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HomeMy WebLinkAbout780009_INSPECTIONS_20171231li � K� L3 Division of Soil and Water Conservation [] Other Agency Division of Water Quality�� .�as�°"..�'"+7�;,.�'3'.'"�.�,�`3'..�. � _'��.i A��; s »;� �:'�Y ,�..�; �nra �`•xav'k�sm�� `m..r 3� ,s,�,� cs�y� vT� O Routine O Complaint O Follow-up of DAVO inspection O Follow-up of DSWC review O Other Date of Inspection �-I a�+�l Facility Number Time of Inspection : 40 124 hr. (hh:mm) © Registered OrCertifi:ed © Applied for Permit Permitted [3 Not Operational Date Last Operated: .......................... Farm Name: ........................... l........ ...---......... ........ County:...... ....... -5e"t R..Qbe............................................... Owner Name:...... C-a rro.11..S..................F............. ............... Phone No:........... 9 .......V.:3......`.'3�d............... jJ . 11 ,J� FacilityContact: L�'..L.l........:�i�c... Title :........................ ........................................ Phone No:............................................-----.. Mailing Address: ....... Rq!....... Il.il+:gvc� .ir•......V......../........................................ ... .�,.?a� y....:.. C ../..d��,3�� Onsite Representative: ........... __. - PA ./.-. .. L�2C.�................k. Integrator: Int rator'.........:...- ................................ Td..`.. .....fi ... Certified Operator;..........................1...................... . Operator Certification Number:.................... Location of Farm: Latitude E =• =' Longitude � • C � � �� _a:Desrgri„ Current,;Design Current ,4 f Destgrt Current Svvme 'Capacity Population Pouhryw Caactty `Populatiiin Gattle �CapactyaPopuiahanT ❑ Wean to Feeder ❑ Feeder to Finish ❑ Farrow to Wean ❑ Farrow to Feeder Farrow to Finish 1,ROO Gilts ❑ Boars " ❑ Layer < ❑ Dairy f: ❑ Non -Layer Non -Dairy[ ❑ Other I I' TotiMestgn Capacity `{ i 4 nA TOtafSS)(. General 1. Are there any buffers that need maintenancelimprovement? ❑ Yes 0 No 2. Is any discharge observed from any part of the operation? ❑ Yes 19 No Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. If discharge is observed, was the conveyance man-made? b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) c. If discharge is observed, what is the estimated flow in gal/min? d. Does discharge bypass a lagoon system? (If yes, notify DWQ) 3. Is there evidence of past discharge from any part of the operation? 4. Were there any adverse impacts to the waters of the State other than from a discharge? 5. Does any part of the waste management system (other than lagoons holding ponds) require maintenance/improvement? 6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 7. Did the facility fail to have a certified operator in responsible charge? 7/25/97 ❑ Yes CO No ❑ Yes 0 No • t A ❑ Yes Vo No ❑ Yes 0 No ❑ Yes 0 No ❑ Yes gNo ❑ Yes f M No ❑ Yes A No Continued on back Facility lumber: — $. Are there lagoons or storage ponds on site which need to he properly closed? Cl Yes XNo Structures (LaQoonS,HoldingPonds, Flush Pits, etc.) 9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes K No Structure 1 Structure 2 Structure 3 Structure 4 Structure. 5 Structure 6 Identifier: Freeboard (ft):..........�,............................. , 10. Is seepage observed from any of the structures? 11. Is erosion, or any other threats to the integrity of any of the structures observed? 12. Do any of the structures need maintenance/improvement? (If any of questions 9-12 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 13. Do any of the structures lack adequate minimum or maximum liquid level markers'? Waste Application 14. Is there physical evidence of over application? (If in excess of WMP, or run ff entering waters offt0the [,State. notify DWQ) 15. Crop type '............. '[ ......M�?N7}!r1!IPY�Y. :S!...... - _......... 1.... lb. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWviP)? 17. Does the facility have a lack of adequate acreage for land application? 18. Does the receiving crop. need improvement? 19. Is there a lack of available waste application equipment? 20. Does facility require a follow-up visit by same agency? 21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? 22. Does record keeping need improvement? For Certil led or Permitted Facilities Only 23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? 24. Were any additional problems noted which cause noncompliance of the Certified AWMP? 25. Were any additional problems noted which cause noncompliance of the Permit? No.violations or de&iencies.were noted during this:visit.-:You.rvi11 receive no further correspondence about this' visit:• : : Comments [refer"to question #t):Explain any YES ariswersand/or anv recotnmendaUons.orauy other corndr Use'drawings of facthtv,'to,hetter explain situations (else addetional pi;ges as necessary} R R• r u. $ n sueA jzzg , ❑ Yes Dd No ❑ Yes JAI No XYes ❑ No ❑ Yes )KNo ❑ Yes W No ❑ Yes 101 No ❑ Yes No ❑ Yes ONo ❑ Yes ;gNo ❑ Yes No ❑ Yes No PN Yes ❑ No ❑ Yes jk�40 ❑ Yes XNo ❑ Yes JANo S Reviewer/Inspector lame Reviewer/Inspector Signature: �aee_z »^ Date: -- — d 13 Division of Soil and Water Conservation ❑ Other Agency Division of Water Quality 10 Routine QC plaint O Fallow -up of DWQ inspection__ _O Follow-up of DSWC review *Other � - 9r- Facility Number Date of Inspection Time of Inspection [� 24 hr. (hh:nun) 17 Registered q Certified nn[GGApplied for Permit Permitted [j Not Operational Date Last Operated:.........., Farm Name: ........................L.l..L...... County t�l�,?.'�!a ............ ............. 1]���........................................................................------......... .. I; Owner Name:.!?./.!. .......... - Phone No: FacilityContact: �. ..�..G..... a Title:................................................................ Phone No: .................. ................................. MailingAddress:..........................................-•--..............................................................................------...---...................................................5........... ...'...................... Ir Onsite Representative:.......4............Integrator:kc._...................................... ..........:....._..... C.........:....----�-- �y....�. Certified Operator ..................................... .......................................................................... Operator Certification Number: Location of Farm: C C Latitude Longitude Desrgn Current ` Design r.Curreint, k Desrgn Curtrent � t, S*W A 4 CaipacrtvT Popiilation Poultry, yCapacity,'Populaiiony ttle Ca µ CapacNty.,.Populahan ean to Feeder ❑ Layer a< to Finish fEDMFeeder „ ❑ Non-LayerFarrow to Wean ❑ Farrow to Feeder ❑Other Farrow to Finish 00 Total Des 3 3 ❑ Gilts r ❑ Boars ❑ Dairy ' J❑ Non -Dairy 7A gn Capactiyk`���W C . imnnr�rir A� General 1. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No 2. Is any discharge observed from any part of the operation? ❑ Yes ❑ No Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes ❑ No c. If discharge is observed, what is the estimated flow in gal/min? /,j d. Does discharge bypass a lagoon system`? (If yes, notify DWQ) ❑ Yes ❑ No 3. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No 4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes ❑ No 5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ❑ No nisi ntenance/i mpro vement? 6. is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No 7. Did the facility fail to have a certified operator in responsible charge? [:]Yes ❑ No 7/25/97 4 Facility Number: 8. Are there lagoons or storage ponds on site which need to be properly closed? Structures (Lagoons.11olding Ponds, .,Flush Pits, etc.) 9. Is storage capacity (freeboard plus storm storage) less than adequate? �Ctructurg,l Structure 2 Structure 3 Structure 4 Identifier. lio Freeboard (ft):.................................... .... 10. Is seepage observed from any of the structures? 11. Is erosion, or any other threats to the integrity of any of the structures observed'? ❑ Yes V Xyes ❑ No Structure 5 Structure 6 .......................................................................... ❑ Yes ❑ No 12. Do any of the structures need maintenance/improvement? (If any of questions 9-12 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 13. Do any of the structures lack adequate minimum or maximum liquid level markers? Waste. Application 14. Is there physical evidence of over application? (If in excess of WMP, or runoff a to �ng "of te, notify DWQ) 15. Crop type ........................ ............... I�'.......... .. _...._ _ ._....._.......... 16. Do the receiving crops differ with those designated in the Animal Waste I'v9anagement Plan (AW,MP)? 17. Does the facility have a lack of adequate acreage for land application? 18. Does the receiving crop need improvement? 19. Is there a lack of available waste application equipment? 20. Does facility require a follow-up visit by same agency? 21. Did Reviewertinspector fail to discuss review/inspection with on -site representative? 22. Does record keeping need improvement? For Certified or Permitted Facilities Only 23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? 