090088_INSPECTIONS_20171231

Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number: 090088 Facility Status: Active
Permit AWS090088
❑ Denied Access
Inpsection Type: Compliance Inspection
Inactive Or Closed Date:
Reason for Visit: Routine County:
Bladen Region:
Fayetteville
Data of Visit: 03/23/2017 Entry Time: 09:30 am Exit Time: 10:00 am Incident d
Farm Name: Farm f13515, 3316, and 3723
Owner Email:
Owner: Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address: Sr 1300 2462 Chicken Foot Rd
Saint Pauls NC 28384
Facility Status: 0Compliant ❑ Not Compliant Integrator.
Murphy -Brown LLC
Location of Fann: Latitude:
34' 45' 06" Longitude:
78° 50' 48"
Chicken Foot Rd. approx. 3 miles S.W. of Tar Heel
Question Areas:
Dischrge 8 Stream Impacts Waste Cal, Star, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator. John S Cain
Operator Certification Number:
23570
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons
Phone
On -site representative Mike Ammons
Phone
Primary Inspector. Robert Marble
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Phone:
Date:
page: 1

1
Permit: AWS090088 Owner - Facility: Murphy -Brown LLC Facility Dumber. 090088
Inspection Date: 03/23/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Feeder
2,000
Swine - Farrow to Wean
5,927
Total Design Capacity: 7,927
Total SSLW: 3.610,391
Waste Structures Observed
Disignated
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
15
19,00
49,00
Lagoon
16-1
19.50
29.00
Lagoon
16-2
19.50
42.00
Lagoon
23
19.50
50.00
Lagoon
3316N
19.00
Lagoon
3316S
19.00
Lagoon
3515
20.40
Lagoon
3723
19.50
page: 2

Permit: AWS09DO88 Owner - Facility: Murphy -Brown Lt_C Facility Number: 090088
Inspection Date: 03/23/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yeah
No
1. Is any discharge observed from any part of the operation?
❑0
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2_ Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No Na No
4. is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
■ ❑
❑
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 Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090088 Owner - Facility: Murphy -Brown LLC Facility Dumber. 090088
Inspection Date: 03/23/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
WastB Application
Yes No Na No
Crop Type 1
Coastal Bermuda Gress
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autrolle loamy sand, 0 to
3% slopes
Soil Type 2
Butters fire sand, 0 to 2%
slopes
Soil Type 3
Norfoik loamy fine sand, 0
to 2% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14, Do the receiving crops differ from those designated in the Certified Animal Waste
❑ ■ ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop andlor land application site need improvement?
❑ 0 ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ 0 ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ N U ❑
18. Is there a lack of properly operating waste application equipment?
❑ ■ ❑ ❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
❑
❑
If yes, check the appropriate box below.
WLIP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS090088 Owner - Facility : Murphy -Brown LLC Facility Number. 090088
Inspection Date: 03/23/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yea No No No
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
E ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
E ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-complianoe:
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 ❑
❑
Qtiher Issues
Yes No Na N!t
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,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon 1 Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ ❑ ❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewrinspecdon with on -site representative? 1101111
34. Does the facility require a follow-up visit by same agency? ❑ 0 ❑ ❑
page: 5

0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
09008E Facility Status:
Active Permit: AWS090088
❑ Denied Access
tnpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Bladen Region:
Fayetteville
bate of Visit: 07/28/2015 Entry Time: 11:00 am Exit Time: 12:00 pm
Farm Name: Farm #3515, 3316. and 3723
Owner: Murphy -Brown LLC
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: Sr 1300 2462 Chicken Foot Rd Saint Pauls NC 28384
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34' 45' 06" Longitude: 78' 50' 48"
Chicken Foot Rd. approx. 3 miles S.W. of Tar Heel
Question Areas:
Dischrge t£ Stream Impacts Waste Col, Stor, 8, Treat Waste Application
Records and Documents Other Issues
incident #
Owner Email:
Phone:
Certified Operator: John S Cain Operator Certification Number: 23570
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone:
On -site representative Mike Ammons Phone:
Primary Inspector: Robert Marble
Inspector Signature:
Secondary Inspector{s):
Inspection Summary:
Phone:
Date:
page: 1

