090031_INSPECTIONS_20171231

Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 090031 Facility Status: 'fie Permit AWS090031
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit Routine County: Bladen Region:
Date of Visit 03l2212017 Entry Time: 08:30 am Flit Time: 9:00 am Incident 0
Farm Name: Edge Farm 1 Farm 74451 Owner Email,
Owner. Murphy -Brown LLC . Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: Sr 1331 1888 Braxton Edge Rd E Fayetteville NC 28301
❑ Denied Access
Fayetteville
910-296-1800
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34° 48' 16" Longitude: 78" 37' 03"
From caution light in Garland, take US 701 S 2 blocks and turn Rt. onto SR 1200 W toward Bladen Co. continue on SR 1528 to
stop sign at NC 210 intersection turn Rt. onto NC 210 for 0.1 mile turn Lt. onto SR 1002 for 6.9 miles continue on 1002 for anot
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Robert T Young Operator Certification Number: 18461
Secondary OIC(s):
OnSke Reprosentafivels): 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

Id
Permit: AWS090031 Owner- Facility : Murphy -Brown LLC Facility Number. 090031
Inspection Date: 03122/17 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
=vAne eeder to Finish 9,604
Total Design Capacity: 9,604
Total SS LW: 1,296,540
Waste Structures
Aisignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7442
19.50
48.00
Lagoon
74421
19.50
60.00
Lagoon
A (LINED)
Lagoon
B
Lagoon
DEPOT
Lagoon
LAGOON A
19.50
Lagoon
LAGOONB
19.50
page: 2

Permit: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number. 090031
Inspection Date: 03/22/17 Inssection Type: Compliance inspection Reason for Visit: routine
Discharees & Stream Impacts
Yea
No Na No
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
11011
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 S 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.e./ 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
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes Naha+ No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number: 090031
Inspection Date: 03/22/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Anntication
Yes -No Na No
Crop Type 1
Coastal Bermuda Grass
(Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Kenansville sand, 0 to 3%
slopes
Soil Type 2
Ocilla loamy sand
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
❑
0 ❑
❑
determination?
17, Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
❑
❑
Records and Documents
Yes 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. -
Wt1P?
❑
Checdists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number. 090031
Inspection Date: 03/22/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Ng
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
M ❑ ❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑ ❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑ ❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
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?
❑
M ❑ ❑
Other Issues
Yea
No Na No
26. Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑M
❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
E ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
M ❑
❑
page: 5

f
0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 090031 Facility Status: Active Permit: AWS090031 ❑ Denied Access
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for visit: Routine County: gladen Region: Fayetteville
Date of Visit: 09/22/2015 Entry Time: 12:00 pm Exit Time: 1:00 pm Incident #
Farm Name: Edge Farm 1 Farm 74451 Owner Email:
Owner: Murphy -Brown LLC. Phone: [phone]
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: Sri331 1888 Braxton Edge Rd E Fayetteville NC 28301
Facility Status: 0 Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34° 48' 16" Longitude: 78' 37' 03"
From caution light in Garland, take US 701 S 2 blocks and turn Rt. onto SR 1200 W toward Bladen Co. continue on SR 1528 to
stop sign at NC 210 intersection turn Rt. onto NC 210 for 0.1 mile turn Lt. onto SR 1002 for 6,9 miles continue on 1002 for anot
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Robert T Young
Secondary OIC(s):
Operator Certification Number: 18461
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone :
On -site representative Mike Ammons Phone:
Primary Inspector: Robert Marble phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Depot lagoon is dry.
page: 1

Permit: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number: 090031
Inspection Date: 09/22/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Boar/Stud
50
[] Swine - Farrow to Wean
1,200
❑ Swine - Feeder to Finish
4,800
❑ Swine - Wean to Feeder
3,500
Total Design Capacity: 9,560
Total SSLW: 1,296.600
Waste Structures Observed
Disignated
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7442
19.50
Lagoon
74421
19.50
Lagoon
A (LINED)
Lagoon
B
Lagoon
DEPOT
Lagoon
LAGOON A
19.50
54.00
Lagoon
LAGOONB
19.50
Sg.QQ
page: 2

Permit: AWS090031 Owner- Facility : Murphy -Brown LLC Facility Number: 090031
Inspection Date: 09/22/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No No No
1. Is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
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)
❑
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?
WastB Collection, Storage & Treatment
Yes No No Ne
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le.l large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not property 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
❑
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
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No No No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11, Is there evidence of incorrect application?
❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 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: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number: 090031
Inspection Date: 09/22/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste ARplication
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Kenansville sand, 0 to 3%
slopes
Soil Type 2
Ocilla loamy sand
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
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
E ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
E ❑
❑
Records and Documents
Yes
No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21, Does record keeping need improvement?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS090031 Owner - Facility : Murphy -Brown Lt_C Facility Number: 090031
Inspection Date: 09/22/15 Inpsection Type: Compliance Inspection Reason for visit: Routine
Records and Documents
Yea
No Na No
Stocking?
0
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
[]
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
M ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(NPDES only)?
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑
No
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structures) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
M []
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
M ❑
❑
Other Issues
Yes
No Na Ne
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31, Do subsurface tile drains exist at the facility?
❑
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
❑
M ❑
❑
CAWM P?
33, Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