24. Were any additional problems noted which cause noncompliance of the Certified AWMP? 25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Ayes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No [] No violations or deficieneies4ere noted -during this visit. Nou.will receive no further eorrespondence About this:visit:• : . Oialllent5;(reter o quesuon f) � xplaln any .hs answers and/or any recommenuatlons or any Oiiter COnm12nL5 4« Jsa drawings o1'facthty ft better'explam sifuations (use additional pages -as;necessarv) AL 7/25/97 Reviewer/Inspector Name : ;i/% r , . Y, ¢ kK Reviewer/inspector Signature: Date: O'Dwis�on of Soil and Wate'ConseRrvatjon °Uperahon Revecw - D Dtvisron of Svil and -Water Conservation Cumpliance'Inspect�oji n Division of Water QuaLty =Compliance"Inspection Y - -Other"Agency Opei atron Review Routine Q Cum taint Q Follow-up of DWQ inspection O Follow-up of DSVVC review 0 Other Facility Number 7 Q Date of inspection® I-ime of Inspection 24 hr. (hh:mm) © Permitted ❑ Certified E3 Conditionally Certified 0 Registered ❑ Not Operational Date/Last Operated: Farm Name: * 757Z.�"T-... .. .. - Countt:...-.-.... L'r �.Q?'�r..................................... .................... ............-. .....--.................... .... ... . Owner Name:.....-Ci.C`Y.Cal.1-.' ,,.//...-...-.. C./r ... rC<..................... Phone No: ........ 22(...'f1k-7"r.................................. Facility Contact: L $....... .�!I I Title: t.l.�.. ..1....................... Phone No: .......... ........................ ................. ,..Q.... �� r ...................... ..& 71�, ' illailing Address: ...�i...�.A........... t?................................................................... .......We r,�aj-..o...� .A!.. C........-.......... z.�....-��.... AV Onsite Representative:... es ....�A .... Integrator: ........................................ Certified Operator:...Pe !1 r ? 15 a Aau O eratnr Certification Number:..-. ..........................................................I.5.............................. p ..... Location of Farm: ` t.......................................................... Latitude Longitude Design Current Design Current Design Current Swine Capacity Population Poultry Capacity Population Cattle Capacity Population ❑ Wean to Feeder ❑ Layer ❑ Dairy ElFeeder to Finish JEI Non -Layer ❑Non -Dairy ❑ Farrow to Wean ❑ Farrow to Feeder ❑Other 56 Farrow to Finish J O Total Design Capacity ZDtJ ❑ Gilts ❑ Boars Total SSLW Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area Holding Ponds / Solid Traps ❑ No Liquid Waste Management System Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation (If yes, notify DWQ)? Discharge originated at: ❑ Lagoon ❑ Spray Field []Other a. If discharge is observed, was the conveyance man-made? h. If discharge'is observed. did it reach: ❑ Surface Waters []Waters of the State c- 11'discharge is observed. what is the estimated liow in gal/mini d. Does discharge bypass a lagoon system? 2- Is there evidence of past discharge from any part of the operation? 3. Were there any 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? Structure I Structure 2 Structure 3 Structure 4 Structure 5 Identifier: Freeboard (inches): ...........r...!......... ....................... ❑ Yes kNo ❑ Yes ®No ❑ Yes &o El �No ❑ Yes JZfNo ❑ Yes ENo ❑ Yes ZNo Structure 6 1/6/99 Continued on back Facility Number: 7Date of Inspection 5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, El Yes 0 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 rbr VU No (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? ❑ Yes WNo 8. Does any part of the waste management system other than waste structures require main tenancelimprovemcnt? ❑Yes JVrP1 No 9_ Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum liquid level elevation markings? ❑ Yes j7 No Waste Application 10. Are there any buffers that need maintenance/irprovement? ❑ Yes No 11. Is there evidence of over application? ❑ Ponding ❑ Nitrogen ❑ Yes No 12. / � J Crop type bef��J.a ....... ......._..x L.�... �'C r.. ............ - .................. ................................................... 13_ Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 10 No 14_ Does the facility lack wettable acreage for land application? (footprint) ❑ Yes No 15_ Does the receiving crop need improvement'? ❑ Yes No 16. Is there a lack of adequate waste application equipment? ❑ Yes No Required Records & Documents 17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes Wo 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 j J No 19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes (1�No 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 'm No 21. Did the facility fail to have a certified operator in responsible 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 KNo NA.vialations.or. deficiencies .were noted during #fife visit:. Y-ou wrill.receive nar further .:. correspondence. about. this visit.. .. .. ......... . ... .... .. . Cornnients.(refer;to question_#): Explaiii any YES answer's and/or anyTrecommett_dations or any -other comments Use'diawirrks of.facilitysto;better explain situations. (use additional pages as necessary) , a.r _ -I ` Ed IV jj .cre!5 S P rr Gc1 �7ermcl Gt ginc� -r h e l was rcrrF{ e.._.. �d�✓ ©l %caT� an pl, b2r-ntu eL -ra_r- D L jl it Z. ha-5a/rc bewtw 1 Reviewer/Inspector Name Reviewer/Inspector Signature: T = _ Date: 3:26 _qq 11/6/99 Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation Reason for Visit $ Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access Facility Number Rate of Visit: Time:rO ofl Not Operational OBelowThreshold Permitted E Certified O Conditionally Certified [3Registered Date Last Operated or Above Threshold: r Farm Name: '�ii�.P� 7'7/ CountyoGCsa..� Owner Name: � �. � i-��/C� Phone No: �;z gJ- Z 37_ Mailing Address: �•�[" 7� / �p-7��� .•�Q Facility Contact: ,A.. 1/ ✓� Title: Phone No: � Onsite Representative: ja�4 6.✓t _ Integrator: �S_a--•, rlrEld z rr5T6_ Certified Operator: 104wol. ze Gtf��44�" Operator Certification Number: Location of Farm: ❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude Design Current Design Current Design Current Swine Capacity Population Poultry Capacitv Pa ulation Cattle C21DRCitV Po ulation ❑ Wean to Feeder ❑ Layer ❑ Dairy ❑ Feeder to Finish ILI Non -Layer I I I[--] Non -Dairy I ❑ Farrow to Wean ❑ Farrow to Feeder JEJ Other Farrow to Finish v0 2 Total Design Capacity ❑ Gilts ❑ Boars Total SSLW Number of Lags ons 10 Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area Holding Ponds I Sond Traps ID No Liquid Waste Management S stem ' Discharees & 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 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 Identifier: Freeboard (inches). s17 " 05103101 ❑ Yes 1KNo ❑ Yes [9No ❑ Yes ;5No ❑ Yes PNo ❑ Yes X No ❑ Yes /14 No ❑ Yes /A No Structure 6 Continued Facility Number: 7,f — Date of Inspection 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7_ Do any of the structures need 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 anv buffers that need maintenance/improvement? 11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload 12. Crop type o ,r S� 13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? 14. a) Does the facility lack adequate acreage for land application? b) Does the facility need a wettable acre determination? c) This facility is peuded 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 or other Permit readily available? 18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ie/ W-UP, checklists, deli , m9s, etc.) 19- Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 21. Did the facility fail to have a actively certified operator in charge? 22. Fail to notify regional DWQ of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? 24. Does facility require a follow-up visit by same agency? 25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 5UNo ❑ Yes KNo ❑ Yes ;9-No ❑ Yes KNo ❑ Yes KNo ❑ Yes KNo ❑ Yes 3R�'No ❑ Yes W-No ❑ Yes �K No ❑ Yes No ❑ Yes No KYes ❑ No ❑ Yes Wo ❑ Yes KNo ❑ Yes N �o El Yes No ❑ Yes (OVo ❑ Yes )RNo ❑ Yes (KNo ❑ Yes ANo ❑ Yes No ❑ Yes o C] No r-iolations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. K,o{FCfer,EO tj3tCshOn ii}pl8in,8t1�' Yl('.'SflSiCtlS and/of-8ny reCOlnnlendat101iSQr 8OV.:6tlter [OmIDentS, Use drawingtnml'nt5 s of fact7rty to better esplatn srtustrous."(use addrtsona! pages as necessary) otes�Y p _ _ . ❑ Field Conv ❑ Final N � ��: /i1 e✓G- �/1 pvu� d�ii:.c - �GNYa,✓ /s NOf��c� �,e�i�'2 � /� clle� .d.rr�.f.�iXfaGI 4ito / r Reviewer/Inspector Name =' Reviewer/Inspector Signature: Date: / O 05103101 Continued Facility' Number: 7 -- Date of Inspection / Q Odor- Issues 26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes El No liquid level of lagoon or storage pond with no agitation? r 27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes g 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.c. 