Permit: AWS090088 Owner - Facility : Murphy -Brown LLC Facility Number: 090088
Inspection Date: 07/28/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Feeder
2.000
Swine - Farrow to Wean
5,927
Total Design Capacity: 7,927
Total SSLW: 3,610,391
Waste structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
15
19.00
50.00
Lagoon
16-1
19.50
37.00
Lagoon
16-2
19,50
29.00
Lagoon
23
19.50
60.00
Lagoon
3316N
19.00
Lagoon
3315S
19.00
Lagoon
3515
20.40
Lagoon
3723
19.50
page: 2

Permit: AWS090088 Owner - Facility : Murphy -Brown LLC Facility Number: 090088
Inspection Date: 07/28/15 Inppeclion Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑M
❑
C. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
EIM
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
013
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑M
❑
❑
State other than from a discharge?
Waste Collection, Storage &_Treatment
Yes
No Na
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (LeJ large
❑
■ ❑
❑
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?
❑
No
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste ApplicatiQn
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
[]
PAN?
❑
Is PAN > 10%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: AWS09008B Owner - Facility : Murphy -Brown LLC Facility Number:
090088
Inspection Date: 07/28/15 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
WastB Application
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autryville
Soil Type 2
Butters
Soil Type 3
Norfolk
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ ■ ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑
❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
E ❑
❑
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 ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS090088 Owner- Facility : Murphy -Brown LLC Facility Number: 090088
inspection Date: 07/28/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Ne
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22, Did the facility fail to install and maintain a rain gauge?
❑
M ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(NPDES only)?
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑
M ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
M ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fait to secure a phosphorous loss assessment (PLAT) certification?
❑
M ❑
❑
Other Issues
Yes
No Na Ne
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
o ❑
❑
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 the drains exist at the facility?
❑
❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
❑
❑
34, Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

R 4
Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
09DO88 Facility Status:
Active Permit: AWS090088
❑ Denied Access
Inpsection Type:
Compliance inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Bladen Region:
Fayetteville
Date of Visit:
10121t2014 Entry Time: 08:00 am
Exit Time: 9:00 am Incident #
Faun Name:
Farm #3515, 3316, and 3723
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-180D
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
Sr 1300 2462 Chicken Foot Rd
Saint Pauls NC 28364
Facility Status:
Compliant ❑ Not Compliant
Integrator: Murphy -Brown LLC
Location of Farm:
Latitude: 34° 45' 06" Longitude:
78° 50' 48"
Chicken Foot Rd. approx. 3 miles S.W. of Tar Heel
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other issues
Certified Operator: John Samuel Cain Operator Certification Number: 987304
Secondary O!C(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone:
On -site representative Mike Ammons Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS090088 Owner - Facility : Murphy -Brown LLC Facility Number: 090088
Inspection Date: 10/21/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Farrow to Feeder
2,000
Swine- Farrow to Wean
5,927
Total Design Capacity: 7,927
Total SSLW: 3,610,391
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
15
19.00
Lagoon
16-1
19.50
Lagoon
16-2
19.50
Lagoon
23
19.50
Lagoon
3316N
19.00
46.00
Lagoon
3316S
19.00
29.00
Lagoon
3515
20.40
45.00
Lagoon
3723
19.50
46.00
page: 2

Permit: AWS090088 Owner - Facility : Murphy -Brown LLC Facility Number: 090088
Inspection Date: 10/21/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No No No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ E
❑
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?
❑
01111
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
N ❑
❑
State other than from a discharge?
Waste Collection, Storage 8, Treatment
Yes No No 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 (LeJ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
E ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No No No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ E ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090088 Owner - Facility : Murphy -Brown LLC Facility Number: 090088
Inspection pate: 10/21/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Coastal Bermuda
Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autryville
Soil Type 2
Butters
Soil Type 3
Norfolk
Soil Type 4
Soil Type 5
Soil Type 6
14, Do the receiving crops differ from those designated in the Certified Animal Waste
❑
■ ❑
❑
Management Pian(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
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?
❑
❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS090088 Owner - Facility : Murphy -Brown LLC Facility Number: 090088
Inspection Dale: 10/21/14 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
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑
❑
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 ❑
❑
Otherlssues
Yea
No Na No
28, Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑0
❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
❑
■ ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
M ❑
❑
page: 5

