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (i.e./ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Blot applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
[] ❑ ❑
If yes, check the appropriate box below_
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS82M5 Owner - Facility : Murphy -Brown LLC Facility Number: 820465
Inspection Date: 12/16/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na 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
Goldsboro loamy sand, o to
2% slopes
Soil Type 2
Norfolk loamy sand, 0 to 2%
slopes
Soil Type 3
Ocilla
Soil Type 4
Wagram loamy sand, o to
6°% slopes
Soil Type 5
Soil Type 6
14 Do the receiving crops differ from those designated in the Certified Animal Waste
❑
❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 D
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑0
0
❑
18, Is there a lack of properly operating waste application equipment?
❑
, ❑
❑
Records and Documents
Yes No Na No
19, Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
[]
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
M ❑
❑
If yes, check the appropriate box below
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21, Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
[]
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS820465 Owner - Facility : Murphy -Brown LLC Facility Number: 820465
Inspection Date: 12/16/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Rec rd5 and Documents
Yes
No Na No
Rainfall?
❑
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
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■ ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
M ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
1101111
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Qth�r lgjues
Yes No Na No
28. Did the facility fail to property 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,
❑
0 ❑
❑
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?
❑
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
❑
0 ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

■ Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
820465 Facility Status:
Active Permit: AWS820465
[ Denied Access
Inppection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Sampson Region:
Fayetteville
Date of Visit:
1211112013 Entry Time: 11:30 am
Exit Time: 12:30 pm Incident #
Farm Name:
Farm 2039
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
478 Junious Lucas Rd
Faison NC 28341
Facility Status:
Compliant ❑ Not Compliant
Integrator: Murphy -Brown LLC
Location of Farm:
Latitude: 35° 04' Longitude:
78' 12' 55
SR 1901 112 mile from intersection with SR 1740,11 112 miles from Hatcher on SR 1901.MB # 2039
Question Areas:
Dischrge & Stream impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Bradley €Jevone Hering 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 Inspectar(s)
Inspection Summary:
page: 1

Permit: AWS820465 Owner - Facility : Murphy -Brown LLC Facility Number: 820465
Inspection Date: 12/11/13 inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
=-uweeder to Finish
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
2039
19.81
Lagoon
A
05/11/07
19.00
Lagoon
B
05/11/07
page: 2

Permit: AWS820465 Owner - Facility : Murphy -Brown LLC Facility Number: 820465
Inspection Date: 12/11/13 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?
❑
■ ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
DO
❑
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?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
E ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na No
4. is storage capacity less than adequate?
❑
E ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (t.e.l large
❑
E ❑
❑
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? (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 Na 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 > 10%110 tbs.?
❑
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 AWS820465
Owner - Facility Murphy -Brown LLC Facility Number 820465
Inspection Date: 12/11/13
Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
(flay, Pasture)
Crop Type 2
Small Gram Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro loamy sand. 0 to
2% slopes
SOIL Type 2
Norfolk loamy sand, 0 to 2%
slopes
Soil Type 3
CrMa
Soil Type 4
wagram loamy sand, 0 to
6% slopes
Soil Type 5
Soil Type 6
14, Do the receiving crops differ from those designated in the Certified Animal Waste
❑
M ❑
❑
Management Plan(CAWMP)?
15 Does the receiving crop and/or land application site need improvement?
❑
M ❑
❑
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?
❑
a0
❑
18, Is there a lack of properly operating waste application equipment?
U
❑
❑
Records and Documents
Yes
No No No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
M ❑
❑
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?
❑
❑
❑
It yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS820465 Owner - Facility : Murphy -Brown LLC Facility Number: 82D465
Inspection Date: 12111/13 inpsection Type. Compliance Inspection Reason for Visit: Routine
Records and Documents
yes No Na Na
Rainfall?
❑
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?
❑
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?
❑
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:
25. Did the facility fail to provide documentation of an actively certified operator in charge?
0
0 ❑
❑
27, Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑
■ ❑
❑
and report mortality rates that exceed normal rates?
29, At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
N ❑
❑
contact a regional Air Quality representative immediately,
30. Did the fadlily fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility?
❑
0 ❑
❑
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 reviewlinspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