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 ® No 32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover? Yes ❑ No 05103101 Facility Number Date of Visit: Time: i D 1 Not Operational 0 Below Threshold ® Permitted Q Certified 0 Conditionally Certified 0 Registered Date Last Operated or Aove Threshold: Farm Name: r-7-5'2County: '(5' Owner Name: _OGi Y-0-0 /r rS S L_J' C Phone No: Mailing Address: _o/) h rrG%4c1 r I '5 �6 ti r-S�w 1�/ C_ Z� Facility Contact: PL c 5 C /Q // _K S Title: i� ✓ . Phone No: Onsite Representative: / Integrator: Certified Operator: rd _ & 11C & P r Operator Certification Number: Location of Farm: ❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 K Longitude ' 6 Design Swine ❑ Wean to Feeder ❑ Feeder to Finish ❑ Farrow to Wean ❑ Farrow to Feeder Farrow to Finish Number of Lagoons Holding Ponds f Solid Traps Current Design Current Design Current o ulation Poultry Ca achy Population Cattle Ca acity Population ❑ La er I 1 1 P:[:)airy I __+ I ❑ Non -La er I I ILI Non -Dairy ❑ Other f Total Design Capacity / 7- ji I Total SSLW Discharges _4 Stream Imnacts 1. Is any discharge observed from any part of the operation? Drains I Vaste M Discharge originated at: ❑ Lagoon ❑ Spray Field P60ther 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 1 Structure 2 Structure 3 Structure 4 Structure 5 Identifier: Freeboard (inches): 05103101 Yes ❑ No ❑ Yes 0 No Cl Yes (O.No %-Yes No El& Yes r❑3 V o ❑ Yes B&No ❑ Yes 53-No Structure 6 Continued Facility Number.- 7Date of Inspection _zo-a 2- 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes (:1 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 [:]No (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No 8. Does any 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 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 ❑ No 12, 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? Cl 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? (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? ❑ 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 ❑ No 25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. un situations.ti(use addidonal pages as necessary) [] Field Copy ❑Final Notes ox, .�aa1+teary l�� d!!?7 Z- re �ve-o1 Gr- re or1 11rJ ' t ore- Aa �ee ti t- re IP_c�S e- �-�- f tip � P. J r 1 ro,", � �k /►tct J � a.,- d/t�r� � �r dMJ►�crr a�Eure Kea.r lay"A_ �6 Pj',Wel �'.� Caraer o f �e A�edot - /110 )r-5 __ rue k- e-4 c, LJ a rs Q > e 5 �e . C erra lI 'S �e is an ne ( 01-5 a kc ltt a� p�e� `f'lte.. W q,s b ac k IA �0 9--e I CZ-� Reviewer/Inspector Name Reviewer/Inspector Signature: O5103101 Date: 1-zo•-�oZ Continued Facility Number "ate of Visit: DI 'fine: E== Printed on: V21/2000 0 Not Operational O Below Threshold • Permitted 0 Certified [3 Conditionally Certified © Registered Date Last Operated or Above Threshold: Farm Name: 7 q County: DULL d7v.............................................. Owner Name:, �Y`a f.Df T'_.._ Phone No: .... .. ..... ............... C�......... Facility Contact: ..........L114? 11t,.6............. Title: . Ali ..... Phone No:................................................... Mailing Address: Onsite Representative: Integrator: Certified Operator:,,,_ O [d U) �:t. fq.k Operator Certification Number: Location of Farm: ❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 < 66 Longitude • 4 14 Design Current Wean to Feeder Feeder to Finish Farrow to Wean —' Farrow to Feeder - . Farrow to Finish 922 Gilts Boars Lag6o*' Design Current Desagn Current :, Poultry, Ca act ..Po ulation Cattle � •-Po tion . ❑ Layer ❑ Dairy ❑ Non -Layer ❑ Non -Dairy 10 Other Total Design Capacity.: ZOO Total SSLw . Subsurface Drains Present 10 I.ag—n Area 113 Spray Field Area ❑ No Liquid Waste Management System Discharges & 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 DWQ) c, li'dischar-e is observed. what is the estimated flow in gal/ruin? 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 S Identifier: ..................................... ................................................ ....................................................................................... Freeboard (inches): /20 5100 / ❑ Yeso ❑ Yes o ElYes No ❑ Yes�No ❑ Yes No ❑ Yes 9No ❑ YesG{ZNo Structure 6 Continued on back � f Facility Number: 7 — Q Date of Inspection FT-�-o Printed on: 119/2001 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? 8. Does any part of the waste management system other than waste structures require maintenance/improvement? 9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level elevation markings? Waste Aanlication 10. Are there any buffers that need maintenance/improvement? 11. Is there evidence of over 12, Crop type on? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload 13. Do the receiving crops diffbr with those designated in the Certified 14. a) Does thefacility 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? �is[, c>rQ r mac. dyBv-SeEc}I Waste Management Plan (CAWMP)? 18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ie/ WUP, checklists, design, maps, etc.) 19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 21. Did the facility fail to have a actively certified operator in charge? 22. Fail to notify regional DWQ of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 23. Did Reviewer/Inspecior fail to discuss reviewlinspection 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 Q•yiolaigris er dfciencie ' were jngted dr�x'icig �h4s:visit: Yvi>t with �-ee iye dti fis t s . % - carrespo dei i& about. this visit • ... - .... • : • . • . • . • . - .. • . •. •. � . • ................. . ❑ Yes Q�No ❑ Yes N0 ❑ Yes )�No ❑ Yes INo ❑ Yes AIINo ❑ Yes VR�o ❑ Yes INo ❑ Yes o ❑ Yes ;rNo ❑ Yes No ❑ Yes o ❑ Yes No ❑ Yes No ❑ Yes P' o ❑ Yes No ❑ Yes No ❑ Yes .qNo ❑ Yes .*_,4i No ❑ Yes 4� No ❑ Yes � No ❑ Yes ,3 No ❑ Yes 19,No Facility Number: Ze — Date of Inspection S S' 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 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 to 28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o roads, building structure, and/or public property) 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 0 32. Do the flush tanks lack a submerged fill pipe or_a permanent/temporary cover? es /❑ No 5100 Routine Q Complaint Q Follow-up of DWQ inspection Q Follow-ue of DSWC review Q Other Facility Number Date of Inspection l�da Time of Inspection 24 hr. (hh:mm) Permitted © Certified ❑ Conditionally Certified Q Registered 3 Not Operatiorial Date Last Operated: FarmName: ............................. 5. 7.....1...................................................................... County: ........... d..QW............................... Owner Name: r7�`a { S �D C Phone No. ..................1...'.................d�......,.......�..................... 2.........d.'.... Facility Contact: ...��......1 f�............................... Title:..4.....�``lfa1................ Phone No:................................................... Mailing Address: ......�1f.....L1I `�'���........... 5.z . . .... ( .�5 ....................... .... ......z / (1... Onsite Representative: Integrator: .............. . . . . . ....... . .. . ............................ . .... . .... . .... . . . Certified Operator: Location of Farm: Latitude =11 Design Cu :Swine .. Ganacrtv._rPtioi Wean to Feeder �] Feeder to Finish ❑ Farrow to Wean p°= ,g ❑ Farrow to Feeder Farrow to Finish / Z OV ❑ Gilts G ❑Boars Operator Certification Number: Longitude - � Design "Current ❑ Dairy ❑ Non-1 Discharp_es & Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes No Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. If discharge is observed, was the conveyance man-made? ❑ Yes No b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes No c. If discharge is observed, what is the estimated flow in gal/min'? d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes No 2. Is there evidence of past discharge from any part of the operation? ❑ Yes No 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No Waste Collection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Freeboard (inches.-): �.................................... 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes XNo seepage, etc.) 3/23/99 Continued on back Ir e Facility Number: 7 p Date of Inspection 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? ; 8. Does any part of the waste management system other than waste structures require maintenance/improvement? 9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level elevation markings? Waste Application 10. Are there any buffers that need maintenance/improvement? 11. Is there evidence of over application? ❑ Excessiye Ponding j(PAN 12. Crop type R4 13. Do the receiving crops differ with those desigVed in the Certified Animal Waste Management Plan (CAWMP)? 14. a) Does the facility lack adequate acreage for land application? b) Does the facility need a wettable acre determination? c) This facility is pended for a wettable acre determination? 15. Does the receiving crop need improvement? 16. Is there'a lack of adequate waste application equipment? Required Records & Documents IT. Fail to have Certificate of Coverage & General Permit readily available? 18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ie/ WUP, checklists, design, maps, etc.) 19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) 20- Is facility not in compliance with any applicable setback criteria in effect at the time of design? 21. Did the facility fail to have a actively certified operator in charge? 22. Fail to notify regional DWQ of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? 24. Does facility require a follow-up visit by same agency? 