0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
090088 Facility Status:
Active Permit: AWS090088
[] Denied Access
Inppection Type:
Compliance inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County: Bladen Region:
Fayetteville
Date of Visit:
02/27/2013 Entry Time: 12:00 pm
Exit Time: 12:30 pm Incident#
Farm Name:
Farm #3515, 3316, and 3723
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
Sr 1300 2462 Chicken Foot Rd
Saint Pauls NC 28384
Facility Status:
0Compliant ❑ Not Compliant
Integrator, Murphy -Brown LLC
Location of Farm:
Chicken Foot Rd, approx. 3 miles S.W. of Tar Heel
Question Areas:
Dischrge & Stream Impacts
Records and Documents
Latitude: 34° 45' 06" Longitude: 78" 50' 48"
Waste Col, Stor, & Treat
. Other issues
0 Waste Application
Certified Operator: John S Cain Operator Certification Number: 23570
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour oontact name Mike Cudd Phone:
On -site representative Mike Cudd Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Records reviewed 2/14113
Site visit 2127113
page: 1

Permit: AWS090088 Owner - Facility : Murphy -Brown LLC Facility Number: 090088
Inspection Date: 02/27/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Feeder
2,000
Swine - Farrow to Wean
5,927
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
15
19.00
Lagoon
16-1
19.50
Lagoon
16-2
19.50
Lagoon
23
19.50
Lagoon
3316N
19.00
Lagoon
3316S
19.00
Lagoon
3515
20.40
Lagoon
3723
19.50
page: 2

Permit: AWS090088 Owner - Facility : Murphy -Brown LLC Facility Number: 090088
Inspection Date: 02/27/13 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?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na Ne
4. Is storage capacity less than adequate?
❑
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
❑
MEI
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No 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%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: AWS090088 Owner- Facility : Murphy -Brown LLG Facility Number: 090088
Inspection Date: 02/27/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 'I
Coastal Bermuda
Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autryville
Soil Type 2
Butters
Soil Type 3
Norfolk
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
M ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes NQ Nam
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
M ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
M ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS090088 Owner - Facility : Murphy -Brown LLC Facility Number. 090088
Inspection Date: 02/27/13 Iripsection 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
❑0
❑
❑
(NPDFS only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
M ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
M ❑
❑
27, Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewrnspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Type of Visit: V Compliance inspection V Vperation Review V Structure Evaluation V 1'echnical Assistance
Reason for Visit: 40 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ' z_ loo Departure Time: County: B�
Farm Name: 3?j�(0f! L �j 5J 3'7Z3-1 - Owner Email:
Owner Name:L�1ini11 l.� Phone:
Mailing Address:
Physical Address: Facility Contact: 1 ` /�/j
tyke Gk1 Title: Phone:
Onsite Representative: q
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Region:
Integrator: A4 adt-i Ao��z$l
Certification Numb r:
Certification Number:
Longitude:
Design
Current
.....
Design
Current
Design Current
Swine
Wean to Finish
Capacity
Pop;Wet
Poultry
�:�; La er
Capacity
Pop.
Cattle Capacity Pop.
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
Da' Heifer
Farrow to Wean
Design
Current
D Cow
a
Farrow to Feeder
- ._--D , Pon'
Ea aci
P,a
Non -Dairy
-
44 Farrow to Finish
I
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
ill
Turke s
NI
Uther
Turkey Poults
JLJ.Other
Other
Discharrees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes fQ No ❑ NA ❑ NE
❑Yes ❑No �NA ❑NE
❑ Yes ❑ No 2 NA [] NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
EP No
❑ NA
❑ NE
❑ Yes
FA] No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

Facili Number: -RK jDateof Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
�Q No
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No
NA
❑ NE
Structure 1 Structure 2 Structur_e/3 Structure 4
Structure 5
Structure 6
Identifier: ' - �s How— N 2,3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ��f� y362 '1
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
0 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
T
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?
7P
Waste Application_
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
CoNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. []Yes M No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window %❑ Evidence
of
Wind Drift D Application Outside
P"side of Approved Area
12. Crop Type(s): e O4.5�� [9`TA r �i `' I Q'y/ r f aL 'J ► �/1., Gd
13. Soil Type(s): it-j`rv!✓t 1 V - /dal f7e)'r
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
570 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes]
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
T
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes iNo
❑ 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 F No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection: a7 I
24. Did, the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ YesLF
No
[DNA
❑ NE
❑ Yes
0No
❑ NA
❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ® No
33. Did the ReviewerlInspector fail to discuss review/inspection with an on -site representative? ❑ Yes P9 No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes JR No
Comments (refer to question #f): Explain any -YES answers and/or any additional recommendations or any=oth
LL:
to
f��cv J.s
ReviewerlInspector Name:
J,'e(_:Ccj—
Reviewer/Inspector Signature:
Page 3 of 3
ZIN43
as
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone:
Date: �2 7
21412011