l ype of visit: W Uompliance inspection V Operation Review U Structure Evaluation c j Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: y`? t'y Arrival Time: Departure Time: County: _�/- Region:
Farm Name: 3 3 Owner Email:
Owner Name: 'iron Phone:
Mailing Address:
Physical Address:
Facility Contact: A)�- /Vdon-� Title: Phone:
Onsite Representative: q Integrator: Ar rl�
Certified Operator: � k(& % g,,e Certification Number:
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: Longitude:
jig
Design Eurrent
Design
Current
Design Current
Swine
Capacity
I Capacity Pap -
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
-
Da' Calf
Da' Heifer
Feeder to Finish
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
D . P,oult .
Ca aci
P.o
Non -Da'
Farrow to Finish
La ers
Non -La ers
Pullets
Turke s
Beef Stocker
Beef Feeder
Beef Brood Cow
Gilts
Boars
Other
I ITurkeyPoults
Other
Other
Discharges and Stream Impacts
1. 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 NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes []No NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes [—]No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Number: Date of Inspection: 7Z7 1'2�_
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes g No ❑ NA [:3NE
a. if yes, is waste level into the structural freeboard? ❑ YesNo F 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 IV
No [DNA ❑ NE
S. 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 MNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, - , et .)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window❑ Eviide ce of Wind Dr i ❑Application Outside of Approved Area
Car;12_ Crop Type(s):"4 r1.�j]�t� i
13_ Soil TYPe(s): t�„a�A
Ale A r L, W4 `.
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crap 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 L� No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
4] No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[j No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
ONE
the appropriate box_
❑ WUP El Checklists []Design ❑ Maps ❑ Lease A&neements ❑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 Tra sfers
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes M No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Q9 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili q Number: Date of Ins Inspection: Z 27 lL
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 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. ©o subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes No
❑ Yes [ No
❑ Yes P No
❑ Yes "o
❑ NA ❑ NE
❑NA ❑NE
❑NA F]NE
❑ NA ❑ NE
❑ Yes
rV13No
` TT
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
&No
❑ NA
❑ NE
refer to question #) Explain any YES answers and/or any addrtional�reco mendations or and other comirients.
Use drawin {: * .; ..
Comments
t;s of facility to better egplam s�tuattons•.(use.addthonal`aQes as necessary,} f.-
c,4 r4e,
�' ��L�IrZ
ReviewerlInspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

Type of Visit: 0 Compliance Inspection 0 Operation Review p Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine Q Complaint O Follow-up O Referral O Emergency Q Other Q Denied Access
Date of Visit; Arrival Time: Departure Time: County: �AAI Region:
Farm Name: /i j' % Owner Email:
Owner Name: r lQrrtrt u'C Phone:
Mailing Address:
Physical Address:
Facility Contact: +t %��I� s Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone:
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current Design Currentiiiii
Design Current
Swine Capacity Pop. Wet PoultryWz'$p city Pop.
Cattle Capacity Pop.
Wean to Finish I 11-ayer I
Cow
Wean to Feeder
I
INon-Layer
I
Calf
Feeder to Finish
ry Heifer
Farrow to Wean
De'sign Current
Dry Cow
Farrow to Feeder
D . Point . _ .: Ca aci P,o
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Pullets
Beef Feeder
Beef Brood Cow
Boars
Turkeys
Turkey Poults
,2_t-h—cFH
01 Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Nuigber: L Date of Inspection: jA
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes RI No ❑ NA
a. If yes, is waste level into the structural freeboard?
Structure l Structure 2 Structure 3 Structure 4
identifier: r
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes ❑ No )F NA
Structure 5 Structure 6
❑ NE
❑ NE
❑ Yes
F� No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [] Yes No ❑ NA ❑ NE
maintenance or improvement? T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes MNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [1Vo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window-/ /�❑ Evidence of Wind Drift
❑ Application Outside of Approv Area
12. Crop Type(s): Cpq�( &-CIC( �f +� J i-
13. Soil Type(s): W0040GV4,4)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes W] No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes W No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes T No ❑ NA ❑ NE
acres determination? T
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
fip 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 1� No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield Ell 20 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes FpNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Nu ber: Date of inspection: I
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 [DNA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
�] No
❑ NA
❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes `r No ❑ NA ❑ NE
❑ Yes T No ❑ NA ❑ NE
❑ Yes 49 No
❑ Yes P No
❑ Yes &5 No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments..(refer to question ft Explain any.YES.answers and/or any additional recommendations or any-tother=comments.'
Use drawings of facility to better eimlain situatiions (use additional panes as necessary).
e ce�rd5 1`pvk h, /1
1 y/i5(1 on 10104 .
Reviewer/Inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone: /D 433"33wtp
Date: ) d Zl 1
214,12011