25. Were any additional problems noted which cause noncompliance of the Certified AWMP? violiat�ionjs ei iletickwiles •mere hoed• iltH'ing �his:visit; - You wits •tj eeeiye 0 futi-titgtr... correspondence. abotit this visit: ..........:........................ . -All, IY Q✓er1 �,�ie- by Z-1�s• P't// ��. �/G PwllsJ f � rG[Q 6C'�1 �,�' (+ir►�S C'd7t�]�i �i �h G� ,'g 41 �d +�I a edS �'Pih't_i[s>,- A! ,9'Ae►" ❑ Yes K(NO ❑ Yes KNO ❑ Yes 4rNo ❑ Yes ¢Io ❑ Yes 00 )fYes ❑ No ❑ Yes No ❑ Yes No ❑ Yes VNo ❑ Yes e(No ❑ Yes WNo ❑ Yes j(No ❑ Yes 0' 60 ❑ Yes o ❑ Yes No ElYes �allo ❑ Yes Wlo ❑ Yes 9NO ❑ Yes No ❑ Yes gNo Yes plia �-iy- x'^.-'ii+—ex ETA.-s-�: yF"+� Y �_ MA .4, Reviewer/Inspector Name s / :� -1 _10 . -3. Reviewer/Inspector Signature: !� Date: 1 ti. [fa-c4 y Number: Dale of Inspection G� Odor Issues 26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No liquid level of lagoon or storage pond with no agitation? 27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes P�No 28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt. ❑ Yes 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 P(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 XNO 31. Do the animalsfeed storage bins fail to have appropriate cover? ❑ Yes NO 32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No r 1-'ut� __.�:w :+.s'^.-"_^:.=� _s'� �' Y=.F.F=-•r�,:"�_;:=�— .:_� :;:: :CTr :4._ .'S'.«: } _ Type of Visit Compliance Inspection O Operation Review 0 Lagoon Evaluation Reason for Visit ® Routine 0 Complaint Q Follow up 0 Emergency Notification Q Other ❑ Denied Access Facility• lumber Date of Visit: O Time: L — — — I >\nt O erational Be1nK' Threshold EM Permitted ® Certified [3 Conditionally Certified © Registered Date Last Operated or above Threshold: Farm Name: C&rrt�,llt5 �G,fM nL, Count-: o F�9?,q 3 Owner Name: __ _ C Z_rr,,A'S Phone No: 4.,n Mailing Address: 1'r d . [� �%�C g S io [.ic i'C Z /Il;e� ae,31 le Facility Contact: In Title: Linn PhoneNo. Onsire Representative: Integrator: rr-'b 1+{� Certified Operator: _ *O k el— Operator Certification Number: Location of Farm: c,vi SAL / i ��' � nc cJ` �ii � .Sho C text Cr-. � Qa Swine ❑ Poultry ❑ Caftie ❑ Norse Latitude ' ° 04 Longitude • 0• �» Design Current Design Current Design Current Swine Ca achy Po elation Poultry Ce arity Population Cattle Ca acity Po ulation ❑ Wean to Feeder 10 Laver I El Dairy Feeder to Finish tl ❑ Non -Laver Non-Dain, ❑ Farrow to Wean ❑ Farrow to Feeder Other farrow ❑ Farro%v to Finish Total Design Capacity ❑ Gilts ❑ Boars Total SSLW Number of Lagoons Holding Ponds / Solid Traps Subsurface Drains Present iU Lagoon Area Lj sprav Field Are; No Liquid waste Management System Disschar#es & Stream Impacts 1. is any discharge observed from any pan of the operation? ❑ Yes [�'No Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. If discharge is obsen ed, was the conveyance man-made? El Yes ❑ No b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) El Yes ❑ No c. if discharge is observed, what is the estimated flow in gal/min? d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No 2. Is there evidence of past discharge from any part of the operation? ❑ yes No 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑Yes No Waste Colleefion 8- Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [0 No Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Freeboard (inches): 4,0 05103101 Continued Facility Number: 9 1 Date of Inspection 5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ 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? ❑ Yes Ej No ❑ Yes 1"r No ❑ Yes [�a No ❑ Yes [p No ❑ Yes Q No Waste Application 10. Are there any buffers that need maintenance/improvement? ❑ Yes [O No 11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes No 12. Crop type 13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)? ❑ 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 P No 16. Is there a lack of adequate waste application equipment? ❑ Yes [;3 No Required Records lot Documents 17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes W 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 [M No 19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes 0 No 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes q No 21. Did the facility fail to have a actively certified operator in charge? ❑ Yes [S No 22. Fail to notify regional DWQ of emergency situations as required by General Permit? ❑ Yes [M No (ic/ discharge, freeboard problems, over application) 23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes No 24. Does facility require a follow-up visit by same agency? ❑ Yes ® No 25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes No © No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. C m e t �(refeiquesti ©� E:pla�nian YES�answersandlor anyrcco'"mmeridahoiEs'ar�any other>ca eats. Useladrawtng%facilrty exp atton(use addrttanalpages as necessary). � Field Copv+. ❑Final No �� •--- e?,t loot Reviewer/Inspector Name = Y Reviewer/Inspector Signature: Date: 0 05103101 d— Continued Facility Number: —,%,g — Date of Inspection 4 is 8 Odor Issues 26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below liquid level ❑ Yes 0�1 No !Z o. x s, of lagoon or storage pond with no agitation? n�-e 27. Are there any dead animals not disposed of properly within 24 hours? ❑ Ycs No 28. Is there any evidence of wind drift during land application? (i.e_ residue on neighboring vegetation, asphalt. ❑ Yes pt 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. '%Vere anv 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 &I No ,I. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes © No 32. Do the flush tanks lack a submersed fill pipe or a permanent/temporary covcr? , ❑ Yes ® No Additional Comments and/or Drawings: w 05103101 Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation Reason for Visit ® Routine O Complains O Follow up C) Emergency Notification Q Other ❑ Denied Access Facility Number Date of Visit: I_ �O¢I Time: ��— Kat O erational Beln�• Threshold Permitted ® Certified 0 Conditionally Certified ❑ Registered Date Last Operated or Above Threshold: Farm Name: C Gf'.(`b� 10OEll C County: e2J6jn zt, { Owner Name: _�dP.a. �.f � �� S rL!'m- _ 1=� Phone No: f Mailing Address: i�' • a • � OTC _ $ f L _ _ L,) Glt� S si �( N _ G Facility Contact: Me'.{t W1eh1,? h CLc _et _ Title: Onsite Representative: 'n&:&� ,, A& Ind ell, b C��IC f C , Certified Operator: L[Ac,(de, t...l K t1Gy—e-r-, Location of Farm: Phone No: Integrator: CG-►'rt:.L I S _ Operator Certification Number: -�4g14 ® SMne ❑ Poultry ❑ Cattle ❑HorseLaritude 0• 01 04 Longitude 0' �• �� Design Current Design Current Design Current Swine Ca acity Population Poultry Capacity Population Cattle Capacity Po ulation ❑ Wean to Feeder 10 Laver I I❑ Dairy El Feeder to Finish ❑Non -Laver ❑loon -Dairy ❑ Farrow to Wean ❑ Farrow to Feeder ❑ Other Farrow to Finish .106 Total Design Capacity ❑ Gilts ❑ Boars Total SSLW Number of Lagoons ❑ Subsurface Drains Present 1101,agoonAre2 S rav Field Area Holding Ponds / Soled Traps No Liquid Waste Management System Discharges & Stream Impacts ? . Is any discharge observed from any pan of the operation? ❑ Yes No Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No b. If discharge is obsen-ed, did it reach Water of the State? (if yes, notify DWQ) ❑ Yes ❑ No c. If discharge is observed. what is the estimated flow in gallmin? d. Does discharge bypass a lagoon system" (If yes. notify DWQ) ❑ Yes ❑ No 2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes PNo Waste Collection & Treatment 4_ Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes allo Strucnre I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Freeboard (incbes): _)1 4 05103101 31 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 qNo 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 El Yes Flo 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 0 No 9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level elevation markings? ❑ Yes B No Waste Application 10. Are there any buffers that need maintenance/improvement? - ❑ Yes P No 11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes V] No 12. Crop type i3 ezoq C'C:b__ G)ca r. ©. S . Co L62WL_ -t' LJ LEIc t" •-- ._ - 13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [:XNo 14. a) Does the facility lack adequate acreage for land application? ❑ Yes 151 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 Required Records & Documents 17, Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes No I & Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ie/ WUP, checklists, design, maps, etc.) ❑ Yes C�3 No 19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes [N No 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes allo 21. Did the facility fail to have a actively certified operator in charge? ❑ Yes R] 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. icw� soy { S4'1le_ 'J" (b/a�'03, PAN ok cc cAw J 4, f� et& f -6 -St o 2 f Cc'l P-('rnl M r =, -4- ti d %n— LP a G.-_ (I O C 4 ReviewerlInspector Name Reviewer/Inspector Signature: Field Copy ❑ Final Notes () 3, 0 tc S 1'.1 k Date: jl 43_6 / 0 05103101 Continued Facility Number: -ff - q Date of Inspection Odor Issues 26. Hoes the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below liquid level of lagoon or storage pond with no agitation? 27. Are there any dead animals not disposed of properly within 24 hours? 