090027_INSPECTIONS_20171231

Type of Visit 6 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Bate of Visit: ��Time:
O Not erational ifl Below Threshold
13 Permitted 13 Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: ve, i-e r'GG/a, Svw �aram, County: Qc4cn Feo
Owner Name: _W . _u Phone No:
Mailing Address: 42. -_ go e 7`s
Facility Contact:
Title:
Phone No:
Onsite Representative: `C.r.. C G G V r-Integratorm �. * kr - 6 r o carJ �
Certified Operator._ Sa h rJ 4 er: C a t S xz , Operator Certification Numb� -2 3 5 i p
Location of Farm:
10 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• Du
Dischaeees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes 10No
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 gallmin? ty JA
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 IV No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3
Identifier: ...... • /
Freeboard (inches): '3�2 /1
Structure 4
❑ Yes M No
Structure 5 Structure 6
12112/03 Continued

F.-icility lumber: — y
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc_)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ,)
7. Do any of the structures need maintenancelimprovement?
8. Does any part of the waste management system other than waste structures require maintenanceAmprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Apylication
10. Are there any buffers that need maintenancelimprovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with ose designated in the Certified Animal Waste Management Plan (CAWMP).9
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste applicarion equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
17- Bare. czf G4
tom-.
0A n c,l 1 r^ ►� C r
ct
wa\` �Vr cab4 r-i-TAS
Reviewer/Inspector Name _
Reviewer/Inspector Signature:
❑ Yes M No
❑ Yes ® No
91 Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes No
❑ Yes
® No
❑ Yes
® No
❑ Yes
No
❑ Yes
No
❑ Yes
[} No
❑ Yes 0 No
❑ Yes 10 No
❑ Yes No
❑ Yes ® No
❑ Yes [P No
Field Copy ❑ Final Notes
i'A I oe rx , E� 04
AW
Date: ///o/%
12112103 / / Continued

FadiitZ Number-T77-7-71 Date of bxspection ///ol%
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
�9 No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
P No
23. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes
❑ No
j1 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
Q No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
10 No
27. Did Reviewer/Inspector fail to discuss review/mspection with on -site representative?
❑ Yes
Jo No
28. Does facility require a follow-up visit by same agency?
❑ Yes
JZ No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
JZNo
NMES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
0 Yes
❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
14 No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
N No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
[] No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
[d Yes
❑ No
❑ Stocking Form R) Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
113 No violations or deficiencies were noted during this visit. You will receive no farther correspondence about this visit.
3,57) N O C- Vo p 1 G1 Ot �O V il�+m 1 E311 W ,yA'\� �Q v Y'�• CGO r y -
,P,3 / !/ C' afo�J��Ca�.pA.S Ta -ell I_ Sihd�� gfrGiiti 0.rG C�"C�+�,�WtL� �J
4-VIe-- 1�rCh Gwep a'%-4Lr khc WlV`pv�q PAN �a.t4.1G� QGGa�d��
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PlqN. PIC-a,cr- ca:-►rick r�cnro�,�.
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�Ia,te_ 6c:..cLo Cor-,
12112103

• '1
Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit & Routine
O Complaint O Follow up
O Emergency Notification O Other
❑ Denied Access
{ Facilitti� Number
pate of Visit:
Time:
}� •
Not (Operational
Below Threshold
® Permitted ® Certified
© Conditionally Certified
C] Registered Date Last Operated or+ Above Threshold:
Farm Name: __ F_ye _—�
County: 1 C'ac.,
�
Owner Name:
Phone No: qI
'Mailing Address: •
IAN
K k it
&LC_
Facility Contact: ='- b Q �-AL _ Title:
Onsite Representative: Q_ o . R 6-it­
Certified Operator: _ —Tn Cey r' —
Location of Farm:
Phone No:
Integrator- hA0^
Operator Certification Number: :13 t :2 e)
0 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 0" Longitude •
Design Current
Swine C nnarity Pnnnlatinn
99 Wean to Feeder
BEFeeder to Finish
EE
® Farrow to Wean`
6 6
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ haver I ❑ Dairy
❑ Non -Laver I I n-Dainr
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ La oon Area 10 Spray Field Area
Holding Ponds / Solid Traps 10 No Li uid Waste Management System
Discharges 8- Stream Impacts
1 _ Is any discharge observed from any pan of the operation?
Discharee oriamated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in sal/min?
d. Does discharge bypass a lagoon system? (if ves, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste oliection g Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure j
Identifier_
Freeboard (inches):
05103101
cL5
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
P No
❑ Yes
® No
❑ Yes
qNo
Structure 6
Continued

Facility Number: 9 — a7j, Date of Inspection Q1 0
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes rNo
seepage, etc.) C
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes [P No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes [P No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [� No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes (9) No
Waste Application
10. Are there any buffers that need maintenance/improvement? - ❑ Yes No
11. is there evidence of over application? I ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes [ No
12. Crop type -
Lc,_
13.
Do the receiving crops differ with those designated in the Certified Animal WaLte Management Plan (CAWMP)?
❑ Yes
(2No
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
MNo
Required Records& Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
ENo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
91 No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
FS] No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
P9 No
22,
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
M No
(ie/ discharge, freeboard problems, over application)
23_
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified A WMP?
❑ Yes
No
(3 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Com�'men�rr�ferdto q estioa)#)�` � Er�plain any YES�answers�and/ar�'any"�recommendations or any other Comm_ eats_ .� � s
Use draw fa` c�iltty to 6ette�r explain sltuabons9(nse add�honat prysgesas necessary): ❑Field Copy ❑Final Notes
�i ,. "�t`•=a �� :� �:�, :�..._._" t� , �,:
Reviewer/Inspector Name - ; , r. ' , _ € �.. a s. ii `'ri
Reviewer/Inspector Signature: Date: !G O
05103101 F,Continued

Facility Number: — Z - Date of Inspeclinn 1 c7
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes (P No
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes [JVo
roads, building structure. and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes qSNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters. etc.) ❑ Yes allo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes allo
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover? ❑ Yes ❑ No
05103101

i Division of Water Quality -
0-Division of Soil and Water:: Conservation
O Other Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: 4-8-2002 Time:
Q Not Operational Q Below Threshold
® Permitted ® Certified [3 Conditionally Certifed © Registered Date Last Operated or Above 'Threshold: .........................
Farm Name: EYergrecia.Som .............................. ..... County: Uladga..................... ............ ............ FRO .............
Owner Name: ................................................... Mmniby.FA pats................................._..... Phone No: 91.Q-i3ff-47..7.$............................ ........................
.......
.-Mailing Address: I'Q.. crx..7. 9................................... ... Rw&.Di]I.MC........................... 2,39.4...............
FacilityContact: 11D.haR.Wc........................................................ Title: ................................................................ Phone No: ...................................................
Onsite Representative:.WSIX_ urxIRy........................................... .............................. Integrator: Uurphy..Fa7 Wy..Far. s...._................................
Certified Operator.J.cr.tuU._D.Qu......................... .I.J'.TldW)............................................ Operator Certification Number:2.6.$,5$ .............................
Location of Farm:
Farm location: From White Oak, take River Rd. toward Cedar Creek. 112 mile past 2nd Burning Road Intersection, take +
right. It will be the 2nd dirt road past Burney Road Intersection. Once on dirt road just follow to the farm.
® Swine ❑Poultry ❑Cattle ❑Horse Latitude 34 • 4$ 37 4 Longitude 7$ • 46 37
Design Current
Swine Capacity Population
® Wean to Feeder
400
® Feeder to Finish
1000
® Farrow to Wean
3500
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Ca acit v Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 4,900
Total SSLW 1,662,500
Number of Lagoons 1 ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds 1 Solid Traps ❑ No Liquid Waste Management System
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 State'? (If yes, notify DWQ) ❑ Yes ❑ No
c. If disclarge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge'? ❑ Yes ® No
Waste 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:...................................................................................
Freeboard (inches): 28
05103101
Continued

Fkrility Number: 9--27
Date of Inspection 4-8-2002
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Applicatioit
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
12. Crop type Coastal Bermuda (Graze) Coastal Bermuda (Hay) Small Grain Overseed Matua
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?
16. 1s there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explaiq,'any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): 0 Field Copy ❑ Final Notes
15- Continue to work on bermuda establishment on newly resprigged sprayfield. Matua should be harvested ASAP to prevent shading of
ermuda.
A not -to -scale irrigation layout map with pull acreage was included with farm paperwork (noted on DS&WC review).
T
wer/Inspector Name PaulSherman
E
wer/Inspector Signature: Date: 6�
05103101 Continued

Facility Number: 9-27 Date of Inspection 4-8-2002
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i_e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged till pipe or a permanenthemporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes []No
Additional omments an orDrawings:
T
05103101

f
Muzhy P*ZAIJs , 1::'VG
)t6S,'vc �(
DrvisioN OF ENv2RONm=AL MANAGEMENT
V '
SUBJECT: Compliance inspection
County 91ADg-^--
Dear : 5 r'12 "
on ?-13;S an inspection of your animal operation was performed by the
Fayetteville Regional office (FRO). Please find enclosed a copy of our
Compliance inspection Report for your information. it is the opinion of this
office that this facility is in compliance with 15A NCAC 2H, Part .0217, and
that Animal Waste Management is being properly performed.
Should you have any questions regarding this matter, feel free to contact
me at (910) 485--1541 .
Enclosure
CC: Facility Compliance Groun
Sincerely,

NORTH CAROLINA DEPARTMENT OF EWUd3NMENT, SLALTH' A NATURAL RESOURCES
DMSIOIIN OF ENVIRONMENTAL MANAGEMENT
Fayetteville Regional Office
4
Animal Operation Compliance Inspection Form
s.
L TEX"HONx. ii ffit
„....'.:FACILIET
All questions answered negatively will be discussed in sufficient detail in
the -Comments Section to enable the deemed Permittee to perform the appropriate
corrections:
SECTION I
Animal Operation T
Horses, tattle, swine poultry, or sheep
SECTION II
1. Does the number and type of animal meet or exceed
the (.0217) criteria? (Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
poultry (30,000 birds with liquid waste
system)]
2. Does this facility meet criteria for
Animal Operation REGISTRATION?
3. Are animals confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a CERTIFIED ANIMAL
WASTE MANAGP.MEN'T PLAN?
S. Does this facility maintain waste management
records (volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover crop)?
6. Does this facility meet the SCS minimum
setback criteria for neighboring houses,
wells, etc?
N0&!f ;
I , S 0 w FA9M
l�446
3 • F�� � 6
(3Sa o�
LA5 do 4/
LV t *Iv Gl°'_OrA .