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ,® Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date or Visit: It/T17V I Arrival Time: I'-f .7t/!�i-t� Departure Time: I [.--vim �1 County:.�%P� . Region: �_
Farm Name: 3 i 3 —��-" `�Ownner Email:
Owner Name:. Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
integrator. — W .U'C_
Operator Certification Number:
Back-up Certification Number:
Latitude: =o ❑0" Longitude: =° =.
Design Current Design Current Design
Swine Capacity iPupulateon Wet Poultry Capacity Population Cattle waiapaciryA
Current
ropulation
❑ Wean to Finish
❑ Layer
iry Cow
❑ Wean to Feeder
❑ Non -Laver
iry Calf
Feederto Finish
/
o Sp
Dry Poultry
airy Heifer
❑ Dry Cow
ElNon-Dairy
Farrow to Wean
❑ Farrow to Feeder
El Farrow to Finish
❑Gilts
❑ La ers
❑Non -La ers
❑ Beef Stocker
❑ Beef Feeder
❑ Pullets
❑ Boars ❑
Turke s
( __ ❑ EZyloultsl
❑ Other ❑ Other
❑ Beef Brood Cowl I
Number of Structures:
Diseharp_es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 11 No ❑ NA ❑ NE
❑ Yes
❑ No
CPNA
❑ NE
❑ Yes
❑ No
TNA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
No
ElNA
ElNE
ElYes
ZNo
❑ NA
❑ NE
page 1 of 3
12128104 Continued

i
Facility Number: $3
Date of Inspection L /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes PNo
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
rNA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): d k
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes] No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ` No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9_ Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers. setbacks, or compliance alternatives that need El Yes No El NA El NE
maintenance/improvement?
] 1. 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 Crap Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
G.Orwaai t, (..�(,
-
13. Soil type(s) p (;�A.
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1PNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
[INA
ElNE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ YeslNo
No
El NA
El NE
17_ Does the facility lack adequate acreage for land application?
❑ YesNo
El
El NE
18. Is there a lack of properly operating waste application equipment?
El Yes
❑ NA
❑ NE
Comments' (refer to question' #) Explain; any YES answers and/or an} recommentlatro or, a y�otheteomments. J
Use drawings of facility to better. explain situations. (use additional pages as necessary),IMO
Reviewer/inspector Name r*,'` Phone: t'f?
Reviewer/Inspector Signature: _ Date: l
12128104 Continued

• Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes � No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
ElWaste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transferst 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
T No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
® NA
!!❑
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
EPNo
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
UR No
ElNA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�] No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
IRNo
❑ 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 concem?
[3 Yes
V No
El NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
tNo
❑ NA
❑ NE
General Permit? 6e/ discharge, freeboard problems, over application)
Page 3 of 3 12128104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: I —Ka Region: 0
Farm Name: jj 0313 Owner Email:
Owner Name: &Vw h C _ Phone:
Mailing Address:
Physical Address:
Facility Contact: _ G"A Care— _ Title:
p
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
-�j
ri✓ �ic1i1�
Integrator:
Operator Certification Number: /8356
Back-up Certification Number:
Latitude: = o =' = Longitude: = ° =' =
Design Current
Swine Capacity opulation
Design Current Design Current
�'¢[ Poultry Capacity Population Cattle CapaciOWN"ty Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
❑ Wean to Feeder
❑ Non -Layer
❑ DairyCalf
eider to Finish Q
Farrow to Wean Dry Poultry
❑ Farrow to Feeder
❑ Farrow to Finish ❑ Layers
❑ Gilts ❑Non-[ a ers
❑ Boars ❑ Pullets
❑ Turkeys
Other ❑ Turkey Poults
❑ Other ❑ Other
❑Dai Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Co
.Brood
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �] No El NA El NE
❑ Yes
❑ No
NA
l�
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
[PNo
❑ NA
❑ NE
❑ Yes
PNo
❑ NA
❑ NE
12128,104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
t�PNo
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No
(�NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
_—
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
I 1No
❑ NA
[I NE
(ic/ large trees, severe erosion, seepage, etc.)
r
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 posts an immediate public health or
environmental threat,
notify
DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[ENo
❑ NA
❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ yes N No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes allo ❑ 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 4 No
❑ 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 Soi
❑ C
12. Crop
13. Soil t,
14. Do th
15. Does the receiving crop and/or land application site need improvement?
❑ NA ❑ NE
❑ Yes
[�?No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ yes 1�3 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes 0 No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes RNo ❑ NA ❑ NE
Comments (refer to question #): Explain any-YES'aniWers and/or any recommendations,or•aay other commeats.
Use drawings of facility to better explain situations. (use -additional pages as.aecessar)
Reviewer/inspector Name Phone: /O3'3D
Reviewer/Inspector Signature: Date; o OS
12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes M No ❑ NA ❑ NE
ElElElthe appropriate box. WUP Checklists Designs ❑ Maps ElOther Fj
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �3 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocicing ❑ 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
O No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
ONA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26_
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
SONA
El 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
O No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
h� No
❑ NA
❑ NE
12128104