1
Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number. 090031 Facility Status: Active permit: AWS090031
Inssection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Bladen Region:
Date of Visit: 08/19/2014 Entry Time: 11:30 am Exit Time: 12:30 pm Incident #
Farm Name: Edge Farm I Farm 74451 Owner Email:
Owner: Murphy -Brown LLC Phone:
❑ Denied Access
Fayetteville
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 29398
Physical Address: Sr 1331 1888 Braxton Edge Rd E Fayetteville NC 28301
Facility Status: 0Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34' 48' 16" Longitude: 78° 37' 03'
From caution light in Garland, take US 701 S 2 blocks and turn Rt. onto SR 1200 W toward Bladen Co. continue on SR 1528 to
stop sign at NC 210 intersection turn Rt. onto NC 210 for 0.1 mile turn Lt. onto SR 1 D02 for 5.9 miles continue on 1002 for anot
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Jeremiah McNeal Bradsher Operator Certification Number: 994951
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: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number: 090031
Inspection Date: 08/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swi no
Swine - Baar/Stud
❑ Swine - Farrow to Wean
❑ Swine - Feeder to Finish
Swine - Wean to Feeder
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7442
19.50
Lagoon
74421
19.50
Lagoon
A (LINED)
Lagoon
B
Lagoon
DEPOT
Lagoon
LAGOON A
19.50
Lagoon
LAGOONB
19.50
page: 2

Permit: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number: 090031
Inspection Date: 08/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na Ne
1. Is any discharge observed from any part of the operation?
❑
■ ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
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?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes xo Na No
4, Is storage capacity less than adequate?
❑
■ ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN ? 10%/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: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number:
090031
Inspection Date: 08/19/14 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yes No Na He
Crop Type 1
Coastal Bermuda Grass
(Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Kenansville sand, o to 3%
slope$
Soil Type 2
Ocilla loamy sand
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?
❑ N ❑
❑
16. Did the facility Fail to secure and/or operate per the irrigation design or wettable acre
❑ ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ ❑
❑
1B. 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?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
N ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
N ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number:
090031
Inspection Date: 08/19/14 Inppection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yes No Na Ne
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
[]
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑0
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
■ ❑
❑
(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
❑
■ ❑
❑
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?
DECO
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[]MO
❑
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?
❑
❑
❑
(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
❑
N ❑
❑
CAWMP?
33. Did the Reviewerllnspector fail to discuss reviewrinspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑E
❑
❑
page: 5

9 A
■ Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 09D031 Facility Status: Active
Inpsection Type: Compliance Inspection
Permit: AWS090031
Inactive Or Closed Date:
Reason for Visit: Routine County: Bladen Region:
Date of Visit: 10/16/2013 Entry Time: 08:30 am Exit Time: 9:30 am
Farm Name: Edge Farm ! Farm 74451
Owner: Murphy -Brown LLC
Mailing Address: PO Box 487
Incident #
Owner Email:
Phone:
Warsaw NC 28398
Physical Address: Sr 1331 1888 Braxton Edge Rd E Fayetteville NC 28301
Facility Status: ■ Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
❑ Denied Access
Fayetteville
910-295-180D
Location of Farm: Latitude: 34" 46 16" Longitude: 78' 37' 03"
From caution light in Garland, take US 701 S 2 blocks and turn Rt. onto SR 1200 W toward Bladen Co. continue on SR 1528 to
stop sign at NC 210 intersection turn Rt. onto NC 210 for 0.1 mile turn Lt. onto SR 1002 for 6.9 miles continue on 1002 for anot
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other issues
Certified Operator: Clifton Daniel Tyndall Operator Certification Number: 989946
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: Dale:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number. 090031
Inspection Rate: 10/16/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Boar/Stud
❑ Swine -Farrow to Wean
[] Swine - Feeder to Finish
Swine - Wean to Feeder
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7442
19.50
Lagoon
74421
19.50
Lagoon
A (LINED)
Lagoon
B
Lagoon
DEPOT
Lagoon
LAGOON A
19.50
Lagoon
LAGOONS
19.50
page: 2

