090086_INSPECTIONS_20171231

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 090086 Facility Status: Active Permit AWSD90086 ❑ Denied Access
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for visit Routine County: Bladen Region: Fayetteville
Date of visit 03/23/2017 Entry Time: 03:00 pm Exit Time: 3:30 pm - Incident d
Farm Name: 2602-1 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 805 NC Hwy 210 W Ingold NC 28441
Facility Status: Compliant ❑ Not Compliant Integrator.
Location of Farm: Latitude:
Hwy. 210 one mile west of intersection of 210 and Hwy. 701, on south side of 210.
Question Areas:
Dischrge & Stream Impacts
Records and Documents
Waste Col, Stor, & Treat
Other Issues
Murphy -Brown LLC
34° 44' 60"
910-296r1800
Longitude: 78° 26' 32"
■ Waste Application
Certified Operator Robert T Young Operator Certification Number: 18461
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone : [phone]
On -site representative Mike Ammons Phone: [phone]
Primary Inspector. Robert Marble Phone:
Inspector Signature: Date:
Secondary fnspector(s):
Inspection Summary:
page: 1

r
Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number: 090086
Inspection Date: 03/23/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Farrow to Wean 2,400
Total Design Capacity: 2,400
Total SSLW: 1,039,200
Waste Structures
Dlsignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
#1
19.00
Lagoon
1
19.00
50.00
page: 2

Z
Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number. 090086
Inspection Date: 03/23/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discha es & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
1101111
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
110
❑
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
❑
2. Is there evidence of a past discharge from any part of the operation?
❑0
❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes No Na We
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Applicatign
yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number: 090086
Inspection Date: 03/23/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No im Me
Crop Type 1
Corn, Wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Butters fine sand, o to 2%
sbpes
Soil Type 2
Centenary 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?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑
❑
Records and Documents
Yes
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
[]
20. Does the facility fail to have all components of the CAWMP readily available?
❑
E ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21, Does record keeping need improvement?
❑
EEIEJ
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

_ .%
Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number. 090086
Inspection Date: 03/23/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
yes No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
[]
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
■ ❑
❑
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 No No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
M ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30, Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
❑
❑
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 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
■ ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

f 1
0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
090086 Facility Status:
Active Permit: AWS090086
❑ Denied Access
Inppection Type:
Compliance Inspection
Inaclive Or Closed Date:
Reason for Visit:
Routine
County: $laden Region:
Fayetteville
Date of Visit:
09/22/2015 EntryTime: 10:00 am
Exit Time: 11:00 am Incident #
Farm Name:
2602-1
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 805 NC !-Ivry 210 W Ingold NC 28441
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Faun: Latitude: 34` 44' 60" Longitude: 78° 26' 32"
Hwy. 210 one mile west of intersection of 210 and Hwy. 701, on south side of 210.
Question Areas:
Dischrge 8 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):
On -Site Representative(s):
Name
Title Phone
24 hour contact name
Mike Ammons
Phone: [phone]
On -site representative
Mike Ammons
Phone : [phone]
Primary Inspector:
Robert Marble
Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

1
Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number: 090086
Inspection Date: 09/22/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean 2,400
Total Design Capacity: 2,400
Total SSLW: 1,039.200
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
#1
19,00
Lagoon
1
19.00
49.00
page: 2

Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number: 090086
Inspection Date: 09/22/15 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?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
■ ❑
❑
C. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
Slate other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ 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 ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the.waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
[�
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090086
Owner - Facility : Murphy -Brown LLC Facility Number: 090086
Inspection Date: 09/22/15
Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Corn, wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Butters fine sand, 0 to 2%
slopes
Soil Type 2
Centenary
sand
SOIL Type 3
Gritney fine sandy loam, 2
to 7% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
001111
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
[]
M ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
M ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M ❑
❑
Records and Documents
Yes
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
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?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS090086 Owner - Facility: Murphy -Brown LLC Facility Number: 090086
Inspection Date: 09/22/15 Inpsection 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
❑
0 ❑
❑
(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
❑
E ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a PGA 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?
❑
E ❑
❑
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?
❑
E ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
E ❑
❑
CAWMP?
33, Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
■ ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
E ❑
❑
page: 5

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
090086 Facility Status:
Alive Permit: AWS090086
[] Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Bladen Region:
Fayetteville
Date of Visit:
08/19/2014 Entry Time: 09:30 am
Exit Time: 10:30 am Incident #
Farm Name:
2602-1
Owner Email -
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 805 NC Hwy 210 W Ingold NC 28441
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 340 44' 60" Longitude: 78° 26' 37
Hwy. 210 one mile west of intersection of 210 and Hwy. 701, on south side of 210.
Question Areas:
Dischrge & Stream Impacts Waste Cot, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Danny Lee Tyner Operator Certification Number. 26715
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone: 910-28MO87
On -site representative Mike Ammons Phone : [phone]
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number: 090086
Inspection Date: 08/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
[] Swine - Farrow to Wean
Total Design Capacity: ~
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon #1 19.00
Lagoon 1 19.00
page: 2

Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number: 090086
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?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
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)
]]
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
■ ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le,/ large
❑
■ ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
[]
M ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
■ ❑
❑
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
❑ ■ ❑ ❑
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: AWS090086
Owner - Facility : Murphy -Brawn LLC Facility Number: 090086
Inspection Date: 08/19/14
Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No No No
Crop Type 1
Com, Wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Butters fine sand, 0 to 2%
slopes
Soil Type 2
Centenary
sand
Soil Type 3
Goldsboro sandy loam,
0 to
3% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
M ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
1101111
determination?
17. Does the facility lack adequate acreage for land application?
❑
❑
❑
18. is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes
No 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?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number: 090086
Inspection Date: 08/19/14 Inpsection 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
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25, Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:.
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑N
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
N ❑
❑
Other Issues
Yes
No Na Me
28, 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?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
N ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
CAWMP?
33. Did the Reviewerlinspector fail to discuss reviewlinspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
❑
❑
page: 5

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
090086 Facility Status:
Inppection Type:
Compliance Inspection
Reason for Visit:
Routine
Date of Visit:
1011712013 Entry Time: 10:00 am
Farm Name:
2602-1
Owner:
Murphy -Brown LLC
Active Permit: AWS090086 ❑ Denied Access
Inactive Or Closed Date:
County: Bladen Region: Fayetteville
Exit Time: 10:45 am Incident #
Owner Email:
Phone: [phone]
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address: 805 NC Hwy 210 W
Ingold NC 28441
Facility Status: 0Compliant ❑
Not Compliant Integrator:
Murphy -Brown LLC
Location of Farm:
Latitude:
34° 44' 60" Longitude: 78" 26' 32"
Hwy. 210 one mile west of intersection of 210 and Hwy. 701. on south side of 210.
Question Areas:
Dischrge & Stream Impacts
Waste Col, Stor, & Treat
Waste Application
Records and Documents
Other Issues
Certified Operator: Danny Lee Tyner Operator Certification Number: 28715
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mitre Ammons Phone : [phone]
On -site representative Mike Ammons Phone: [phone]
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number: 090086
Inspection Date: 10/17/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean
Total Design Capacity:
Total SSLW:
Waste Structures Observed
Designated
Type identifier Closed Date Start Date Freeboard Freeboard
Lagoon
#1
19.00
Lagoon
1
19.00
page: 2

Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number: 090086
Inspection Date: 10/17/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na Ne
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
[In
❑
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)
❑
❑ N
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na 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.1 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?
❑
00
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
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)?
[l
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090086 Owner -Facility: Murphy -Brown LLC Facility Number: 090086
Inspection Date: 10/17/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Corn, Wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Butters fine sand, 0 to 2%
slopes
Soil Type 2
Centenary 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
❑ E ❑
❑
Management Plan(CAWMP)?
15, Does the receiving crop and/or land application site need improvement?
❑ E ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ E ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑
❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ N 0 ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
[]
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS090086 Owner - Facility : Murphy -Brown LLC Facility Number: 090086
Inspection Date: 10/17/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No No No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
N ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes No No No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
E ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWO of emergency situations as required by Permit?
❑
E ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface 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
❑
E ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewfinspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Type of visit: 0 c:ompliance inspection U operation Review U structure Evaluation U Iechnical Assistance 1
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access 1
Date of Visit: L� Arrival Time: Departure Time: County: FLAP F—PRegion: rr---760
Farm Name: 6o�i Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: M r - fh pA C _ Title: Phone:
tf �ocJl�
Onsite Representative: Integrator: !"[ L ,41W
Certified Operator: R ei �''' 1 /►Q�/ _ Certification Number:
'�
Back-up Operator: �� -5" 4i1 _ Certification Number: 2h076
Location of Farm: Latitude: Longitude:
Design Current
Design
Current
Design Current
Swine: Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle
C►►specify Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Dairy Heifer
Feeder to Finish
Farrow to Wean DD
it!
Dry Cow
Farrow to Feeder
D , P■oWt :
La ers
Ca act
$o
Non -Dairy
Beef Stocker
Farrow to Finish
Gilts
Non -La ers
Pullets
Turkeys
Beef Feeder
Beef Brood Cow
Boars
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at-, ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
® NA ❑ NE
[�] NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ) ❑ Yes ❑ No N NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes P No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes fo No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Number: -2 Date of Ins ection: - Z — -2—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
,r,m,No ❑NA ❑NE
[:]No � NA ❑ NE
Structure 6
[:]Yes M No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
V§ 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
[0 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
Pg No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [M No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acce table Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): h Ltj
13. Soil Type(s): " C
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes N No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
I6. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [yj No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
M No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
5D 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
[�g 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 M No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to' install and maintain a rain gauge? [—]Yes `0 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [T No
[] NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes � No ❑ NA [3 NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non. -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [n No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �a 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:
❑ Yes P No ❑ NA ❑ NE
❑ Yes 0] No [DNA ❑ NE
❑ Yes [�P No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
32, Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [P No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ElYes 4
No ❑ NA ❑ NE
Comments (refer to question f: Explain any YES answers-and/or_any additional recommendations or_any other commentsra
Use drawings.of facility to better explain situations (use additional pages as necessary): „
,Vt5116112
�, � t/is►� c n `�vrM'
Reviewer/Inspector Name:
Phone:
Reviewer/Inspector Signature:
Page 3 of 3
Date:
2/4/20H

