770007_INSPECTIONS_20171231

MW
NUH I H LAHULINA
Department of Environmental Qu6

i ,V
Division of Water Resources
Division of Soli and Water Conservation
Other Agency
Facility Number: 770007 Facility Status: Active Permit: AWS770007
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for visit: Routine County: Richmond Region:
Date of Visit: 02/14/2017 Entry Time: 09:00 am Exit Time: 10:00 am Incident 0
Farm Name: 7685 Owner Emall:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address:
❑ Denied Access
Fayetteville
910-296-1800
Facility Status:
Compliant ❑ Not Compliant
Integrator.
Murphy -Brown LLC
Location of Farm:
Latitude:
34" 49' 33" Longitude: 79° 38' 55"
Hwy. 381 Hamlet near SR 1802.
Question Areas:
Dischrge & Stream Impacts
Records and Documents
Certified Operator: James Brian McGugan
Secondary OIC(s):
Waste Col, Stor, & Treat Waste Application
Other Issues
Operator Certification Number: 986752
On -alto Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone:
On -site representative Mike Cudd Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

w
Permit: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number: 770007
Inspection Date: ' 02/14/17 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
n
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)
❑
110
❑
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
❑
SO
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
You
No No 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 (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?
❑
❑
❑
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
❑
❑
❑
maintenance or improvement?
sta Applicatlon
Yea 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?
❑ ME3O
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 Ibs,?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

r
Permit: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number: 770007
Inspection Date: 02/14/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes
No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Ailey
Soil Type 2
Wakulla
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]iN
❑
❑ .
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
❑
0 ❑
❑
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?
❑
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?
EIM
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑.
page:
4

h
Permit: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number. 770007
Inspection Date: 02/14/17 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 Surrey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
❑ ❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑ ❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
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 surrey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
❑ ❑
27. Did the facility fall to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑ ❑
Other issues
Yge
Ug NA Ng
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?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
■ ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

y
0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
770007 Facility Status:
Inppection Type:
Compliance Inspection
Reason for visit:
Routine
Date of Visit:
03/09/2015 Entry Time: 09:00 am
Farm Name:
7685
Owner:
Murphy -Brown LLC
Malling Address:
PO Box 487
Physical Address:
Active
Permit: AWS770007 ❑ Denied Access
Inactive Or Closed Date:
County: Richmond Region: Fayetteville
Exit Time: 9:00 am Incident #
Owner Email:
Phone: [phone]
Warsaw NC 28398
Facility Status:
Compliant Not Compliant
Integrator:
Murphy -Brown LLC !
Location of Farm:
Latitude:
34' 49' 33" Longitude: 79° 38' 55"
Hwy. 381 Hamlet near SR 1802.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: James Brian McGugan operator Certification Number: 986752
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone:
On -site representative Mike Cudd Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Dale:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number: 770007
Inspection date: 03/09/15 Inppection 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 E00:1
s
page: 2

Permit: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number: 770007
Inspection Date: 03/09/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
[]
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
110
❑
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?
❑
❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
MEI
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le,/ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
■ ❑
❑
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 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?
r]
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: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number: 770007
Inspection Date: 03/09/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
, Yes No Nn No
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Ailey
Soil Type 2
Wakulla
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
M ❑
❑
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?
❑
■ ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
❑
❑
If yes, check the appropriate box below.
WU P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
M ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number: 770007
Inspection Date: 03/09/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yea
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?
❑
■ ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
M ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
■ ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
M ❑
❑
Other Issues
Yea No Na Ne
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,
❑
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?
❑
M ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
CAWM P?
33, Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34, Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number:
770007
Facility
Status: Active Permit: AWS770007
[] Denied Access
Inpsection Typo:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Richmond Region:
Fayetteville
Date of Visit:
03/18/2014 Entry Time:
08:00 am Exit Time: 8:30 am Incident 0
Farm Name:
7685
Owner Email:
Owner
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
Facility Status: Compliant El Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34' 49' 33"
Hwy. 381 Hamlet near SR 1802,
Longitude: 79' 38' 55"
Question Areas:
S Dischrge & Stream Impacts . Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Michael L Cudd Operator Certification Number: 25233
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone :
On -site representative Mike Cudd Phone:
Primary Inspector: Robert Marble
Inspector Signature:
Secondary Inspector(a):
Inspection Summary:
Records reviewed 2125/14.
Site visit 3118114.
Phone:
Date:
page: 1

4 '1
Permit: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number: 770007
Inspection Date: 03/18/14 Inspection 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 Data Freeboard Freeboard
Lagoon 1 19.00
page: 2

Permit: AWS770007 Owner - Facility: Murphy -Brown LLC Facility Number: 770007
Inspection Date: 03/18/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharaea & Stream Impacts
Yes No No No
1. Is any discharge observed from any part of the operation?
❑
E ❑
❑
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)
❑
❑ 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
❑
❑
❑
State other than from a discharge?
Waste Collection. Storane & 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 (I.e./ large
❑
E ❑
❑
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?
❑
❑
❑
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
❑
E ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10, Are there any required buffers, setbacks, or compliance alternatives that need
❑ N ❑ ❑
maintenance or improvement?
11, Is there evidence of incorrect application?
❑ 0 ❑ ❑ Y
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: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number:
770007
Inspection Date: 03/18/14 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yes No No No
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Ailey
Soil Type 2
Wakulla
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ ❑
❑
Records and Documents
Yes No Na 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 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

C
Permit: AWS770007 Owner - Facility : Murphy -Brawn LLC Facility Number: 770007
Inspection Date: 03/18/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yos No Nn _NQ
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22, Did the facility fail to install and maintain a rain gauge?
❑
■ ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑
❑
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?
❑
ED
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No No Ne
28, Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
❑
❑
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?
❑
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
❑
M ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency? '
❑
M ❑
❑
page: 5

j ( 4
M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 770007 Facility Status: Active Permit: AWS770007
Inpsoction Type: Compliance inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Richmond Region:
Date of Visit: 02/25/2013 Entry Time: 09:00 am Exit Time: 10:00 am Incident #
Farm Name: 7685 Owner Email:
Owner: Murphy -Brown LLC Phone:
❑ Denied Access
Fayetteville
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address:
Facility Status: Com Pant ❑ Nat Com liant Int
eraa.
Question Areas:
Dischrge & Stream Impacts
Records and Documents
Waste Col, Stor, & Treat Waste Application
Other Issues
Certified Operator:
James Brian McGugan
Operator Certification Number: 986752
Secondary OIC(s):
On -Site Representative(s):
Name
Title Phone
24 hour contact name
Mike Cudd
Phone
On -site representative
Mike Cudd
Phone;
Primary Inspector:
Robert Marble
Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
inspection Summary:
Records reviewed 214113
Site visit 2125I13
page: 1

Permit: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number: 770007
Inspection Date: 02/25/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine -Farrow to Wean 2,400
Total Design Capacity:
Total SSL.W:
Waste-3tructurea
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00
page: 2