28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, roads, building structure, and/or public property) 29. Is the land application spray system intake not located near the liquid surface of the lagoon? 30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or or broken fan blade(s), inoperable shutters, etc.) 31. Do the animals feed storage bins fail to have appropriate cover? 32. Do the flush tanks lack a submerged fill pipe or a permanent temporary cover? ❑ Yes ❑ No ❑ Yes ® No ❑ Yes Q.No ❑ Yes 0 No ❑ Yes ® No ❑ Yes No ❑ Yes ❑ No O5103101 0 �4 Type of Visit ® Compliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance Reason for Visit ®Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access Date of Visit: Arrival Time: Departure Time: County: Region: Farm Name: 55-7 9 % C O 11 C&t- .b U s "'757 i �} Owner Email: Owner Name: , /q y4e k... B ko t:.yl ^I Phone: Mailing Address: Physical Address: Facility Contact: Title: Onsite Representative: _ Ai K C_ 1kk4f,"In! S Certified Operator: Back-up Operator: Al.one` No: Integrator: Al�-.il�.. Operator Certification Number: Back-up Certification Number: Location of Farm: Latitude: ❑ e ❑ 1 = Longitude: 0 0 ❑ ❑ u Design Current Design Current Design Current Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population to Finish ❑ Layer ❑ DairyCow to Feeder ❑ Non -Layer ❑ DairyCalf r to Finish ❑ DairyHeifer to Wean Dry Poultry ❑ D Cow w to Feeder El Non -Dairy w to Finish 200 F ❑ Layers ❑ Non -Layers ❑ Beef Stocker ❑ Beef Feeder ❑ Pullets El Beef Brood Co ❑ Turkeys ❑ Turkey Poults ❑Other Number of Structures: Discharges & Stream impacts 1. Is any discharge observed from any part of the operation? ❑ Yes to No ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made? ❑ Yes [p No ❑ NA ❑ NE b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes INo ❑ NA ❑ NE c_ What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes I No ❑ NA ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes P No ❑ NA ❑ NE 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes RNo ❑ NA ❑ NE other than from a discharge? Page I of 3 12128104 Continued Facility Number: -79—,09-1 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 [Z No ❑ NA ❑ NE Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): ?�.Q Observed Freeboard (in): Ly 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes jNo ❑ NA ❑ NE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes [p No ❑ NA ❑ NE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes [� No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require ❑ Yes ?No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE maintenance/improvement? Y 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [�'No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑`Evidence of Wind Drift El Application Outside of Area 12. Crop type(s) (Lirwt da.. (CoRoAl . L.3 k-_& V _ So-,.1,,ee„r5 i�. ) Cor-Af . SQ/ MW 13. Soil type(s) � Ard L 4, 6e A tia R in�f1 v IIt 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [P No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes 1� No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes [;9 No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes [4 No ❑ NA ❑ NE 18. is there a lack of properly operating waste application equipment? ❑ Yes 0 No ❑ NA ❑ NE Comments (refer to question ft Explain -any YES answers and/or any recommendations or;any. other comments. Use drawings of facility to better explain situations. (use additional pages as necessary): Reviewer/inspector Name 1 /5,jf�[/t, /<,e— V Phone: HAP) V33 330 Reviewer/inspector Signature: Date: Z— Lc Page 2 of 3 12128104 Continued G Facility Number: Date of Inspection Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 14 No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes MNo ❑ NA ❑ NE the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [WNo ❑ 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 V] No ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes 1?1 No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes O No ❑ NA ❑ NE 2T Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes Q9 No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [r No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes 17No ❑ 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 1� 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 Wo ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes [)fNo ❑ NA ❑ NE Additional Comments. and/or Drawings - Page 3 of 3 12128104 Type of Visit ® Compliance Inspection Q Operation Review O Structure Evaluation O Technical Assistance Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access Date of Visit: UZ-ZO-631 Arrival Time:: /a♦I; Departure Time:: County: Ro�YiAf Farm Name: S�721 I d Kd QYVb 11S # �S 7_I__ Owner lJmail: Owner Name: Muy,011, _ � VAt:!jd Phone: Mailing Address: Physical Address - Facility Contact: tJir it u �'r l f-, Title: Onsite Representative: �PXYU Lr'i e� ft�` Certified Operator: Back-up Operator: Location of Farm: Swine ❑ Wean to Finish ❑ Wean to Feeder ❑ Feeder to Finish ❑ Farrow to Wean ❑ Farrow to Feeder ® Farrow to Finish ❑ Gilts Region: FAQ Phone No: Integrator: aizi k ; &A,-4 Operator Certification Number: Back-up Certification Number: Latitude: =0 0' = Longitude: =]c ❑' 0 L Design Current Design Current Capacity Population Wet Poultry Capacity Population ❑ La er 11 ❑ Non -Layer Other ❑ Other-- Dry Poultry ❑ Layers ❑ Non -Layers ❑ Pullets ❑ Turkeys ❑ Turkey Poults ❑ Other Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made? Design Current:' Cattle Capacity Population,:` ❑ Dairy Cow ❑ Dairy Calf ❑ Dairy Heifer ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stocker ❑ Beef Feeder ❑ Beef Brood Co Number,of Structures: �1 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 M No ❑ NA ❑ NE ❑ Yes MNo ❑ NA ❑ NE ❑ Yes ® No ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes & No ❑ Yes ® No ❑ NA ❑ NE ❑ Yes KNo ❑ NA ❑ NE 12128104 Continued Facility Number: 7 - Q Date of Inspection Z-70 --6-7357 Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes RNo ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes D(No ❑ NA ❑ NE Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: �t Designed Freeboard (in): Observed Freeboard (in): 37 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes X 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 T 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 PLNo ❑ NA ❑ NE (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require ❑ yes No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑Yes No ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ElYes DdNo ❑ NA ❑ NE ElExcessive Ponding ElHydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 101bs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area U. Crop type(s) gUrWt'&� �W"_) c0+1.0"j W�► e&.'� soyL[iA S VO, SOU11C'ra4'AJ 13. Soil type(s) e(_ jgj lj j H 044 &h , a'yW*/R_ — -- 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes CKNo ❑ 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 [K No ❑ NA ❑ NE 17. Does the facility lack adequate acreage fbr land application? ❑ Yes [KNo ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes NNo ❑ NA ❑ NE ;....... _ ... rZ," '7;. : Reviewer1lnspector Name V L Phone: Reviewer/Inspector Signature: Date: / Z - Z O - Z OO.S 12128104 Continued Facility Number: % g — Date of Inspection F t z-zo-o Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [9No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 9 No ❑ 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 C] 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 KNo ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? - ❑ Yes CK 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 (K No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes PQ No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes KNo ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes IN No ❑ NA ❑ NE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ® 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 N No ❑ NA ❑ NE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did ReviewerAnspector fail to discuss review/inspection with an on -site representative? ❑ Yes JR No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes 29 No ❑ NA ❑ NE ""dttmnal Comments+and/ar Drawru s `4 12128104 N Division of Water Resources ❑ Division of Soil and Water Conservation ❑ Other Agency Facility Number: 780009 Facility Status: Acti'1e Permit: AWS780009 ❑ Denied Access Inpsection Type: Compliance Inspection Inactive Or Closed Date: Reason for VisEtr Routine County: Robeson Region: Fayetteville Date of Visit: 02/1512017 Entry Time: 08:00 am Exit Time: 9:00 am Faun Name: Farm 5579 Owner. Murphy -Brown LLC Incident # Owner Email: Phone: 910-296-1800 Mailing Address: PO Box 487 Warsaw NC 28398 Physical Address: 11044 Hwy 130 W Facility Status: ECompliant ❑ Not Compliant Integrator. Murphy -Brown LLC Location of Farm: Latitude: 34° 39' 10" Longitude: 79' 21' 48" From Maxton take 130 East (from intersection where 83 turns off) and proceed 3 miles on 130 and the farm entrance is on the right. Question Areas: Dischrge & Stream Impacts Waste Col, Stor, 8 Treat Waste Application Records and Documents Other Issues Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008 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($): Inspection Summary: page: 1 Permit: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number: 780009 Inspection Date: 02/15/17 Inspection Type: Compliance Inspection Reason for Visit: Routine Regulated Operations Design Capacity Current promotions Swine ❑ Swine - Farrow to Wean 3,927 Total Design Capacity: 3,927 Total SSLW: 1,700,391 Waste Structures Disignated Observed Type Identifier Closed Date Start Date Freeboard Freeboard Lagoon 1 19.00 45.00 Lagoon 7579 page. 2 Permit: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number. 