t
Permit: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number: 090031
Inspection Date: 10/16/13 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?
❑
❑ M
❑
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)
❑
❑ 0
Cl
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 No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (LeJ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number:
090031
Inspection Date: 10/16/13 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yea No Na No
Crop Type 1
Coastal Bermuda Grass
(Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Kenansville sand, 0 to 3%
slopes
Soil Type 2
Ocilla loamy sand
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?
❑ ❑
[]
18. Is there a lack of properly operating waste application equipment?
❑ []
❑
Records and Documents
Yes No No Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ M ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ M ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ M ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS090031 Owner - Facility : Murphy -Brown LLC Facility Number: 090031
Inspection Date: 10/16/13 1npsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Ne
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
❑
❑
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?
❑
0 ❑
❑
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
❑
E ❑
❑
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?
❑
E ❑
❑
(i.e., discharge, freeboard problems, over -application)
31, Do subsurface tite drains exist at the facility?
[]
E ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Certified Operator:
Back-up Operator:
type of visit: 1p Compliance Inspection V Uperation Review V Structure Evaluation V "I eclinical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: r� Arrival Time: _400 Departure Time: Qz:[;Q County: Region: FP_G
Farm Name: [ 1 S I r6y13 Owner Email:
Owner Name: Lt4W h Ux—, Phone:
Mailing Address:
Physical Address:
Facility Contact: prt Title: Phone:
N 114
Onsite Representative:
<_ -1
l a r�
Integrator: q
Certification Number: f ( q !�
Certification Number: 1 �e
Location of Farm: Latitude: Longitude:
Design
Swine Ca aci
Current Design Current
Po OPMOU,+�,' aCapacity Pop.
_�
Design
Cattle Capacity
Current
Pop.
Wean to Finish
La er
Da Cow
Wean to Feeder
3 5Z>0
I Non -Layer
Da Calf
Feeder to Finish
-
Da" Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
'©esign t-0 U
D . PouI apaci P.
Dry Cow
Non -Dairy
Layers
Non -Layers
Pullets
Turkeys
-Turkey Pouits
Beef Stocker
Beef Feeder
Beef Brood Cow
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes � No ❑ NA ❑ NE
❑ Yes
❑ No
® NA
❑ NE
❑ Yes
❑ No
Qq NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ) ❑ Yes ❑ No 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

Facility Number: jDate of Ins ection: - Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes V9 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No rr09 NA ❑ NE
StructurbA
Struc ,Strucl�3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 _
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [$5 No
❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes P No
❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No
❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) T
9. Does any part of the waste management system other than the waste structures require [:]Yes No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes P] No
❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes P No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Window] ❑ Evidence of Wind Drift❑ Application Outside of Approved Area
,Crop
%��
12. Crop Type(s): L G -l' �Mp. qA " 0 � `t'v►, , ✓ k,r C/ H,5e p'
13. Soil Type(s): Q VL
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 T 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?
IS. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes ® No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [P No ❑ NA ❑ NE
the appropriate box.
❑WUP [I Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes No ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
Page 2 of 3 214/2011 Continued

Facility Number: 17 jDate of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M 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 D 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 terrified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes [P No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes E No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes No
❑ Yes No
❑ Yes Dg No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations,or- any.other comments .
>,.
Use drawings of facility to better explain situations (Useadditional pages as necessary).'
ends 5_l►7��Z+
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: q1 !'RA
Date:
__2_ q _I Z_
21412011

Certified Operator:
Back-up Operator:
Location of Farm:
Type of Visit: 0 Compliance Inspection n 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
it i
Date of Visit: Arrival Time: Departure Time: County: �j L� J Region: Azo
Farm Name 751 ���M Owner Email:
Ulf
Owner Name: J "{ L J n LLC. Phone:
Mailing Address:
Physical Address:
Facility Contact: I T�7Y1 rr T 1 S Title:
N
Onsite Representative: TT
Jl�X>e.Y1'1 i r� S
26.,L
Latitude:
Phone:
Integrator:
Certification Number: f 9 t/9,57
Certification Number: / g70
Longitude:
Swine
Design Current Design Current Design Current
Capacity Pop. Wet Poultry Capacity F Pop: Cattle Capacity Pop.
*_. g. -
Layer Da' Cow
Wean to FinishIm
Wean to FeederrM
Non -La er
ALL
D . P,oulhCa
La ers
airy Calf
yj
Feeder to Finish
`{ Dai Heifer
D s n�Current D Cow
aci Non -Dairy
Beef Stocker
Beef Feeder
Farrow to Wean
7�p
Farrow to Feeder
Farrow to Finish
Gilts
Non -La ers
Boars
(00
jPullets Beef Brood Cow
Turkeys
Twke Poults
Other
Qther
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
® NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
[—]Yes [:]No
❑ Yes ; No
❑ Yes No
[� NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page I of 3 21412011 Continued

jFacility Number: - Date of Inspection. 11$ (j
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes C711 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [] Yes No 99 NA ❑ NE
Structure 1 Structure2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 A
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in): j
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �g No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes � No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
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
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
0 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): LI.U4`fA_ I S Q N �,1. �M Gem"—
13. Soil Type(s): 4yn A2& tJ E le le , C6 i a —OC
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
KA 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 I No
❑ Waste Application ElWeekly 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 ® No
Page 2 of 3 T
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
21412011 Continued