Permit: AWS770007 Owner- Facility : Murphy -Brown LLC Facility Number: 770007
Inspection Date: 02/25/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yea No Na No
1. Is any discharge observed from any part of the operation?
❑
N ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ N
❑
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)
❑
1:10
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
011
❑
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 & Treatment
Yea
No No 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
❑
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?
❑
■ ❑
❑
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
❑
❑
❑
maintenance or improvement?
Waste Application
Yaa N9 No Me
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ■ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number: 770007
Inspection Date: 02/25/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Ailey
Soil Type 2
Wakulle
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
■ ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
[]
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
■ ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
01311
Records and Documants
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?
E]
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
[a
■ ❑
[]
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page:
4

Permit: AWS770007 Owner - Facility : Murphy -Brown LLC Facility Number:
770007
Inspection Date: 02/25/13 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
❑
❑
❑
(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?
❑
ED
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
MEI
❑
Other Issues
Yes
No Na Ns
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 ❑
❑
CAWM P?
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?
❑
❑
❑
page: 5

1 ype oI vlsn; w i:ompnance inspecrnon v Lrperarion meview V 3rrucrure r vaivanon tV i eennicai Assurance
Reason for Visit: 10 Routine O Complaint O Follow-up O Referral O Emergency 0 Other O Denied Access
Date of Visit: • 3 Arrival Time: o '•oDq�,_ Departure Time: o'er County: ►h►TA(j- Region: T: NJ
Farm Name: to gco, -- � Owner Email:
Owner Name: C ) L Phone:
Mailing Address:
Physical Address:
Facility Contact: M
i )4e-
l.� '� Title:
Phone:
Onsite Representative:
�� r
Integrator: M u r - &DCp�
Certified Operator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Current
Swine
Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
DairyCow
Wean to Feeder
Nan -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
D . P■ault�.
C*.a aci
l;o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
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)?
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?
1 Werc there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes NX No ❑ NA ❑ NE
❑ Yes ❑ No ® NA ❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes [:]No
[] Yes ISM No
❑ Yes No
NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page 1 of 3 21412011 Continued

Facility ]Number: rl- Date of Inspection:
—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Ig No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
§d NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Frccboard (in):
Observed Freeboard (in): /44
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
D. NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
0 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
21 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
rRNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
)E No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes � No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
[] Outside of AccKos
e CrO Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): I �t'.r(h ( a, L HcGu)J rY1. L,� fCLr n Ot)e ' sc
13. Soil Type(s): I ��-N . �� 1�(.l �C.__
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
® No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 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
jN No
❑ NA
❑ NE
20, Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[8 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 G]o , No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ 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 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
[DNA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection: —
5-1
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
❑ 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
�q 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/[nspector 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
Mim No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations.or any other comments:.
Use drawings of facility to better explain situations (use additional pages as necessary).
5;4-e- v j�s i �-
Reviewer/] n spector Name:
Reviewer/inspector Signature:
Page 3 of 3
be.(4 atyl&(
Phone: `i O L4 33 13306
Date:
21412011

V
n0 Division of Water Quality
1Falility Number - © 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
npAn
Date of Visit: Arrival Time: :fJD Departure Time: t0;it?Z.., County: Region:
, Farm Name:Owner Email:
Owner Name: ai��,,y.P,,,p aW010 (.LC Phone:
- - -
Mailing Address:
Physical Address:
Facility Contact:
milk acu Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feede
Farrow to Finish
Gilts
Boars
Other
Other
Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
ory ri
Layers
Non-L
Pullets
Other
Poults
Design Current
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)?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes IF
No ❑ NA ❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes ❑ No NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes] No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters E] Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

FacilityNumber: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
u
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes KR No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No [DNA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [] PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops
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?
IS. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes E� No
[:]Yes P No
❑ NE
❑ NE
❑NA []NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
[DNA ❑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 No ❑ NA ❑ NE
the appropriate box. IR
❑ WUP []Checklists ❑ Design ❑ Maps [] Lease Agreements []Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes y No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis [] Waste Transfers
❑ 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 0] No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes T N
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
o ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - fj
I Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes tP No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes F No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ 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. IV
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes j� No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application) T
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
[3 Application Field ❑ Lagoon/Storage Pond ❑ Other: TT
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
r
No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
R,No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No ❑ NA ❑ NE
N
Comments (refer to question ##): Explain any YES answers and/or any additional recommendations or any other comments.``
I1se',drawines of facility to better explain situations (use additional panes as necessary).
Recces reAj i`;e J,eJ
1 el
Reviewer/Inspector Name:
Reviewer/Inspector Signature: TJAT±V !9"
Page 3 of 3
Phone:
Date: 7 y
2/412O1

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
Date of Visit: ry / Arrival Time: [ RIOC&" Departure Time: County: � Region:O
Farm Name: 76 9)! ' 1 Owner Email:
Owner Name: i `i�{� 1_1'(M Phone:
Mailing Address:
Physical Address:
Facility Contact: fvl.2e Title:
Onsite Representative:
Certified Operator: f�,G �e►'��/(/1
Back-up Operator:
Location of Farm: ,
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
U Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Phone No:
Integrator• �LLc
Operator Certification Number:
Back-up Certification Number:
Latitude: = e 0 = ' Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ s
Poults
t
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
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
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 F No ❑ NA ❑ NE
❑ Yes
❑ No
W NA
❑ NE
❑ Yes
❑ No
ONA
❑ NE
J�FNA
❑ NE
❑ Yes
❑ No
[]Yes
[%No
❑ NA
❑ NE
[--]Yes
R§No
❑ NA
❑ NE
Page I of 3 12128104 Continued

Date of Inspection
acllity Number: —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
IFNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No >® NA ❑ NE
St cture I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[P 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 ElNA [INE
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
rNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No ElNA ElNE
maintenance or improvement?
(13
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No ElNA ElNE
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 l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window idence of Wind ❑ Application of Area
�DriftJ �Outside
� 62rptzh
:),
12. Crop type(s) al�7fT/.( ,I;{'.//7W4 Aw, r !/►�.�.�it
13. Soil type(s),'
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
&No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable 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
PNo
❑ NA
❑ NE
IDS v-&V l ewevi
S.-e t1,54�t Q '314111 .
Reviewer/Inspector Name fgF Phone: 9/D-33�33aa
Reviewer/Inspector Signature: Date: 9/411
Page 2 of 3 12128104 Continued

01 I
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [A No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [�No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists �n / ❑ Design ❑Maps El
21. Does record keeping need improvement'? If yes, check the appropriate box below. ❑ Yes U No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[$YNo
❑ NA
❑ NE
23, if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
F No
❑ NA
❑ NE
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
10 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes q No ❑ NA ❑ NE
26, Did the facility fail to have an actively certified operator in charge? ❑ Yes jo 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
[� 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 tail 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
Page 3 of 3 12128104