780009 Inspection Date: 02/15/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine Discharges & Stream Impacts Yes No Na Ne 1. Is any discharge observed from any part of the operation? ❑ 0 ❑ ❑ Discharge originated at: Structure ❑ Application Field ❑ Other ❑ a. Was conveyance man-made? ❑ ❑ 0 ❑ b. Did discharge reach Waters of the State? (if yes, notify DWQ) ❑ ❑ M ❑ c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (if yes, notify DWQ) El ❑ M [] 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 ❑ ❑ ❑ State other than from a discharge? Waste Collection Stora a & Treatment Yes No Na No 4. Is storage capacity less than adequate? ❑ ❑ ❑ If yes, is waste level into structural freeboard? ❑ 5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large ❑ ■ ❑ ❑ trees, severe erosion, seepage, etc.)? 6. Are there structures on -site that are not properly addressed and/or managed through a ❑ 0 ❑ ❑ waste management or closure plan? 7. Do any of the structures need maintenance or improvement? ❑ 0 ❑ ❑ B. Do any of the structures lack adequate markers as required by the permit? (Not applicable ❑ M ❑ ❑ to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require ❑ ■ ❑ ❑ maintenance or improvement? Waste Application (ration Yes No Na He 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ M ❑ ❑ maintenance or improvement? 11. Is there evidence of incorrect application? ❑ 0 ❑ ❑ If yes, check the appropriate box below. Excessive Ponding? ❑ Hydraulic Overload? ❑ Frozen Ground? ❑ Heavy metals (Cu, Zn, etc)? ❑ PAN? ❑ Is PAN > 100/o/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: AWS780009 Owner - Facility: Murphy -Brown LLC Facility Number: 780009 Inspection Date: 02/15/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine Waste Apalication Yes No Na No Crop Type 1 Coastal Bermuda Grass (Hay) Crop Type 2 Com, Wheat, Soybeans Crop Type 3 Small Grain Overseed Crop Type 4 Crop Type 5 Crop Type 6 Soil Type 1 Goldsboro loamy sand, a to 2% slopes Soil Type 2 Lakeland sand, 0 to 6% slopes Soil Type 3 Lynchburg sandy loam Soil Type 4 Norfolk loamy sand, 0 to 2% slopes Soil Type 5 Soil Type 6 14. Do the receiving crops differ from those designated in the Certified Animal Waste ❑ ❑ ❑ Management Plan(CAWMP)? 15. Does the receiving crop and/or land application site need improvement? ❑ 0 ❑ ❑ 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre ❑ N ❑ ❑ 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 Me 19. Did the facility fail to have Certificate of Coverage and Permit readily available? ❑ E ❑ ❑ 20. Does the facility fail to have all components of the CAWMP readily available? ❑ ❑ ❑ If yes, check the appropriate box below. WUP? ❑ Checklists? ❑ Design? ❑ Maps? ❑ Lease Agreements? ❑ Other? ❑ If Other, please specify 21, Does record keeping need improvement? ❑ E ❑ ❑ If yes, check the appropriate box below. Waste Application? ❑ Weekly Freeboard? ❑ Waste Analysis? ❑ Soil analysis? ❑ Waste Transfers? ❑ Weather code? ❑ page: 4 Permit: AWS780009 Owner - Facility : Murphy -Brawn LLC Facility Number. 780009 Inspection Date: 02/15/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine Records and Documents Yes No Na Ne Rainfall? ❑ Stocking? ❑ Crop yields? ❑ 120 Minute inspections? ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey ❑ 22. Did the facility fail to install and maintain a rain gauge? ❑ ❑ ❑ 23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment ❑0 ❑ ❑ (NPDES only)? 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ 0 ❑ ❑ 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the ❑ ❑ ❑ 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? ❑ E ❑ ❑ 27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification? ❑ ■ ❑ ❑ Other Issues Yea No Ne No 28. Did the facility fail to property dispose of dead animals within 24 hours and/or document ❑ 0 ❑ ❑ and report mortality rates that exceed normal rates? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, ❑ 0 ❑ ❑ contact a regional Air Quality representative immediately. 30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit? ❑ E ❑ ❑ (i.e., discharge, freeboard problems, over -application) 31. Do subsurface file 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 ❑ ❑ ❑ 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? ❑ E ❑ ❑ page: 5 M Division of Water Resources ❑ Division of Soil and Water Conservation ❑ Outer Agency Facility Number: 780009 Facility Status: Active permit: AM780009 Denied Access Inppection Type: Compliance Inspection Inactive Or Closed Date: Reason for Visit: Routine County: Robeson Region: Fayetteville Date of Visit: 03/11/2015 Entry Time: 12:30 pm Exit Time: 1:00 pm Farm Name: Farm 5579 Owner. Murphy -Brown LLC Incident # Owner Email: Phone: Mailing Address: PO Sox 487 Warsaw NC 28398 Physical Address: 11044 Hwy 130 W Facility Status: 0Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC 910.2W1800 Location of Farm: Latitude: 34' 39' 10" Longitude: 79" 21' 48" From Maxion take 130 East (from intersection where 83 turns oft) and proceed 3 miles on 130 and the farm entrance is on the right. Question Areas: Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application Records and Documents Other Issues Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008 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: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number: 780009 Inspection pate: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine Regulated Operations Swine Design Capacity Current promotions Swine - Farrow to Wean 3,927 Total Design Capacity: 3,927 Total SSLW, 1,700,391 Waste Structures Disignated Observed Type Identifier Closed Date Start Date Freeboard Freeboard Lagoon 1 19.00 59 00 Lagoon 7579 page: 2 Permit: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number: 780009 Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine Discharges & Stream Impacts Yes No Na Ne 1. Is any discharge observed from any part of the operation? ❑ 0 ❑ ❑ Discharge originated at: Structure ❑ Application Field ❑ Other ❑ a. Was conveyance man-made? ❑ ❑ 0 ❑ 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) ❑ ❑ ❑ 2. Is there evidence of a past discharge from any part of the operation? ❑ N ❑ ❑ 3. Were there any observable adverse impacts or potential adverse impacts to Waters of the ❑ M ❑ ❑ State other than from a discharge? Waste Collection, Storage & Treatment Yee No Na No 4. Is storage capacity less than adequate? ❑ N ❑ ❑ If yes, is waste level into structural freeboard? ❑ 5. Are there any immediate threats to the integrity of any of the structures observed (I.e.1 large ❑ 0 ❑ ❑ trees, severe erosion, seepage, etc.)? 6. Are there structures on -site that are not properly addressed andfor managed through a ❑ ❑ ❑ waste management or closure plan? 7. Do any of the structures need maintenance or improvement? ❑ ❑ ❑ B. Do any of the structures lack adequate markers as required by the permit? (Not applicable ❑ ■ ❑ ❑ to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require ❑ N ❑ ❑ maintenance or improvement? Waste Application Yes No Na Ne 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ M ❑ ❑ maintenance or improvement? 11. Is there evidence of incorrect application? ❑ 0 ❑ ❑ If yes, check the appropriate box below. Excessive Ponding? ❑ Hydraulic Overload? ❑ Frozen Ground? ❑ Heavy metals (Cu, Zn, etc)? ❑ PAN? ❑ Is PAN > 10%110 lbs.? ❑ Total Phosphorus? ❑ Failure to incorporate manure/sludge into bare soil? ❑ Outside of acceptable crop window? ❑ Evidence of wind drift? ❑ Application outside of application area? ❑ page: 3 Permit: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number: 780009 Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Beason for Visit: Routine Waste Application Yes No Na No Crop Type 1 Coastal Bermuda Grass (Fray) Crop Type 2 Corn, Wheat, Soybeans Crop Type 3 Small Grain Overseed Crop Type 4 Crop Type 5 Crop Type 6 Soil Type 1 Goldsboro loamy sand, 0 to 2% slopes Soil Type 2 Lakeland sand, 0 to 6% slopes Soil Type 3 Lynchburg sandy loam Soil Type 4 Norfolk loamy sand, 0 to 2% slopes Soil Type 5 Soil Type 6 14. Do the receiving crops differ from those designated in the Certified Animal Waste ❑ M ❑ ❑ Management Plan(CAWMP)? 15. Does the receiving crop and/or land application site need improvement? ❑ 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? D M ❑ ❑ Records and Documents Yes No Na No 19. Did the facility fail to have Certificate of Coverage and Permit readily available? ❑ 0 ❑ ❑ 20. Does the facility fail to have all components of the CAWMP readily available? ❑ 0 ❑ ❑ If yes, check the appropriate box below. WUP? ❑ Checklists? ❑ Design? ❑ Maps? ❑ Lease Agreements? ❑ Other? ❑ If Other, please specify 21. Does record keeping need improvement? ❑ M ❑ ❑ If yes, check the appropriate box below. Waste Application? ❑ Weekly Freeboard? ❑ Waste Analysis? ❑ Soil analysis? ❑ Waste Transfers? ❑ Weather code? ❑ page: 4 Permit: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number: 780009 Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine Records and Documents Yes No Na Me Rainfall? ❑ Stocking? ❑ Crop yields? ❑ 120 Minute inspections? ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey ❑ 22, Did the facility fail to install and maintain a rain gauge? ❑ 0 ❑ ❑ 23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment ❑M ❑ ❑ (NPDES only)? 24, Did the facility fail to calibrate waste application equipment as required by the permit? ❑ M ❑ ❑ 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 PDA for sludge levels ❑ Non -compliant sludge levels in any lagoon �] List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ 0 ❑ ❑ 27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification? ❑ M ❑ ❑ Other issues Yes No Na Ne 28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ 0 ❑ ❑ and report mortality rates that exceed normal rates? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, ❑ ❑ ❑ contact a regional Air Quality representative immediately. 30, Did the facility fail to notify regional DWQ of emergency situations as required by Permit? ❑ ■ ❑ ❑ (i.e., discharge, freeboard problems, over -application) 31. Do subsurface tile drains exist at the facility? ❑ 0 ❑ ❑ If yes, check the appropriate box below. Application Field ❑ Lagoon 1 Storage Pond ❑ Other ❑ If Other, please specify 32. Were any additional problems noted which cause non-compliance of the Permit or ❑ 0 ❑ ❑ CAWM P? 33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ S ❑ ❑ 34. Does the facility require a follow-up visit by same agency? ❑ 0 ❑ ❑ page: 5 ti I E Division of Water Resources ❑ Division of Soil and Water Conservation ❑ Other Agency Facility Number: 780009 Facility Status: Active permit: AWS780009 Inpsectlon Type: Compliance Inspection Inactive Or Closed Date: Reason for Visit: Routine County: Robeson Region: Date of Visit: 03/20/2014 Entry Time: 03:00 pm Exit Time: 4:00 pm Incident # Farm Name: Farm 5579 Owner Email: Owner; Murphy -Brown LLC Phone: Mailing Address: PO Box 487 Warsaw NC 28398 Physical Address: 11044 Hwy 130 W Facility Status: 0 Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC Location of Farm: Latitude: 34' 39' 10" Longitude: 79° 21' 48" From Maxton take 130 East (from intersection where 83 turns off) and proceed 3 miles on 130 and the farm entrance is on the Question Areas: Dischrge & Stream Impacts Records and Documents Waste Col, Slor, & Treat Waste Application other issues ❑ Denied Access Fayetteville 910-29&IBDD 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 Phone: Inspector Signature: Date: Secondary Inspector(s): Inspection Summary: Records reviewed 3/10114. Site visit 3/20/14. page: 1 Permit: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number: 780009 Inspection Date: 03/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine Regulated Operations Design Capacity Current promotions Swine Swine - Farrow to Wean Total Design Capacity: Total SSLW: Waste Structures Disignated Observed Type Identifier Closed Date Start Date Freeboard Freeboard agoon 1 19.00 agoon 7579 page: 2 Permit: AWS780009 Owner - Facility: Murphy -Brown LLC Facility Number: 780009 Inspection Date: 03/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine Discharges 8, Stream Impacts Yes No Na No 1. Is any discharge observed from any part of the operation? ❑ 0 ❑ ❑ Discharge originated at: Structure ❑ Application Field ❑ Other ❑ a. Was conveyance man-made? ❑ ❑ m ❑ b. Did discharge reach Waters of the State? (if yes, notify DWQ) ❑ ❑ N ❑ 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? ❑ m ❑ ❑ 3. Were there any observable adverse impacts or potential adverse impacts to Waters of the ❑ m ❑ ❑ State other than from a discharge? Waste Collection, Storage & Treatment Yes No Na He 4. Is storage capacity less than adequate? ❑N ❑ ❑ If yes, is waste level into structural freeboard? ❑ 5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large ❑ 0 ❑ ❑ 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? ❑ N ❑ ❑ 8. Do any of the structures lack adequate markers as required by the permit? (Not applicable ❑ 0 ❑ ❑ to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require ❑ 0 ❑ ❑ maintenance or improvement? Waste Application Yes No Na No 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ 0 ❑ ❑ maintenance or improvement? 11. is there evidence of incorrect application? ❑ 0 ❑ ❑ If yes, check the appropriate box below. Excessive Ponding? ❑ Hydraulic Overload? ❑ Frozen Ground? ❑ Heavy metals (Cu, Zn, etc)? ❑ PAN? ❑ Is PAN > 10%/10 lbs.? ❑ Total Phosphorus? ❑ Failure to incorporate manure/sludge into bare soil? ❑ Outside of acceptable crop window? ❑ Evidence of wind drift? ❑ Application outside of application area? ❑ page: 3 Permit: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number: 780009 Inspection Date: 03/20/14 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 Com, Wheat, Soybeans Crop Type 4 Crop Type 5 Crop Type 6 Soil Type 1 Goldsboro loamy sand, 0 to 2% slopes Soil Type 2 Lakeland sand, 0 to 6% slopes Soil Type 3 Lynchburg sandy loam Soil Type 4 Norfolk loamy sand, 0 to 2% slopes 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? ❑ E ❑ ❑ 18. Is there a lack of properly operating waste application equipment? ❑ 0 ❑ j] 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? ❑ ❑ ❑ If yes, check the appropriate box below. WUP? ❑ Checklists? ❑ Design? ❑ Maps? ❑ Lease Agreements? ❑ Other? ❑ If Other, please specify 21. Does record keeping need improvement? ❑ 0 ❑ ❑ If yes, check the appropriate box below. Waste Application? ❑ Weekly Freeboard? ❑ Waste Analysis? ❑ Soil analysis? ❑ Waste Transfers? ❑ Weather code? ❑ page: 4 Permit: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number: 780009 Inspection Date: 03/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine Records and Documents Yes No Na No Rainfall? ❑ Stocking? ❑ Crop yields? ❑ 120 Minute inspections? ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey ❑ 22. Did the facility fail to install and maintain a rain gauge? ❑ 0 ❑ ❑ 23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment ❑ M ❑ ❑ (NPDES only)? 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ 0 ❑ ❑ 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the ❑ 0 ❑ ❑ appropriate box(es) below: Failure to complete annual sludge survey ❑ Failure to develop a PDA for sludge levels ❑ Non -compliant sludge levels in any lagoon ❑ List structure(s) and date of first survey indicating non-compliance: 26, Did the facility fail to provide documentation of an actively certified operator in charge? ❑ 0 ❑ ❑ 27. Did the facility fail.to secure a phosphorous loss assessment (PLAT) certification? ❑ 0 ❑ ❑ Other Issues Yes No Na No 28. Did the facility fail to property 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? ❑ 0 ❑ ❑ If yes, check the appropriate box below. Application Field ❑ Lagoon 1 Storage Pond ❑ Other ❑ If Other, please specify 32. Were any additional problems noted which cause non-compliance of the Permit or ❑ 0 ❑ ❑ 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? ❑ 0 ❑ ❑ page: 5 M Division of Water Resources 13 Division of Soil and Water Conservation El Other Agency Facility Number. 780009 Facility Status: Active Permit: AVVS780009 Inpsection Type: Compliance Inspection Inactive Or Closed Date: Reason for Visit: Routine County: Robeson Region: Date of Visit: 02/2612013 Entry Time: 02:30 pm Exit Time: 3:00 pin incident# Farm Name: Farm 5579 Owner Email: Owner: Murphy -Brown LLC Phone: ❑ Denied Access Fayetteville 910-296-1800 Mailing Address: PO Box 487 Warsaw NC 28398 Physical Address: 11044 HWY 130 W Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC Location of Farm: Latitude: 34' 39' 10" Longitude: 79° 21' 48" From Maxton take 130 East (from intersection where 83 turns off) and proceed 3 miles on 130 and the farm entrance is on the right. Question Areas: Dischrge & Stream Impacts Waste Cot, Stor, & Treat Waste Application Records and Documents Other Issues Certified Operator: James Brian McGugan Operator Certification Number. 986752 Secondary OIC(s): On -Site Repmsentative(s): 24 hour contact name On -site representative Primary Inspector: Inspector Signature: Secondary lnspector(s): Inspection Summary: Records reviewed 218113 Site visit 2126113 Name Title Mike Cudd Mike Cudd Robert Marble Phone Phone: Phone Phone: Date: page: 1 N Permit: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number: 780009 Inspection Date: 02/26/13 Inppection Type: Compliance Inspection Reason for Visit: Routine Regulated Operations Design Capacity Current promotions Swine ■ =Wnearrow to Wean 0 Total Design Capacity: Total SSLW: Waste Structures Disignated Observed Type Identifier Closed Date Start Date Freeboard Freeboard agoon 1 19.00 agoon 7579 page: 2 Permit: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number: 780009 Inspection Date: 02/26/13 lnpsection 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? ❑ 110 ❑ b. Did discharge reach Waters of the State? (if yes, notify DWQ) ❑ ❑ M ❑ c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (if yes, notify DWQ) ❑ ❑ M ❑ 2. Is there evidence of a past discharge from any part of the operation? ❑ 0 ❑ ❑ 3. Were there any observable adverse impacts or potential adverse impacts to Waters of the ❑ M ❑ ❑ State other than from a discharge? Waste CoTlection, Storage & Treatment Yea No Na Ne 4. Is storage capacity less than adequate? ❑ M ❑ ❑ If yes, is waste level into structural freeboard? ❑ 5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large ❑ M ❑ ❑ trees, severe erosion, seepage, etc.)