Facill Number: - Date of Inspection:
j
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
1�1 No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
0No
❑ 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
M 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
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30, Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes W No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes W No ❑ NA ❑ NE
❑ Yes No
❑ Yes No
[::]Yes No
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Comments .(refer to question.4 • Ea lain an YES answers:and/or an . addibanal recommendatyons organ oth-;_- meats �.
p y y y
Use -drawings of facility; to better explain situations (use additional: pages as necessary). r
ae
�e 5 ee jl 4 jilt i
ReviewerAnspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: l0 33 33d0
Date: q I -20b 1
21412011

Type of Visit 4D Compliance Inspection Q Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine Q Complaint Q FoElow 1up Q Referral Q Emergency 0 Other ❑Denied Access
13
Date of Visit: I s I�- U 1 Arrival Time: r ��,�-- Departure Time: I] 14 I County: t' �p�" Region: l�l��
Farm Name: FrdGtQ`� - 1l -Owner Email:
Owner Name: _ M, i (l,r„ "— &Owii , Uf— Phone:
Mailing Address:
Physical Address:
Facility Contact: 1 ' 11 rp:e ri in ryt a & 15 Title:
Onsite Representative: i!
Certified Operator. De rAo'r —
Back-up Operator:
Phone No:
Integrator: YA q,T — Pyow �C
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: � P = ' 0" Longitude: � ° E=I ' =
Design
Current
Design Current
Design Current
Swine
Capacity Populatton Wet Poultry
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
Wean to Feeder
❑ Non -Layer
❑ Dairy Calf
Feeder to Finish
0El
Dairy Heifer
Dry Poultry
i _
El Dry Cow
El
❑ Layers
�,
ElNon-Dairy
F_
El Beef Stocker
ElNon-La ers
El Beef Feeder
El Pullets
Beef Brood Co
ElTurkeys
Other
` a ;4� El Turkey Pouets
❑ Other
❑Other
Number of Structures:
-,.
arrow to Wean
1 aDQ
Farrow to Feeder
❑Farrow to Finish
[] Gilts
Boars
�
Discharees &Stream Impacts
1. Is any discharge observed from any part of the operation?
El Yes
9 No
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
[I Yes
❑ No
ERNA
❑ 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
1�NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
[PNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
FiVo
ElNA
❑ NE
other than from a discharge'?
((
Page 1 of 3
12/28/04
Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment ll tt
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes IS No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ONA ❑ NE
Struc e l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 6y
5_ Are there any immediate threats to the integrity of any of the structures observed? ❑ yes
[PNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
[P No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
59 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
10 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
J§ 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
No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc_)
❑ PAN ❑ PAN > 10% or 10 ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ElE W ence of Wind Drift ❑ Aplplication Outside of Area
6�mk
12. Crop type(s) ,�' a -$�r
13, Soil type(s)
Illeo l DG`yta
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 acre determination ?
❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
;9 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P9 No
❑ NA
❑ NE
Comments (refer to question #f): Explain any YES answers and/or any recommendations or any other commie s _
Use drawings of facility.to better explain situations. (use additional pages as,necessary) . ;
Reviewer/Inspector Name I Phone: la--113.33_3oo
Reviewer/Inspector Signature: Date:
Pape 2 of 3 12/28 4 Continued

` Facility Number: — Date of Inspection MM&J
I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ElNA ElNE
the appropriate box. ElWUP ElChecklists ❑ Design ElMaps ElOther
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
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
® No
❑ NA
❑ NE
❑ Yes
4.
Wo.
❑ NA
❑ NE
❑ Yes
'O No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
El yes
�No
❑ NA
❑ NE
❑Yes
0No
❑NA
❑NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
(E�No
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
qNo
❑ NA
❑ NE
Additional Comments and/or Drawiugs:
AL
Page 3 of 3 12128104

Type of Visit 40 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: It' Departure Time: County:
Farm Name: n" Owner Email:
Owner Name: M4 U" rbLL Phone:
Mailing Address:
Physical Address: �]/] /�
Facility Contact: !_ t r� &!! 4400 S Title:
Onsite Representative: G
Certified Operator:
Back-up Operator:
Region:
Phone No:
Integrator #V0wu
4
Operator Certification Number:
Back-up Certification Number: ! e
Location of Farm: Latitude: = c =[ = « Longitude: = ° = I =
gd
Design
Swine Capacity
Current
Population
Wet Poultry
Design Current Design Current
Capacity Population Cattle Cpa acity Population
❑ Wean to Finish
ID Layer 1
❑ Dairy Cow
Wean to Feeder
10 Non -La er1
❑ Dairy Calf
Feeder to Finish 114 M
Ury Poultry
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑Beef Feeder
ElBeef Brood Cowl
Number of Structures:
Farrow to Wean
Farrow to Feeder
❑ La ers
❑ Farrow to Finish
❑ Non -La ers
❑ Gilts
oars
a
❑ Pullets
El Turkeys
❑ Turkey Poults
Other
❑ Other ❑ Other
Diseharp_es & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
&0
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
P
ElNE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
ElYes
❑ No
(INA
❑ 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
IRNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
YR�o
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
�lo
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: — Date of Inspection S ?
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 J4 NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: VAr
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
�I S
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_) Pff
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
T Do any of the structures need maintenance or improvement? ❑ Yes .Iallo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes rNo ❑ 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 bqNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 No ❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
M No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop ' ow ❑ Evidence of Wind Drift El Application Outside of Area
12.
Crop 5A
type(s)�
13.
Soil type(s) ir" 5yt i [ Pe X 0 A
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
P No ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
Lp No ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
r8 No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
01 No ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment? [:3 Yes
�] No ❑ NA
❑ NE
Comments (referao question #) Explain any YESfanswers and/or any recommendations'or any other comments
IT
.Use drawings_4facility to better explain situations. (use additional pages as necess
Reviewerlinspector Name Phone:
Reviewer/Inspector Signature: - 016L Date: S
12128104 Continued

