090004_INSPECTIONS_20171231

Division of Water Resources
❑Division of Soil and Wager Conservation
Other Agency
FaciINy Number: 090004 Facifity Status: Acbve Permit: AWS090004 [] Denied Access
Inspection Type: Compliance Inspection
Reason for Yrsit: Routine
Date of Visit: 03/23/2017 Entry Time. 10:30 am
Fann Name: Cain Complex
Owner. Murphy -Brown LLC
Exit Time
Inactive Or Closed Date:
County: Bladen Region: Fayetteville
11.00 am Incident #
Owner Email:
Phone: [phone]
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 882 Opportunity Ln White Oak NC 28399
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Fenn: Latitude: 34° 45' 35" Longitude: 78° 40' 27"
From Ammon take NC 242 South 2.4 miles, turn right onto SR 1325, go 5.9 miles to complex entrance on left.
Question Areas:
Dischrge & Stream Impacts Waste Col, Slor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Robert T Young Operator Certification Number: 18461
Secondary OIC(s):
On-Slte Repnesentative(s):
24 hour contact name
On -site representative
Primary Inspector.
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Lagoon 2 is dry.
Name Title Phone
Mike Ammons Phone
Mike Ammons Phone
Robert Marble Phone:
Dale:
page: 1

Permit: AWS090004 Owner - Facility: Murphy -Brown LLC Facility Number. 090004
Inspection Date: 03t23/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine- Farrow to Wean
2,500
[] Swine- Feeder to Finish
10,000
Swine - Wean to Feeder
7,000
Total Design Capacity: 19,500
Total SSLW: 2,642,500
Waste_ Structures Observed
Dis ignated
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7443-1
19.00
31,00
Lagoon
7443-2
19.00
Lagoon
7443-3
19.00
48.00
Lagoon
7443-4
19.00
56.00
Lagoon
DEPOT
Lagoon
DEPOT 1
19.00
Lagoon
FINISHER
Lagoon
FINISHER 2
19.00
Lagoon
NURSERY
Lagoon
NURSERY 3
19.00
Lagoon
SOW
Lagoon
SOW 4
19,00
page: 2

Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number. 090004
Inspection Date: 03/23M Inpsection Type: Compliance Inspection Reason for Visit: Routine
Dischames & Stream Impacts
vet
No Na Me
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 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 We
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.eJ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
B. Are there structures on -site that are not property addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No No No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 100/o/10 Ibs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number. 090004
Inspection Date: 03/23/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application _
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Natural Vegetation
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Centenary sand
Soil Type 2
Leon sand, 0 to 3% slopes
Soil Type 3
Wagram fine sand. 0 to 6%
slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop andlor land application site need improvement?
❑
❑
[]
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M ❑
❑
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?
[]
■ ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number. 090004
Inspection Date: 03/23/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes NO Na No
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
[]
M ❑
❑
23. If selected, did the facility fail to instal and maintain a rainbreaker on irrigation equipment
El
El
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑
❑
appropriate box(es) below:
Failure to complete annual sludge surrey
❑
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?
❑
❑
❑
Other Issues
Yea
No Na No
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,
❑
❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, Freeboard problems, over -application)
31. Do subsurface file drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ 0 ❑ ❑
CAWMP?
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.
090004
Facility
Status: Active Permit:
AWS090004
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or
Closed Date:
Reason for Visit:
Routine
County: Bladen
Region:
Fayetteville
Date of Visit:
09/23/2015 Entry Time:
12:00 pm Exit Time: 1:00 pm
Incident #
Farm Name:
Cain Complex
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-f 800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 882 Opportunity Ln White Oak NC 28399
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34° 45' 35" Longitude: 78' 40' 27"
From Ammon take NC 242 South 2.4 miles, turn right onto SR 1325, go 5.9 miles to complex entrance on left.
Question Areas:
Dischrge & Stream Impacts Waste Col, Star, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Robert T Young
Secondary OIC(s):
Operator Certification Number: 18461
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone:
On -site representative Mike Ammons Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number: 090004
Inspection Date: 09/23/15 Inppection Type: Compliance inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Farrow to Wean
2.500
Swine - Feeder to Finish
10,000
❑ Swine - Wean to Feeder
7,000
Total Design Capacity: 19,500
Total SSLW: 2,642,500
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7443-1
19.00
31.00
Lagoon
7443-2
19.00
83.00
Lagoon
7443-3
_E
19.00
50A0
Lagoon
7443-4
19.00
67.00
Lagoon
DEPOT
Lagoon
DEPOT 1
19.00
Lagoon
FINISHER
Lagoon
FINISHER 2
19.00
Lagoon
NURSERY
Lagoon
NURSERY 3
19.00
Lagoon
SOW
Lagoon
SOW 4
19.00
page: 2

Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number: 090004
Inspection Date: 09/23/15 Inpsection Type: Compliance Inspection Beason for Visit: Routine
Discharges & Stream ImpaCtS
Yes
No Na Ne
1. Is any discharge observed from any part of the operation?
❑
0110
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
0 ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
■ ❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
0 ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures tack 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
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance altematives 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: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number:
090004
Inspection Date: 09/23/15 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yes No No Ne
Crop Type 1
coastal Bermuda Grass
(Hey, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Natural vegetation
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Centenary sand
Soil Type 2
Wagram fine sand, 0
to 6%
slopes
Soil Type 3
Leon sand, 0 to 3% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ ■ ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ M ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ ❑
❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑
❑
20, Does the facility fail to have all components of the CAWMP readily available?
[] 0 ❑
❑
If yes, check the appropriate box below
WU P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ M ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS090D04 Owner - Facility : Murphy -Brown LLC Facility Number: 090004
Inspection Date: 09/23/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes
No Na Na
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,
❑
M ❑
❑
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?
❑
■ ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon 1 Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-comp[iance of the Permit or
❑
0 ❑
❑
CAWMP?
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

U Division of Water Resources
El Division of Soil and Water Conservation
El Other Agency
Facility Number: 090004 Facility Status: Active Permit: AWS090004
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for visit: Routine County: Bladen Region:
Date of Visit: 08/20/2014 EntryTime: 11:30 am Exit Time: 12:30 pm Incident #
Farm Name: Cain Complex Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 882 Opportunity Ln White Oak NC 28399
Facility Status: ECompliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34' 45' 35" Longitude: 78° 40- 27"
From Ammon take NC 242 South 2.4 miles, turn right onto SR 1325, go 5.9 miles to complex entrance on left.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
❑ Denied Access
Fayetteville
910-296-1800
Certified Operator: John S Cain Operator Certification Number: 23570
Secondary OIC(s):
On -Site Representative(s):
24 hour contact name
On -site representative
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Lagoon 4 is dry.
Name
Mike Ammons
Mike Ammons
Title
Phone :
Phone:
Phone
Robert Marble Phone:
Date:
page: 1

Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number: 090004
Inspection Date: 08/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean
Swine - Feeder to Finish
Swine - Wean to Feeder
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7443-1
19.00
Lagoon
7443-2
19.00
Lagoon
7443-3
19.00
Lagoon
7443-4
19.00
Lagoon
DEPOT
Lagoon
DEPOT 1
19.00
Lagoon
FINISHER
Lagoon
FINISHER 2
19.00
Lagoon
NURSERY
Lagoon
NURSERY 3
19.00
Lagoon
SOW
Lagoon
SOW 4
19.00
pages 2

Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number: 090004
Inspection Date: 08/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
DischaEgees & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
M ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
M ❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
0 ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
El
M ❑
❑
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?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
■ ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
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
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number: 090004
Inspection Date: 08/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Appllcabon
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Natural Vegetation
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Centenary sand
Soil Type 2
vvagram fine sand, 0 to 6%
slopes
Soil Type 3
Leon sand, 0 to 3% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
E ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
E ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes
No N@ 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?
❑
N ❑
❑
If yes, check the appropriate box below
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21, Does record keeping need improvement?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Page: 4

Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number: 090004
Inspection Date: 08/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No No Ne
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
❑
M ❑
❑
(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
❑
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?
❑
M ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na Ne
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,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
❑
❑
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/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:
090004 Facility Status:
Active permit: AVVS090004
❑ Denied Access
Inppection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Bladen Region:
Fayetteville
Rate of Visit:
10/21/2013 Entry Time: 10:00 am
Exit Time: 11700 am Incident #
Farm Name:
Cain Complex
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
882 Opportunity Ln
White Oak NC 28399
Facility Status:
Compliant ❑ Not Compliant
Integrator: Murphy -Brown LLC
Location of Farm:
Latitude: 34' 45' 35" Longitude:
78° 40' 27"
From Ammon take NC 242 South 2.4 miles, turn right onto SR 1325,
go 5.9 miles to complex entrance on left.
Question Areas:
Dischrge & Stream Impacts Waste Col, Slur, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: William Victor Sutton Operator Certification Number: 26076
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone
On -site representative Mike Ammons Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number: 090004
Inspection Date: 10/21/13 inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to wean
Swine - Feeder to Finish
Swine - Wean to Feeder
Total Design Capacity:
Total SSLW:
Waste Structures
Designated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7443-1
19.00
Lagoon
T7443-2
19.00
Lagoon
7443-3
19.00
Lagoon
7443-4
19.00
Lagoon
DEPOT
Lagoon
DEPOT.1
19.00
Lagoon
FINISHER
Lagoon
FINISHER 2
19.00
Lagoon
NURSERY
Lagoon
NURSERY 3
19.00
Lagoon
SOW
Lagoon
SOW 4
19.00
page: 2

r
Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number: 090004
Inspection Date: 10/21/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ ■
❑
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?
❑
E ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection Storage & Treatment
Yes
No Na, No
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le.l large
❑
M ❑
❑
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?
❑
S ❑
❑
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
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
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: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number: 090004
Inspection Date: 10/21/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Applicabon
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Natural Vegetation
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Centenary sand
Soil Type 2
Leon sand, 0 to 3% slopes
Soil Type 3
Wagram fine sand, 0 to 6%
slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
M ❑
❑
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 Ne
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?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS090004 Owner - Facility : Murphy -Brown LLC Facility Number: 090004
Inspection Date: 10/21 /13 Inpsedon Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No No No
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall inspections
❑
Sludge Survey
❑
22, Did the facility fail to install and maintain a rain gauge?
❑
M ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDFS only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
01111
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
01111
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
M ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■ ❑
❑
Other Issues
Yes No No No
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,
❑
M ❑
❑
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?
❑
❑
❑
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
❑
M ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Type of Visit: *Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 0 Routine Q Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: �'S� Arrival Time: Z', M Departure Timer County: 5� � Region: ` O
lq L43 Qnn,'
Farm Name: — Owner Email:
Owner Name: r.�Oli1—r,. Phone:
Mailing Address:
Physical Address:
Facility Contact: Wilk inthoy+s _Title:
N
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: P4
Certification Number: dip
Certification Number: I S✓
Longitude:
- � rt .Design Current - D gu Current
Swine Capacity Pop. Wet Poultry Cap ity Pap.
r
Design Current
Cattle Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
I ILayer
I
Dairy Cow
70M
Non -La er
I
Dairy Calf
D , Pouf
Layers
Ca'a�ci P,o ,
Dairy Heifer
Dry Cow
Non-Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Qther
Turke s
Turkey Poults
Other
Other
Discharees and Stream Imnacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
i
❑ 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
Qq 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
1�51 NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page l of 3 21412011 Continued

Faotlity Nuanber: - Date of inspection- y 2 t—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No �q NA ❑ NE
Struc e I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: S
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): u piZY
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
0 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)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes
`1"' No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
`ham No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes M No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
� r
12. Crop Type(s): -6 ` RjerGM95 / , kv
13. Soil Type(s): C , wa'g-
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes FM No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
lb. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ( No ❑ NA ❑ NE
acres determination? T
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes ep No
❑ Yes No
[:]Yes [P No
❑ Yes `p No
❑ Other:
❑ NA ❑ NE
❑ NA ❑ NE
[] NA ❑ NE
❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ YesIs
No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste fers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

FaeiliNumber: jDate of Inspection: 2_
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 to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes Qa No
[]Yes �§ No
❑NA ❑NE
❑NA ❑NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes Q§ No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes Qa No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAV*rw? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ® No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes T No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
0kX
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
�L�
Phone: ?to-'Y; j3- 3W
Date:
21412011