Itype of visit: V Compliance Inspection V Vperanon Review V Structure Evaluation V I ecnnical Assistance I
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ` l Arrival Time: � Departure Time: 2.t /�. County:
Farm Name: 3`3i�_1�t S- +!j? a'� j Owner Email:
Owner Name: MaLI&yV 4 U6 Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: k c4 d Title: Phone:
Onsite Representative: - ^ 0 Integrator: 61OL-3r, o n
Certified Operator: Certification Number: 2--3S-10
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design
Current111111111111111111111111111jesign Current
Design Current
Swine Capacity
. ,Pop. Wet Poultry C•apacityz Pop
Cattle Capacity Pog.
Layer
Dairy Cow
Wean to Finish
Wean to Feeder
Non -La er I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
=Cur enf .
Dry Cow
Farrow to Feeder
ZL3
D , I',oul Ca aei
.
Non-Daixy
Farrow to Finish
I Layers
Beef Stocker
Gilts
Non -Layers
113eef Feeder
Boars
Pullets
I Beef Brood Cow
Turkeys
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)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes Wo ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑Yes
No
�NA
❑NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes No
❑ Yes No
NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facili Number: - Da-ofinspection: Z_
y
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 T❑ No Q13NA ❑ NE
Structure I Structure 2 Structure Structure 4 Structure 5 Structure 6
Identifier: 15 1 ('3 16J3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3� �31( 2_?y o2
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) T
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan? 0
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 0 No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) 41
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No ❑ NA ❑ NE
maintenance or improvement? `�'
Waste ADDlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �j No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes h 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 AcccAcceptableptablee Crop &Wiindow ❑%Evidence of Wind Drift ❑_A_ptplication Outside of Approved Area
12. Crop TYpe(s): GI Z G�[ /NA o4 C.r-fvo aa-,, `�'.ZT Ji ,�" ' `�•'"W 1 /
M,- 0w NOWAY
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
0 Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
1� No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps [—]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tra sfers
❑ Rainfall [] Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [�j 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

Facili Number: C1 - Date of Inspection: 31 Iz—
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No
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 fast survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes ❑ No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [—]No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [::]No
❑ Yes ❑ No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer5to question#).!Explain any YES answers;and/or:any additional recommendations or: anylother�codifnents. I
Use drawings of facility to better explain situations (use addittonal pages,as'necessary). .�
514e
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 1/" q 4
Date: 3 fig I I Z
21412011

Type of Visit: 0 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 O Denied Access
Date of Visit: Ew
Arrival Time: �R � Departure Time: County: SLAOPV
Farm Name: 331 �113S1 SI 137�01 (Favr� Isl �,23,Owner Email:
Owner Name: NIIkD�t�t~f vow-14 . LLC- Phone:
Mailing Address:
Physical Address:
Region: FA0
Facility Contact: M Iw� rnpis Title: Phone: /�
OnsiteRepresentative: tl Integrator: MU.f )1M4WU)J'7j
Certified Operator: J d ^ �-[x .1r Certification Number:
Back-up Operator: Anfrior15 Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current Design" °Current Design Current
Swine CapacityWet.Poultry „ Cap rtv{ -Pop. Cattle Capacity Pap.
Wean to Finish La er Dai Cow
Wean to Feeder
Non -La er Dai Calf
<-• Dai Heifer
...
.-esign Cu ent Cow
D , - P:uult " Ca achy, Po Non -Dairy
La ers Beef Stocker
Feeder to Finish
Farrow to Wean
&60
Farrow to Feeder
Z
Farrow to Finish
1 200
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I Beef Brood Cow
��.
OtherS
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes P No DNA ❑ NE
a. Was the conveyance man-made?
0 Yes
❑ No
P] NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DW Q)
❑ Yes
D No
P 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
P NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[� No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[] Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Pacilit}, Number: Ej - Date of Inspection: (1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[,�j No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: I S 110S 16 AJ 23
Spillway?:
Designed Freeboard (in):
_
r!
Observed Freeboard (in): rg 4
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
A No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
� No
❑ NA
❑ NE
waste management or closure plan?
T
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)
77��
9. Does any part of the waste management system other than the waste structures require
[] Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Aanlication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
®No
❑ NA
❑ NE
maintenance or improvement?
TT
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind
r�Drift
�,,�) ❑ Application Outside of Approved Area
12. Crop Type(s): CVa4a 1j&,,,m t4 GM5$ I-IQ'zi r r4," , 5ro - GM: n t)a
13. Soil Type(s): *-�' ,1 V , ( � f'G k N" S �� l )"
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ® No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [)g No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
❑ Yes
Q3 No
❑ NA
❑ NE
❑ Yes
�j No
[] NA
❑ NE
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
P 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
[9 No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall [:]Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
0 No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA D NE
Page 2 of 3 21412011 Continued