Facility Number: — Date of Inspection Di
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �rNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
EjNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
rONA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
J9 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
6No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
�PNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
BNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
o
to
El NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
❑ 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
P No
❑ NA
❑ NE
General Permit? (icl discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
�gNo
❑ NA
❑ NE
12128104

1
I
(Type of Visit compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit (Dl outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ` Arrival Time: f>O Departure Time: r County:
Farm Name: 9 s Ll►�►'i'�� _ Owner Email:
Owner Name:II Phone:
Mailing Address:
Physical Address:
Facility Contact: , � za_zu XAK- J1E'i'` Title:
Onsite Representative: .f-L
Certified Operator: 1 /�%� i✓
Back-up Operator:
Region:
Phone No: /1_4x;�11Z71`—tq& �d
Integrator: l vila r1B
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: [= 0 [� s F--I 61 Longitude: 1--] ° =1 I = 1
1
Design
Current
Design @urgent
Design Current
Swine
Capacity
Population
Wet Poultry
Capacity Pop lation
Cattle Capacity Population
ElWean to Finish
❑ Layer
❑Dai Cow
10 Wean to Feeder
• CYO
[7
❑ Non -Layer
❑Dairy Calf
.Feeder to Finish
O
❑Dai Heifer„
arrow to Wean
C"7
Dry Poultry
,�`�-
El D Cow
ElFarrow to Feeder
Az
❑ La ers
_
❑ Non -Dairy
ElFarrow to Finish
on -Layers
❑ Beef Stocker
ElGilts
❑ Pullets
❑ Beef Feeder
ElBoars
❑ Beef Brood Cowl-
Turkevs
—
Other
❑ Turkey Pouets
❑ Other
❑ Other I
Number o€ Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[M No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation'?
❑ Yes
[9 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
R1 No
❑ NA
❑ NE
other than from a discharge'?
Page I of 3
12128104
Continued

y Facility Number: — 3
Date of Inspection �J
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ANo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: /
Designed Freeboard (in): ! f
Observed Freeboard (in): 3_3
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 C4No ❑ 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
maintenance/improvement?
❑ Yes 14 No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 tbs ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El
ElEvidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) I`� rryf'1? fCJ� 4 Q�V C!Cje!_ ,%
13. Soil type(s) V Le Qom;
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes D4 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
(9No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
54 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
ANo
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone: 9/I� 1/33 33 DO
Reviewer/Inspector Signature: Date:y?��
12128104 Continued

ti Facility Number: 52 — ` j 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 4SI No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes O No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
.) No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ 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
fM No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
MNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
N No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ERNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
EfNo
❑ 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
19j 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
DkNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freehoard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
54No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
R No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

r
t
Type of Visit Q-Co_rnpliance 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: �-�- 7= Z-T Arrival Time: Departure Time: County: Region:
Farm Name: ��f g-� l�u ✓I�- Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: �B H %�i�rrr L��/>7 W✓- Title: Phone No:
Onsite Representative: _��'"i-C_ Integrator:
Certified Operator: Tor fil-ovc--c Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: o E:J Longitude: = 0 = t u
Swine
DesiAfflC4urrent
Capapulation
Wet Poultry
Design Current
Capacity Population
Design Current
Cattle Capacity Population
❑ DairyCow
❑ DairyCalf
❑ DairyHeifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑Beef Feeder
❑ Beef Brood Cow
Number of Structures:
❑ Wean to Finish
❑ Layer
Feeder to Finish V
I>D
Farrow to Wean
❑ Farrow to Feeder
1 C)
Dry poultry
❑ Farrow to Finish
❑ Layers
❑ Non -Layers
❑ Gilts
Boars D
!! D
❑ Pullets
Other.
❑ Turke s
❑ TurkeyPoults
❑ Other_11❑ Other
Discharges
Wean to Feeder
� ❑Non -La Non -Layer
&Stream Impacts
1. Is any discharge observed from any part of the operation?
El Yes
SNo
❑ NA
❑ NE
Discharge originated at: ❑Structure El Application Field El Other
a. Was the conveyance man-made?
El Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑Yes
R No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
®No
❑ NA
❑ NE
other than from a discharge'?
Page I of 3
12/28/04
Continued