type of visit: ! Compliance inspection U Vperation Review U Structure Evaluation U Iectinical Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: L.Al Region: Ro
Farm Name: a/00 21 Owner Email:
Owner Name:126 Phone:
Mailing Address:
Physical Address:
Facility Contact: m I .�yy y., C, Title: Phone:
h
Onsite Representative:
Certified Operator: }I rl04 14y1e�I'
Back-up Operator: i l{ 5Gc.yyk%
Location of Farm:
Latitude:
Integrator: MuAoh L.(J—
Certification Number: ;* 71
Certification Number: 2-6OZ
Longitude:
Swine
Wean to Finish
Design
Capacity
Current
Pop.
Wet Poultry
Laver
Design
Capacity
Current
Pop
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
Non -La er
-
Dairy Calf
Dairy Heifer
Feeder to Finishy,
.
D �I'roul
Design
@a aci
Currents
P,o € __
Farrow to Wean 2-.x
Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
-
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
PQ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
� No
[3 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
� No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
rM 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
El Yes
10 No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: q Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: t
Spillway?:
Designed Freeboard (in).
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
No [] NA ❑ NE
T❑ No Ep NA ❑ NE
Structure 6
❑ Yes �] No ❑ NA ❑ NE
❑ Yes T No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes {� No ❑ NA ❑ NE
maintenance or improvement? 1`
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Pg No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land 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 lbs. ❑ 'Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
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
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes P] No
❑ Yes M
0 No
❑ Yes No
❑ NA [] NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes M No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [-]Yes [�3 No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements El Other:
21. Does record keeping need improvement? 1 f yes, check the appropriate box below. [-]Yes M No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [—]Yes 0 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No
[] NA ❑ NE
❑ Weather Code
[] Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

FaciL Number: - Date of Inspection: 76
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes P No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes 0 No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [—]Yes No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer, to question #): Explain any YES answers and/or any additional recommendations or, any oti<er comments:
Vie -drawings of facility to better explain situations (use additional pages as necessary).
4e c-J,� SA
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
M
Phone: 9i� J7 33�
Date: Z,5
21412011

'�
�3
�,

6-
Division ofrWater Quality
�R�lVt ty Number 0 Div_ision of Soi! and Water Conservation
Date of Visit: p Arrival Time: !p0 Departure Time: County: 00 Region: r
Farm Name: f Owner Email:
Owner Name: rwk _ Phone:
Mailing Address:
Physical Address:
Facility Contact: � off� Title:
Onsite Representative:
Certified Operator: n
Back-up Operator: Wrl 1
Phone No:
Integrator: 1y��7-AWt.J1 LtC
Operator Certification Number: CPO
Back-up Certification Number:
PW- f V
Location of Farm: Latitude: = O = I = u Longitude: = ° 0 t = "
Swine
Design Current
Capacity Population
Wet Poultry
Design
Capacity
gn Current
Current WO
Population Cattle city Population
❑Dairy Cow
❑Dairy Calf
❑Dai Heifer
❑ Dry Cow
Non -Dairy
El Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number, of Structures:
it
❑ Wean to Finish
❑ La er
❑ Wean to Feeder
❑Non -La er
❑ Feeder to Finish
Farrow to Wean
Farrow to Feeder
Dry Poultry
❑ Layers
❑Non -La Non -Layers
❑ Pullets
El Farrow to Finish
❑ Gilts
❑ Boars
❑ Turkeys
Other El Turkey Puults
❑ Other ❑Other
Discharges & Stream Impacts
Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
❑ NE
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
F NA
❑ NE
2. Is there evidence of a past discharge from any part oi'the operation?
❑ Yes
No
[❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: Date of Inspection 1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes f NO ❑ NA [I NE
a. If yes, is waste level into the structural freeboard? El Yes ❑ No [*KA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
N
Observed Freeboard (in):
5_ Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 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 0 No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) I
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 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 Croq 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?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
I S. Is there a lack of properly operating waste application equipment?
❑ Yes
*o ❑ NA ❑ NE
EpNo ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
o ❑ NA ❑ NE
Comments (refer to question #): Explain any:YES answers and/oc any recommendations or=any other comments
,Use drawings of facility to better explain situations. (use additional pages as necessary): `
�p w
Reviewer/Inspector Name �__ - — - - —n Phone:
Reviewer/Inspector Signature:
Page 2 of 3
Date:
12128104 Continued

a Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [] Yes 9 No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps
p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �3 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall [:]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
FNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[�No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ONo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
]]��
O No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
P No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
O No
❑ NA
❑ NE
Additions! Commeiit5`'andlor Drawings.
f
T
Page 3 of 3 12,28/04