SECTION III
yield Site Management
1. Is animal waste stockpiled or lagoon
construction within 100 ft. of a USGS
Map Blue Line Stream?
2. Is animal waste land applied or spray
irrigated within 25 ft. of a USGS Map
Blue Line Stream?
3. Does this facility have adequate acreage
on which to apply the waste?
4. Does the land application'site have a
cover crop in accordance'with the
CERTIFICATION PLAN?
5. Is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar man-made devices?
5. Does the animal waste management at this
farm adhere to Best Management Practices
- (BMP) of the approved CERTIFICATION?
7. Does animal waste lagoon have sufficient
freeboard? How much? (Approximately)
8. Is the general condition of this CAFO facility,
including management and operation,
satisfactory?
SECTION IV
Comments
r

State of North Carolina
Department of Environment,
Health and Natural Resources •
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary [D E H N Pt
Andrew McCall, Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
July 19, 1995
Murphy Farms, Inc.
P_ O. Box 759
Rose Hill, NC 28458
SUBJECT: Compliance Inspection
Murphy Farms, Inc.
Bladen County
Dear Sir.-,
On July 13, 1995, an inspection of your animal operation was performed by
the Fayetteville Regional Office (FRO). Please find enclosed a copy of our
Compliance Inspection Report for your information. It is the opinion of this
office that this facility is in compliance with 15A NCAC 2H, Part .0217, and
that Animal waste Management is being properly performed.
Should you have any questions regarding this matter, feel free to contact
me at [phone].
Sincerely,
10- 1
-9iU"'-
D. T_ Jones
Chemist
Enclosure
cc: Facility Compliance Group
Wachovia Building, Suite 714, Fayetteville, North Carolina 28301-5043 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

NORTH CAROLINA DEPARTMENT OF ENVIRONMENT, HEALTH a NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
Fayetteville Regional Office
Animal operation Compliance Inspection Form
All questions answered negatively will be discussed in sufficient detail in
the Comments Section to enable the deemed Permittee to perform the appropriate
corrections:
SECTION I
Animal operation Type:
Horses, cattle, swine, poultry, or sheep
SECTION II
1. Does the number and type of animal meet or exceed
the (.0217) criteria? (Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
poultry (30,000 birds with liquid waste
system)]
2. Does this facility meet criteria for
Animal Operation REGISTRATION?
3. Are animals confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a CERTIFIED ANIMAL
WASTE MANAGEMENT PLAN?
5. Does this facility maintain waste management
records (Volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover crop)?
6. Does this facility meet the SCS minimum
setback criteria for neighboring houses,
wells, etc?
NOTES:
*Doesn't need until 1997.
1. Sow Farm (3500)
2. 8 Acrg plus Lagoon
3. Farrow to wean operation
1��
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INN
is=

SECTION III
Field Site Manacgement
1_ Is animal waste stockpiled or lagoon
construction within 100 ft. of a USGS
Map Blue,Line Stream?
2. Is animal waste land applied or spray
irrigated within 25 ft. of a USGS Map
Blue Line Stream?
3. Does this facility have adequate acreage
on which to apply the waste?
4. Does the land application site have a
cover crop in accordance with the
CERTIFICATION PLAN?
5. Is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar man-made devices?
6. Does the animal waste management at this
farm adhere to Best Management Practices
(BMP) of the approved CERTIFICATION?
7. Does animal waste lagoon have sufficient
freeboard? How much? (Approximately )
8. Is the general condition of this CAFO facility,
including management and operation,
satisfactory?
SECTION IV
Comments
NOTES:
Section III - Items #4 and #6
Does not have to have WMP until 1997.
But he already has one in place.
The facility is already adhering to BMP
ee
11M
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1�0
mom.
11=�
Directions
SR 1318 Evergreen Farm Road (.1 mile North of SR_ 1320)

State of North Carolina
Department of Environment,
Health and Natural Resources • •
Fayetteville Regional Office
,lames B. Hunt, Jr., Governor Adam
ID
Jonathan B. Howes, Secretary C
Andrew McCall, Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
July 19, 1995
Murphy Farms, Inc.
P. O. Box 759
Rose Hill, NC 28458
SUBJECT: Compliance Inspection
Murphy Farms, Inc.
Bladen County
Dear Sir
On July 13, 1995, an inspection of your animal operation was performed by
the Fayetteville Regional Office (FRO). Please find enclosed a copy of our
Compliance Inspection Report for your information. It is the opinion of this
office that this facility is in compliance with 15A NCAC 2H, Para .0217, and
that Animal Waste Management is being properly performed.
Should you have any questions regarding this matter, feel free to contact
me at [phone].
Sincerely,
D. T. Jones
Chemist
Enclosure
CC: Facility Compliance Group
Wachovia Building, Suite 714, Fayetteville, North Carolina 28301-5043 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post-corzumer paper

NORTH CAROLINA DEPARTMENT OF ENVIRONMENT, HEALTH & NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
Fayetteville Regional Office
Animal operation Compliance Inspection Form
All questions answered negatively will be discussed in sufficient detail in
the Comments Section to enable the deemed Permittee to perform the appropriate
corrections:
SECTION I
Animal Operation:
Horses, cattle, swine, poultry, or sheep
SECTION II
1. Does the number and type of animal meet or exceed
the (.0217) criteria? [Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
poultry (30,000 birds with liquid waste
system)]
2. Does this facility meet criteria for
Animal Operation REGISTRATION?
3. Are animals confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a CERTIFIED ANIMAL
WASTE MANAGEMENT PLAN?
5. Does this facility maintain waste management
records (Volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover crop)?
6. Does this facility meet the SC5 minimum
setback criteria for neighboring houses,
wells, etc?
NOTES:
*Doesn't need until 1997.
1. Sow Farm (3500)
2. B Acrg plus Lagoon
3. Farrow to wean operation
ee
11■
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n1OEI1O
INN
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SECTION III
Field Site Management
1. Is animal waste stockpiled or lagoon
construction within 100 ft. of a USGS
Map Blue Line Stream?
2. Is animal waste land applied or spray
irrigated within 25 ft_ of a USGS Map
Blue Line Stream?
3. Does this facility have adequate acreage
on which to apply the waste?
4. Does the land application site have a
cover crop in accordance with the
CERTIFICATION PLAN?
5. Is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar man-made devices?
6. Does the animal waste management at this
farm adhere to Best Management Practices
(BMP) of the approved CERTIFICATION?
7. Does animal waste lagoon have sufficient
freeboard? How much? (Approximately )
8. Is the general condition of this CAFO facility,
including management and operation,
satisfactory?
SECTION IV
Comments
NOTES:
Section III - Items #4 and #6
Does not have to have WMP until 1997.
But he already has one in place.
The facility is already adhering to BMP
ee
OEM
0�0
UNIONS
is=
Directions
SR 1318 Evergreen Farm Road (.1 mile North of SR. 1320)