Wacifit# Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0 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 InNo ❑ 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
Eg No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
0 No
❑ NA
❑ NE
(refer
of facaity to better explain situations (use additiotal pages necessary). y5^
Comments refer to question Ex lain an : YES answers and/or an additional recommendations or an iother comments.
U'se drawings
' "T cov4c'N 41,111,
9"'A cev wd 1111#1,,
Reviewer/Inspector Name
Reviewer/Inspector Signature
Page 3 of 3
ff!A
Phone: 41f O--g33 -3300
Date: gILI // j
21412011

40
I
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑I Denied Access
Date of Visit: �� Arrival Time: 2® Departure Time: � County: A�j" Region:
Farm Name: ' J r i. ��/� 5 Owner Email:
Owner Name:
Mailing Address:
Physical Address:
yt-C_. Phone:
Facility Contact: _ !„� �f t kAwyzon's Title: Phone No:
u /}�
Onsite Representative: Integrator: Ls. � P Lr%A?0
Certified Operator: `-'� Operator Certification Number: 423S-90
Back-up Operator: at Back-up Certification Number: L 9—�7I 0
Location of Farm: Latitude: = e = i = « Longitude: = o = 1 = "
Design Current
Swine Capacity Population
Wet Poultry
Design Current Design Current
Capacity Population Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ DairyCow
❑ Wean to Feeder
❑Non -La er
❑ DairyCalf
❑ Feeder to Finish
:,. ❑ DairyHeifer
D , :Dial
❑ D Cow
❑ La ers
❑ Non -Dairy
❑ -Layers
" ❑ Beef Stocker
❑ Pullets
❑Beef Feeder
❑ Beef Brood Co
❑ Turkeys
Other
❑ Other
Poults
❑ TurkeyMM
❑ Other
41 Number of uresllyl
Farrow to Wean
Farrow to Feeder
Discharges
Farrow to Finish
Gilts
❑ Boars
&Stream Impacts
1. Is any discharge observed From any part of the operation?
❑Yes
P No
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
El Yes
❑ No
10 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
❑ No
0 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
O NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
� No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
� No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 10No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No RNA ❑ NE
Structure 1 cture 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: tru_S 'b -AlP3
Spillway?:
Designed Freeboard (in):
210k
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 environmenta 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? ElPNo
Yes ElNA ElNE
(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 ElNA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes A No ❑ NA ❑ NE
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes �3No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
r No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
1P No
❑ 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
`P No
❑ NA
❑ NE
Comments (refer to question #): Explain any YE5 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 , o Phone: -3
Reviewer/Inspector Signature: Date: D
rage o of Y j ZI.& v s a vr+ssnaru

Facility Number: Date of Inspection*ko
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 4 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists ❑Design El maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 19 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
0 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
d No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P 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
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
IN] 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
)E 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
U 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
go No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
EPNo
❑ NA
❑ NE
Additional Comments audtor Drawings:
Page 3 of 3 12128104

j
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
I A-n
Date of Visit: Arrival
lTTime: Departure Time- Z;� County: Region: GOQ
rr
Farm Name: 1�i,ems I S71 6, d'? `� Owner Email:
Owner Name: ►ul - EtVU, 7, ,. _ Phone:
Mailing Address:
Physical Address:
Facility Contact: [ ` t Title: Phone No:
Onsite Representative: N _ Integrator:
l
Certified Operator: �d ` `�^'-► Operator Certification Number: o� 3 sgo
Back-up Operator: Back-up Certification Number: I ��
Location of Farm: Latitude: = o = i = Longitude: = ° = 1 = "
h
Sw
❑ Wean to Finish
Design Current
Capacity Popularion
Design Current
Wet Poultry Capacity Population
❑ Layer
DHi esign Current
Cattle Capty Population
❑Dai Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Da' Calf
❑ Feeder to Finish
❑ Da' Heifer
Farrow to Wean
aCO17
D . Poult �
rY rY
❑ Dry Cow
Farrow to Feeder
..'
❑ Non -Dairy
Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑Beef Feeder
❑ Boars
❑ Pullets
❑Beef Brood Co
❑ Turkeys
Others
_
❑ Turkey Poults
51113 Other
❑ Other
mbar ofiSructur tes:° Nu
�
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[]No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ 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
❑ No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Date of Inspection
Facility Number:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes "� No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
RNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: �—Al 0�3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): i^~ � � _ �3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes bg 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 r No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes $No
❑ NA ❑ NE
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)
9. Does any part of the waste management system other than the waste structures require
❑ Yes 14 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes [�Mo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window 0 Evidence of Wind ❑AAppllication Outside of Area
& _M�(la��
Drift
�, k"
12. Crop type(s)
f� C1 � V� Kagbo"l
—sit,.
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
PONo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
P] No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
P3 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
rM No
❑ NA
❑ NE
I S. Is there a lack of properly operating waste application equipment?
❑ Yes
ONo
❑ NA
❑ NE
Reviewer/Inspector Name F_ 1phone. p- 33-3 W
Reviewer/Inspector Signature:�=NQ!:,MADate: !
Page 2 of 3 1212 04 e:onfinuea