r
FacilityNumber: —3
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3
Identifier: -".
Spillway?:
Designed Freeboard (in): f I
Observed Freeboard (in):
Structure 4
❑ Yes 54 No
❑ Yes allo
Structure 5
El NA ❑NE
❑NA ❑NE
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes R 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 10 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 ANo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ yes M No El 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 10 No El 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 KNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) p ; •ti
13. Soil type(s) KyiILa: ZZE - —
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 5d No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes Ej No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
v L ea n mot r ua`�e�/" ; . rr 4 l ��SChdr�q ve6 i �OW r�van.
Doh-P) of
Reviewer/Inspector Name Phone:�jp33�3300
Reviewer/Inspector Signature: �i�Date: J — /';;2—pP7CD �?
ruge 4 Uj -3 [_'/6d/U4 %-U► dinueu

Facility Number: -4 j Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes &C No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑Design El maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 9 Yes ❑ No ❑ NA ❑ NE
Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes EKNo ❑ 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
52LNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
q No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
4
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
,91No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[ANo
❑ 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
K No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31 _
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
allo
❑ 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
VNo
El NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
fiQ No
❑ NA
❑ NE
Additional. Comment5:and/or Drawings:
Page 3 of 12128104

Type of Visit &Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency &6 her ❑ Denied Access
Date of Visit: =3a- 6 Arrival Time: Jam: ! Departure Time: , fl'� County: Z rrtt Region: r9z)
Farm Name: ig-WsrJE;i Owner Email:
dv
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Xo" 4.' 73 Title:
Onsite Representative: -Se+-rr»
Certified Operator:
Phone No: !2/0-21 % /e.3 4:-
Integrator:
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Latitude: 0 e = ' = u Longitude: = ° = ' 0 u
Design
Current
Design Current
Design Current
Swine
Capacity
Population
Wet Poultry
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
ID Non -Layer
❑ Dairy Cow
Wean to Feeder
❑ Dairy Calf
® Feeder to Finish
❑ Dairy Heifer
❑ Dry Cow
�$ Farrow to Wean Dry Poultry
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Giits
❑ Non -Layers
El Beef Feeder
Boars
❑ Pullets
❑ Beef Brood Coyd
<,:.m
❑ TurkeysOther
K-
❑ Turkey Poults
❑ Other
❑ Other
Number of Structures:
Discharixes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field W Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
NYes El No El NA El NE
❑ Yes
JZ No
❑ NA
❑ NE
54 Yes
❑ No
❑ NA
❑ NE
at) -ter r
2SYes
❑ No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
29 No
❑ NA
❑ NE
12128104 Continued

Facility Number: — �j % Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No ❑ NA V NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ENE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ No ❑ NA nNE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ❑ No ❑ NA R[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 [gNE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA PSNE
(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 R NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No Cl NA Z NE
maintenance/improvement'?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA DR 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)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
JA 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
9 NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
(A NE
'Comments.(refer to question#): Explain any YES answers and/or any recommendations or any other comnieutsL
-Use drawings of>facili to better explain situations. use.additional a es as necessary)
1} �' p ( p g' CAM
y-cc.n�rnrr-- Gall�� mil ra fZw�prfr� l� ry k o ryrc�r r •�.G. ,z/� �•�-
i "" J�'S �I s�� Q� C�l'< C�!.�,5 i �L y, f lJh r.+� c��%fly J,, �bb'`�ro"• LC/��'�"Lr
v
�Or�In 6{/'as T B-� 7 .R.7L / .i lv�i r rc 7`�► c r /tpor...: 7 c �s e A
L � tNa3 FD�,- � �L r. � �/ (/�-cs_.� �'sGG�"+� ��G/+ /1a+•L
Reviewer/Inspector Name Phone: 9yD—&33r 3�3.2
Reviewer/Inspector Signature: Date: S ,3D—rP170 6
Page 2 of 3 12128104 Continued

Facility Number: T— Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA [XNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA 5Z'NE
the appropriate box. ❑ wup ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA JX NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
NNE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
CRNE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
29 NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
WNE
26. Did the facility fail to have an actively certified operator in charge?
wyes
A No
❑ NA
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
P!�VE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
t,NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
PQNE
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
IN 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
C,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?
W Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
/F'rUu�h Tfi tP p l e• 7� J c/tai�Cei J Nf �^of �t,�el�/ 6 k r wa3 rta�l�c7u"�+
.�� AT A FLOW F7_V� err 40 /V-rkr a-d-we Qe c+.� • . ���t 1� �r a S �rr�
/,z1 n,-J i� Lvcts u/J!{ !J� //��Govr� flJ�rr� i`� Co�� � t
Y r>!a Mxj �DK r /s C 191ITi h Gte C 3A.p if"'Kr-pi; r— L i n Y A S X Jam.
UU w ; ! t boo 0+ 3, +c R-*r 8 = 3 E- O to
Page 3 of 3 12128104