Type of Visit 0 Compliance Inspection Q Operation Review a Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine O Complaint O Fallow up Q Referral 0 Emergency O Other ❑ Denied Access
Date of Visit: 124 Arrival Time: Departure Time: i RQj,,, County: -�7�1 � Region:
Farm Name: Parry,.2 J9 , 1 � Owner Email:
Owner Name: I I — �WY1 o LL- -- Phone:
Mailing Address:
Physical Address:
Facility Contact:Co-rr _ Title: Phone No:
Onsite Representative: !t Integrator.lDh.•���ll2cJ�'I.
Certified Operator: rn 72, Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: ED o = I a u Longitude: = ° = 1 = u
Design Current
!'*VeIVoultry
Design Current Design Current
Swine
Capty Population
Capa ccity Population C*attle Capacity Population
❑ Wean to Finish
10 Laver
❑ Dairy Cow
❑ Wean to Feeder
110 Non -Layer
I
Dairy Calf
19 Feeder to Finish
IDLM2
❑ Dairy Heifer
❑ Farrow to Wean
Dry I'ottltry
❑ Dry Cow
❑ Farrow to Feeder
- ❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
�: El Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars ❑ Pullets
El Turkeys
❑Beef Brood Co
Other
❑ Turkey Poults
❑ Other
: ❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
%No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
®NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
® NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
❑ No
]
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
4NO
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
LprNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12129104
Continued

• Facility Number: 0,'Z- Date of InspectionI
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
rNo
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[--]No
)9 NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
I
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 66
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
f No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
N No
❑ NA ❑ NE
maintenance or improvement?
Waste Applicadon
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
q No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN ? 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
ElYes
T No
ElNA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
&No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
9 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
(R,No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
MNo
❑ NA
❑ NE
ercommennwfefef-W qugtioo'EIo tp
10,210M
lnYEanssaXa%me�},
Udwingsoffacilobptis{useaddi onal�pages as necessaryet4an
Reviewer/Inspector Name Phone 3�
Reviewer/Inspector Signature: Date:
Page 2 of 3 IZ/Z&V4 Continued

Facility Number: ate— 4AS1 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes IT No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes { No ElNA ❑ NE
ElElEln
the appropirate box. WUP Checklists Desig
n El 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
P No
❑ NA
❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
i No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
[]Yes
§DNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ONo
❑ 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
R No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
MNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
0 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
1p 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
EANo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss reviewAnspection with an on -site representative?
❑ Yes
& No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
&No
❑ NA
❑ NE
Ad.ditioaal,Connnnents aaidLor
Page 3 of 3 12128104
Page 3 of 3 12128104

Division of Water Quality
Facility Number ��— 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit ! Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 4 Routine Q Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: t[ 3 d1 Arrival Time:'ti' departure Time: Countv: Region: PAID
Farm Name: c7 f 3 Q� Owner Email:
Owner Name: Mw✓i�-„ u'h Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: ll
Certified Operator: y IQ-,e-
21
Back-up Operator:
Phone No:
Integrator: � _ .�2e uy`
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: E=1 0 0 ' Q Longitude: E__1 ° =] i
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
} ❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
'_Design Curre
Cattle Capacity 'Topalat
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Da Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:Ell
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
e. 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 '"No El NA El NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
® NA
❑ NE
;j?NA
❑ NE
❑ Yes
❑ No
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
1P No
❑ NA
❑ NE
12128104 Continued

Facillty Number: On -
Date of Inspection �JJ
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a_ If yes, is waste level into the structural freeboard?
�tructure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): U
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes r No ❑ NA ❑ NE
❑ Yes ❑ N0/49 NA ❑ NE
Structure 5 Structure 6
❑ Yes 'Sp No
❑ Yes in No
❑ NA ❑ NE
❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes t No ❑ NA ❑ NE
8. Do any of the sluctures 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 A91 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [] yes )D No ❑ NA ❑ NE
maintenance/improvement'?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 01 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 tvpe(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
M No
[I NA
❑ 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
E0 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
n No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary)-
Reviewer/inspector Name Phone: 9./0
Reviewer/lnspector Signature: Date: / 6
12128104 Continued

Facility Number: -- b, Date of Inspection
Required Records & Documents
19, Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes `P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily availablc? If yes, check ❑ Yes N No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below_ ❑ Yes El 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
ff) No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
® No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
(ig No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[19 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EP 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
29 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
BNo
❑ NA
❑ NF
Comments and/or Drawings:
12128104