Y
Facility Number
® Division of Water Quality
O Division of Soil and Water Conservation
Q Other Agency
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit a Routine O Complaint Q Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: 3 ✓ 1 Arrival Time: ,3. C0 ^,,. Departure Time: County:
Farm Name: 2(O0,-7, Owner Email:
Owner Name: + wr'1 t Phone:
Mailing Address:
Physical Address:
Facility Contact: /rN ►V10kl S Title: Phone No:
Onsite Representative:
Certified Operator: p rh �-I L4 P_.tr-
Back-up Operator
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
❑ Other
Region:
Integrator: 1VAh=2-rJZUid 212,u G
Operator Certification Number:����
Back-up Certification Number: bo 7
Latitude: = e = 0 Longitude: = ° =' = "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heife3
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: F j I
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any pan of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
i
❑ Yes [�Iqo ❑ NA ❑ NE
❑ Yes
❑ No
MNA
El NE
❑ Yes
[I No
W] NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
r No
❑ NA
❑ NE
❑ Yes
IR No
❑ NA
❑ NE
12128104 Continued

Facility Number: q— Date of Inspection
Waste Collection & Treatment 7
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 RhJA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
l
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
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
P No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
q@ 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
E0 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
J& No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 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) C&,rtn{ ( Q-1 y�g•I �gztAS
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0 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
E9 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
W No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E1No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facRity to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name Phone:
Reviewer/Inspector Signature: Date: / 4g
12128104 Continued

Facility Number: — Date of Inspection
Re aired 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 ®INo ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑Checklists ❑Design ❑Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ 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 NNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes S No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
9No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
W)No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
55No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
C�'Vo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
R No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[gNo
❑ 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
V 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
Pio
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
99 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
99 No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: (e Arrival Time: l Departure Time: County:
Farm Name: _ � Q _� ^ ! Owner Email:
Owner Name: \ Ij
r0 i $ lzoo 4 Phone:
Mailing Address:
Physical Address: ) j
Facility Contact: .1�-e aj%.MQW5:> y��
Title: Ly � r t Phone No:
Onsite Representative: r le Integrator: i h
Certified Operator: rA.J[ Operator Certification Number: .;2�� `
Back-up Operator: C)'T v Back-up Certification Number: WW I
Location of Farm: ( ) La 141e: 0 0 ❑' ❑ Longitude: [—] o ❑ ' = u
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population C►attle Capacity Population
❑ Wean to Finish ❑ Layer ❑ Dairy Cow
❑ Wean to Feeder
10 Non -Layer I
1 ❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
Farrow to Wean
aw} Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
El Beef Feeder
❑ Beef Brood Co
M
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
El Boars
❑ Turkeys
Other
❑ Other
❑ Turkey Poults
❑Other
Ilumber of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c_ What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
pa NA
❑ NE
❑ Yes
❑ No NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
ElNE
Page I of 3 12128104 Continued

Facility Number; - Date of Inspection ro O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
%No
❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
P No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
ElNA ElNE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
ElNA ❑ 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
pro
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit'?
❑ Yes
No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10, Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA [INE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
4 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
C: W
12. Crop type(s)
13_ Soiltype(s) DQ't`OrS . (_C j C—_7 Q
l
14. Do the receiving crops differ from those designated in the CAWMP?
❑Yes
No
9
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�ffNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑
Yes
9}No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application`?
[I Yes
/'No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Wo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments_.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name [ / A QAl-J Phone: L tV Y" J
Reviewer/Inspector Signature: Date:
12128/0 Condmeed

Facility Number: Gq —0 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �INo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ElNA El NE
the appropirate box.
❑ WUP ❑Checklists El Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �No ❑ NA [3 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 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes MN
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PEAT) certification?
❑ Yes )a No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes Rlo, ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Poo
❑ 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
�ZNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
�No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
Wo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
D%No
❑ NA
❑ NE
Page 3 of 3 12128104

Facility Number
VDivision of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit V.Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit ®'+Routine 0 Complaint O Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: J Departure Time:
Farm Name:
Owner Name I.Jn
Mailing Address:
County:
Owner Email:
Phone:
Region
Physical Address:
Facility Contact: M ITitle: Phone No
Onsite Representative: 1 Integrator: —6
r /1
Certified Operator: Aok,_t Operator Certification Number: J O
Back-up Operator: _.. Yh I Mf A915 Back-up Certification Number:
Location of Farm:
Swine
Latitude: ❑ o ❑ 9 = N Longitude: 1:1 ° = 1 = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
[[]Layer
❑ Non -Laver
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
Farrow to Wean
7
Farrow to Feeder
CCC9Zi
93
arrow to Finish
�
iss
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'?
❑ Yes
&No ❑ NA
❑ NE
❑ Yes
❑ No �ZNA
❑ NE
❑ Yes
❑ No ))3NA
❑ NE
r�1
❑ No )5�NA
❑ NE
❑ Yes
❑ Yes 0 No
❑ Yes �No
❑ NA ❑ NE
El NA El NE
12128104 Continued