1 L
Facility Number: Date of Inspection S O
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes qNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes No ❑ NA ❑ NE
the approprrate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other I
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes (PNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes � No El 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
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
Wo
❑ 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
�INo
❑ 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? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings
Page 3 of 3 12128104

0
Type of Visit �Zutaine
'nce Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: i bU Arrival Time: ® Departure Time: County: Region:
Farm Name: 1(0 1 � _ 'g"� _ Owner Email:
Owner Name: $ `--' U Ufa Phone:
Mailing Address: _
Physical Address:
FacilityContact: lV)1" U VAVftGn S Title: L' y M Phone No:� I o 2,� l G W
ZI
Onsite Representative: m S Integrator: Mufptum
�'� 1 rl O erator Certification Number: `�'j3� 0
Certified Operator: —_ p
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = 1 = " Longitude: = o = 1 = "
Swine'IN
Design
Capacity
Current
Population
Wet Poultry
Design Current
Capacity Population
Design Current
Cattle Capacity Population
❑ Wean to Finish
2
a
10 Layer
ILI Non -Layer I
Dry Poultry
❑ Layers
❑ Non -Layers
El Pullets
❑ Turkeys
El Turkey Poults
❑ Other
I
I-T
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
El Beef Feeder
❑ Beef Brood Cowj
Number of Structures:
❑ can to Feeder
❑ Feeder to Finish
53!Farrow to Wean-Z000
arrow to Feeder
Z000
ElTarrow to Finish
Z01)
❑ Gilts
❑ Boars
Other
❑ 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)
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 gNo ❑ NA ❑ NE
❑ Yes ❑ No @ NA ❑ NE
❑ Yes ❑ No [�PNA ❑ NE
❑ Yes ❑ No _L NA ❑ NE
❑ Yes o [:1NA ❑ NE
❑ Yes tNo ❑ NA ❑ NE
Page 1 of 3 I2/2"4 Continued

e
Facility,Number.0—�U Date of Inspection 1 �►
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? El Yes //�o ❑ NA ❑ NE
Structure I St cture 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: --
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): t
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
o ElNA ElNE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
Wo ❑ 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
fKPVo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
�PNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
[ No ❑ NA ❑ NE
maintenance or improvement?
v
Waste Aeplication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes"IfNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
XNo ❑ 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 ❑ Evi ence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) M U C yq 1 l �] YCt 1 n
-I
l/0. zz
V
A �
13.
Soil typer �/O
s) L k
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o ElNA
ElNE
15.
Does the receiving crop and/or land application site need improvement`?
El
o El NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
Mio ❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or, any other:comment&"'
,Use drawings of facility to better explain situations. (use additional pages as necessary). r
Reviewer/Inspector Name (� Q�� � ~� -6 LA V `ribN f �-� Phone'q (0 Y33 W�
Reviewer/Inspector Signature: Date: 1Jcz,
Page 2 of 3 12128104 Continued

Facifity Number:Q —Q Date of Inspection 12T41011
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Xo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ANo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Ye No ❑ NA El 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 Cade
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
o
to
ElNA
ElNE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
ElYes
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes�3No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
o
[INA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
EljNo
o
El NA
El NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ 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
P9 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
kNo
❑ 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
)RVNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32_
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o
ElNA
ElNE
33_
Does facility require a follow-up visit by same agency?
ElYes
to
❑ NA
❑ NE
Additional Comments and/or Drawin'S:.
Q+`Z ' n u Ab CbV& Cr0_ 40,
vro„�k ►r1 e Y p0.' s .
Page 3 of 3 12128104