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: .ems Departure Time: lqp County: 13
Farm Name: `l ^- l_QA r\ CD r-rl Owner Email:
Owner Name:u,y�p�..t -?,�.Ow vt , LLC Phone:
Mailing Address:
Physical Address:
Region: F02D
Facility Contact: jLA �-e -Am "ns Title: Phone:
Onsite Representative: Integrator: h w
- 1
Certified Operator: �p n (n� n Certification Number: 2.3-5-70
Back-up Operator: to I'6 rvt p rL5 Certification Number: 90 5 I0
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Cnrrept
Deslgn Current
Swine
C•agacity Pop.Poultry
C►apacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
10
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Design
ci
Current
P,o
Dry Cow
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Turke s
Beef Brood Cow
t?ther
Turkey Poults
Other
1� Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of 3
❑ Yes ;D No ❑ NA ❑ NE
[—]Yes ❑ No
[-]Yes [:]No
�NA ❑NE
�NA ❑NE
❑ Yes ❑ No PNA ❑ NE
❑ Yes In No ❑ NA ❑ NE
[a Yes F No ❑ NA ❑ NE
.214/2011 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ® NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: N J F .150
Spillway?:
Designed Freeboard (in):
re
Observed Freeboard (in): 101, �yu
Q
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes `f1 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 N No [DNA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [$a 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 P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? 1p
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes W 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 ofApprovedArea
12. Crop Type(s): C�a_Q k r1j�[{J� LJ'rl�a' i��i �Jh � D{JQ/ �/ j hR /Irees
/I --�—
,i ,- a . n t a
13. Soil Type(s): :1!1
14. Do the receiving crops differ from those designated in the CAWMP?
[:]Yes
® No
��
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
D NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[� No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes]
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
7�
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [;9 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE
Page 2 of 3 T 21412011 Continued

y.Y
Facility Number: jDate of Inspection: 11,0111
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey 0 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:
No ❑ NA ❑ NE
No ❑ NA ❑ NE
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other issues
28- Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately-
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes W No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional vases as necessarv).
514C 411'_Sl� corjua�j
pe,lS red k ewea(
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
elln
Phone: 9IV"t ✓ J �✓�.(J
Date: 4 2D
214120; l

j
Type of Visit 0 Compliance Inspection Q Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 4PRoutine Q Complaint 0 Follow up O Referral O Emergency O Other ❑ Denied Access Q�
Date of Visit: vor"Gp?�Ieh(—
Arrival Time: ®r Departure Time: County: Region:Farm Name:
I 1 L13-�Ownner Email:
Owner Name: /' 9wmf
Mailing Address:
Physical Address: Facility Contact: � I/�
'le`hDGi�s _Title:
y
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Phone No.
Integrator: r
Op� ertification Number:
92
Back-up Certification Number:
Latitude: 0 c = ' ❑ " Longitude: ❑ 0 0 d = it
Design Current
`U'esign Current
Design C►urrent
Swine Capacity Population
Wet Poultry Capacity Population
Cattle C•apaci#y Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
Wean to Feeder
❑Non -La er
❑ Dairy Calf
Feeder to Finish 0
z:- ' `
Y
❑ DairyHeifer
Farrow to Wean
Dry Poultry r
❑ Dry Cow
r' Farrow to Feeder`
❑ La ers
Non -Dairy
❑ Farrow to Finish
El Beef Stocker
❑ Gilts
❑Non -La Non -Layers
❑ Beef Feeder
�❑Boars
El Pullets
❑Beef Brood Cowi
-
❑ Turke s
"Other
❑ Turkey Poults.„k
❑ Other
❑ Other
Numtiefaof Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes r No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes ❑ No
NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes ❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes ❑ No
NA
/❑
❑ 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 1P No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

OQ
Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes )21 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No to NA ❑ NE
tructure 1 ActurL Structure3 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 'on 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 ADDliCatiOn
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes {Q] No ❑ NA ❑ NE
maintenance/improvement? {{
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 1P 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 Malit
indow ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) A PWtte) 5r, Gza, (JIQfI�J Ae 47,-Q,,�
13. Soil type(s) 010 l WL(.tI/
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�?No
❑ NA
❑ NE
1P No
❑ NA
❑ NE
No ❑ NA
❑ NE
No
❑ NA
❑ NE
IP No
❑ NA
❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name r �— --� Phone:
Reviewer/Inspector Signature: Date: /D
rage z of -i LL/6dVU4 Lonrinuea

Facility Number: — Date of Inspection WIVO
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 1PNo ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 9allo ❑ 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
1PNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
AQNo
❑ NA
❑ NE
24. Did the facility fait 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?
❑ Yes
No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
PNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�9 No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
W'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
10 No
❑ NA
[INE
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
Ep 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
O No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
EpNo
❑ NA
❑ NE
Additional Comments and/or Drawings:'
Page 3 of 3 12128104