Date of Inspection i �1IOQ
Facility Number: —
Waste toilection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes IN No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes 6 No ❑ NA ❑ NE
Structure_L Structure 2 / Struc •e 3 S cture 4
33
Structure 5 Structure 6
Identifier: �� -5r
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _ c�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes V,No El NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes ,!.No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes ;RNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [I Evidence of Wind DriflQ ❑ Application Outside
of Area
12. Crop type(s) I �r rn �
/C-7 . � C' R,§
13. Soil type(s)
6 Lk'
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
PP No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
$dNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
�No
El NA
❑ NE
17. Does the facility lack adequate acreage for land application'?
❑ Yes
P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
allo
❑ 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):
ReviewerfInspector Name Phone:4 /0�
Review
erllnspector Signature: Date:
12128104 Continue

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �TNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes RhNo ❑ 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
EQ No
❑ NA
❑ NE
23_
If selected, did the facility tail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
WA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
litNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
PUNo
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Facility No. f Time In Time Out Date
Farm- Name 1" 3 Integrator
Owner Site Rep riS
Operator _ �a �S�—f No. �3S
Back-up u� No.
COC Circle: le�
or NPDES
MWMME
- -.
.
�..T�
_i _,,
FREEBOARD: Design I / / I 9
O erved 3-7
Crop Yield 4 AV J(p
Rain Gauge 4�2�c°,�
Soil Test Wettable Acresy
Weekly Freeboard
Spray/Freeboard Drop
Weather Codes
Daily Rainfall 1-in Inspections
120 min Inspections
Sludge Survey-
Calibration/GPM /
Waste Transf
Rain Break r
PLAT
--*!- 6�q
Waste Analysis: I ! 6Z 1�­ 2-
Date Nitrogen (N) 3 Date Nitrogen (N)
T, V Z. �j 2,9
L-7 2_0 I.9
Pull/Field Soil Crop.Pan Window
� ra-
cf
YI
U

I
W Division of Water Quality �[1[1 ` Facility Number a �g (p 0 Division of Soil and Water Conservation 11 '
0 Other Agency I 41 Q
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit WRoutine 0 Complaint 0 Fallow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: '2 p7 ,Arrrivval Time: � Departure Time: � County;
CP v Farm Name: (� 1 ld Owner Email:
Owner Name: \ �1r0 l i r-, T,-%n VV V Phone:
Mailing Address:
Region:
Physical Address: (n�., ,,__-- ��nn
Facility Contact: + F 11�SL. �nmt �S Title: �vlSa"4�­Phone No:
Onsite Representative: _ Integrator: ` " i( Q
Certified Operator: `C-4 +r __ /, Y Ql� Operator Certification Nu 1 t Q
Back-up Operator: Win 2 4 Back-up Certification Number:
Location of Farm: Latitude: e Longitude: o
Design Current Design Current Design Currents'•` .
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedei
Farrow to Finish
Gilts
Boars
Other
❑ Other
❑ Layer
❑ Non -La ez
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
rke s
❑�Turk
❑e Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
❑ No
A
❑ NE
ElYes
❑ No
5ZA
❑ NE
❑ Yes
❑ No
EZNA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
[� No
❑ NA
❑ NE
12128104 Continued

Facility Number Date of Inspection '1 v
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes PG No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No t3NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: }
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ANo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes NVo
❑ 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 P No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes J'2$qo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes 1� No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 101bs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable CropWindowEl Evidence Wind Drifl El Application Outside of Area
-of
12. Crop type(s) � `^�,��A 1 3A I ``C
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
El t!fNO
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes -'ElNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes [XNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes ieiNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑ No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
w
,I
ReviewerAnspector Name } � Phone: Y
Reviewer/Inspector Signature: ISL Date:(. t )yje q '� on
12128104 Continued

Facility Numbe — Date of Inspection 1 O�
Required Records & Documents
19_ Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Wo ❑ NA El NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Vo El NA ❑ NE
ElEl❑ Design ❑
the appropirate box. WUP Checklists Maps 7�' El
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Wo ❑ 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
[)MNo ❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
o XNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El
o ❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
IgNo ❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No ❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No _WA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CA W MP? ❑ Yes KNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes �9No ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes [ No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
E
12128104

11
Facility No. ^ Time In Time Out Date
Farm Name �Q C� _ Integrator
Owner Site Rep
Operator. No.
Back-up �a No. ( LQ
COC ircle: ever or NPDES
Design
Current
Design
Current
Wean " Feed
Farrow— Feed
Wean — Finish
Farrow — Finish
Gilts 1 Boars
arrow.— We-ar,
Others
FREEBOARD: Design
"Lidge Survey; V/ J • y` J-LI - 0nl�v
Crop Yield
Rain Gauge
Soil Test PLAT
Weekly Freeboard 61� Daily Rainfall
Spray/Freeboard Drop
Weather Codes
Waste Analysis:
120 min Inspections -
Date Nitrogen (N)
`+
Observed
Calibration!GPM L
Waste Transfers
Rain Breaker
Wettable Acres f 1'
1-in Inspectiont
Date Nitrogen (N)
�•
11 TT
Pull/Field
Soil
Crop
Pan
Window
z
tam
- D
�!
b