h
Type of Visit p Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral Q Emergency O Other ❑ Denied Access
Date of Visit: 1p 07-D(o Arrival Time: Departure Time: /,%$ County: 81jTd4A00' Region: L�0�
Farm Name: t�4G IQL�.1 C Owner Email:
Owner Name: 9)Zult/ Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Title:
Phone No:
p
Integrator• /M. I X, Byac .1n/
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o = t 0" Longitude: = ° 0 I = "
Design Current
Capacity Population
Design Current
Wet Poultry C►►opacity Population
Desig n Current
Cattte Capacity Population
ean to Finish
F.jFeeder
�
❑ La er
❑ Da' Coean
to Feeder
3500
❑Non -La er
❑ Da' Calf
to Finish
O
❑ Dairy Heifer
IN Farrow to Wean
260
Dray Poultry
❑ Da Cow
❑ Farrow to Feeder
❑ Nan-Dat
❑ Farrow to Finish
❑ La ers
❑ Beef Stacker
❑ Gilts
❑Non -La ers
El Beef Feeder
Boars
D
❑ Pullets
El Beef Brood Cowl
Other
:.'y. -
,
❑ Turkeys
❑ Turkey Poults
❑ Other
❑ Other
Number of Structures:
Discharges & 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
[I No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[4 No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
[gNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation'?
❑ Yes
UY No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
® No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

. Facility Numher: D Q — 31 Date of Inspection -07—
Waste Collection & Treatment
NNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ NA
❑ NE
a. I f yes, is waste level into the structural freeboard?
❑ Yes
[Z No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: Lct ood l4 Lct40&'j g
Spillway?:
lr p
Designed Freeboard (in):
Observed Freeboard (in): 1, 33 �l Z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
0No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[)9 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
MNo
❑ NA
FINE
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
[4 No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [R No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift [:]Application Outside of Area
12. Crop type(s)-S"_P,L � CC_ 6-a � C r_ 5XI41 (;Iniw1- 451W X t_
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes EgNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
[;9No El NA El NE
No ❑ NA ❑ NE
[ONo ❑ NA ❑ NE
P No ❑ NA ❑ NE
Comments (refer to -question #): Explain any YES answers,and/or any _recomtnefidations`or any other'c�omm
Useedrawings of facility. to better explain situations:. (use,addrtional pages as necessary):. sic F
. .. � 4 rx...?
Reviewer/Inspector Name wz-fGK" �� S --� Phone: 9/0 z-
Reviewerlinspector Signature: Date: 6, —O - &
Page 2 of 3 12128104 Continued

Facility Number: O4 — 3 Date of Inspection
' Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ® No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps
p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [;4No ❑ ❑ NE j
eA,k., 4d
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers F Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concem?
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
[Z No
❑ NA
❑ NE
❑ Yes
[H No
❑ NA
❑ NE
❑ Yes
9 No
❑ NA
❑ NE
❑ Yes
ip No
❑ NA
❑ NE
❑ Yes
[H No
❑ NA
❑ NE
❑ Yes
[f No
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
? No
❑ NA
❑ NE
❑ Yes
�1 No
❑ NA
❑ NE
[:]Yes [� No ❑ NA El NE
❑ Yes
[9 No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
Additionai;Com_ments eid/oi•Drawings: = ,
AL
t
Page 3 of 3 12128104

0
Type of Visit CrCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: D Arrival Time: 3 D Departure Time: �r ; 3� County: r,ol Region: ER-0—
Farm Name: 'EF,p/_. _ Owner Email:
Owner Name: _44_2&&U '6n/Aw I Phone:
,Mailing Address: ?21 Y ,� �Z
Physical Address:
Facility Contact: y �R Title: %�
Onsite Representative: l n,
Certified Operator: fit Q D 1' 3::
Back-up Operator:
Phone No: &_4
Integrator: ✓
Operator Certification Number: _C7v?1
Back-up Certification Number:
Location of Farm: Latitude: =O = ` Longitude: E__1 ° = I ED
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
DO ❑ Non -La et
❑ Wean to Finish
Wean to Feeder
[gFeeder to Finish
D
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ urk ey Poulis
❑ Other
Discharees & 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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non-Dairy-
0 Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: J�
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 J@ No ❑ NA ❑ NE
❑ Yes
[0 No
❑ NA
❑ NE
❑ Yes
rV No
El NA
El NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: —
Date of Inspection —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): AID
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes RNo ❑ NA ❑ NE
❑ Yes VLNo ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes (d No ❑ NA ❑ NE
❑ Yes JZ No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
JK 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
Myes
❑ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
W No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) r,
13. Soil type(s)��
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes QqNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? LKYes ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination' Yes
1KNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
PO No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
R No
❑ NA
❑ NE
Comtnentsf(refer, to question # Explatnlany YES aaswers and/or,any recommendations 0r aniy other comments.
Se arawing�s or [acilsty tabetter'eaplatn sEr�aa`(aaattzo pages asnsa:y):
�; ,,? C•c l�rd r m7 J�a L �,���1
/57IL
of
s
1
GCS j* mix ���r" �u�ir ,-•r 7`�f s �'
ector Name
Reviewer/ins r �^� '
/r'r G D �.: ..ram Phone:
p _
Reviewer/inspector Signature: Date:
12128104 Continued