B-Im-5 g117'12010
Division of Water Quality
Facility Number I �] 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit
I,c",omn�pliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
(Yl outine 0 complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: .� Zy l0 Arrival Time:-1S0UA*•� Departure Time: 7.Cv �,,, County: �G"6AJCL Region: /C72-0
Farm Name: 7&85/ _ Owner Email:
Owner Name: �` 9"W" LLC. Phone:
Mailing Address:
Physical Address:
Facility Contact: M 1 Ke CuAct Title: L-N to WiaN ee Phone No:
Onsite Representative: Integrator: M' .gyaWN
Certified Operator: �V74� retr✓�l
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
/7434/
Latitude: = = i ❑ Longitude: = o = ` =
Design Current Design Current
Swine Capacity Population, Wet Poultry Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean :ZY0D
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑❑ Layer __.... __ 1
Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ 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?
Design Current
Cattle Capacity Population
❑
Daia Cow
❑
Dairy Calf
❑
Daia Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures: E]
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
L17NA
❑ NE
NA
❑ Yes
❑ No
Q
❑ NE
2 NA
❑ NE
❑ Yes
❑ No
❑ Yes
;<o
❑ NA
❑ NE
❑ Yes
lJ No
❑ NA
❑ NE
12128104 Continued

Facility Number: -77 —00 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Zq
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
B o ❑ 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
�
3 o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
3No ❑ NA ❑ NE
maintenance/improvement'?
II. 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 ❑ FAN > 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) � vk�.,e�t•-- if + SlrnR L� �vQrf�/ �4. S.J
13. Soil type(s) _� r ��c�W aLet
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
dNo
❑ 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
❑ NA
ElNE
17. Does the facility lack adequate acreage for land application?
❑ Yes
�eNo
No
[I NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
,l_'�
LDS o
❑ NA
❑ NE
_ r.tzez..ai;.°a :.
Comments (refer: to question.#).. Explain any YESeanswers and/or, any, recammendations,or any o ther comments
Use drawings loffacili to getter ex lain'situations.a(use;addttional pagesas necessar x
Reviewer/Inspector Name Phone: 91 p—Sf33 -3340
Reviewer/Inspector Signature: Date: Ayi) 4i j Z49/0
12128104 Continued

Facility Number: '7 7 —Ob7 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ETNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [] Yes [ No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
R o
❑ 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
B<o
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
oo
❑ NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
,L��"
El NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
,L_�,3,"N�o
L o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
IB<o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ffNo
❑ 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
BNo
❑ 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?
El Yes
,,.,
I "fNo
❑ 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
ErNo
❑ 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
No
❑ NA
❑ NE
12128104

8T/1lS zwk,,-q
V/03/0,
Type of Visit
Inspection
Q Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
,,o�mpliance
0 Routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: 3; $.S .y. Departure Time: County: A4/1Awa1,ral
Farm Name: %t'O 25­ Owner Email:
Owner Name: _ ajjff- Dk !j f,5vrn-1AJ Phone:
Mailing Address:
Region: '�' 0
Physical Address:
Facility Contact: R4N� uvt� c✓YiJW Title: '^ ✓ Phone No:
Onsite Representative: R0-^4 4 Ck►%, c C. W Integrator: %u+�✓%�W�, Q r3 �✓
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =e ❑t ❑it Longitude: Qo ❑" ❑
,Design �� t'Current .,
�. � " M
.sDesign Current -
Design Current
Swine G
capaty Popu�ri
v Wet Poultry
Capacity Population
Cie
Capacity Population
_�5�,'
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
❑Non -La ec
❑ Dairy Calf
"
❑ Feeder to Finish
"
❑ Daia Heifer
Farrow to Wean
Z DO
Dry Poultry
`
f
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑Farrow to Finish
La
❑ Layers
� ❑Beef Stocker
`
Gilts
Non -La ers
Beef Feedcr
PBoars
❑ Pullets
❑ Beef Brood Cow
❑ Turkeys
Other
❑Turke Pouets
�
y❑Other
El Other
Number of Structures:
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation'?
❑ Yes
E too
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
Ef A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
E3 A
❑ 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
G<A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
To
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
B-Igo
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: 77 -0-] I Date of Inspection 3 /O-t79
Waste Collection & Treatment �,,�
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'? El Yes L7 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 3* A ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 7& gq
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 CO
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
lT No ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed El Yes
,,����
E 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? ElC Yes
o ❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the pen -nit? ❑ Yes
2 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
0< ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
❑'90 ❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
❑.N< ❑ 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 ❑ Evidence of Wind Drifl ❑ Application Outside of Area
//Window
12. Crop type(s) - -�G/ ►..«da, t�itw
�u.�a t^9i�N i 0�5�
--
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
El NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
,B
I_]'No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
0-10
❑ 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
9No
❑ 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 P,j CKil Re-V e,I S Phone: 4/O, j�33, 330
Reviewer/Inspector Signature: Date: 3 /Q —
12128104 Continued

-, r
Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ONo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E o ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[2 o
❑ 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?
El Yes
'El
NNo
El NA
El NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
�L7,
L7 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
2'1vo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes0No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
io
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[T No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes Bl o ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E<o
❑ 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
91go
❑ 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
[I Yes
,�,�
LEI 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
©1`o
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑'IT6
❑ NA
❑ NE
Comments and/or Drawings:
12128104

t. 1
- - - ivisian of water � uulity
Ifi-acili-60jagr �% % % O Division 6W
f So;i and Water wonservation
- --�--- - Q Other Agency
Type of Visit weom pliance 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: -3 Arrival Time: %/"/'qDeparture Time: /�'30 County: Region:
Farm Name: ' -76 T-5-j Owner Email:
Owner Name: Nit! DeL _ 46"/A/ Phone:
Mailing Address:
Physical Address:
/�Mc>✓� `� CNN[.r � ytl Phone No:
Facility Contact: Title: / f/
Onsite Representative: L"4CjA'^1e ✓ Integrator: — _ K���r•� !�(✓d�
101,
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
t
Location of Farm: Latitude: = o ❑ ' ❑ Longitude: 0 ° 0 ' =
Uesi�;n Current
Design Current
Design wurrent
Swine Capacity Population
wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -Layer-
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
Farrow to Wean 2tlOo
❑ Farrow to Feeder
❑ Farrow to Finish
Gilts
PCI Boars
Dr}' Poultry
❑ La ers
❑Pullets
❑ Turkeys
❑ Dry Cow
❑ Non -Dais
❑ Beef Stocker
ElBeef seeder
❑ Beef Brood Cow
Other
❑ Other
❑ Turkey Poults
El Other
ONber of Structures:
Discharges & Stream Impacts
l . 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?
Page 1 of 3
❑ Yes [9No ❑ NA ❑ NE
❑ Yes
[0 No
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
4 No
❑ NA
❑ NE
❑ Yes
[;VNo
❑ NA
❑ NE
❑ Yes
PNo
❑ NA
❑ NE
12128104 Continued

Facility Number:
Date of Inspection 13 ZS-
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
ONO
❑ NA
❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway`?:
Designed Freeboard (in): %Q
r/
Observed Freeboard (in): Z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
(R'No
El NA
[I NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
9No
❑ 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
E No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[ffNo
❑ 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
[16No
❑ NA
❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application'? If yes, check the appropriate box below. ❑ Yes
®No ❑ NA
❑ NE
❑ Excessive Ponding ❑ llydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift El Application Outside of Area
12.
Crop type(s) ReAIW u S+h+a.!/ ►"rvlV
13.
Soil type(s) 411
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
It] No ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement? ElYes
(p No ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
0 No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
(21 No ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
[Z No ❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendat►ons'or any dther comments ��. • r,
Use drawings of facility.to bitter explain,situations. (use additional pages as neeessary):, a
Reviewer/Inspector Name l - %21' ie�1%[� SF.'x Phone: 9r�• �3--33oO
N
Reviewer/Inspector Signature: Date: 3 —25' Zoo pQ
Page 2 of 3 12128104 Continued