Type of Visit d Compliance Inspection C7 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: -fTo Arrival Time: c ` Departure Time: 3-*� County: Sam Region.
Farm Name: 0 a03 JW Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
6±ea rr Title:
C�
Onsite Representative:
Certified Operator:
Bark -up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: av ❑1 =" Longitude: ❑o a
Design Current Design Currenf Design CarreIIt
Swine Capacity Population Wet I',oultry� (:apac9ty Popnl_ a�t�on Cstiie Capacity Population
❑ Wean to Finish ❑ La er El Dairy Caw
❑ Wean to Feeder ❑ Nan -La er ❑ DairyCalf
Feeder to Finish O w ` , ❑ Dai Heifer
Farrow to WeanUlt., _ ❑ D Cow
❑ Farrow to Feeder �' "` "" �"^ °{
❑ Non -Dairy
❑ La ers
❑ Farrow to Finish ❑Beef Stocker
❑ Giits ❑Non -La ers
❑ Pullets ❑ Beef Feeder
Q Boars ❑ Beef Brood Co
❑ Turkeys - - —
Other ❑ Turkey Poults
❑ Other 10 Other N;a
Number of Structures:
Discharges & Stream Impacts
I . Is any discharge observed from any pan of the operation?
❑ Yes
®No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
FXJ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[] No
W 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
[ INA
❑ 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 I of 3
12128104
Continued

Facility Number: — Date of Inspection 7�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
StrnreI Structure 2 Structure 3 Structure 4
Identifier: Am))
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 11 u
❑ Yes "" No ElNA ElNE
❑ Yes []No �DNA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
( No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement'? ❑ Yes
No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? [:]Yes
t
[PNo ❑ 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 0 Yes
[PNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
® No El NA ❑ NE
maintenance/improvement?
`_
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
[allo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 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 types) AF 40,61
,n�t"6 /&U'7to i
('� i 5� t�� 1"Ar %6`14+-5ftell
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
J� No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[�] No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
[� No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other eomments.
Use drawing- of facility to better explain situations. (use additional pages a- necessary):
Reviewer/Inspector Name � p� �b��� Phone-rq (o) 43 3 -33po
Reviewer/Inspector Signature: Date:�"U�o
Page 2 of 3 12128104 Continued

Facility Number. — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes QNo ❑ NA ❑ NE
20_ Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes IN No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
&] No
❑ NA
❑ NE
23.
If selected.. did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
V9 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
W No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
V3 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
E�LNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
N NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�jNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
D Yes
�ANo
❑ 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
[I 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
0 No
❑ NA
❑ NE
General Permit'? (iel discharge, freeboard problems, over application)
32.
Did ReviewerAnspector 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
fid No
❑ NA
❑ NE
Additional Comments and/or Di avQutgs:
a
Page 3 of 3 12128104

;x a 41 ("
Type of Visit .[D Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit P Routine Q Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: S t{ 0 Arrival Time: - Departure Time: County: ►A Region..
Farm Name: _ ra- "� H ;2L 53 Owner Email:
Owner Name: - a-",--M L-t 5' Phone:
Mailing Address:
Physical Address:
Fi`0
Facility Contact: Title: Phone No:
Onsite Representative: _ _-+r G�=-v` integrator: _ (t ti
Certified Operator: -<< _ 1 � _ Operator Certification Nurnber: _ _2 s 9 `re _
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: = o = I ❑ Longitude: = ° = = u
Design ' Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer I I
❑ Non-Layet I P
❑ Wean to Finish
❑ Wean to Feeder
® Feeder to Finish
I 10 q 7 (a
❑ Farrow to Wean
I!
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boar5
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turke Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
+
❑ Dry Cow
❑ Non-Dai
❑ Beef Stockez
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: ED
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 ffNo ❑ NA ❑ NE
❑ Yes
❑ No
VNA
❑ NE
❑ Yes
❑ No
EX -NA
❑ NE
qNA
❑ NE
❑ Yes
❑ No
❑ Yes
W No
❑ NA
❑ NE
❑ Yes
JgNo
❑ NA
. ❑ NE
12129104 Continued

J
Facility Number: 8,2- — t(
Date of Inspection Q
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structu e 1
Identifier: rA
Structure 2
r D
Spillway?:'
Vt 0
Designed Freeboard (in): !(�
z
_
Observed Freeboard (in): _
7
Structure 3 Structure 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes ONo ❑ NA ❑ NE
❑ Yes ❑ No t9NA ❑ NE
Structure 5 Structure 6
❑ Yes 59No []NA ❑ NE
[]Yes W No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �9 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 KNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �INo ❑ 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 Drifl ❑ Application Outside of Area
01
12. Croptype(s) -feu% �'r�C_X e— 5:+� �_� - �i�rt,{c� Etf� � T A-C- A cYrrsi�S
13. Soiltype(s)--
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes R No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes LEI No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination` ❑ Yes 9[No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes 5ZNo
❑ Yes Cg.No
El NA ❑NE
❑ NA ❑ NE
Reviewer/Inspector Name "'�� Phone: '�
Reviewer/Inspector Signature: Date:
/ I2128104 Continued

fFacility Number:K— 4( Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E,No ❑ NA ❑ NE
20- Does the facility fail to have ail components of the CAWMP readily available? If yes, check ❑ Yes ONo ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑ Checklists El Design El 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 l" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ,9jNo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ONo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
Cl Yes
� No
El NA
El 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
RNo
❑ 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
P No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
19 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
RNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
Vj No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
25-No
❑ NA
❑ NE
Addtttonal�Cominents�and/oF�Drawtngs. ,y"�, � ,�"�� _ Y '�;'�� -+ -z
12128104