I
,/ ivision of Water Quality S t/
Facility Number'. �s 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit t?6mpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: �✓� Arrival Time: Departure Time: ,3v County:
Farm Name: 1G�li�'i- �S ���, Owner Email:
()wnpr Namr- _0 rD 1,U k1 b, Al-- C, / 174 : '7 Phnne-
Mailing Address:
Physical Address:
Region: ic� Q
Facility Contact: &e_y,1 / Title: Phone No:
Onsite Representative: _ <.-1 r Integrator: Off w
Certified Operator: �6� — L—� 1 ' i Operator Certification Number: ,26- 3
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [= a [� I = Longitude: 0 ° 0 { = "
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current `Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
lI ❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Cu
Cattle Capacity --.Pop
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
c. What is the estimated volume that reached waters of the State (gallons)?
Beef Brood Cow,
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ;.No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes J, No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
12128104 Continued

• Facility Number: — Date of Inspection
Waste Collection & Treatment
4_ Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes R No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: d _ / 5— �v
Spillway?:
Designed Freeboard. (in): T / /
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes [.No ❑ NA ❑ NE
Oe/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes JRNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes ®.No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes P9.No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 2�[NNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) An'"
13. Soil type(s) `(
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 14 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 desigm or wettable acre determination?❑ Yes No ❑ NA ❑ NE
IT Does the facility lack adequate acreage for land application? ❑ Yes "No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes g_No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name ' T/"� Phone: �jp'yjo­ 33y0
Reviewer/inspector Signature: Date:
11Z/Z0/U-r a,unnnueu

Facility ]Number: — Date of Inspection
9
e
Re uired 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 appropirate 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 ❑ t20 Minute inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[RNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
0 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
JZNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
,jNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[�(No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
WNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[XNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
if 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
JKNo
❑ 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
,"t No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
KNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
NNo
❑ NA
❑ NE
Comments and/or Drawings:
12128104

S
Type of Visit Q.etimpliance 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: �b Arrival Time:rDeparture Time: 3 : Oo County:
Farm Name: XJ9 L oc�t_" I I Owner Email:
iwnPr Names• CllP"r-n 1 //4 PhnnP-
Mailing Address:
Physical Address:
Region: exi-)
Facility Contact: Title: Phone/No:
1001
Onsite Representative: ��1.�-�•-2� Integrator:
Certified Operator: .,[ P bci Operator Certification Number: �l O
Back-up Operator: �r�` Back-up Certification Number: /�7
Location of Farm: Latitude: E]D E:J, =1" Longitude: 0o =
Swine
Design Current Design Current Design
Capacity Population 110 ultry C►apacity Population Cattle Capacity
Current
Population
❑ Wean to Finish
❑ Layer
❑Dairy Cow
❑ Wean to Feeder
on -Layer
❑Daily Calf
❑ Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
-
Other
Wo O vie Dry Poultry ,
El Layers
El Non-Layers
❑Pulle
;....-;; ❑ Turke s
a;lL ❑ Turkey Poults
❑ Dairy Heifer
El Dry Cow
ElNon-Dairy
❑ Beef Stacker
El Beef Feeder
❑ Beef Brood Co
Y .
-
Number of Structures:
❑ Other
❑Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[[No
❑ NA
❑ NE
Discharge originated at- ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
14 No
❑ NA
❑ NE
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
&No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation'?
❑ Yes
No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
,FIND
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: —
Date of Inspection EE
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
2�No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
IN No
❑ NA ❑ NE
Structure I Structure 2 Structure 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
L�No
❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
A 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
14 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
El Yes
No
❑ ❑ NA NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
j(No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
ZNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s)
13. Soil type(s)
_ Lr
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
LKNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
RNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
9 No ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
C�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
WNo
❑ NA
❑ NE
Comments (refer to question # ): Explain; any YES ,answers and/or any recommendations or any other comments
Use drawrn s,of facility to better explaisituations. (use additional pagesUSMecessa
Reviewer/Inspector Name ! _ B-`�- Phone:
Reviewer/Inspector Signature: Date:
rage z of -i IL/L61V4 uununuea

Facility Number: — Date of Inspection ` -95 0'6
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes (ffNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes KNo ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 5& 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
ER 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
[4 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
R No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
04 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
EKNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
f9 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Do 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
WNo
❑ NA
El 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
ANo
[I NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/]nspector fail to discuss review/inspection with an on -site representative?
❑ Yes
QQ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
;,No
❑ NA
❑ NE
Additional Comibents and/or Drawings: F
Page 3 of 3 12128104