E
Facility No. �) D Time In Time Out Date
Farm Name331 LD I 35 IS 1 3 Integrator ` 1�_
Owner As Site Rep m qLMVW
Operator No.
Back-up _ I No.
COC I/ Circle: General or PDES
Desi n
Current
Design
Current
Wean — Feed
Farrow — Feed
ZrDi�, 0
O
Weari — Finish
Farrow — Finish
f ?JzC7
Feed — Finish
Gilts 1 Boars
Farrow — Wean
Others
' r
FREEBOARD: Design
Sludge Survey l.__�
Crop Yield ✓~
Rain Gauge D
Soil Test I Z 0� PLAT
Observed
Calibration/GPM
Waste Transfers
Rain Breaker
Wettable Acres
Ckly Freeboard ✓ Daily Rainfall 1-in Inspections
y/Freeboard Drop r
Weather Codes 120 min Inspections
Waste Analysis: iS lb-f I{a_z 23
Date trogen N)
Wz z-$ f % -z
5-1 b 3.1t
3.1 z •4 S. 'Zj
Date Nitrogen (N)
C >Ile
-I—, (--I?
Pull/Field
Soil
Crop
Pan
Window
00 A
&,,,r...
—
s
No -A
A u Aai
a o I- 5b
jF
c�

jr
Type of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: u Arrival Time: B=OD Departure Time: = County: ��/ Region: E --
Farm Name: tto at,4 z3 Owner Email:
Owner Name: _ _FCaM2 - •S of G�o vt..a Phone:
Mailing Address: Po BOX -?51 41Mc 2$�
Physical Address:
Facility Contact:
Title:
Onsite Representative: _ r1re, ifarr
`— 14
_
Certified Operator: +��"� s • 26.
Sr- -
Back-up Operator:
Location of Farm:
Swine
Phone No: p
Integrator: _ A Uri!
Operator Certification Number:
Back-up Certification Number:
Latitude: E=1 o =' = u Longitude: = ° = I = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
7,eao
Farrow to Feeder
ZA60
5-7-5'8 11
Farrow to Finish
Zbt]
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
I
I =d
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Da Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures: �!
1
.A
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 Wo ❑ NA ❑ NE
❑ Yes
❑ No
;RNA
❑ NE
-❑ Yes
❑ No
[RNA
❑ NE
9KNA
❑ NE
❑ Yes
❑ No
❑ Yes
EjrNo
] NA
❑ NE
❑ Yes
J,No
❑ NA
❑ NE
12128104 Continued

Facility Number: `r - Date of Inspection E?
• 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 ❑ No RNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: - !y - ( r 2 Z3 1
Spillway?: :moo n.0
Designed Freeboard (in): (�� _'t,�•s -�-�
Observed Freeboard (in): K=� 4. (p
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
r
KNo
❑ NA
❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed
El Yes
��,//
(i'No
❑ NA
❑ NE
through a waste management or closure plan?
I
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
91 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
21,Vo
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
D(No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
M No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ;5No ❑ 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
❑ O}�tside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application,Outside of Area
12. L'�'op//type(s) ruP_e_ ra.Aak. ro-. v`
13. So-il type(s) Ku A A, -A- g A
Z6.1. 5 vl o "o
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [XNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Q�No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[] Yes 9No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes VINo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ANo ❑ NA ❑ NE
Conpments;{refer to question #) sExplam any YES answers and/or any ammendat> ans�,or;anyA otlser comments.
Use dram Hof acili to better a lautisitnafaons., itse addihoual 'Ma
}y
V . 5 "V'A cc" ; a.' fvv'J04i 0­ oc- a-k� lno� CP'X 't- f b , P tee mf-a_ l T-
as
s6er^- aS. Posh+
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone: _ 710 `
Date:
12128104
Continued