Type of Visit i Compliance Inspecton O Operation Review O Lagoon Evaluation
for Visit * Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: ®Tune: e?: O
Q Not Operational Q Below Threshold
12 Permitted [YCertified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .._ .. ......
Farm Name: ....... . ra------ County:
Owner Name: . _ _ ... _.... _ _ ....____.........._w_._._._._.. Phone No:..._......... .».._... ...._ -- - WW._ .... .
MailingAddress:..__... ..._ ........._ - - ,_.,� ....., _............ - ---�........_�......._ _.._ ......» . __................
Facility Contact: Title: ... ....... Phone No:
Onsite Representative: v - ----- .» _ _ w ... Lrtegrator-
Certified Operator: _ ,qt,�_� _ Operator Certification Number: _ ^.
Location of Farm:
[:]Swine ❑ Poultry []Cattle ❑ Horse Latitude • 4 « Longitude • C 96
t Design �CurrentF=-DesrgnCurretQt
Swine „ .Caivacsty:..Potiniation__. "3'r _ zCanaaity `_PoDalatioa
Wean to Feeder
Layer1
1
Feeder to Finish
FENon-Layer
---]
Farrow to Wean
Farrow to Feeder
Farrow to Finish
p 00
Total
R 7
Gilts
Boars
Number of Iagooas � �.
Discharges & 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 Statc? (If yes, notify DWQ) [] Yes ❑ No
c. If discharge is observed, what is the estimated flow in galJmin? Al CQ
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 jfNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [�$ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..._._—._� ........... _W.. �_ .�_.»..... _.. w--. __W ...... ._ .--�...._. »...... ......_.......... ...
Freeboard (inches): 3W/
12112103 Continued

Facility Number: V z — 4rC Date of Inspection / O
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
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? I'Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancerimprovement? ❑ 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 maintenancerimprovement? ❑ Yes ❑ No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Ga.3 /Kim g�/CLU.' S sIg cdMs, 1f'lifit'1-_
.T
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ 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.
Feld Copy ❑ Final Notes
-_UT
J7 " I&P4 $�Op4�1 ou %t1oaU �Q,Jk rletoL jom c. u�'�-t.. �eN �o Prcv ,
e~aLioo.
WR4�`j SG�`i�y�5 6►�
+O t p � ,} 11 C_tt ' c
10,400J0
a.1.dZ
bQ&jk
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Reviewer/Inspector Name =- - -3
x— . _ �_ - _ . -
Reviewer/Inspector Signature: Date: 7&Y
11)/11/02

Facility Number: �.2 _yCj�— Date of Inspection
Renuired Records & Documents
21. FaiI to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes INo
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie! WUP, checklists, design, maps, etc.) El Yes IP No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [V No
❑ 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?
❑ Yes
[P No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
Eg No
26. Fail to notify regional DWQ of emergency situations as required by General Pernut?
(ie/ discharge, freeboard problems, over application)
❑ Yes
qNo
27. Did Reviewerllnspector fail to discuss review/inspection with on -site representative?
❑ Yes
[U No
28. Does facility require a follow-up visit by same agency?
❑ Yes
% No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
NPDES Permitted Facilities
30_ is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
[j No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
*m 1-0
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
jXWo 1-8
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
[k1Qo 1. l6
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
;414oIJ
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
9 No kS
❑ Stocking Form ❑ Crap Yield Form ❑ Rainfall ❑ Inspection After V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O* Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 8Z 465
® Permitted ® Certified 13 Conditionally Certified 13 Registered Date of Visit 3/131ZOf10
Q Not Operational 0 Below Threshold Date Last Operated or Above Threshold: .........................
Farm Name: Carr.QUs.Farm.#.ZS39 ........................... ..... County. SaWsan............................................ FRO............
Owner Name:. .................................................. Cat:ro]1's.RcWty PArtnership.......... Phone No. 9,jQcZ93-34,34......-......... ............ ............ .._...............
FacilityContact:...............................................................................Title:...........................................----................ Phone No: ................... .............. .................
.
Mailing Address: I'0 ..B.Ox.85.6................................ . 1'.l'.a11 AW-.N-C................................. ... 2$39.8..............
Onsite Representative:........................................................................................................... Integrator: C11<MQ.IIt'sYM&.IttC.......................... ...................
Location of Farm:
513.E 9Ri..�l .�naiil�.%K.ann.intaxs tiQtt. x�it�t.S1i .X?40..� .1lZ.�railes iru alto#let .sr .Sfi. 90��............ ................ ---.... -...................... ..................
®Swine ❑ Poultry ❑ Cattle. ❑ Horse
Design ;Ciirriht , Design Current Design . Curt ent
Swine Capacity Population Poultry Ca �acit Population Cantle Cani Po -elation
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
® Farrow to Finish
1000
❑ Gilts
❑ Boars
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 1,000
Total SSLW 1,417,000
_ Number of Lagoons I Holding Ponds /Solid Ti�tps"
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes 0 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 gal/min?
2. Is there evidence of past discharge from any part of the operation?
3. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Waste Collection & Treatment
Please see attached Lagoon Field Data Sheets
❑ Yes ® No
❑ Yes ® No
q==_ r +� F i7:..�, -r6e .�.e '4� fir^" -r K " st -x r 'iy
Reviewer/Inspector Name'' s #_. y -,t ,
Rrcttard $rooks �F - _ ,_ _.. �. _.
Reviewer/Inspector Signature: Date:
Printed on: 5/12/2000