Type of Visit 4P Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit r Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: 0 /O
�'7Lj �
Farm Name: t /I I �I 3 _ Own
County: Region: r`
er Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
�,�AA
Facility Contact: /I�l l m014��. _._ Title: Phone No:
Onsite Representative: I f Integrator: tL(�
Certified Operator: �ro-.SA R+''{'I Operator Certification Number: �z ���
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = e 0 I = " Longitude: 0 ° =' ED «
11 Design
Current
Design Current Design Current
Swine Capacity
Population
Wet Poultry Capacity Population @attle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
Wean to Feeder
r7 CW
❑ Non -Layer
❑ Dairy Calf
Feeder to Finish
Dairy Heifer
Dry Poultry ❑ Dry Cow
❑ Non -Dairy
❑ La ers
Farrow to Wean
a
Farrow to Feeder
❑ Farrow to Finish
❑ Beef Stocker
on -Layers
❑ Pullets ❑Beef Feeder
❑ Beef Brood Co
❑ Turkeys
❑ Gilts
❑ Boars
Other
❑ Turkey Pouits
❑ Other
❑ Other Number of Structures:
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
❑ Yes 'PNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes ❑ No
[�l 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
t�NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes [9�.No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes `�No
El NA
El NE
other than from a discharge?
``
Page I of 3
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?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Struct re Structure 4
c �
Identifier: I SO
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes P No ❑ NA ❑ NE
[]Yes [:]No In NA ❑ NE
Structure 5 Structure 6
❑ Yes PNo ❑ NA ❑ NE
❑ Yes Jjj 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 1PNo ❑ 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'? l
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes YyNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes V% No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P No
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
10 No
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
ONo
17. Does the facility lack adequate acreage for land application?
❑ Yes
P9 No
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA El NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers aadtor any recammendatians or any other comments.
Use drawings of facility to better explain situations. (nse additional pages as necessary):
rq1 ��r
ReviewerlInspector Name 4 ` Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection I _T__► _HY Il
Required Records & Documents �
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes PNo El NA El NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes 0 No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
P No
ElNA
❑ NE
[IWaste Application ElWeekly Freeboard ElWaste Analysis ❑ Soil Analysis ElWaste 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
e] No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
0 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
1PNo
❑ 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
MNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
bnNo
[INA
ElNE
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
10 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? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes]
No
❑ NA
❑ NE
Page 3 of 3 12128104

r
Type of Visit (),C5`mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑Denied Access
Date of Visit: 11;2__7y,V Arrival Time: Departure Time: •�� County:
/�
Farm Name: C_ Gt It rt �ffim� k Owner Email:
Owner Name: zi Lr,4&ajyt 116 Phone: _
Mailing Address:
Region: �[2
Physical Address:
Facility Contact: !r u Title: Phone No: g/D--,y776--OG y�
Onsite Representative: --��-- J'f�^--� Integrator: N
Certified Operator:� jiA -- �"r�i' Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑ u [= f ❑ t. Longitude: ❑ ° ❑ ❑
ds
Design
Current
Design C++urgent Design Current
Swine
Capacity
Population
Wet Poultry
Capacity Population ...-- Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
50
❑ Dai Calf
Feeder to Finish
pop
/12000
❑ Dai Heifer
Farrow to Wean
O
Dry Poultry
}
❑ Da Cow
$,
❑ Farrow to Feeder`
rs [I Non -Dairy
❑ Farrow to Finish
❑ Lavers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl
❑ Turkeys
_
Other
❑ TurkeyPoults
r;=-�_1
❑ Other
❑ Other
�- Number of Structures:
Discharges
Wean to Feeder
p� p
O
❑Non -La er
&Stream Impacts
. Is any discharge observed from any part of the operation'?
❑Yes
$4 No
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made'?
El Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El 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. notif}' D1ItirQ)
❑Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
A No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
14 No
❑ NA
❑ NE
other than ls-om a discharge?
Page 1 of 3
I2/28/04
Continued

Facility Number: — ® Date of Inspection D
Waste Collection & 'Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes B-No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure, 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: 41116e,,IK
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes �Rj 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 JZ 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
igio
7. Do any of the structures need maintenance or improvement?
Ryes Iffo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes El ❑ NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes W No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes PNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 5-No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ElEvidence of Wind Drift ElApplication Outside of Area
12. Crop type(s) Ze "'!7 --t
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[XNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
U No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
R 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
9 No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name r. Phone: �j /y-33�37aO
Reviewer/inspector Signature: Date:
12128104 Continued