I �
Facility lumber: —31 Date of Inspection %
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes XNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes A,No ❑ NA ❑ NE
the approprrate box. ❑ WDP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes M No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crap Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
t4 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
K No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
RNo
❑ NA
❑ NE
25,
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
2 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
ANo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
RNo
❑ 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
RNo
❑ 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
[KNo
❑ 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
[q No
❑ NA
❑ NE
33_
Does facility require a follow-up visit by same agency?
❑ Yes
jQ No
❑ NA
❑ NE
12178104

(Type of Visit 4D Compliance inspection O Operation Review O Lagoon Evaluation I
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number LLP
d Date of Visit: %% d / A Tine:
lw'orl O Not Operational O Below Threshold
T Permitted M Certified 13 Conditionally Certified Q Registered Date -Last Operated or Above Threshold:
Farm Name: _Q.- 12,r w.. . _ County: ct o�e� ] fi r,9
Owner Name: x r d� �q . w. s- - Phone No: .. !R to 1 .2,9 _ a I i L
Mailing Address: C7. b �6 7SQft-bs'
Facihty Contact:
Title:
Phone No:
Onsite Representative: _ _ r, ,��++ , C 4 Y rr Integrator. m y L — . • Q w �,L
Certified Operator. iCA t%-Qh2-1'_ _ , _ _ Operator Certification Number:
Location of Farm:
0 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • u Longitude • 44
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation? ❑ Yes f4 No
Discharge originated at: ❑ lagoon ❑ Spray Feld ❑ 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? U &-
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 13 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 q§ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier: -- i. ` "�" e, ......_
Freeboard (inches): {j 9 `� 14(-
12112103 Confirmed

�hr3 , �f�
� ' y�Ghe 7 ,L ��i
�� �L C � �' � `1 7

Facility Number: 9 — Date of Inspection
5. Are there any immediate j ats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc-)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ® No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWty
7. Do any of the structures need maintenancefimprovement? ® Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance./improvement? ❑ Yes (0 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes [%No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelunprovement? ❑ Yes [ No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crcp type iC er"'3".Z' /i i 6 7 r.oY S 1v1 c1.1 1 Ci 1^ d S
13. Do the receiving crops differ with dose designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 5 No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes MNo
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 [P No
16. Is there a lack of adequate waste application equipment? ❑ Yes Q No
Odor issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes [jNo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes QNNo
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes 14 No
Air Quality representative immediately.
Feld Copy ❑ Final Notes
a ro 4-1— k v, tclZ
a1_cs s c__.Q o t.,J- �,r Q R o v a s l a e S b
e •• a s c au 40 4-�. c -, Q 1 L
Reviewer/inspectorName
Reviewer/Iuspector Signature. ,I„ � Date �% f>
12lI2103
COnfinued

Facility Number: — Date of inspection Il D 1
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss reviewrmspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record beeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crap Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes [P No
❑ Yes No
❑ Yes ® No
❑ Yes q No
❑ Yes E�No
❑ Yes P No
❑ Yes No
❑ Yes No
❑ Yes No
❑t'Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes &B No
❑ Yes ® No
❑ Yes] No
12112/03

Site Requires Immediate Attention: Iqe- s
Facility No. O 9 - 1 O 4-
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: '? - S , 1995
Time: l Z � 10
.Farm Name/Owner:
Mailing Address: Kf s �-K 3 St7 Fay e.++e.v i i fe— N C= Z S 3 01
County: Sla.c1e_N
Integrator: Phone:
On Site Representative: ►3mdf csL Crr- Phone: C9lo) SY9- ic7673
Physical Address/Location: 5K 13.31 / 87 S �3ra;,�fo nr Ed�_t Rom,
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: / Z 0 0 Number of Animals on Site: / Zo o
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 0 Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes o No A; ual Freeboard: Ft. 3 Inches
Was any seepage observed from the la oon(s)? Yes o Was any erosion observed? Yes ot�
Is adequate land available for spray? or No Is the cover crop adequate? � or No
Crop(s) being utilized: C" ,L� /uuc(o�
Does the facility meet SCS minimum setback criteria? 200 Feet from DwellingPs? or No
100 Feet from Wells? 6M or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or 49
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes o I
Is animal waste discharged into water of oe state by man-made ditch, flushing system, or other
similar man-made devices? Yes or If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Y) or No
Additional Comments: `oltow - k,o iIfZpec4%o,v v6e- r.N duc e-
% ck Re ve is
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.