Facility Number 82 — 465 Lagoon Number 1............ Lagoon Identifier
O Active O Inactive Latitude 35 ®17
Waste Last Added Q/.1.5.9.9.................... ................
Determined by: ® Owner ❑ Estimated
Surface Area (acres): Q.: ...........................
Embankment Height (feet): Q................................
Longitude 78 12 49
By GPS or Map? Map
GPS file number: 82a465
Distance to Stream: 0 <250 feet O0 250 feet - 1000 feet 0 >1000 feet
By measurement or Map? ® Field Measurement ❑ Map
Down gradient well within 250 feet? 0 Yes 0 No
Intervening Stream? O Yes O No
Distance to WS or HOW (miles): 0 < 5 DQ 5 - 10 0 > 10
Overtopping from Outside Waters? 0 Yes @ No O Unknown
Spillway O Yes O No Adequate Marker (@ Yes 0 No
Freeboard & Storm Storage Requirement (inches):
AJ
inspection date 3/13/2000
appearance of 0 Sludge Near Surface
lagoon liquid 0 Lagoon Liquid Dark, Discolored
0 Lagoon Liquid Clear
0 Lagoon Empty Freeboard (inches): 42
embankment condition 0 Poorly Built, Large Trees, Erosion, Burrows, Slumping, Seepage, Tile Drains, Etc.
*Construction Specification Unknown But Dam Appears in Good Condition
0 Constructed and Maintained to Current NRCS Standards
outside drainage O Poorly Maintained Diversions or Large Drainage Area not Addressed in Design
0 Has Drainage Area Which is Addressed in Lagoon Design
0 No Drainage Area or Diversions Well Maintained
liner status O High Potential for Leaking, No Liner, Sandy Soil, Rock Outcrops Present, Etc.
No Liner, Soil Appears to Have Low Permeability
O Meets NRCS Liner Requirements
nation equipment fail to make contact
and/or Spraytield 0 Yes Op No 0 Unknown with representative O Yes No
unavailable
comments research being conducted by NCSU. Liner has been cut in many places.

Site Requires Immediate Attention:
Facility No. ?
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 1995
Time:
Farm Name/Own
Mailing Address: tV 4(j 4 Y- n /V'C �t f,` l e 4 2lig 3 — 3y3 f _
County: Sampson
Integrator: Carroll Foods Phone:
On Site Representative: non Larne Phone:
Physical Address/Location:_ �R I T .0
Type of Operation: Swine _LL Poultry Cattle
Design Capacity: Number of Animals on Site: 4�
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: " Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon h ) sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes or No ual Freeboard: Ft. Inches
Was any seepage observed from the la n(s)? Yes o Nb Was any erosion obse ? Yes or®
Is adequate land available for spray? 'e )or No Is tfie cover cro adequate9 or rlo
Crop(s) being utilized: 3 Al E2/1"ud
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin or No
100 Feet from Wells? YYd or No
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
Is animal waste discharged into water of state by man-made ditch, flushing system, or -other
similar man-made devices? Yes or o% If Yes, Please Explain.
Does the facility maintain adequate wast management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? es r No
Additional Comments:
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

JUL 14 -.: 11 : 4E --Mj
SORTS CAROLIM DEPARTMENT OF Efv3--R0N =, HFALTS & NATURAL RFZ013RCF-S
DIVISION OF ZKV3M0N?M TAL MANAGMUVT
Fayetteville Regional Office
Animal Operation Compliance Inspection Form
7
.
41.. ° Ps t. ��..U.iiRT "1:✓Di�.G+7r�~ - ..�r�
/a T +.r.�/ r��a
t-`�'ii-r :-si:PACIL { �' _. %0NX'+
All. questions answered negatively will be discussed in sufficient detail in
the Comments Section to enable the deemed 'Pe mittee to perforce the appr'opria.te
corrections:
Ocr:rcrN I
._maI 0 eration T
Sorses, cattle, Lew , poultry, or sheep
—CTION 11
Y 1 a I COMETS
1. noes 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 REGISTRATION?
3. Are animals confined fed or maintained
in this facility for a 12-month period? .
4. Does this facility have a Cor IF ED ANIMAL
WASMANACZKE TI' PLAN?
S. Does this facility maintain waste management
records (volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover mop)?
6. Does this facility meet the SCS minimum
setback criteria for neighboring houses,
wells, etc?