.I
Facility Number: �0' —O!y I Date of Inspection LZ
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 appropiatc box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps []Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes ®-No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [5No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? . ❑ Yes �9 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
9 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[3No
❑ 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
BNo
❑ 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
(,� No
❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
® No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA ❑ NE
12128104

Type of Visit &Compliance
Inspection
O Operation Review Q Structure Evaluation
O Technical Assistance
Reason for Visit
outine O Complaint
O Follow up O Referral O Emergency
O Other ❑ Denied Access
Date of Visit: [ Arrival Time: � i0 Ot Departure Time: County:
Farm Name: L1213_ - __ J!::1m 2L eY, Owner Email:
Owner Name: 7&ii/iSf Lf� _ aoezm_S Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:��.-,_�
Certified Operator:. .�e�
Back-up Operator:
Location of Farm:
Swine
Phone No:
Integrator:
Operator Certific ton Number:
Back-up Certification Number:
Region:
Latitude: [= Q = , Longitude: 0 ° = ❑ u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
h �.❑Layer
r Da O D to !..-❑ Non -La et
❑ Wean to Finis
29 Wean to Feede
0 Feeder to Finish
DOOD
DD00
Farrow to Wean
0
a
El Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
ElNon-Layers
El Pullets
ElTurkeys
ElTurke Poults
El Other
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field El Other
a. Was the conveyance man-made'?
Design. Current
Cattle Capacity Population
El Dairy Cow
El Dairy Calf
[I Dairy Heife3
El Dry Cow
ElNon-Dairy
El Beef Stocker
El Beef Feeder
El Beef Brood Cow
Number of Structures: �iyf
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 ,.vaste 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 [9No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
(WNo
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes & No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: Fi p _ttr t —5buJ TfVjjlsl
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): `� —� p� C) yr 41
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 10 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 J& 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?
W Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes J@ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes 60 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes LANo ❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) /
13. Soil type(s) / - C= �� A Lt a's
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
P No ❑ NA ❑ NE
14 No ❑ NA ❑ NE
�f No ❑ NA ❑ NE
No ❑ NA ❑ NE
V]No [I NA El NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
{,rj
Reviewer/Inspector Name j T�-�--�� Phone: 9jp-3�3 3D0
r
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection
114 Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 10 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 25 No ❑ NA ❑ NE
the appropriate 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Comments and/or Drawings:
QD_5' nad
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
4 No
❑ NA
❑ NE
❑ Yes
FM No
El NA
El NE
❑ Yes
C&No
❑ NA
❑ NE
❑ Yes
IMNo
❑ NA
El NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
UNo
❑ NA
❑ NE'
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes [KNo []NA [:]NE
❑ Yes
1,No
❑ NA
❑ NE
❑ Yes
[9 No
❑ NA
❑ NE
Page 3 of 12128104

I
-- ® Division 01' _ter Quality
�Faeility Number 9 1® �jL Q Division of 5oi1 and Water Conservation
0 Other Agency
Type of Visit ®Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 4W Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: f Z ; County: BlQclC.y Region:
Farm Name: . w ("AAA ] -e- JQ _ Owner Email:
l
Owner Name: . _K Jest-.1'�I Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: plat4j �u vise
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: E=1 o El' =" Longitude: = ° 0 I = u
Design
Current Design Current
Design Current
Swine
Capacity
Popufatian Wet Poultry Capacity Popu
r
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑Non -La er
x
DrY Poulit'ryxi'
❑
Dairy Cow
Wean to Feeder
❑
Dairy Calf
Feeder to Finish
Dairy Heifer
® Farrow to Wean
00
El
Dry Cow
❑ Farrow to Feeder`
El
Farrow to Finish
❑ N erson-Laers
on-Layers❑ ❑
El Pullets
ti ❑ Turkeys
❑ Turkey Poults
El
Beef Stocker
❑ Gilts
❑
Beef Feeder
❑Boars
❑Beef
Brood Cold
- ,...,:
Other
µ
Number o#'Structures:
❑ Other
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
[91 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
[R No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
1�1 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
M No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
E4 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
V No
❑ NA
❑ NE
other than from a discharge'?
Page I of 3
12128104
Continued