Site Requires immediate Attention:
: Facility No.
DMSION bkk` tM` RI EIIT L 1W4AGEl NT
ANIMAL FEE )Len�OPERATIONS :STTE`VISTTATION RECORD
DATE:�;.4.
•Farm Name/Owner. e n k
Mailing Address: 4- 8
County:
Integrator. P OnC:_ s�i tQ1• 2��_ % a 11 I
On Site Representative: _ ^r:' 1 ::?Phone::
Physical Address/L,ocativn: 6a Ilk La IPA) aio
Type of Operation: Swine ,g, Poultry, r ;Cattle
Design Capacity: _q0'� Number. of*1i#Ws on-.Sit,Ss�s
DEM Certification Number: ACE_, � "DEM, Cm t fkadon Number: ACNEW
Latitude:_ " Ai' 4S• Longitude:. 7' "
. C rcle.Ycs'or,No;Y�
Does the Animal Waste Lagoon have z ifficicnE frezboard`:Of. ., Foot + 25 y=. 24 hour storm event
(approximately I Foot + 7 inches) ".Yes or No : `_ `� :.; Actual` Freeboard La L �L_ Inches
Was any seepage observed from the. lagoon(s)?. Y_cs or -No. Was 'any.erosion observed? Yes or No (Seepage was
Is adequate Iand available for spray?Isa ' YeS'orNo: hc covcr'crop; a�.cquate? Yes or No Not Evaluated
Crop(S) being utilized:_ (Spray Field'or� covet rcrop was''.not evaluated)
Does the facility meet SCS minimum setback' criteria?.`:200:FeztfromDwellings? Yes or No
°y :1W.Fect'fromVells? Yes or No
* Is the animal waste stockpiled within 100` Feet of<:USGS Blu Lit a •Stre' ant ..Yes or No*
* Is . animal waste land applied or spray .irrigator �withi 25 poet. of-i USGS Map Blue Line: Yes or No
Is animal waste discharged into water of the° state by: ;man-niade`ditch--'flushing. system, or4other
similar man-made devices? Yes or No. if ,Ya,: Please•Ezplain.
Does the facility maintain adequate waste' ntWgtment records --'(volumes of manure, land applied,
spray irrigated on specific acreage witI Ycover crop)? Yes-or'No(waste management records were not.
Additional Comments:_ r=v�wedl
_This was a y2ry bZlef'�_'nQre t�orouh insvectiori will be conducted in the _future.
Please contact,-DEM should that`pases'�&- danger to surface waters.
* This farm was not located on "a •USGS 'T0P0`map to' -determine Mue Line" status.
,•4
If you have'questions .coneerriimCthis -re ort,,. lease• do~not-.fieftitate ta,.contact the inspector
at [phone]. Please contact: 'the specter'' � the above information is incorrect.
'Inspector Name Signature
cc: Facility Assessment Unit b� - ' ' . - Use Attachments if Needed. -

Onsite Representative:...
Certified Operator:
0 Routine 0 Complaint 0 Follow-up of DWQ ins ection 0 Follow-up of DSWC review 0 Other
Date of Inspection S
Facility Number 4
Time of inspection Z •'30 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status* ❑ Registered ❑ Applied for Permit (ex:1.25 for 1 hr 15 min)) Spent on Review
P$Certified ❑ Permitted or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated:
Farm Name: County:
-7D
Land Owner Name: _1� , �l .e, .. _ ... Phone No: '?_ ` �Z..,[ y— _ . ..
Facility Conctact: 51.- .t1 _ _.. Title ..... _ Phone No:...
Mailing
Integrator:
Operator Certification Number:
Latitude �� �� u Longitude
is
Type of Operation and Design Capacity
,�Dsigne� ` �.''� .
1CaclVPO �flCO 1110nR01X lDr
li
wCi❑ Wean to Feeder La ' ;; ❑ Dairy
h ❑Feeder to Finish3 Non -La er ❑Nan
Farrow to Wean
�
t^
Farrow to Feeder # To aI DeStg> "Capaelty� Q
Farrow to Finish S�� SOS T �o SSLW
1# M ,
❑ Other-IN:,-;x"s+,s.,vs"R
r,�': - �'
Number OUI agoatrtTAHolding Pori Sl ❑Subsurface Drains Present ✓
Lagoon Area ,, ❑Spray Field Area r
Genera
l . Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water'? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes Xfo
❑ Yes nKNo
❑ Yes No
❑ Yes No
❑ Yes Wo
❑ Yes M No
r—
❑ Yes 'a No
9
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
❑ Yes N No
Continued on back

Facility Number: -.j2Y
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
VrNo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
C$[No
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
KNo
Structures (Lagoons and/or Holding Pon js
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
kNo
Freeboard (ft): Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
;2 7
10. Is seepage observed from any of the structures?
❑ Yes
tZNo
11. is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
fS No
12. Do any of the structures need maintenance/improvement?
Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
XNo
Waste ApUlication
14. Is there physical evidence of over application?
❑ Yes
, No
(If in excess of WLM_P, or runoff entering waters of the State, notify DWQ)
15. Crop type _ lr�. +�.�ZIPt-- •—.... __._.........
16. Do the receiving crops differ with those designated in the Animal Waste Management PIan (AWMP)?
❑ Yes
No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes[
No
18. Does the receiving crop need improvement?
❑ Yes
J`No
19. Is there a lack of available waste application equipment?
❑ Yes
ANo
20. Does facility require a follow-up visit by same agency?
❑ Yes
A No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
[:]Yes
gNo
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes.
❑ No
24. Does record keeping need improvement?
❑ Yes
❑ No
Comments (refer to "questtoa #} Ezplain any YES answers andlor any recommeu(Ianons'arony other comments
Use drawings of ftixpan iuiosµue`aditonalpagenessr)acwy is 3
a
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

`-ua�s���x>+s:i _ .�K ,...-_ _ 2:i�5aa§44oa�b. a�'� _,. '.«�' °,t '" !""�s' . ,�c,
�3❑ Div of Soil and Water Conservation ❑ Other Agency
�® Division of Water Quality��
® Routine 0 Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review 0 Other
Date of Inspection
Facility Number o L% '
Time of Inspection /O: P 1-6 124 hr. (hh:mm)
0 Registered 13 Certified [3 Applied for Permit 13 Permitted 113 Not O erational Date Last Operated: ............
Farm Name: .......... rG �7,��-t •-- Gounty',!............................................................
................ ... ..... .......... ,
Owner Name:........; .. ..............?� f ............... Phone No:..1.. d�./......................
j............................. .
FacHi€y Contact: .....sr"' ............... # > .f. r..... Title:.................... ....... Phone No:................................................. ......... ......................................................
MailingAddress:.........�........��....�..r. ..7J_1 6dr //............................ Y .....- - --.. ....................... ..
�... .............. f.......
Onsite ..... ,............... ....Integrator:.............�...............
Certified Operator:............................................................................................................... Operator Certification Number:. ......------------.............
Location of Farm.
Latitude =• ` 46 Longitude =• 6 "
<f 34" "il}`iT 'i43k i+'✓R��- >Des�p� Gbt CUrre7lt� '"^�«Destgn -.CUrrent-C Y
'' ds•
$h,f..;.t,;i•.
,h
r latn 4Paw. oCapactkn wiiPut_ry Cactw` CKPp�rlav-f
mnJl�5.'*kRHG A`fMr '.d..D® oLtYn
x. h -law�irug:Y€*tc,3.':+r." R'6^,'.�,
g
.l��-fi4_Few ....>��JSy.
1.
Wean to Feeder
fm
pa
❑ Layer ❑ Dairy
❑Non Layer ❑ Nan Dauy
.vs<t; ..rt „ter" ri w •wa mtt g-_.. s cyc 's4., rai�.
111Other
Feeder to Finish
poD
D06
Farrow to Wean
3X7,00
s-Da
❑Farrow to Feeder
N^��
^` -. Kdi�'4o: .WW-..W,.v�4 C+. ']v3.-.. ':�NR-A.✓�R�SFti
Total De5>Egn'Capaci#y',
"
❑ Farrow to Finish
�e
❑Gilts
�d
a Tot91 SSLW
❑ Boars
m+.rs:..._
.-..-_.. . .. ...:.. .....—,.�_ :..
...,. ... _._. ..
.....
�r �'
.-..-v,u.... r: ..: ..t ✓:_...-.^^.¢' .'°'R°°+.,':2fbaF"_ ..Y-�a .xylay-zd
d�M. �ili�-&�'k%'.�Yft�i 'x°�� 'fie mR"3 9. '�n�A'.'m•.'^.x
^Nnmber�uf Lagoons! Hoidutg Ponds �',
�,'.r,:
❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Y ✓��(Jh`���bi �h F� %wrote Y N 11:nA. �r �D �T $ �`�_..❑
No Liquid Waste Management System
a
General
1. Are there any buffers that need maintenancelimprovemeat?
2. Is any discharge observed from any part of the operation?
Discharge originated at: [ILagoon ElSpray Field [3Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify Ml'Q)
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) -
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than ]agoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25197
❑ Yes KNo
❑ Yes PtNo
❑ Yes EO No
(:]Yes ' CR[No
❑ Yes fiallo
❑ Yes gNo
❑ Yes A No
KYes ❑ No
❑ Yes 1,:No
❑ Yes to No
Continued on back

Facility Number: 0 — Z?
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes XNo
Structures (1-agoons.11olding Pands Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I
Identifier:
Freeboard ft -.._._...../� .......� ........ ......
( ): ........... ...�...................
Structure 2 Structure 3 Structure 4 Structure 5
10. is seepage observed from any of the structures?
11 _ Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste :'Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type +e2... ._ .....................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewedlnspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24, Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0 No.violations or deficiencks.rvere noted during this:visit..Yau.will receive no further
coriespi)6deh& about this.visit:..
❑ Yes Wi To
Structure 0
❑ Yes No
❑ Yes �No
Ad Yes ❑ No
❑ Yes M(No
WYes ❑ No
❑ Yes Od No
❑ Yes 9No
M Yes ❑ No
❑ Yes P9 No
❑ Yes JgNo
❑Yes No
❑ Yes ,{ No
❑ Yes NNo
Yes El No
❑ Yes J1 No
Comments (iefer'to,questidri #) ,ExpUin'any;YES answers`andlor any recoimmeiidatzons oe any oxther comments , vR
Use drawtrigs of facthty to betterexplain situatioms. (use additioiusl12
pages as.necessary) :.€
47
S • �� . �,� , �`����,�.� ��� w,� /�- � �� ,� � ,tom �// �
��1���` /�;/''�.� Ovfaflc���t/%�/Ai �/+�' /r7�ff^.t/4��.�1�'�-� �'��►.TGi�J��/�
12. /�✓ri�/�� ems'a �oa�o.•� v1� / / OA 4pw�/
�,.Oe A <' "-fr,91 Re VIC 161, r1o®ter, S6 . Zo 1.Z
Reviewerfin Spector Name
Reviewer/Inspector Signature: ,�� Date:

Facility Number Date of Inspection 7
Time of Inspection / , dV 124 hr. (hh:mm)
Permitted 0 Certified [3 Conditionally Certified [3 Registered 113 Not O erationa] Date L%st Operated:
Farm Name: ..... ll. ...-... .c .ok........50-f.S.3......4f ........ ................ County:..... .......... ..............------------
Owner Name:.............. u r' . 5.......... Phone No: ............ ......
Abs,Y
��ii �
Facility Contact: .....i .!`......- l !1. ...... Tale �, !�'f ... ......... Phone No :...................................................
....... .....
Mailing Address* .....�j.l..... ...L�.s�. 't'...ir..�%`......�r11'. *.... .......... ....�l.l l.! ...(. 4 .............. .Z
OnsiEe Representative: t'.. ..t.G.............. Gt/?41�5...................................... Intel;rator:.................... ......... ...................... ...................................
.........
Certified Operator:........tF r..t'�, ,,,,,,,,,,,, >rTl, S Operator Certification Number:..........................................
.......... ........ ........... .........
Location of Farm:
r
.......................... ............ ................................... ............................. ......................... ..................................... .......................... ................ ............................. ...... ...........
Latitude �' �' �•� Longitude
Design Current Design Current Design Current
Swine ,- _ Ga acity Po Mahon Y Cattle Capacity Po ' Matron
Point Ca acrty Po ulation paci
❑ Wean to Feeder " ❑ Layer _ ❑ Dairy
❑ Feeder to Finish ." ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean ::,. _
❑ Farrow to Feeder ❑ Other
t-.
rOB4]oars
rrow to Finish T6tai1 D8ign 'Opacity
'
:Tota1'SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area, ❑ Spray Field Area
Haldurg Ponds 7 Solyd-Traps ww ❑ No Liquid Waste Management System
_ -- —
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
h. 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?
d. Dins discharge bypass a lagoon system? (If yes, notify DWQ) ❑Yes ANo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure 2 Structure, 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): ................ ................................... ............................. ....... ...........................
........ ......................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes Alklo,—
seepage, etc.)
3/23/99 Continued on back

Facility Number: — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any pan of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11, Is there evidence of over application? []Excessive Ponding ❑ P
12. Crop type
toe- / llJP_rty
13. Do the receiving crops differ with thdse designated in the Certifie@ Animal Waste Man
14. a) Does the facility lack adequate acreage for land application? /
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
(CAWMP)?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
. : �F6•vi0iaa..Qris:or deficiencies were note#• d(;}ring fbis:visjt: • Y:oir will-reeeiye Rio forthoe
corres ondeitce aN ' f this visit. _
❑ Yes XNO
❑ Yes WNo
XYes ❑ No
❑ Yes VIO
❑ YesANo
[]Yes JKNo
❑ Yes KNo
❑ Yes J�No
❑ Yes o
❑ Yes EKNO
❑ Yes P(No
❑ Yes ONO
❑ Yes 9No
❑ Yes ;,No
Ayes' ❑ No
❑ Yes allo
❑ Yes ANo
❑ Yes P�No
❑ Yes [6No
❑ Yes R�No
❑ Yes WNo
lieeds rewt o w'^
q• %Need -4 e; +Ler �p records 6 P4 //S ir c. CG �- u-x-� ( Pach,
0[ranT �aS belt. w� ed aP[ '�' ek o�r'ofk 4e okl
6iA eK-Pre cicrea►ge.
Reviewer/Inspector Name = _ d S : nT,
R.+.0 7T�' . _ , 'o-•`-
`�
Reviewer/Inspector Signature:
Date:
3/23/99

Facility Number: >7 q — Z Date of Inspection
Odor Issues
26_
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
Ayes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
®' o
roads, building structure, and/or public property)
1
29,
is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
j r0
'
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
kNo
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
Poo
32.-
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
es --El No
trona m oments i - -
.r
3/23/99

0_Division of, Soil. and Water..Conservation - Operation Review' =
O Division of Soil and Water Conservation -Compliance Inspection
(♦ Division of Water Quah -. ty - Compliiance Inspection
a
0 OtherAgency - Op eration)Review..n�
LORou tine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review 00ther
Facility Number 09 27 Date of inspection 2-22-2000
Time of Inspection 11:45 24 hr. (hh:mm)
® Permitted 0 Certified [3 Conditionally Certified [3 Registered 0 Not O erahonal Date Last Operated:
Farm Name: Exec reemSom........................................................................ .. County: BlAdem ............................................... FRO .............
Owner Name:.. ................................................. Murphy-FAmily.farm ...................... Phone No: 9104.6"IM ..........................................................
Facility Contact: .............................................................................. Title:
................. Phone No:...................................................
Mailing Address: 652.EyRxgr.Pwa-Farm.Rd.................................................................. W.W1P..QaM..N.G..................................................... Z9399 .............
Onsite Representative:........................................................................................................... Integrator: NlulCi hyfamilyfAr7auS........................................
Certified Operator: Rtyb t.1............................... Y.QUlg............................................... Operator Certification Number:18.4(1,..........
Location of Farm:
Latitude 34 • . 48 37 Longitude 78 • 46 37
Design Current
Swine Canacitv Ponulation
® Wean to Feeder
400
® Feeder to Finish
1000
29 Farrow to Wean
3500
Lj Farrow to Feeder
Farrow to Finish
t is
Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I 1 ❑ Dairy
❑ Non -Layer I I ❑ Non -Dairy
❑ Other
Total Design Capacity 4,900
Total SSLW 1,662,500
Number of Lagoons 1 ❑ Subsurface Drains Present 110 Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps L ❑ No Liquid Waste Management System
Dischar es R Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...................................
Freeboard (inches): .15...................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
3/23/99 Continued on back
Printed on 3/7/2000

Facility Number: 09-27 Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
2-22-2000
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
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?
16. Is there a lack of adequate waste application equipment?
'Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
:No vh atiotis'or deficiencies-were;noted :during• tAN visit:: You: will :receive uo further ' -
correspondence ibouf this'visit..
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Comments (refer to question #):. Explain any YES answers and/or any•recomdiendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Site visit was made to check on lagoon level. Did not speak with an on -site representative.
Reviewer/Inspector Name Jeffery Brown
Reviewer/Inspector Signature: Date:
Printed on 317/2000

I t
Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
090027 Facility Status:
Inspection Type:
Compliance Inspection
Reason for Visit
Routine
Date of visit:
03/23/2017 Entry Time: 08:30 am
Farm Name:
Evergreen Sow
Owner:
Murphy -Brown LLC
mauve Permit AWS090027 ❑ Denied Access
Inactive Or Closed Date:
County: $laden Region:
Exit Time: 9:00 am Incident 9
Owner Email:
Phone:
Fayetteville
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 658 Evergreen Farm Rd White Oak NC 28399
Facility Status: E Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farts: Latitude: 34° 48' 49" Longitude: 78" 46' 60"
Fans location: From White Oak, take River Rd. toward Cedar Creek. 112 mile past 2nd Burning Road Intersection, take right. It will
be the 2nd dirt road past Burney Road Intersection. Once on dirt road just follow to the farm.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator. .John S Cain Operator Certification Number. 23570
Secondary OIC(s):
OnSite Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone
On -site representative Mike Ammons Phone
Primary Inspector. Robert Marble
inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Phone:
Date:
page: 1

Permit: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number. 090027
Inspection Date: 03/23/17 lnppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean 3,839
Total Design Capacity: 3,839
Total SSLW: 1,662,287
Waste Structures
Disignated Observed
Type Identifier Closed Date start Data Freeboard Freeboard
Lagoon
1
19.50
30.00
Lagoon
EVERGREEN
19.00
page: 2

k
Permit: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number. 090027
Inspection Date: 03/23/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na Na
1. Is any discharge observed from any part of the operation?
El
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)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes No Na Me
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
S. Are there any immediate threats to the integrity of any of the structures observed (I.eJ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
MEI
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Ys No No No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
is PAN > 10%/10 Ibs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

L
Permit: AWS090027 Owner - Facility: Murphy -Brown LLC Facility Number. 090027
Inspection Date: 03/23/17 Inssection Type: Compliance Inspection Reason for Visit: Routine
Waste ApOication
Yes 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 i
Blanton sand, 2 to 7%
slopes
Soil Type 2
Lakeland sand, 1 to 7%
slopes
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
❑
❑
Management Plan(CAWMP)?
15, Does the receiving crop and/or land application site need improvement?
❑0
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Ygs No Na 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?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number. 090027
Inspection Date: 03/23/17 Inpsection Type: Compliance Inspection Reason for visit: Routine
Records and Documents
Yes
No Na No
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fait 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
❑
E ❑ ❑
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?
❑N
❑ ❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑ ❑
Other Issues
Yea No Na N4
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,
❑
E ❑
❑
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?
❑
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 reviewfinspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
E ❑
❑
page: 5