JuL 14 �✓ LL So'niE
TIT
r
Field Site Ma_na em nt
1_ Is animal waste stockpiled or lagoon
construction within W ft_ of a USGS
Map Blue Line Stream?
2. IS animal waste land applied or spray
irrigated within 25 ft. of a DSGS Man
Slue Lisle Stream?
3. Does this facility have adequate acreage
on which to apply the waste?
4. Does the land applieation'sita have a
cover crop in accordance with the
CFRTIJPICATIaNs PLAN?
S. Is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other sis<► K, man -wade devices?
6. Does the animal waste management at this
farm adhere to Best Management Practices
UMP) of the approved CZR7UFICAITaN
7. Does animal Waste lagoon have sufficient
freeboard? Sow much? (Approximately
S. Is the general condition of this CAFO facility,
including management and operation,
satisfactory?
SECTION Iv

CARROLL'S FOODS, ENC.
P. 0. Drawer 856
Warsaw, North Carolina 28398
910-293-3434
910-293-755-1 (Fax)
FAX TRANSWITAL SHEET
DATE:
TDAE:
TO_
FROM:
FAX NUMBER
NUMHER OF PAGES
SUBMCT:
p
WJ vV 1

15 .5 `I
Plan Amendment to Include S&WCC Chronic Rainfall Practices and Standards through March 31, 2000
1. 1f this facility can comply with its existing permit and CAWMP it must do so.
2. T,,e'porary Addition of New Sprayficlds N (Check appropriate boxes.)
ld A. acres of cropland. List crop types used, t t I I I Od -
�___ 03. acres of hardwood woodland-@ 10D-ibs PAN 1 acre added.-
D C. acres of pine woodland added @ 60 lbs PAN 1 acre added.
3. Summer Perennial Grass (Check appropriate box.)
0 A- Application window extended for acres of perennial grass until first killing frost.
&-5. An additional 50 lbs of PAN applied to Y3,jL6 cres of perennial grass prior to killing frost.
4. PAN Application increased for Small Grains & Winter Grasses to be harvested. (Check appropriate box-)
��. PAN application increased up to 200 lbs per acre for acres of small grains or winter grasses to be harvested.
PAN application increased up to 150 lbs per acre for �sce �cres of ovcrded summer perennial included in 3. B_
5. Waste Analysis (Check appropriate box.)
0 A. Prior to December 11°. 1999 the calculation of PAN will be based on a 35% reduction of the last analysis taken
or to the frrst 25 year 24 bour storm event- (Current waste analysis must be used after Dec. V4 .}
Use current waste analysis to determine PAN.
6. Rea uired -Maximum Nitrogen Utilization Measures for Small Grains and Winter Grasses.
A. Use of nigher sending rates,
B. Timely ha -vest of forage to increase yield, and
C. Irrigating during periods of warmer weather.
7. Reouired - Irrigation Management Techniques to Reduce Runoff and Ponding Potential.
A. Making frequent, light irrigation applications, and
B_ Not irrigating immediately before predicted rainfall.
8. The owner / manager is required to manage the movement of animals to and from the facility to minimize environmental
impacts, ensure compliance with the facility's permit and amended CAWMP, and avoid discharge to surface waters.
9- Authorization to use the additional practices included in this amendment expires if a facility discharges to swfac waters.
Any discharge is a violation and may result in an enforcement action.
10. a nn owner / operator is rtquirnd to keep records of all waste applications.
11- This revision must include a map or sketch of new land application areas.
Facility Number O 112 - '/ 6
c J Y%�,lf 3 ma' s . h L1),iC(A1C1JiP%'
Facility Owner / Manage: Name itPRIN7)
6 /,
FacHity Owner / Manager Simarure
Date n
�? 5.3
Facility Name
W4ab L . AAD 85 c �v
Technical Specialist Name (PRINM
Tech n — Specialist Signature
Date_ /
This document must be filed at the SWCD office and be attached to the facilities CAWN2
and be available for inspection at the facility.
New tc nDorzr—' Sprat'Irn1cs must rnttt apoiicabit buffer and setback re-oulr_rntnts. Wastt must not be anDfitd to wetl2,tt^7-
1 1/10/1999