r
i,
Facility Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
[9 No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes
0 No ❑ NA
❑ NE
Structure 1 Structure Structure 3 Structure 4 Structure
5 Structure 6
Identifier: DePo+( 7VY_?- F`uAsL� 4�V3 3 N 1rl13-2 $o �` 3-/
Spillway?:
Designed Freeboard (in): / 9.r
Observed Freeboard (in): .39 7 � , 3 zr
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
[0 No ❑ NA
❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
pfNo ❑ 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
S. 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)
T
9. Does any part of the waste management system other than the waste structures require ❑ Yes
No [INA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
[;9 No ❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
[RNo ❑ 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 type(s) tSCVk&"e-.. Swrr_// (s n i
13. Soil type(s)
T
14. Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
DO No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[9 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'?
❑ Yes
[;I No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ZfNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[:NNo
❑ NA
❑ NE
Comments (refer to question: Explain any YESanswers and/or any recommendations or any other comments
[Ise.drawtngs;of.faciliry to better explain plain situatton�s, (use additional pages as necessary): 3
Reviewer/Inspector Name G fze4dS Phone:(910) $
Reviewer/Inspector Signature: Date: (p-©7- ZUA
►-age t of s 12128104 Continued

1� Facility Number: Q' -041 1 Date of Inspection 4-07-0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes (A No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 1�9 No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [51 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
to No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[0 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[RNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
151 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
(A No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
M No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[2 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[HNo
❑ 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
PYNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 L
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
�dNo
❑ 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
[YPNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
RYNo
❑ NA
❑ NE
Additional Comments and/or Drawings: x,
Page 3 of 3 12128104

Type of Visit
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: ; t) f] County: ffi�Region: /F90
Farm Name: e " ► - Owner Email:
Owner Name: `ta ✓ Phone:
Mailing Address: /� a f RVA .z � 3Y !�,'
Physical Address: .5.V 1 a oz
Facility Contact: ��'h��L�N�.ti'Nri Title:
Onsite Representative: /Tics s: r— IP' �,1 e r/
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone No: %G 061
Integrator: /tIk��►�
Operator Certification Number: 624.
Back-up Certification Number:
Latitude: ❑ o [= ❑ Longitude: = o E ❑ u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population '
❑ Layer
DDO ❑Non -La ei
❑ Wean to Finish
Wean to Feeder
Feeder to Finish
c>
(Farrow to Wean
D�7
El Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Soars
Other
❑ Other '
Dry Poultry
[__1Layers
ElNon-Layers
El Pullets
ElTurkeys
[EllTurke Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure El Application Field El other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
Design Current
Cattle Capacity Population
El Dairy Cow
El Dairy Calf
El Dairy Heifei
El Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:R]
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?
1 Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes M No ❑ NA ❑ NE
❑ Yes
[0 No
❑ NA
❑ NE
❑ Yes
CK No
❑ NA
❑ NE
❑ Yes
R No
❑ NA
❑ NE
❑ Yes
MNo
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
12128104 Continued

Facility number: Date of Inspection --O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
RBI No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No ❑ NA ❑ NE
Structure I Structure 22 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:' ' Jwr.t ►Z i, h .. it
Spillway?:
Designed Freeboard (in):.. x- A ,a """
Observed Freeboard (in):
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
Z 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?
RSYes
NNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
X 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
RNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
EKNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
9jNo ❑ 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. Crap type(s) .d*/3ri'n�ua/e� rZ/y o� Gruzc / See l/•`�-
13. Soil type(s)
ry
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
i4 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
IQNo
❑ 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
RNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
CNo
❑ NA
❑ NE
Comments (refer to question #}: Explain any YES answers and/or any recommendations or any other comments.
ro
Use drawings of facility to better explain situations. (use addition_! pages as necessary):
(Ocpnrho ' G�vrf: i�ti w� i .7�e �+'1' � .5 cam'+
Reviewer/Inspector Name f rl Phone:
Reviewer/Inspector Signature: Date: 1i_7--OS
12128104 Continued

Facility'Number: p —p Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available'? ❑ Yes KNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 54 No ❑ NA ❑ NE
the appropirate box_
❑ WUP ❑Checklists El Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes R 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
[I No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
E&No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
54No
❑ 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
[A No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
f)? No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Z 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
[K 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
ElNE
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
ja No
❑ NA
❑ NE
Addl[tip4alCori7lllentS;sQd/or"Dra�S'Iitp6S:;i_! Iy
'�. u.( ii ,H
I2/2&04