FacilityNumber: 9 — 8 Date of Inspection Zh1'
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 55.k4o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes %No ❑ NA El NE
the appropiate box. ❑ W[.�❑ Checklise ❑ DesigV1 ❑ Ma ps-"' ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes RNo ❑ NA ❑ NE
❑ Waste Applicatiow'El Weekly Freeboard, -El Waste Analysi+0'00 Soil Analysj/ ❑ Waste Transfers ❑ Annual Certificatiot✓
❑ Rainfapl,0'0 Stockir@r ❑ Crop Yieltfi ❑ 120 Minute Inspectionpo'-❑ Monthly and 1" Rain Inspectionbos ❑ Weather Cod4-1
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
[8 No
❑ NA
❑ NE
❑ Yes
&No
❑ NA
❑ NE
❑ Yes
K No
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
,Bii 'N..o
L-+]+tvo
❑ NA
❑ NE
❑ Yes EgNo ❑ NA ❑ NE
❑ Yes
EK No
❑ NA
❑ NE
❑ Yes
ZI No
❑ NA
❑ NE
❑ Yes
[--y�No
El NA
ElN E
❑ Yes
2jNo
❑ NA
❑ NE
❑ Yes RNo ❑ NA ❑ NE
t
Additional CO�LIDeQts aAd%OF'Drawuigs
r.
`TU 61 p er svr'ej 3 41- tk s %t eax- "na.v; vt,& 6e,
Yet. Faxl'� raj CL srud�e_ s.rc'-__y f., V x ;to zCoY .
P1ca.ser Pcv�r:a� a�cr�u.N-���lM aE g.sdr c-e+'wt
4
12128104

Facility Number Dale of Veit: // o2/b Time: l=
Q Not Operational Q Below Threshold
® Permitted 13 Certified © Conditionally Certified Q Registered Date -Last Operated or Above Threshold:
Farm Name: & f M a 15.) (. .DCounty: d ll 1cAJ _ �O
Owner Name: _� c. r 4S
Mailing Address:
Facility Contact:
Title:
Phone No:
Phone No:
Onsite Representative:._ -4g r ,- ... Integrator. n2 t&
Certified Operator. To L !a `` C a k u 5 Operator Certification Number: a 3S 7Q
Location of Farm:
j3Swine ❑ Paultry ❑ Cattle ❑ Horse Latitude ' �� �" Longitude •
swine.
V, ii a l bh
Wean to Feeder
Feeder to Finish
Farrow to Wean
9pvo
Farrow to Feeder
20oo
Farrow to Finish
1,2oo
Gilts
Boars
N
ttlOr! =;Cattle ,, . -
der
Tot8lDes�gn �at9
T01W ;SLW
Discharees &StreamImpacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min? NIA
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes i31,No
Stricture 1 Structure 2 Structure 3 Strulcture 4 Structure S Structure 6
5 Identifier: /_ e 6 501", A/ —
Freeboard (inches): Z/ y 9 /� 3 S "`�� �.3 •r
12112103 Confinued

Facility Number: 9 — 8 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
[] Yes
No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
No
closure plan?
(If any of questions 4-6 was answered yes, and the situation, poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancerimprovement?
Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenancclunprovement?
❑ Yes
j� No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement?
❑ Yes
No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
;9 No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type lJ�rn-rkc+�� Axg zi,, /l cerczr`n ...
._
..
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
P No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
[�No
b) Does the facility need a wettable acre determination?
❑ Yes
[jNo
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15. Does the receiving crop need improvement?
❑ Yes
® No
16. Is there a lack of adequate waste application equipment?
❑ Yes
R No
Odor issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building s=cn=, 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 [viNo
Air Quality representative immediately.
,-+�-s—^-��� _sue 4� e:_ i �iY;'ems �.. �-
Com (tt �er w "qu oa ) 3 YE$ asvvas ad/or _ 6 _�..r hy- a�Gc eO[3 tS5. '�� �v
•r^^r..#a. I.zwn-r .sue S'
dravvmgs .�"ljtq pages ty)- �9 Field Copy 0 Final Notes
.�j.....qr.+�
.. J �r�• r L 5 btS rd r� C 4 6 D F-1 C I� e �q 1 yl.� 1 V y A.
s- _'•sue�i, is �yt,�r'==
ReviewerAN spector Name __ 3�� _� . �x - �� - �� �. _ .
ReviewerAWspector Signature: --- - Date: //10 2
12112103 Continued

Facility Number: Date of Inspection
Renuired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes W No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.) ❑ Yes C9 No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Z1 No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
11 No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
CO No
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/inspectar fail to discuss review/mspecdon with on -site representative?
❑ Yes
[P No
28. Does facility require a follow-up visit by same agency?
❑ Yes
[P No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP7
❑ Yes
W No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
1@ Yes
❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Q3 No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
ERNo
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
1A No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
(li No
35. Does record keeping for NPDFS required forms need improvement? If yes, check the appropriate box below.
❑ Yes
R1 No
❑ Stocking Form ❑ Crap Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

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