13
Facility Number: .77 — Date of Inspection 3'.75-47
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 [,2 No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
2 L Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes RNo ❑ 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 ❑ Wcather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes M No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes P No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
M No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
EffNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge'?
❑ Yes
01 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[iiNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes,
[FNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[)j 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
ER 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
ERNo
❑ 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
EP No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[R No
❑ NA
❑ NE
Additional Comments and/or Drawings:
w
Page 3 of 3 12128104

a gis 0341alen LT'/S
Type of Vlsit ® Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 7 —/t{ —O Arrival Time: 1 7 : vD 4-1„t 1 Departure Time: 7.011 nq County: IQ1'CAm6'Vd Region: /=40
Farm Name: HA 141 e- f 't % 6 g51 Owner Email:
Owner Name: Alyt A 4 Snu,. nl Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
OnsiteRepresentative: Integrator: BrUCJA/
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: 0 0 = I 0 11
Longitude: = ° = 4 = i!
Design Current
Design Current
Design
C►urrent
Swine C►apacity Papulation
Wet Poultry Capacity Population
Cattle Capacity
Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
❑ Wean to Feeder
❑ Non -Layer
❑ DairyCalf
❑ Feeder to Finish
❑ Dairy Heifer
Farrow to Wean 7400
❑ D Cow
Farrow to Feeder
❑ Non -Dairy❑
Farrow to Finish
rDullry
❑ Beef Stocker
❑Gilts
ers
❑ Beef Feeder
❑ Boars
❑ Beef Brood Cow
❑ Turkeys
Other
❑ Turkey Poults
❑ Other
❑ Other
Number of Structures:
Discharees & 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?
Page 1 of 3
❑ Yes [� No ❑ NA ❑ NE
❑ Yes
CKNo
❑ NA
❑ NE
❑ Yes
W No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
P No
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
PNo
❑ NA
❑ NE
12128104 Continued

Facility Number: 7"7 -�- O'] Date of Inspection Z-/*-G
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[�?No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z 2
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
rO No
El NA
El 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 [p No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes V No ElNA ElNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes F No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes IUNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN [:IPAN > l0% or ] 0 ]bs ❑ 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.
�j i
Soil type(s) A; L eL4 W o►.K"IcL_
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[WNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
W No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
(� No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
/1� No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations-or,a.ny other comments y
Use drawings of facility to better explain situations. (use additional pages: as necessary):
Reviewer/Inspector Name �Z C .�S Phone: 9/0, 4Z33.333?�
Reviewer/InspectorSignature: '�, R-414 ._& Date: 24y—Zoo-7
Page 2 of 3 12128104 Continued

Facility Number: -7-7 — Q7 Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [ZNo ❑ 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 [I Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
CpM No
❑ NA
ElNE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El[ 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
J�j 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
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
;N 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
W No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did ReviewerAnspector 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
J0 No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

IType of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 9 �S�Q Departure Time: ` 0 Q County: /? o Region: F�t7
Farm Name: aW off .81-04 ' S Owner Email:
Owner Name: s. w t i� 11� L SO( . Phone:
Mailing Address: '-TI/ ri
Physical Address: l le' -Ile Pf C a9 3 —
Facility Contact: --ko) Dt j r--� _ Title: Phone No:
Onsite Representative: LI Integrator: I L.41%/) 5
Certified Operator: t Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = I = 11
Longitude: = o = 6 =
10
Design Current
Swine C**opacity Population
Wet Poultry
Design Current Design Current
Capacity Population Cattle Capacity Population
❑ Wean to Finish
JO Layer
❑ Dairy Cow
❑ Wean to Feeder
ILI Non -Layer I
1 ❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
ElBeeF Stocker
❑ Beef Feeder
❑ Beef Brood Cow
INumber of Structures:
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Giits
Dry Poultry
❑ La ers
El Non-Layers
El Pullets
❑ Boars
El Turkeys
TurkeyPou Its!
Other
❑ Other
EJ 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?
Page 1 of 3
❑ Yes 9LNo ❑ NA ❑ NE
❑ Yes
❑ No
q NA
❑ NE
❑ Yes
❑ No
(51 NA
❑ NE
❑ Yes
❑ No
[P NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
E4No
❑ NA
❑ NE
12128104 Continued

FAcility Number: 1 -- / D Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes R1 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No P NA ❑ NE
Structure 1 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 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? P Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [� No ❑ NA ❑ NEB
(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 Yes N No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 10 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [RNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13, Soil type(s) f cc- , AC_
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
W 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
0 No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments;n'
Use drawings of facility to better explain situations. (use additional pagei 4s'necessaiy)
►' or, �(N W i'hq r1 ere CAMS 0 h i.a��n 5 � � i
ReviewerlInspector Name +cD Phone: 910200
Reviewer/Inspector Signature: Date:
Page 2 of3 12128104 Continued

Faciltily Number: 7rl -- Q Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes P] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0 No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
W Yes
❑ No
❑ NA
❑ NE
❑ Waste Application 2� Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
Rainfall ERStocking 4 Crop Yield ❑ 120 Minute Inspections EP Monthly and V
Rain Inspections 1�
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
No
❑ NA
❑ NE
27,
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
m NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes S' No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
R 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
EgNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
(PNo
❑ NA
❑ NE
Additional Cornments'and/or Drawings; • e r.+.. r * .a.e . 4�.='I" , ,x s 771
.
i,.
al) 51en-1 Ar4jst'-5 re 6 56t-k 4-o WtmvAl G4J� � I � 0�r�'
--ti. pr'o�,�ss- u �axiC sic ,v�ana�t?rn,p� P1ar
tjaak -K � ieCe-v4s AS mavW IIn (-a )
12128104

it
IType of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: `d6 0 Arrival Time: 2; '1�0 I Departure Time: /; Q County: 4 Region: /'C1,2�
Farm Name: . & $S pp Owner Email:
Owner Name: /V Phone:
Mailing Address:
Physical Address:
Facility Contact: e= -' Title: Phone No:
OnsiteRepresentative: Integrator: Ay!44-. gvnwnr
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = i = 11 Longitude: = ° = 1 =
SA
Design Current
Swine C*apacity Population
❑ Wean to Finish
Design Current Design
Wet Poultry Capacity Population Cattle Capacity
10 Layer I 1 ❑ Dairy Cow
I ID Non -Layer I 1 ❑ Dair Calf
❑ Dairy Heifer
Dry Poultry ❑ Dry Cow
ElNon-Dairy
❑ Layers
❑ Beef Stocker
❑ Non -Layers
El Pullets El Beef Feeder
❑ Beef Brood Cow
Current
Population
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Turkeys
❑ Turkey Poults
ther
Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes ($No ❑ NA ❑ NE
❑ Yes
®No
❑ NA
❑ NE
[--]Yes
Z No
❑ NA
❑ NE
❑NA
FINE
❑Yes
ONo
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
WNo
❑ NA
❑ NE
12128104 Continued