0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 090027
Facility Status: Active permit: AWS090027
❑ Denied Access
Inpsection Type: Compliance Inspection
Inactive Or Closed Date:
Reason for visit: Routine
County: Bladen Region:
Fayetteville
Date of Visit: 07/28/2015 Entry Time: 09:00 am Exit Time: 10:00 am Incident #
Farm Name: Evergreen Sow
Owner Email:
Owner: Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address: 658 Evergreen Farm Rd
White Oak NC 28399
Facility Status: 0 Compliant ❑
Not Compliant Integrator: Murphy -Brown LLC
Location of Farm:
Latitude: 34' 48' 49" Longitude:
76° 46' 60"
Farm location: From White Oak, take Rarer Rd.
toward Cedar Creek. 112 mile past 2nd Burning Road Intersection, take right.
It will
be the 2nd dirt road past Burney Road Intersection. Once on dirt road just follow to the farm.
Question Areas:
Dischrge i£ Stream Impacts
Waste Col, Stor, & Treat Waste Application
Records and Documents
Other Issues
Certified Operator: John S Cain Operator Certification Number: 23570
Secondary OC(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: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number: 090027
Inspection Date: 07/28/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Farrow to Wean
3,500
❑ Swine - Feeder to Finish
1,000
Swine - Wean to Feeder
400
Total Design Capacity: 4,900
Total SSLW: 1,662,500
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
1
19.50
Lagoon
EVERGREEN
19.00
1 31.00
page: 2

Permit: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number: 090027
Inspection Date: 07/28/15 Inppection 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?
❑
❑
❑
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?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
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 No
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: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number: 090027
Inspection Date: 07/28/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
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
Blanron
Soil Type 2
Lakeland
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
M ❑
❑
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
❑
M ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
❑
❑
1 B. 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?
❑
E ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
E ❑
❑
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?
❑ MEJ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number:
090027
Inspection Date: 07/28/15 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yes No No Na
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
01111
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■ ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
M ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
N ❑
❑
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?
❑
0 ❑
❑
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-compliance of the Permit or
❑
0 ❑
❑
CAWM P?
33. Did the Reviewerlinspector fail to discuss review/inspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
M ❑
❑
page: 5

0 Division of Water Resources
El Division of Soil and Water Conservation
11 Other Agency
Facility Number 090027 Facility Status: Active Permit: AVVS090027
Denied Access
Inppection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Bladen i Region:
Fayetteville
Date of Visit: 10/21/2014 Entry Time: 11:00 am Exit Time: 12:00 pm Incident #
Farm Name: Evergreen Sow +'
Owner. Email•
Owner: Murphy -Brown LLC Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 658 Evergreen Farm Rd White Oak NC 28399
Facility Status: E Compliant Not Compliant Integrator: Murphy -Brown LLC
Location of Fam1: Latitude: 34' 48' 49" Longitude:
78' 46' 60"
Farm location: From White Oak, take River Rd. toward Cedar Creek. 112 mile past 2nd Burning Road Intersection, take right.
It will
be the 2nd dirt road past Burney Road Intersection. Once on dirt road just follow to the farm.
Question Areas:
Dischrge 8 Stream Impacts Waste Cal, Stor, 8 Treat Waste Application
Records and Documents Other Issues
Certified Operator: John S Cain Operator Certification Number: 23570
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: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number: 090027
Inspection Date: 10/21/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine -Farrow to Wean
3,500
Swine - Feeder to Finish
1,000
Swine - Wean to Feeder
400
Total Design Capacity: 4,900
TOtal SSLW: 1,662,500
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
1
19.50
32.00
lagoon
EVERGREEN
19.00
page: 2

Permit: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number: 090027
Inspection Rate: 10/21/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No No Ne
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 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 Ne
4. Is storage capacity less than adequate?
❑N
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not property addressed andfor managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
& Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
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: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number: 090027
Inspection Date: 10/21/14 Inpsection 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
Blanton
Soil Type 2
Lakeland
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
determination?
17, Does the facility lack adequate acreage for land application?
❑
N ❑
❑
1 B. 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?
❑
E ❑ ❑
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?
❑
[] ❑
If yes. check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number:
090027
Inspection Date: 10/21/14 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yes
No Na No
Crop yields?
11
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
❑
M ❑
❑
(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
❑
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?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
M ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
❑
❑
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?
❑
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-comp[iance of the Permit or
❑
M ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewrnspection with on -site representative?
❑
M ❑
❑
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: 090027 Facility Status: Active Permit: AWS090027
❑ Denied Access
Inppection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Bladen Region:
Fayetteville
Date of Visit: 02/27/2013 Entry Time: 01:00 pm Exit Time: 1:30 pm Incident #
Farm Name: Evergreen Saw Owner Email:
Owner: Murphy -Brown LLC Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 658 Evergreen Farm Rd White Oak NC 28399
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34° 48' 49" Longitude:
78" 46 60"
Farm location: From White Oak, take River Rd. toward Cedar Creek. 112 mile past 2nd Burning Road Intersection, take right.
It will
be the 2nd dirt road past Burney Road Intersection. Once on dirt road just follow to the farm.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other issues
Certified Operator: John S Cain Operator Certification Number: 23570
Secondary OiC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone:
On -site representative Mike Cudd Phone :
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Records reviewed 2114113
Site visit 2/27/13
Robert Marble
Phone:
Date:
page: 1

Permit: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number: 090027
Inspection Date: 02/27/13 Iripsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean
3,500
Swine - Feeder to Finish
1,000
Swine - Wean to Feeder
400
Total Design Capacity:
Total SSLW:
Waste Structures
Dlslgnated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.50
Lagoon EVERGREEN 19.00
page: 2

Permit: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number: 090027
Inspection Date: 02/27/13 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?
❑
❑ 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)
❑
00
❑
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
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 (I.eJ large
❑
M ❑
❑
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?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
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.?
Q
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: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number: 090027
Inspection Date: 02l27/13 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
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Blanton
Soil Type 2
Lakeland
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
N ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
■ ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes
No No No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
N ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
E ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS090027 Owner - Facility : Murphy -Brown LLC Facility Number. 090027
Inspection Date: 02/27/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na Ne
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
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
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
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
❑
❑
❑
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,
❑
E ❑
❑
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?
❑
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
❑
❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewfinspection with on -site representative?
❑
N ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
E ❑
❑
page: 5

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: :OOQ Departure Time: County: (3lAJOP�AJ Region: 1:;W
Farm Name: FjertA re ry 5w Owner Email:
Owner Name: ew&.)Vy Phone:
Mailing Address:
Physical Address:
Facility Contact: 0 -, ��,�,�� MS Title: Phone:
Onsite Representative: r. T .� Integrato_0 rt(kv (�
Certified Operator: U O n ca�'k _ - Certification Number:
Back-up Op'e ator: Certification Number: -1 0S 97
Location of Farm:
Latitude:
Longitude:
Design Current 1 DesignCurreat
Design Current
Swine Capacity Pop. Wet Poultry C p cttvPop
Cattle Capacity Pop.
:.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I INon-Layer
I
Daja Calf
Feeder to Finish
QQ
Dairy Heifer
Farrow to Wean
Design . Current
D Cow
Farrow to Feeder
D . P,oult � Ca aci Po .
Layers
Non -Layers
Non -Dairy
Farrow to Finish
Beef Stocker
Gilts
Beef Feeder
Beef Brood Cow
Boars
Pullets
fi T
Turkeys
Other ' _
Turke Poults
Other
LJOther
Dischar es 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)
❑ Yes P No ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes ❑ No
['] NA ❑ NE
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 [ZNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [] Yes [P No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [] Yes [P No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility umber: jDate 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 Vj NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):T
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.) TT
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? 0
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 [P No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures
require ❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure
to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[] Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
[] NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes `P No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and i " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes � No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes N No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412011 Contdnued

Fneili umber: -a rl Date of Inspection:
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? ❑ Yes No [DNA ❑ 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
E) 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
53No
❑ 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
rj No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ban
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Ig No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or,,any.otherrcommentst
Use drawings of facility to better explainsituatioas(use addjhonahpages as necessary). ,
sty. awl
ILL411 /ij
j ec'ojS v_w+' q1)V1111
Reviewer/Inspector Name: ::A4 M&UC
Reviewer/inspector Signature:
Page 3 of 3
Phone: R t"i3
Date: g1►g1 j1
21412011