w
Type of Visit AD�-Cbmpliance 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: Arrival Timet� Departure Time: &� County: �' Region:
r
Farm Name: D — f Owner Email:
Owner Name: i ar'� w1'lr Phone:
Mailing Address: - -) x/V G
Physical Address: , /
Facility Contact: fl 6 Y YD tk K �L Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Integrator: /irk�A�1 ,�iD o
Operator Certification Number: Z_
Back-up Certification Number:
Latitude: =' =' ="
Longitude: = ° =, =
sign Current
g6a
Design Gurrent - ;r DesignCurrent
Swine 1
pacity Populatioq.- Wet Poultry
t•ap ty Pop Mahon Cattle GA acity Population
❑ Wean to Finish
❑ La er'
❑ DairyCow
❑ Wean to Feeder
w ❑Non -La et
❑ DairyCalf
❑ Feeder to Finish
�'i `"`� ❑ DairyHeifei
.Farrow to Wean
t7i7 T
a Dry Poultry ,
,4 ❑ D Cow
❑ Farrow to Feeder
❑ Layers
'" "`'" El Non -Dairy
❑ Farrow to Finish
❑Non
; ❑ Beef Stocket
❑ Gilts
-Layers
El Beef Feeder
❑ Boars
ElPullets
❑ Beef Brood Cowl
El Turkeys
Other
❑ Other
❑ Turkey Poults
A❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑Yes
�No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made`?
❑ Yes
EkNo
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
LNo
❑ 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
[qNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
RkNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
MNo
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

'1 .
Facility Number: - Date of Inspection — 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): ZT��
Observed Freeboard (in): (39 0
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 0 No ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
Structure 5 Structure 6
El Yes $4No ❑NA ❑NE
❑ Yes tZ 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 BNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [9 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 [I 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 CKNo ❑ 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) C'%%iK- Z_6��/ r�
13. Soil type(s)
c
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�io
El NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
RNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,
❑ Yes
allo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
NJNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
,kNo
❑ NA
❑ NE
ReviewertInspector Name ' ` ' � _ a 'r phone:
Reviewer/inspector Signature: Date:
IL/LV/V7 LV��s "Cq �

•I
1 1
Facility Number: Q — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 9 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes allo ❑ NA ❑ NE
the approprrate box. ❑ WUP ❑ Checklists ❑ Desi n g El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes allo ❑ 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
allo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
K 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
MNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Cl Yes
K No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Jq 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
jq No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 1 .
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
VtNo
❑ 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
�RNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
CqNo
❑ NA
❑ NE
rG d rds (�z-Vr t��10U `
12128104

i
(Type of Visit • Compliance Inspection O Operation Review O Lagoon Evaluation
(Reason for Visit • Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: 11 - o rune: ; U t)
Facility Number ®��
- - - .. ,. O Not Operational O Bellow Threshold
MF10'ermitted Qtertified 0 Conditionally Certified © Registered Date Last Operated or Above Threshold:
Farm Name: Fter,•z .;2 612,9 I County: Q 142e%n O
Owner Name: C�tt.� .. ,. �i _ �, _ . 'Phone No: - -2
Mailing Address: A o X �/ - 7 59- - - -- RM, rr' L Al C ?-8 `Yf'$- --- -- - -- —
Facility Contact:=5 Title: Phone No:
Onsite Representative: ---- -- `+ar S.r, . i Integrator Cc+ r�o 11 �S
Certified Operator Operator Certification Number: -_-GSG fe
Location of Farm:
2-!!rvnne ❑ Poultry ❑ Cattle © Horse Latitude • Longitude •
Dischmes & Stream Im cts
1. Is any discharge observed from any part of the operation? ❑ Yes 31;O
Discharge originated aL ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes Q'No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes Ego-
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑'-<
2. Is there evidence of past discharge from any part of the operation? ❑ Yes BfO
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes EKO
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes Ej o
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): y-3
12112103 Continued

Farr7ity Number: q — F&
Date of Inspection - �o
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes O'�o
seepage, etc.)
5. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes Earl�o
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancerunprovement? ❑ Yes 9tvo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes 017 o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes o
elevation markings?
Waste ApiAication
10. Are there any buffers that need maintenancelunprovement? ❑ Yes eggo
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ❑,Ko
❑ Excessive Ponding� ❑PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
1, i s'? S 3? s � „b
12. Crap type
r
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 9-Wo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes BNO
15. Is them a lack of adequate waste application equipment? ❑ Yes UKo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes E qo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 9 No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes M-Ko-
Air Quality representative immediately.
Final Notes
PIeG56
LDr/`er.T
rAG
-ERR - !
rOlry ��tur
Aas
-6el—..-14
Al r,, �ns�t�oS
OT
A YAP IV
r4xlei.
ileuse
120
0".'.r .-Ae
Reviewer/Inspector Name ; ;
Reviewer/Inspector Signature:
Date: I i-
12112103 Confinued

Facility Number: q — (�
Reauired Records & Documente,
Date of Inspection
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
es o
22_ Does the facility fa} to have' 1 cnents of the Certified Animal Waste Management Plan readily available?
{ie(W9yP; ch ts, , etc.)
❑ Yes
�iQo
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
OM
❑ A"Usadon ❑ l bed ElW,a�— Elsru i-Sa S —
10•�1 —')I.r1 8.13 ( i; --7 /. 3 F7 _>/-s y.,s -».Y J'17 7 7.7
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
O-No-
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
a
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ wo
27. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
2r9oo
28. Does facility require a follow-up visit by same agency?
❑ Yes
❑qqo�
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
EWo
NI MES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑Yes
❑ No
3I. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑.Alm
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
UM
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
L�No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
!ld'No
❑ Stocking Form 04ki"
01,V. ❑ Annual CeAificat;onrom
12112103