Facility Number: % 7— Date of Inspection
t
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[6 No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
IM No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): / +�
Observed Freeboard (in): ( Af
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
EgNo
❑ NA [:]NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
�N 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 ;9 No ❑ NA ❑ NE
8. Do any of the stuctures 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'? LP
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 W?No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) k ev-1w _,-A;__ /fir., ,-SkAW1/ �Ya,
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[1 No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
[M No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
19 No
❑ NA
❑ NE
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
[9No
❑ NA
❑ NE
f V �P k dm t f 41,,C°
Comments (refer to question #): Explain any YES answers and/or any:recommendatio6 or any other comments
Use drawings of facility to better explain situations. (use additional pages.as necessary): Y+-
. - - .;,r. IFS.' ➢ k,
L
Reviewer/inspector Name
L �,V $ I Phone: /O)
Reviewer/Inspector Signature:
Date: ZD"lf (47
Page 2 of-3 12128104 Continued

Facility Number: 7 — '7 Date of Inspection
Required Records & Documents ��qq
19, Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 9No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes (6No ❑ NA ❑ NE
the appropriate box. ❑ +WUP ❑ Checklists ❑ Design El Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes D9 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 09 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
0 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
IN No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[NNo
❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[9No
❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
C§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
M 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
PNo
❑ 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
R No
❑ NA ❑ NE
Page 3 of 3 J2128104

Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit O Routine Q Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: ii'z i7 Arrival Time: Departure Time: County: F_iG6Mo.hLj_ Region: F90
Farm Name: M 8 "'� 7G2 9 5 Owner Email:
Owner Name: 91aIN 4 A::, Phone:
Mailing Address: 1 `
Physical Address:
Facility Contact:
Title:
Onsite Representative: I_aAJ j S u M q r,VlUe' .IC
Certified Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: ❑ e ❑ 6 ❑if Longitude: = ° ❑ j ❑
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
® Farrow to Wean Z j�vo
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Puults
❑ 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?
Design Current
Capacity Population
❑
Dai Cow
❑
Dairy Calf
❑
Dairy Heifei
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:
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 N No ❑ NA ❑ NE
[]Yes
CRNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
No
❑ Yes
[XNo
❑ NA
❑ NE
❑ Yes
CC No
❑ NA
❑ NE
12128104 Continued

Facility Number: 7-7— 0'7 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
NNo
❑ 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:
Spillway?:
Designed Freeboard (in): _ _ j 9
Observed Freeboard (in): Z/ 0
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[9 No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed
❑ Yes
5a No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
JgNo
❑ 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?
I. Is there evidence of incorrect application? if yes, check the appropriate box below.
❑ Yes
[)6 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ihs ❑ 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) CYt�t+►�e� a` .�� ct �� (� jar 0 V ✓Se _c1
13. Soil type(s) �j C'�[�� r�r
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
(A No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
X No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[] Yes
X No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[9No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA ❑ NE
l�.-.j x�i yP., PrY y „1.r'v�" . T F V"'V' Cv ii 6ioe 4" �'c�r�i'A',ti � GR.-.. -
p ,} W :�( i" "y. yy
C�nmrt�Pnt�frttt'Pr.�trtnunctinn�3l1 F.YntAin`�anv �iT.T�'.C6rinau�nrc/:AnrllnrTs�nv ri�rnmmPnrlAtinna n, wnvr nthar rnmmr+n+a
Reviewer/Inspector Name i G K _V:� f S ,; ``,x %4,At�fi t Phone: 9/[9 #$6/Sy
Reviewer/Inspector Signature: Date: 9:f
12128104 Continued

Facility Number: 7 —0-] Date of Inspection
Required Records & Documents
19. Did the facility fail to have 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 [XNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Nf No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes % No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes tA 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
® 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
C@ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
(N 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
0 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
Z1 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[R No
❑ NA
❑ NE
Additional Comments;and/or:.Ilrawings;�w,u
12128104

v' ? E '�'Dtvisioa-!of�Wa'ter-�]�,yji �., x+, tya"�,1`�'+� Y,4'-'"�x .tr"°5'*„x•„C c€i { F.
i"
17 i4'r � '�i 'I"lcc°i aY'''1 �..� i'�u..�i - � JI.M .�jt� IT^ � '� •F �yp1C 'rT. 5:. _.x� i`�."'t..
37� H F � I � � �': SM ,� F. � C a it y.'x-f"t l w✓ :S•' , 1- �,� ,� �..... - '�"}„ i y t t '; .i .. ; ,� � �
. L � I M• -r� n�i l.��j f�f�� M '� �� N � • s i � �. ...
Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up Q Emergency Notification O Other ❑ Denied Access
Date. of Visit: i O �? Time.: ��
Faciliry Number
• •.. • •.��. Not O erational Below Threshold
❑ Permitled 0 Certified (a Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm name: 11 t. County: _a i Ck Mffy'rfi Ego
Owner Name: Phone No:
Mailing Address:
Facility Contact: Title:
Onsite Representative: rA6'jj= Me4 6"a_bChCU er _
Certified Operator:
Location of Farm:
Phone No:
Integrator: i� S„ _
Operator Certification Number:
19Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� �4 0" Longitude • I Du
Design Current
Swine Canstrily Pnnivin inn
❑ Wean to Feeder
❑ Feeder to Finish
® Farrow to Wean
Z oo
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Laver EEI
Dairy
❑ Non -Layer Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons I I ; `;°", t. ;;; lU SubSurtac
Holding Ponds / Solid Traps
.' ° ❑ No Li uid
item ,� •r � ''
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge ori,inated at: ❑ Lagoon ❑ Svrav Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in galimin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Irvatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
ldentifier:
Freeboard (inches):
05103101
❑ Yes 5� No
❑ Yes ❑ No
❑ Yes ❑ No
U Yes U No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Continued

Facility Number: — 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
closure plan? El Yes ❑ No
(if any of questions 4-6 was answered yes, and the situation posts an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Wasic !Ill
10, Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
t2. Crop type
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
RgaUIred Records 8& Donpownts
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ❑ No
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ❑ No
24, Does facility require a follow-up visit by same agency? ❑ Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments relertto questlonr#) Explain any YES answEaRldiMn ytrecom&NiI8tlans or any other, comments.
Use drawings of fsicility ta6cttcr cxplaio situations. (uspageas nece'ssary,): ❑Field Copy ❑Final Notes
Reviewer/Ins ector Name
pm Lr5+iS, i
ReviewerlInspector Signature: Date:
w/vi/of "nunuea