Itype or visit: ® i:ompuance inspecuon l..j uperanon xevtew V arrucrure nvaivauun V i ecnnicai Assisrance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0_Emergency 0 Other 0 Denied Access
Date of Visit: j Arrival Time: Departure Time: 1 ounty
Farm Name: � `QOwner Email:
Owner Name: tl��Q �rftx_�7i1 , LUL Phone:
Mailing Address:
Physical Address:
Region:_
Facility Contact: t Title: Phone:
OnsiteRepresentative: I Integrator: M ".xQ-gyp , ?>row�
'T
Certified Operator: Uc6 fN _ Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pap.
Cattle
Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I jNqn-La er
DairyCalf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D . Paul
Ca aci
Po
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Pouets
Other
Other
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
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)?
O Yes M No ❑ NA ❑ NE
❑ Yes ❑ No Co NA ❑ NE
❑ Yes ❑ No 0 NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) [] Yes ❑ No O NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 25 No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes F�r) No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: tf - Date of Inspection:
Waste Collection & Treatment ,
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? L Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑Yes r] No Xj NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): d ��
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[RNo
❑ 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
F2 No
[DNA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
[] Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[� No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[4 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc,))
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift !❑ Application Outside of Approved Area
12. Crop Type(s): CO�Stc�.�YiMc� �.�i 4.c-i ,�GZSufG fr... G ra;n Ciue�se��
13. Soil Type(s): 1'i kzn � L-Q-Y-e IQ 0L4 , WC). So lo-
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
QTNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
QDNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
EP No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Rg No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Pg No
❑ NA
❑ NE
Required Records _& Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�PNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
V No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking [] Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [:]Yes �No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes rNo [] NA] NE
Page 2 of 3 21412011 Continued

Facil Number: - Date of Inspection: 0 /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes VNo ❑ 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? ❑ Yes [2{ No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No (DNA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes `M 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?
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 [3 No ❑ NA ❑ NE
❑ Yes CffNo ❑ NA ❑ NE
❑ Yes fil No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [4 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes Pg No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes P No ❑ NA ❑ NE
lComments (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 pagesas necessary)..
Reviewer/inspcctor Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: Q 10A'X-t� 33oo
Date: !I2% 7 f / L
21412011

hype of Visit: 0 Compliance Inspection U Operation Review U Structure Evaluation U "Fechnical Assistance
Reason for Visit: a Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 1Z Arrival Time: Departure Time: Doti County: BLftm
Farm Name: 1� �� Owner Email:
Owner Name: j'�t�.rJJIt�.I���}�.}�.�-i[. _ _ Phone:
Mailing Address:
Physical Address: A J� i j
Facility Contact: M � (2Title: Phone:
Onsite Representative: it
Certified Operator: U-6 kh
Back-up Operator:
Location of Farm:
Latitude:
Region: FWD
Integrator: t4w--VOL-)"
Certification Number: Z�
Certification Number:
Longitude:
Design
Current F�Design Current
Design Current
Swine Capacity
Pop. Wet Poultry C p ty Pop. Cattle
Capacity Pop.
Wean to Finish
La er Dairy Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
Coo�;
Dairy Heifer
Farrow to Wean
35M
esign Current Dry Cow
Farrow to Feeder
D . P,oui , 2 Ca bl. i J P■o , Non -Dairy
Farrow to Finish
Layers Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Qther
Turkey Poults
Other
Other
Discharnes and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes q
No ❑ NA ❑ NE
Discharge originated at: ❑Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No KM NA ❑ NE
b. Did the discharge reach waters of the State? (If yes. notify DWQ) ❑ Yes ❑ No 5 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 I of 3 21412011 Continued

1\
Facility Number: q - Arl IDate of Ins ection: WV
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 MNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): pG
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
❑ Yes No
❑ NA ❑ NE
[DNA ❑ 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?
Waste Aoolieation
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [�No ❑ NA ❑ NE
maintenance or improvement? T
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [] Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): C
13. Soil Type(s):
❑ NE
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Kn 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
P 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
IV 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 R, No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall 0 Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspectio
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facilitj Number: q -7:1 Date of Inspection: M
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 El Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes CP 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 Ik�1 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.
❑ 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?
❑ Yes No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Reviewer/Inspector Name: "� lq"[e Phone: 9i0—t{33-- 3300
Reviewer/InspectorSignature: �`uiatC.l�Q Date: 3 0 1z
Page 3 of 3 V4/Z011

Type of Visit 'G 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 of Visit: S 10 Arrival Time: Departure Time: /f� County: Region:l'7�-tJ _
Farm Name: _!�_ekd Owner Email:
Owner Name:
Mailing Address:
(tc-
Physical Address:
Facility Contact: f r1 nt wk5 Title:
j/
Onsite Representative:
Certified Operator: C1_0
Back-up Operator rey a IT14✓ i9, is
Location of Farm:
Phone:
Phone No:
Integrator:
Operator Certification Number:
090
Back-up Certification Number: l
Latitude: 0 0 = t ="
Longitude: = ° = = W
1111WDesign
@urrent
Design Current
Design Current
Swine
Capacity
Population
1
Wet Poultry Capacity Populafion
❑ La er
❑ Non -Layer
Cattle Capacity Population
❑ Da Cow
❑ Da' Calf
❑ can to Finish
can to Feeder
14 00
Feeder to Finish
❑ Dairy Heifer
Farrow to Wean
Dry Poultry
❑ Dry Cow
Farrow to Feeder''
❑ I a ers
❑ Non -Dairy
❑ Farrow to Finish
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl
Turkeys
❑ Other
-
s .
❑ Turkey Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation? ❑ Yes ONo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
❑ Yes
❑ No
r NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
[PNA
❑ 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
P NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
M No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
*o
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

�. Facility Number: I Date of Inspection �D
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
eLrNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No PNA ❑ 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
ONo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
oNo ❑ 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)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
VNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
I%No ❑ NA ElNE
maintenance/improvement?
`1
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
P5No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [:1 Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] O lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop do'w ❑ E idenncce ofWind Drift ❑ Application Outside
of Area
�"4 12. Crop type(s) - 31 i �1.1 i' ` Aaiw vO d
13. Soil type(s)
14_ Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
lNo
❑ 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
E#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 pagesTas necessary):
Reviewer/Inspector Name y Phone: '
Reviewer/Inspector Signature: Ych 21L ALQ"Date:
rage .e of .3 It Li-193ivv W, onunuea

Facility Number: —,A f Date of Inspection 10
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 30 No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists [I Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA [I NE
El Waste Application El Weekly Freeboard El Waste Analysis El Soil Analysis El 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
ONo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
El NA
El NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
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
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
k9 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
P No
❑ NA ❑ NE
Page 3 of 3 12128104

Division of Water Quality
Facility Number � � � Division of Soil rand Water Conservation y
- - - - - Other Agency
Type of Visit 41 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: i Arrival Time: Departure Time: County: BLADE40 Region: r ram'
Farm Name: r Owner Email:
Owner Name: I( 1' I U vrJt' " " 6rOW13 _ - Phone:
Mailing Address:
Physical Address:
Facility Contact: 0', O ns Title:
Onsite Representative: T_r�
Certified Operator: ,/Vy�i�`_nf C n _
Back-up Operator: 1 ' tt K t'�My►�L]►1 S
Phone No:
integrator: tti` K
Operator Certification Number: ;� 3.57/0
Back-up Certification Number. ?Ss -0
Location of Farm: Latitude: E::] o [=] ' = Longitude: = ° ❑ ' = u
__.,.o
` ^Des �n �� £{Current'
P
MO
f�.
DeS.gn Cur�ren`t Design Current
Swipe, Ca aci Po ulatton
ty¢
Wet Poultry
CapacttyPapulahon Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
Wean to Feeder
ILI Non -Layer I
I Dairy Calf
_ ❑ Dairy Heifer
�. _ ❑ D Caw
eeder to Finish
Dry Poultry
Farrow to Wean
Farrow to Feeder
❑ Non -Dairy
Beef Stocker
❑ Beef Feeder
a s❑
FFONover-a
❑ Farrow to Finish
Non -Layers
❑ Gilts
❑ Pullets
❑ Boars
❑ Beef Brood Go
�•
❑ Turkeys
Ocher T`;#kW
ILI Turkey Pouits
❑ Other
I JE3 Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
�No
rr
El NA
El NE
Discharge originated at: ❑ Structure ❑ Application Field El Other
a. Was the conveyance man-made?
❑ Yes
❑ No
E�NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
1PNA
❑ 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
P 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
IftNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: Lf — 3 r] Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
IMNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
'M NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
R
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
toNo
❑ 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 o ❑ 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
Wo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below_ ❑ Yes
)j] No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) &%A - �9•�L�`i .
{{�� II
13. Soil type(s) Blayr4')1n . l t;�dQ i LZke it?tij-
- -- -
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
91No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre deterrnination?❑ Yes
EANo
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
N No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
JRNo
❑ NA ❑ NE
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature:UVA:Date: S
Page 2 of 3 12128104 Continued

.% 4
Facility Number: ZI — 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 ICJ No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ ❑ Maps
Design
g p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes f9 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 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 1h No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
A No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[P No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
0 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
q%No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Q9No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[PNo
❑ 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
Wo
❑ 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
[9No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewerl]nspector fail to discuss review/inspection with an on -site representative?
❑ Yes
Wo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
V No
❑ NA
❑ NE
Additional Gomtnentsand/or Drawings`8�, 1 ,
AL
Page 3 of 3 12128104

v 1=
Facility Number �--�
Division of Water Quality
O Division of Soil and Water Conservation
O Other Agency
C
Type of Visit+Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit V Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Tune: Cp��� Departure Time:
Farm Name: /�J�-+
Owner Name•. u.1'i1.� !: W-&,Jn r �C
Mailing Address:
Physical Address:
County:
Owner Email:
Phone:
FacilityContact: 1 Oa t Kra O.MM Dfl� Title: LJ\+ i f Phone NA l � C4 L 1yo
t
Onsite Representative: log ,i� Integrator:
Certified Operator: _ t'1 I r Operator Certification Number:
�3S`70
Back-up Operator: l rhAsh—T Back-up Certification Number: L ,
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
❑ Other
Latitude: = O = i Longitude: = ° = = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
601 10 Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pou Its
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Cattle
Design Current
Capacity - Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
E]Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'?
❑ Yes Wo ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
[--]No
NA
❑ NE
❑ Yes
❑ No A NA
❑ NE
❑ Yes
00 No
❑ NA
❑ NE
❑ Yes
'M No
❑ NA
❑ NE
12128104 Continued