Site Requires Immediate Attention:
Facility No- —OR - $L
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: z s , 1995
Time: S"- 3 v
Farm Name/Owner: s-
Mailing Address: ��_ ax © �?_ P,
County: t3 -P, VDT. N
Integrator: CWK&-L-S Foods Fki%Lv� Phone:_ qko "Sal]_ _ 01 t'k t
On Site Representative: 'Qn vt w -_ _ Phone: c:k t 0 — S"l-_'- -- O %Lt 1
Physical Address/Location: _ �/� ��� aX- NL `1 a 1
Type of Operation: Swine A Poultry Cattle
Design Capacity: -2-'{0 d Number of Animals on Site: -LLk oc�
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon ufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes r No Actual Freeboard: 3 Ft. Inches
Was any seepage observed from the n(s)? Yes or �as any erosion ob ed? Yes or(9
Is adequate land available for spray? es or No Is the cover crop adequate? Ye or No
Crop(s) being utilrzed: __ -- Cc_`
Does the facility meet SCS minimum setback criteria?
200 Feet from Dwellin a or No
100 Feet from Wells? YesArNo
Is the animal waste stockpiled within 100 Feet of USGS Blue Line .Stream? Yes o%N9,2
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes o No
Is animal waste discharged into water ostate by man-made ditch, flushing system, of other
similar man-made devices? Yes o No If Yes, Please Explain.
Does the facility maintain adequate waste management recovolumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes r No
Additional Comments: F C-_C C- "'�'o �,., • �
MICtoa&t_ W %GtcV_' R IY141G6G c_le_ 6t/1 �K
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.

FayettWI3e Beg;c:al office
Anisal Operation Co::Plia ~e lnspecti= Fo
I�dW�tA� �EL^D5 TALC.
7
� 2 70l
:. �� a:.2S11xw-
a $ACILI':"Y .TET..=?Erii3 �iI7�3�? _
0 293— 4
All questiers azsvered aegativelp vi?l be discxssed in s::fficient detail in
the Co.:.sne_nts Section to enable the de --=ea Pe mittee to pert= t-.e a_ ' op_ -ate
corractions:
,SP_CTTO?7 I
Tiwal Operation
Ec ses, cat tie, y, or sheep
SZCTTOM IT
Y I N I Ca�'�5
1 . Does the n=aber and type of anal meet or exceed
the (.0217) criteria? (Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
Poultry (30,000 bi-rds with liquid write
systesz)
3. Does Lhis facility meet criteria fa
Animal Cperation BiGTSTRATIQN?
3. Are animals ss confined fed or maintained
in this facility far a ZZ-mcath per--od?
4. Does this facility have a AHa'-?tL
WAS Gar �.
5. Does this facility maintain waste managewent
records {volumes of manure, lard applied,
spray irrigated on specific acaage Wits
specific cover ccp)?
6. Does this facility meet t-he 5C5 azn-';run
setback criteria for neigh-bori—ng hcases,
wells, etc?

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'49d 8MIS s421 AjolsiBuiS I — - — - — - — - — - —

O2 04/00 FRI 11:23 FAX [phone] Human Resources Z 004
Date: -1jr-A ZZOOO
Division of Water Quality
225 Green Street -Suite 714 ; P
Fayetteville, NC 28314
Subject: Plan of Action
Name: CQA4ee II s ;�eo J-1 -
Farm Name: - I
Facility No: og orre.
Address: P o aQ r 756 AX. '�83 97r ' a Frs4
Phone: 4ia• a9� ��y3y -exf 37�I
Checked below are the items to be carried out on the above farm:
✓ 1. Check inside and outside of buildings for water leakage and
water usage.
2. Repair and adjust any problems concerning excess -water.
3. Inspect berms around the lagoon(s) to make sure that
water is not entering the system: Repairs will be made
where problems are identified.
t/ 4. Review flushing and pit recharge schedules. Reduce
flushing and -pit recharges where possible.
✓ 5. Closely monitor the soaking and clean -out of buildings
between herd placements. Reduce time and amount of
water usage as much as possible.
,/ 6. Check the moisture levels and crop conditions in all
spray fields. Utilize applications on winter cover crops
according to MAMP (original or amended).
7. Utilize the 30 day prior to planting practice on those fields
to be planted in row crops.

4-02I04/00 FRI 11:23 FAX [phone] Human Resources Q 005
✓ S. Review CWAND and begin spraying on coastal bermuda as
soon as plan allows (follow all regulations re: runoff).
9- Obtain required permission from adjacent landowner to
spray on designated fields. Amend the CWAW before
any fields.not currently on the CWAW are utilized.
4
10. Investigate the feasibility of installing pressure reducers
on water lines.
11. Aerate soils to improve absorption and reduce potential for
runoff.
Additional practices to be used:
Signature Z,, (f.%� -- Via. 'p ;Z-1- L -,C-
Date

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