.­
��.-I�,iK� , ,��"x'� �® Division of Water Halt � �'•�^ �: �..���• ,�.. J�„ x ��'�s � �; ", •.�,,, �.�
l .� ' �1 4.+F.,...' L' n.n w..7,... ^n s.. � .s. L "•^� iM4 s J y3" r�. �_ -
��f� s� ita'� t 0� Divi;laa of Sai! and VVattt- Conservation " r
� L�,,'�. I t'a+' 1r r� 4 &pi` i +� � wx 1if ' �:.&`.: � - �. w � !. w � M r '• iq t �; w• _ "
Type of Visit ® Compliance Inspection Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number �- -��� Date (if ViAt: Time:
10 Not O erational 0 Below Threshold
® Permitted ® Certified ©ConditionalIv Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: -S -. rr, _ Na , d Z� G , -- County: A n.t.C�aj �=
Owner Name: i „� f"C.I'.,v. __ __ __7•-(tgL� __- PhoneNa: -7Ln _�,�•G -' Mailing
7--
Mai6ng .Address: ���. R C>k e% 6 Lj 6_1` C G t.l 0,
Facility Contact: bA-x_1," tati. [1Ge/ Title: Phone No:
r
On site Representative: M6_+ jXd e- 6 6-, (a G. cL<,-r Integrator: Y'
Certified Operator: r i t' /`r e t i Operator Certification Number:
Location of Farm:
M Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ° Du Longitude • t
Design Current
Design Current Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle Capacity Population
❑ Wean to Feeder
10 Laver
I
I
I❑
Dairy
❑ Feeder to Finish
❑ Non -Layer
❑ Non -Dairy
Farrow to Wean
❑ Other
El Farrow to Feeder
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSLW
Number of Lagoons 0 `, ❑Subsurface Drains Present [] La Dori Area ❑ S rati Field Area
�
0 r ❑ ufd Waste Mane emnt SvsiemHoldin Ponds I S41id Traps
pischarees 8 Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify D WQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): o�T
05103101
❑ Yes RNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes QR No
❑ Yes P No
❑ Yes tE No
Structure 6
Condnued

Facility Number. Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes IgNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? (If any of questions 4-6 was answered yes, and the situation poses an ❑ Yes q No
Immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes Rlo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes O No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes BNo
Waste Atanlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes C.No
11, Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes [&No
12. Crop type 4—
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes JUNo
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 [F No
16. is there a lack of adequate waste application equipment'? ❑ Yes DNo
Reguired
Regords & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
ESNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
9No
(icl WUP, checklists, design, maps, etc.)
❑ Yes
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
P No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
Cl Yes
414o
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
&] No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
❑ Yes
[gNo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
[SbNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
0 No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
E4No
0
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
+�
Reviewer/Inspector Name
Reviewer/Inspector Signature.,
05103101
❑ Field Copy ❑ Final Notes
Date;
Continued

Facility Number: Date of inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
29. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
05103101
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes C9 No
❑ Yes No
❑ Yes No
❑ Yes ❑ No

k. i
Type of Visit 19 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ® Routine O Complaint 0 Follow up Q Emergency Notification Q Other ❑ Denied Access
Facility \umber DoIeofVisit: S o T'imc: ' = O
Not Operational 0 Below Threshold
Permitted IQ Certified Conditionally Certified Registered Date Last Operated or Above Threshold:
Farm Name: �6�.1,�-wv rL'kA Count: _��tL.rw�di �
Owner Name: Grrtz:,L0S #-- Lt?S' Phone No: (iib
Mailing Address: 9,19 91
Facility Contact: _..filer 6 r ih: na Title: I-Af M _ Phone No: t'a►�t
Onsite Representative: Integrator: ___C-dv`rn{( S
Certified Operator: tr_ SA'J,!_._, Operator Certification Number: � � t n,s ,,-,,,,__,_
Location of Farm:
IR Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• ��K
Design Current
Design . Current Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle Capacity Population
❑ Wean to Feeder
JED Layer
I
1
10 Dairy
❑ Feeder to Finish
10 Non -Layer
I
1
10 Non-Dairy
Farrow to Wean
❑ Other
❑ Farrow to Feeder
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ La oon Area S ra\ Field Area
Holding Ponds / Solid Traps , ` ❑ No Liquid Waste Management System
D' c areyes g Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is obsen-ed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & IrRatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure S
Identifier:
Freeboard (inches):
05103101
❑ Yes [jZ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes X No
❑ Yes IN No
❑ Yes q No
Structure 6
Continued

Facility Dumber: -j- Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (icl trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Annlicntion
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Pending ❑ PAN ❑ Hydraulic Overload
12. Crop type a
❑ Yes 4 No
❑ Yes [3j No
❑ Yes No
❑ Yes No
❑ Yes [&No
❑ Yes E] No
❑ Yes allo
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
[ZLNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Reauired Records & Document
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
RNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
M No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
] No
(ie/ discharge, freeboard problems, over application)
23,
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
[!JNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[9 No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
*c; � :' _- .:. A' ...'. .. SASd :h' '�.
Co ments {'refer to question #) Explalnoany&kYES answers andlorsny recommendations or anyafhecottiments: �Y'
Use drawings of facility to.bett�er explaln�sEtuatlbns: (use additlonalpages:as necessaryW" '401'�❑ Field Copy ❑Final Notes
( U
L.S' - cc*;
Reviewer/inspector Name - k
Reviewer/Inspector Signature: Date: r a
05103101 Continued

Facility Number: Date of Inspection _"_
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon?
30. N ere any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s). inoperable shutters. etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover?
mments
AYes ❑ No
❑ Yes ® No
❑ Yes 5c No
El Yes 25No
❑ Yes No
❑Yes No
LbU Yes ❑ No
05103101

s'1iiililQQ V1 1i �t�■ Uidit
4tlK(�`Divialo>i oft -and Water Co>iservaHon
El{i gin
D Other Agency f ;i °E' l_ 1
aril6 Ff{ ,�� iti.l.a.. �s€T a � �i.' � ,i,?illt�•�i�i . z E.,Rs.. gf, ,,r, :�,. �i , ;, ai 1j- •�E �1i�3§i : >�s• .,rg ±@ �.�s r a.i+! ! •� n � . ;r's z .
Type of Visit Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit 0 Routine O Complaint Q Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number
(late of Visit: D Time: •Z = �i
7
Not O merational 0 Below Threshold
M Permitted M Certified D Conditionally Certified ©Registered Date Last Operated or Above Threshold:
Farm Name: �it! County: ppR� \ a_=6dVxz
Owner Name: SRwY4 hiF-� Phone No:
Malling Address: �_ �C.vG/d.,p ;�'3/hh�
Facility Contact: k Title: Phone No:
Onsite Representative: �� �ds Integrator:
Certified Operator: -SAS✓ ��/�✓-r Operator Certification Number:
Location of Farm:
❑ swine ❑ Poultry []Cattle ❑Horse Latitude ' �• 0" Longitude 0 �• ��
Design Current i f -3i PDesign Current'i Design _, ''Current.
( '.:S►�ine :3-@. ,E. w ._ ,>>., I;Ca acitvr . Po iili�tion_ ; IPadif , t,. ' Ca 'aciCv ,. 'Population, . ie.Cattic f ,f,.,` _.: 3.Co"acity •a Pa ulation `
Wean to Feeder
EE
❑ Feeder to Finish
® Farrow to Wean
2 V0,0.7
OO
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
�il1 ,lief is tea E @ '� .1 i Eq�
4Halditt9Ponds /`Solid .Traps
h Layer ❑ Dairy
Non -Layer
�. . � ❑Non -Dairy;
❑ Other
Total Design Capacity '
.`.Total SSLW
rface Drains Present
iuid Waste Manaaen
Riseharees & Stream impacts
1. Is any discharge observed from any part of the operation? ❑ Yes A No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 5�No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes tXNo
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 R'No
2, is there evidence of past discharge from any part of the operation? ❑ Yes gNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 9 No
Waste Collection & Treatment
4, Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes XNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
05103101 Continued