. Facility Number: —p Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes N No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ® No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: Designed Freeboard (in): Xi `rr
P
Observed Freeboard (in): al
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
n�Io
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
pq 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 ❑ Yes
❑ No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
9_kNo
❑ 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
12. Crop type(s)
13_ Soil type(s)
Ail
wry
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
M No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[b No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
,TNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application'?
❑ Yes
h No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes *No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name ) Phone:� Cf��!�)
Reviewer/Inspector Signature: Date: rn
12128104 ontinue

Facility Number: M —Oal Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ Un Tp ❑Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
❑ Yes
[fNo
❑ NA
❑ NE
❑ Yes
t5No
❑ NA
❑ NE
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
t 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
(P No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
(] No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
j NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes O�No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[M 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
tg No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
bNo
❑ NA
❑ NE
Comments and/or Drawings:
12128104

• Facility No. V Time In Time Out Date
Farm Name+��
Owner
Operator -
Back -up T�
Integrator
Site Rep
No. a + —To
No. Q v L
COC Circt-n or NPDES
MR
Design
Current
Design
urr nt
Wean - Fe
O�
w -Fee
Wean - Finish
Farrow =
e - inrs
p
Gilts / Boars
arrow - can
Others
FREEBOARD: DesignSludge Survey �•� /
Observed Calibration/GPM 1
Crop Yield Waste Transfers-'
...
Rain Gauge Rain Breaker
Soil Test Wettable Acres PLAT----'
Weekly Freeboard Daily Rainfall
Spray/Freeboard Drop
Weather Codes
Waste Analysis:
120 min I
Date Nitrogen (N)
y
t Lo
Pull/Field I Soil
1-in Inspections
Date Nitrogen (N)
Z�
Crop Pan Window �j

111
Division of Water Quality
Facility Number ? O Division of Soil and Water Conservationa��'7
Q Other Agency
Type of Visit
ompliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
outine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: ! a Departure Time: County: Region: tzQ
Farm Name: l/C/��t�r+'l_ _5n u/ Owner Email:
Owner Name: , vr�f • Phone:
Mailing Address:
Physical Address:
Facility Contact: Z& /\f' Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator: 44eak ,.,✓
Operator Certification Number:s-��5
Back-up Certification Number:
Latitude: = 0 0 d = Longitude: ❑ ° = = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
/O ❑ Non -Layer E�A
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
_ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Cattle
Design Cu 'rrent
Capacity Population
I'h
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: n
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
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
L�
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection T>
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:
Spillway?: q
Designed Freeboard (in):
Observed Freeboard (in): ' 6
5. Arc 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 0 No ❑ NA ❑ NE
❑ Yes [SNo ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes � No El NA ❑ NE
❑ Yes A 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 XNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ,4 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes D& No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes C&No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 9No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > I0% 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 types)]
13.
Soil type(s) Zyw u
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
g No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
[4 No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
[, No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any.YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date:, m00%

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 9No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 10 No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes DO 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
[4 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
0 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
JgNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
J4 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
54 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
PNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
6Q 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
[Z 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
ElYes
[4No
❑ 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
OQ,No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
allo
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Type of Visit omph nce Inspection O Operation Review O Structure Evaluation p Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Dlv Arrival Time: Departure Time: County: Q Region:
Farm Name: { cen Sq���------ Owner Email:
Owner Name• -` �MS Phone:
Mailing Address:
Physical Address:
ll r�
Facility Contact: M ke G-M rn ens Title: L N�j _ I" 1 _ Phone Nog„10 Z Q1 0� !
Onsite Representative: YN-1 k.,P— 0-mmon S integrator: VAr ax:)n
Certified Operator: �n \ �1 Operator Certification Number: Q 3S ! 0
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑ 0 ❑ , ❑ « Longitude: = o ❑ I = u
Design
Current Design
Current Design Current
Swine Capacity
Population Wet Pauitryrc . Capacity
❑ La er
Population Cattle C►►specify Population
❑
Wean to Finish
El Dairy
Cow
Calf
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'? ElYes No ElNA ❑ NE
Discharge originated at: ElStructure ElApplication Field ElOther
a. Was the conveyance man-made'? ElYes ❑ No 36NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ElYes ElNo /'INA ElNE
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 )lA ElNE
2. Is there evidence of a past discharge from any part of the operation'? ❑ Yes No ❑ NA ElNE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes No [:INA ElNE
other than from a discharge?
Page 1 of 3 12128104 Continued

Facility Number: C) 4— Qa
Date of Inspection 1 O(v
Waste Collizction & 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
Identifier:
Spillway?:
Designed Freeboard (in): IC
Observed Freeboard (in): 3-,-,,')
Structure 2 Structure 3 Structure 4
El Yes No El NA El NE
❑ Yes (❑ No )dNA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yeso
PM
El NA
El NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
To
❑ 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
o
❑ 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 �ANo ❑ 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 lW�indow El Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) -&.1(MtAdk +Aa.,w i G is zecZoRi 1 C ra ; ✓Q�Q
13. Soil type(s) NC11r)l0? l.Ve,t,Z�Gi Cl . takeAnd,
nd, _
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �qo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes o El NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes No ❑ NA ❑ NE
IT 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 `RNo ❑ NA ❑ NE
Comments refer to question Explain an YES answers -and/or an recommendations or an other comments
( R P Y y y �a
Use drawings of facility to better explain situations. (use additional pages as necessary)c _ c
Reviewer/Inspector Name CA U�-n 0:_ 2i Phone:! /0 7 33 A,_�Q0
Reviewer/Inspector Signature: ,vY� /�,Q�, � _ Date: A 1 <7 / 1632)
Page 2 of 3 12128104 Continued

Facility Number:-1 - Da'1 Date of Inspection d
Reuuired Ytecords & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes �To
�/ `
[I NA
Cl NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
El Yes o
❑ NA
❑ NE
the appropriate box. ❑ VVUp ❑ Checklists ❑ Design ❑ Maps
p El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes %o
[—INA
ElNE
ElWaste Application ElWeekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [I 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 �o
❑ NA
El 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—PtNo❑
NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes )R.No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes (
No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 1� No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes f 'No
El 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
ElNA
❑ 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 ONo
[INA
❑NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes No
❑ NA
❑ NE
additional Comments and/or Drawings:
� v
4z) 6L %ood .
Page 3 of 3 12128104

Facility No. Q-)(� - ox-1 Time In Time Out ,2 Date !
Fcrm Named S� Integrator VA 6
Owner _ U1 &A fYL�_ T Site Rep 0-w-o n S
Operator n cp_'� « No. Q _'>S r) C)
Back-up
COC
Ll---,-
Circle: General
No.
or(:NPDES
Design
Current
Design
Current
Wean - Feed
qo
Farrow - Feed
Wean - Finish
Farrow -- Finish
Feed - Finish
Gilts 1 Boars
Farrow - Wean
Others
FREEBOARD: Design
Sludge Survey ✓
Crop Yield
Observed 3.?� _/
Calibration/GPM 1
Waste Transfers~
Rain Gauge ` Rain Breaker
Soil Test j ;L1 b r � PLAT �1L`
Weekly Freeboard Daily Rainfall
Spray/Freeboard Drop MOW , W t iy � �a
Weather Codes 120 min Inspections
Waste Analysis:
Date Nitrogen (N)
I :L-) Ian i Z
s1 f ce 10(p Z o
Wettable Acres J
1-in Inspections
To ] ��
Date Nitrogen (N)
a(11 -2,a
..
..
��
1• rr
WM=��, /4•
f
r /
f
I

1
Division of Water Quali
acility ,umber = 2- O Division of Soil and Water Conservation
Other Agency
Type of Visit ® Compliance Inspection Q Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: [ Arrival Time: Departure Time: County: �g«an­ Region: EII
Farm Name: ever*T�& � _ �Ci!-�� Owner Email:
Owner Name: /� urp stow-5 Phone:
Mailing Address: PO &X 30 _ Qo>rse� a N L '•lY
Physical Address: -
Facility Contact:
Title:
Onsite Representative: C�!
Certified Operator: •-�d S• sct; s`
Back-up Operator:
Phone No:
Integrator: ___— AA — F1�.,rr�
Operator Certification Number: Z35"�O
Back-up Certification Number:
Location of Farm: Latitude: [=1 0 ET [= Longitude: = o = = u
Design CurrentG DeBw
sign V CurreSfil
- Design Cne E,city Ppulahori .. Wet Poultry Capacity Populatttle CRP ac�ty,Populatio�.,� x.f.�..�.
❑ Wean to Finish ❑ La er ❑ DairyCow
❑ Non -La etEE
❑ DairyCalf
❑ DairyHeifer
Dry Poultry Y.�
❑ D Cow
❑ Non -Dairy
❑ Layers
-, El Beef Stocket
❑ Non -Layers ❑ Beef Feeder
❑ Pullen ❑ Beef Brood Co
MA 09 - ❑ Turkeys
Other _ El Turkey Pouln ;
❑ Other 10 Other � IVitmber of Structures:
,
Wean to Feeder
Y00
Feeder to Finish
Da-�
Farrow to Wean
3SOD
• El Farrow to Feeder
❑ Farrow to Finish
Gihs
Fc]Boars
Discharees &Stream Impacts
1.
Is any discharge observed from any part of the operation?
El Yes
59 No
❑ NA
❑ NE
Discharge originated at: ❑Structure El Application Field El Other
a. Was the conveyance man-made?
El Yes
❑ No
YNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
❑ No
Pq 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)
El Yes
❑ No
V[NA
❑ NE
2, Is there evidence of a past discharge from any part of the operation?
❑Yes
R No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
D�No
❑ NA
❑ NE
other than from a discharge?
I2/28/04
Continued