Facility Number: 77 - -
Date of Inspection 0
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Ao-z o.,w4 c , Q"voU
❑ Yes <No
❑ Yes KNo
❑ Yes VNo
❑ Yes �o
❑ Yes KNo
❑ Yes No
❑ Yes XN0
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes $2 No
I4.
a) Does the facility lack adequate acreage for land application?
❑ Yes
5D No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
JR No
15.
Does the receiving crop need improvement?
❑ Yes
VN 0
16.
Is there a lack of adequate waste application equipment?
❑ Yes
RNo
Regufred
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
QD'No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
&No
(ie/ WUUPchecklists, design, maps etc.)
❑ Yes
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
RNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
5[No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
'ONo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
C No
(ie/ discharge, freeboard problems, over application)
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
P.No
25,
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
allo
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (* f r to'question If) Explain siiy YES.answers and/oe'anycrecommehdations or any oth_er:eomments. ^
�_ � _ _
Use drawings,of facility tt' better explain situations:.(use:addidonal;pages,es necessary) ,,;' �4� Field Canv El Final Notes
.. .,-.�-.. •..E,..,----,-----�---�---» --
411
/� w,t Oz A4%,-t) �et h7 /L��G .ro--W- .ClI -'A
G✓E�EL'r �G/
/V p�y lfJ Ty's`tc'�c ,Q.tO'!%.✓�^�� �✓ 9rd�i� I/, 1.C�.r.�-6�
Reviewer/Inspector Name
p IiuL�..
Reviewer/Inspector Signature:Ar� Date:
05103101 Continued

Facility Number: —2 Date of Inspection S� Q
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
2& is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, andlor public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Additional Comments and/ow.Drawings,
05103101
❑ Yes XNO
❑ Yes �rNo
❑ Yes �RNo
❑ Yes RrNo
❑ Yes ® No
❑ Yes O No
❑ Yes XrNo

0Dtrision of Water Quality
11 l,+ : Q Division of Soil and Water Conservation
a{; 7� � t sd.,
Type of Visit P Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: ' oig^ 'Circe: Printed on: 7/21/2000
6
0 Not Operational Q Below Threshold
Permitted [] Certified [] Conditionally Certified ❑ Registered Date Last Operated or Above Threshold: .........................
Farm Name: ......... ....l..lf?............................................................. I............ + F�rnon ......................
................................ County:................G.......................................
Owner Name:.... 5 U u S ... P(:J:S..........7;< .......................... Phone No:.......................................................................................
Facility Contact: .. u �...... (I nS.............................. Title: ...... F Y!....t............................ Phone No:
Mailing Address:.....
OnsiteRepresentative: ............................................... .... .............
I
Certified Operator:..... . �.x ............ t.{ti�� .............
Location of Farm:
........... Integrator:... ............................ .............
Operator Certification Number: ..........................................
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • L 66 Longitude ' S «
Design Current
Canacity. Ponulat on
r: Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Design Current Design I C.urrm
Poultry capacity Fo ulation Cattle Ca aci Pu alatJ
❑ Layer ❑ Dairy
❑ Non -Layer 10 Non -Dairy
_❑ Other
>� P tY I a�
Total Deli ' Ca acl
Total SSLW
Nruii>etber of+Lagootns ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
3
"Holdiiug Ponds / Solid Traps 10 No Liquid Waste Management System
Discharges & Stream ImRacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyancc man-made?
h. If discharge is observed. did it reach Water of the State'? (if yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4
❑ Yes )Io
❑ Yes No
❑ Yes I
No
❑ Yes No
❑ Yes No
❑ Yes o
❑ Yes 1M No
Structure 5 Structure 6
Identifier:
Freehoard (inches)
5100
....................................
37
Continued on back

Ra
Facility Number: fj — 6 % Date of Inspection 5'-o?g-o Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes OP(No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes 4No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes ANo
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes�gNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes No
Waste Application
10, Are there any buffers that need maintenance/improvement?
❑ Yes No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes o
12. Crop type _C;� p (Syc; r,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes No
14. a) Does the facility lack adequate acreage for land application?
El No
b) Does the facility need a wettable acre determination?
❑ Yes 1� No
c) This facility is pended for a wettable acre determination?
❑ Yes R�10
15. Does the receiving crop need improvement?
❑ Yes)I�No
16, Is there a lack of adequate waste application equipment?
❑ Yes JK No
Reauired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes0
18, Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes _-E�No
19, Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes Wo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes fiKNo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes J<No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, Freeboard problems, over application) ❑ Yes K�No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'? ❑ Yes 4kyo
24. Does facility require a follow-up visit by same agency'? ❑ Yes \\\No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes o
ns.ore ji4w. . ot°tng th js;vis}ti Yojt wi�i eegiye o; #'�> tiler .
cor'res• inidence'. ahoulk this visit.
Comments (refer to question. #} Explain any YES answers and/or any recommendations or any otlier comments '- I 3
Use drawin�g+s of facility to Mtter explain situahoas `(use` eddit<onai pages as necessary) '
,�%/'CLy ,� � fa[5 �✓G fp CQr- `j'pI"A-«� P�4' �� OJ �plS #
Reviewer/Inspector Name
,G4
Reviewer/Inspector Signature: Date: '' Z ►- 5100

I tr
Facility Number: 7 7 —d 7 Date of Inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below K'Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27, Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes �No
roads, building structure, and/or public property) .
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30, Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes <No
31, Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 99-No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? CKes ❑ No
Additional Comments and/orDrawings:
5/00

State of North Carolina
Department of Environment
and Natural Resources
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Carroll's Realty Partnership
7685
PO Drawer 856
Warsaw NC 28398
Dear Carroll's Realty Partnership:
fflTXAJ
IT 0 0'
A&4 2�A
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL REsouRCEs
October 2, 2000
"RE C
OCT 13 2000
Subject: Notification for Wettable Acre Determination
Animal Waste_ Management System
7685
Facility Number 77-7
Richmond County
A letter dated January 15, 1999 was sent to advise you about concerns associated with Certified Animal
Waste Management Plans and the method by which the irrigated acres within the plans were calculated. Only
the acres that are wetted can be credited in the waste management plan as receiving waste application. Any
acreage within the plan that can not be reached by waste application equipment can not be used as part of your
plan.
An evaluation by Jeffery Brown on 5/14/99 was made to review the actual number of acres at your facility
that receive animal waste during land application. The evaluation of your facility has yielded one of the
following two results as indicated by the box marked with an "X".
Category 1:
The evaluation of your facility could not be completed due to a lack of information. Please
contact your Technical Specialist to assist in providing John Hasty the necessary
information to potentially exempt your facility from undergoing a complete wettable acre
determination. Please submit this information to John Hasty, at 225 Green Street, Suite
714, Fayetteville, NC 28301, within in 90 days of the receipt of this letter. If you have any
questions please contact John Hasty at [phone]. If within 90 days you are unable
to provide Jahn Hasty with the information you are automatically required to complete
a Wettable Acre Determination as described by Category 2 below, within 180 days
of receipt of this letter.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 'Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

4i . -
HLP -age
Routine 0 Complaint 0 Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection
Time of Inspection � 24 hr. (hh:mm)
Permitted C] Certified 0 Conditionally Certified [3 Registered IQ Not O erational Date Last Operated: ..........................
Farm Name: .....Carrn.L...} .................1... ..{.......... .r ...............
County: ......... 1 r 4 h1�...........
....... ........ I ...........
...
IS
Owner Name:.... T.�[.ir �... ... ..d% ii°l lt..'. [� Phone No: 27{? ���.................................
Facility Contact: ........�5........i`k� . ............................ Title:...a.`-,................... . Phone No:......... `�... .....,....,...........
Mailing Address: ....... 1....f.://,���4%er .. lr///��.el �!' j... /v ......... z0 3 Qt
............ ....................................
Onsite Representative:................................................. ......... Integrator:.....................................,................................................
Certified Operator:,...r U....9:: " ....................... �elC\.(h.s............................. Operator Certification Number:..........................................
Location of Farm:
A
............ ..
Latitude • 6 44 Longitude ' t 44
Discharges & Stream ImllaetS
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If'yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
4No
Structure 6
Identifier:
Freeboard (inches): ........
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 0, No
seepage, etc.)
3/23/99 Continued on back

j. . ti:
Facility Number: 7— Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence 6f over application? ❑ Execssiv Po ding ❑ PAN
12. Crop type &I-144ja-��j ,��v1
13. Do the receiving crops differ with those designat d n the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. 1s facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
�i'S16.violatliQns or.iier1eiencie mere npteo.d ririgt1hls'visit}.'You wiii.ree$iye 46 futt�er.
Corr espolidence. about this .visit.
❑ Yes XNo
❑ Yes 4No
❑ Yes KNo
❑ Yes 'A�No
❑ Yes ANo
[:]Yes KNo
❑ Yes O(No
❑ Yes [ No
❑ Yes W No
❑ Yes 9No
❑ Yes ❑ No
❑ Yes P�No
❑ Yes XNo
❑ Yes. No
❑ Yes No
❑ Yes U� No
❑ Yes 00 No
❑ Yes OdNo
❑ Yes No
❑ Yes No
❑ Yes No
99

Facility Number:77 _Q Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 0
roads, building structure, and/or public property) r
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes 42fNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes �No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No

RECEIVED
ifm-ig; �im 21h I
March 23, 2000
MAR 2 7 2000
FAYETTEVILLE
REG. OFFICE
Jeffery Brown
North Carolina Department of
Environment and Natural Resources
Division of Water Quality
225 Green Street, Suite 714
Fayetteville, NC 28301-5043
CARROLL'S FOODS, INC.
Box 1767 - 325 McKay Street
Laurinhurg, North Carolina 28353
PH: 9101276-0648 FX:9101276-2950
SUBJECT: Response to letter dated March 17, 2000 regarding freeboard levels.
Dear Mr. Brown:
The following; facilities were lowered to or below the required freeboard level as
of March 3, 2000. Facility 77-7.
If you have any questions, please feel free to call me at 910-276-0648, ext. 432.
Sincerely,
Carroll's Laurinburg Division
Leslie L. Stutts
1]nvironniental Manager
cc: Mark Pahl

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
FAYETTEVILLE REGIONAL OFFICE
March 17, 2000
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Carroll's Realty Partnership
PO Drawer 856
Warsaw, NC 28398
SUBJECT: NOTICE OF DEFICIENCY
Carroll's Farm #7685
Facility No. 77-7
Permit No. AWS770007
Richmond County
Dear Sir:
On January 31, 2000, you or staff from your farm notified the Fayetteville Regional Office
of the Division of Water Quality, as required by General Permit condition 111.6.e, that the freeboard
level of the lagoon was less than the minimum required by the General Permit. The liquid level of
the lagoon was reported as 17 inches. General Permit condition V.3 states that "The maximum
waste level in lagoons/storage ponds shall not exceed that specified in the CAWMP. At a
minimum, maximum waste level for lagoons/storage ponds must not exceed the level that provides
adequate storage to contain the 25-year, 24-hour storm event plus as additional 1 foot of structural
freeboard.".
The Division of Water Quality will take no further action for this reported incident at this
time. However, you are asked to please notify this office in writing within 15 days of receipt of this
letter as to what date the lagoon was lowered to the required freeboard level. This information is
essential in determining if the lagoon was lowered within the specified time frame in which the Plan
of Action (POA) allotted. It will also close this event out within your file. If you have any questions
concerning this matter, please do not hesitate to contact myself at [phone].
Sincerely,
Jeffery Brown
Environmental Engineer
cc Sonya Avant - Compliance Group
Central Files
Trent Allen - DSWC Fayetteville Office
Velma Marra, Richmond County NRCS
225 GREEN STREET, SUITE 714 / SYSTEL SLO. FAYETTEVILLE, NORTH CAROLINA 28$01.5043
PHONE [phone] FAX [phone]
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State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
Carroll's Realty Partnership
7685
PO Drawer 856
Warsaw NC 28398
Dear Carroll's Realty Partnership:
1 � •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RE50URCE5
December 30, 1999
,1:11N 5 2000
FAYET E-EVILLE
REG. OFFICE
Subject: Fertilizer Application Recordkeeping
Animal Waste Management System
Facility Number 77-7
Richmond County
This letter is being sent to clarify the recordkeeping requirement for Plant Available Nitrogen (PAN)
application on fields that are part of your Certified Animal Waste Management Plan.
In order to show that the agronomic loading rates for the crops being grown are not being' exceeded, you
must keep records of all sources of nitrogen that are being added to these sites. This would include nitrogen
from all types of animal waste as well as municipal and industrial sludges/residuals, and commercial fertilizers.
Beginning January 1, 2000, all nitrogen sources applied to land receiving animal waste are required to
be kept on the appropriate recordkeeping forms (i.e. IRR1, IRR2, DRY1, DRY2, DRY3, SLUR], SLUR2,
SLD1, and SLD2) and maintained in the facility records for review. The Division of Water Quality (DWQ)
compliance inspectors and Division of Soil and Water operation reviewers will review all recordkeeping during
routine inspections. Facilities not documenting all sources of nitrogen application will be subject to an
appropriate enforcement action.
Please be advised that nothing in this letter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State -Statute, Local County Ordinance, or permitting
requirement.
If you have any questions regarding this letter, please do not hesitate to contact Ms. Sonya Avant of the
DWQ staff at [phone] ext. 571.
Sincere) ,
Kerr T. Stevens, Director
Division of Water Quality
cc: Fayetteville Regional Office
Richmond County Soil and Water Conservation District
Facility File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
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