�iKacility Number: — Z Date of Inspection 2(i
Waste Collection & Treatment ,tee
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ElP Yes fNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes �gNo ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: KID
Designed Freeboard (in): W .
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
6d 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
R No
❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
KNo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
RNo
❑ NA ❑ NE
maintenance or improvement?
Waste Aoolieation
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
[3No
❑ NA ❑ NE
maintenance/improvement?
11, Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
9No
❑ 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 Drill ❑ Application Outside of Area
12. Crop type(s) 91LrW%t if AA L%", ,O / a,rrczP Swa..t( c. ram:
13. Soil type(s)
14. Do the receiving crops 5-I fer from those designated ated in the CAW V?
❑ Yes
El No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
L^F.No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,
El Yes
ERNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
14 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
®,No
❑ NA
❑ NE
Reviewer/Inspector Name
Reviewer/Inspector Signature:
�) ;: Phone: 9/0-`LB�y-lS�l
Date: G
12/2&04 Continued

`Facility Number: 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 ® No ❑ NA ❑ NE
the appropiate box. ❑ WOP— ❑ Checklislg"❑ Desigt>too'd Maper ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EffNo ❑ NA ❑ NE
❑ Waste Application/❑ Weekly Freeboa*e❑ Waste AnalysiVEl Soil Analysis"1❑ Waste Transfers ❑ Annual CertificatioiYe'
❑ Rainfall/❑ Stockir- ❑ Crop YieN**T1 120 Minute Inspections ❑ Monthly and 1 " Rain Inspectionir*� ❑ Weather Code'-`
22. Did the facility fail to install and maintain a rain gauge?
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33_ Does facility require a follow-up visit by same agency?
❑ Yes
IN No
❑ NA
❑ NE
❑ Yes
[9 No
❑ NA
❑ NE
❑ Yes
69-No
❑ NA
❑ NE
❑ Yes
[9No
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
U�SNo
❑ NA
❑ NE
❑ Yes
H No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El Yes
®No
❑NA
El NE
❑ Yes
[8No
❑ NA
❑ NE
❑ Yes
[Z No
❑ NA
❑ NE
❑ Yes CRNo ❑ NA ❑ NE
Additional.CommentsandJon.Drawings:
,20, Plea- ; r-e-i,Ae cep-.�k} loao, i „ %�- rS ,
72128104

Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up Q Emergency Notification O Other ❑ Denied Access
Date of Visit: d/ Time:
r rQ Facility Number 4
Not Operational Q Below Threshold
0 Permitted ® Certified 0 Conditionally Certified © Registered Date Last Operated or Above Threshold: .........................
Farm Name: .............. r1xFc .e�.....�.?................................... County: 14411 f.�
...............................................................
Owner Name:......... .....�.... ................. Phone No:.zAra 1-1i
.....................................................................
FacilityContact: !!:(... .......G�....... ' .............a. Title: ............................................................... Phone Na: ....................................................
Mailing Address:...... .Q' drL".__.a .......h o �s+^iAl( ....................................
Unsite Representative: ,,,,,,,1!r`,,,,,.C! .... ......., Integrator: .... f!���....,i✓.................
Certified Operator: /�.���!y Operator Certification Number:
p .. / ...............................
Location of Farm:
[]Swine []Poultry ❑ Cattle []Horse Latitude • 1 14 Longitude ' ° 44
Design Current
❑ Wean to Feeder
❑ Feeder to Finish
® Farrow to Wean �,Oe
❑ Farrow to Feeder
n Farrow to Finish
Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non -Layer I I JE1 Non -Dairy
❑ Other I A I
Total Design Capacity
Total SSLW
Nurtiber:of'-Lagogns ❑ Subsurface Drains Present Lagoon Area Spray Field Area
Holding -Pon& /Solid Traps ❑ No Liquid Waste Management System
Discharges & Streun impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Dischar.ge orieinated 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/mini'?
d. Does discharge bypass a lagoon system? (If vex, notify DWQ) ❑Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes tRl No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes N No
01/01/01 Continued

J
Facility Number: 0 — 2.7
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Freeboard (inches): ........ S'r �..
❑ Yes )N No
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9_ Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16_ Is there a lack of adequate waste application equipment?
17. Are rock outcrops present?
18. Is there a water supply well within 250 feet of the sprayfield boundary?
❑ On -site ❑ Off -site
❑ Yes No
❑ Yes No
,J$ Yes ❑ No
❑ Yes Q No
❑ Yes a -No
❑ Yes X No
❑ Yes ONo
❑ Yes IUNo
❑ Yes k No
❑ Yes No
❑ Yes No
Yes ❑ No
❑ Yes RNo ``
[I Yes ❑ Nw %4
❑ Unknown ❑ Yes ❑ No/)//4
Required
Records & Documents
19,
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
ONo
20.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, check
,j!,sjs, design, maps,etc.) ✓ .� ✓
❑ Yes
No
21.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
R No
22.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
WO
23.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
J$No
24. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ONo
25. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes No
26. Does facility require a follow-up visit by same agency? ❑ Yes No
27. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 5j7No
Odor Issues
28. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below OJ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
29. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes IR No
01/01/01 Continued

Facility Number: D _,Z? Date of inspection
30. Is there any evidence of wind drift during Iand application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
33. Do the animals feed storage bins faiI to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Printed on: 1/4/2001
❑ Yes ,j'No
❑ Yes W No
❑ Yes No
❑ Yes No
CR Yes ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
01/01/01

1
Facility- Number
Date of Visit: `Time: f�'4"w Printed on: 7/21/2000
c3
NNot Operational Q Below Threshold
H Permitted ® Certified 13 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: ..............
Farm Name:.........!�y4'/iE......ao...�!C� �..... CountF•:............11��.............................................
...... ................... q
... ifs /h'S..l( /Q� .2�/ — .Z // /
Owner Name:.....,�%i`f'P��. Phone Nt�:............ ....... ....................................................
FacilityContact: X?c e................. .ritle:................................................................ Phone No: ...................................................
Bailing Address: !'��`''. ....0 �.................... 4.4.1 ......
...-........................................................................................................
4. Onsite Representative: 6 !/.E![ �e� ... ,t' !''.... a Integrator :......................................................................................
Certified Operator:......
,,,, �R9it........... , „ , ,,, „ , „ , Operator Certification Nu nber:.. i?r '`
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 4 =i Longitude • ' "
Design Current Design Current Design Current
Swine Ca aci Population Poultry Capacity Population Cattle Capacity Population
NI —Wean to Feeder ❑ Layer I ❑ Dairy
KFeeder to Finish I0 Non -Layer ❑ Non -Dairy
[X,Farrow to Wean jGaD Gad
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons JE1 Subsurface Drains Present ❑.Lag w^ n Area I0 Spray Field Area
Holding Ponds / Solid Traps • ❑ No Liquid Waste Management System
Discharges c- Stream Impactti
I. Is any discharge observed from any part of the operation? ❑ Yes A No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes ffNo
h. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) ❑Yes RNo
c. if dischan e is observed. what is the estimated flow in gal/min''
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes 51No
2- Is there evidence of past discharge from any part of the operation? ❑Yes C9No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ftNo
Waste Collection h Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes J�rNo
Structure I Structure ? Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ,1............................................................................................................ ...................................................
Freeboard (inches):
5100 Continued on back

Facility Number: 09 — z7 Date of Inspection � Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes Xf No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan'? ❑ Yes tO No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
No
8. Does any pan of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes
No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
[ffNo
11. Is there evidence of over application? [].Excessive -Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
RNo
12_ Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
JK No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
g] No
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
igNo
15. Does the receiving crop need improvement'?
"KYes
❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes XNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes XNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes KNo
19. Does record keeping need improvement? 0c/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ID No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes )9 No
21. Did the facility fail to have a actively ccrtihed operator in charge? ❑ Yes IgJ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes 'KNo
24. Does facility require a follow-up visit by same agency? ❑ Yes X No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ANo
yioiatioris or defcieacie5 were noted dui`iitg 4his:v. sit.*- You wiil•rebd*ce iid MUrther: -
corresnontieHee, about this .visit. ' ..... ' . ' . ' . ... . ' :::::: ::: ' ::::::::::: : ' : :
Comments (refer to question fit): 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):
47
i
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: 1if6iz~ 5100

T Facility Number: OQ — Date of Inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge At/or below MYes [I No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes JU No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes JRNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes K No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes 01No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes KNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Ryes ❑ No
Additional: Comments andor rawings:
5100