? 6. Are there structures on -site that are not properly addressed and/or managed through a ❑ ■ ❑ ❑ waste management or closure plan? 7. Do any of the structures need maintenance or improvement? ❑ M ❑ ❑ B. Do any of the structures lack adequate markers as required by the permit? (Not applicable ❑ M ❑ ❑ to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require ❑ M ❑ ❑ maintenance or improvement? Waste Application Yes No Na No 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ ❑ ❑ maintenance or improvement? 11. Is there evidence of incorrect application? ❑ 0 ❑ ❑ If yes, check the appropriate box below. Excessive Ponding? ❑ Hydraulic Overload? ❑ Frozen Ground? ❑ Heavy metals (Cu, Zn, etc)? ❑ PAN? ❑ Is PAN > 10%M 0 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: AWS780009 Owner - Facility: Murphy -Brown LLC Facility Number: 780009 Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine Waste Application Yes No Ne Ne Crop Type 1 Coastal Bermuda Grass (Hey) Crop Type 2 Small Grain Overseed Crop Type 3 Com, Wheat, Soybeans Crop Type 4 Crop Type 5 Crop Type 6 Soil Type 1 Goldsboro Soil Type 2 Lakeland Soil Type 3 Lynchburg Soil Type 4 Norfolk Soil Type 5 Soil Type 6 14. Do the receiving crops differ from those designated in the Certified Animal Waste ❑ E ❑ ❑ Management Plan(CAWMP)? 15. Does the receiving crop and/or land application site need improvement? ❑ E ❑ ❑ 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre ❑ ❑ ❑ 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? ❑ ■ ❑ ❑ 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? ❑ 0 ❑ ❑ If yes, check the appropriate box below. Waste Application? ❑ Weekly Freeboard? ❑ Waste Analysis? ❑ Soil analysis? ❑ Waste Transfers? ❑ Weather code? ❑ Rainfall? ❑ Stocking? ❑ page: 4 Permit: AWS780009 Owner - Facility : Murphy -Brown LLC Facility Number: 780009 Inspection Date: 02/26/13 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 ❑ 0 ❑ ❑ (NPDES only)? 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ ❑ ❑ 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the ❑ M ❑ ❑ appropriate box(es) below: Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels ❑ Non -compliant sludge levels in any lagoon ❑ List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ M ❑ ❑ 27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification? ❑M ❑ ❑ Other issues Yes No Na Me 28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ M ❑ ❑ and report mortality rates that exceed normal rates? 29, At the time of the inspection did the facility pose an odor or air quality concern? If yes, ❑ ❑ ❑ contact a regional Air Quality representative immediately. 30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit? ❑ ❑ ❑ (i.e., discharge, freeboard problems, over -application) 31. Do subsurface tile drains exist at the facility? 0 ❑ ❑ ❑ If yes, check the appropriate box below. Application Field Lagoon / Storage Pond ❑ Other ❑ If Other, please specify 32. Were any additional problems noted which cause non-compliance of the Permit or ❑ 0 ❑ ❑ CAWMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ ❑ 34. Does the facility require a follow-up visit by same agency? ❑ 0 ❑ ❑ page: 5 Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance Reason for Visit *Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access Date of Visit: Arrival Tinge: CB' �O Departure Time: OS! County: PDOF-60 " Region: Farm Name: S"9j C7 L? 9 l _ Owner Email: Owner Name: _ i4W1'x LLC Phone: Mailing Address: Physical Address: Facility Contact: /' �L C"al Title: Phone No: Onsite Representative: h Integrator: f�"l �:4y -_` c Certified Operator: !!!MR f d- � Operator Certification Number: Back-up Operator: Location of Farm: Back-up Certification Number: 075LPg Latitude: = o =' = " Longitude: = ° =' = " Design "Current Design Current Desigr► Current Swine Capty 'Piipufation Wet Poultry Capacity Population C•at#le Capacity Population ❑ an to Finish ElLa er ❑ Da' Cow ❑ Wean to Feeder ElNon-Laer ❑ Da' Calf ❑ Feeder to Finish Dry Poultry111 1100 Da'try Heifer El Dry Caw ❑ Farrow to Wean ElFarrow to Feeder ElNon-Dairy ❑ La ers Farrow to Finish ❑ Beef Stocker Gilts ❑ Non -Layers ❑ Boars ❑ Pullets ❑❑Beef Turkeys Uther ❑ Turkey Poults ❑ Other ❑Other ❑ Beef Feeder Brood Co 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 I? No ❑ NA ❑ NE ❑ Yes ❑ No NA ❑ NE ❑ Yes ❑ No NA ❑ NE �PNA ❑ NE ❑ Yes ❑ No ❑ Yes PNo ❑ NA ❑ NE ❑ Yes F No ❑ NA ❑ NE 12128104 Continued Facility Number: Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes IoNo ❑ 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: I Spillway?: Designed Freeboard (in): Observed Freeboard (in): h 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No [--].NA ❑ NE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes 13 No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No (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 maintenance or improvement? fff Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes ro maintenancelimprovement? Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �No ❑ Excessive Ponding ❑ Hydraulic 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 ❑ Application Outside of Area 12. Crop type(s) 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CA 15. Does the receiving crop and/or land application site need improvement? ❑ Yes V No ❑ Yes q, No ❑ NA ❑ NE El NA ONE El NA El NE ❑ NA ❑ NE ❑ NA ❑ NE ❑NA [I NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes [�j No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? P(_Q-4S f'P_1) I'twed 42--6/q . Si`f \)'%�i�_Ctrr d V/1/1 I ❑ Yes No ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE Reviewer/Inspector Name " /1., Phone: 91e::V 5 3 Reviewer/inspector Signature: Date: 7J24VII Page 2 of 3 IZ12AV04 Continued Facility Number: Date of Inspection Required Records & Documents l 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes *No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes No ❑ NA ❑ NE the appropirate box. ❑ WUP ❑ Checklists ❑ Design El 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 I" Rain Inspections ❑ Weather Code 22_ Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P No ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes rO No ❑ NA ❑ NE 23. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes V9 No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes P0 No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes [ 5 No ❑ NA ❑ NE Otber Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes q4No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes 0 No ❑ NA ❑ NE and report the mortality rates that were higher than normal? 30. At the tiine of the inspection did the facility pose an odor or air quality concern? ❑ Yes O)No ❑ NA ❑ NE f 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 71 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 OpNo ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes ONo ❑ NA ❑ NE Additlonal:.COInmPIItS and/or litaWi11g5:' Page 3 of 3 12128104 P41,1, -; 4it -=5RU"Numbe—f C� D.Divisi_on of Soil and Water°Conservation Ageney , Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: ID Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: '�t •J Arrival Time: Departure Time: County: RD�� Region: Farm Name: S97 I ` 1 Owner Email: Owner Name: t,Vyiu f �7.p Phone: Mailing Address: Physical Address: Facility Contact: Title: Phone: Onsite Representative: Integrator: P4 G,y�oJ�y �jtocyr� Certified Operator: Certification Number: �7� Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Design Current - ..r Design Current ':" Design Current Swine Capacity Pop. Vet Poultry C►apacity Popf_..f.; .. Cattle Capacity Pop. Wean to Finish La er` ', z Dairy Cow Wean to Feeder Non -La er Dairy Calf Feeder to Finish 2 ...+6 Dairy Heifer Farrow to Wean STLI Design Current ,; Cow Farrow to Feeder D . P„„bultry Y Ca aci Po;= n Non -Dairy W: Farrow to Finish IUD >La ers "^ Beef Stocker Gilts Non -La ers Beef Feeder Boars Pullets Beef Brood Cow _. Turke s Other ,a „ =_ Turkey Poults Other Other Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? ❑ Yes ❑ No NA ❑ NE b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No NA ❑ NE c. What is the estimated volume that reached waters of the State (gallons)? d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No P] NA ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No [] NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE of the State other than from a discharge? Page I of 3 21412011 Continued Facility Number: Date of lns ection: y Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes a. If yes, is waste level into the structural freeboard? ❑ Yes Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Identifier: J No ❑ NA ❑ NE nNo ® NA ❑ NE Structure 6 Spillway?: Designed Freeboard (in): _ Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �0 No ❑ NA I—]NE (i.e., large trees, severe erosion, seepage, etc_) TT 6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE maintenance or improvement? Waste ADDUC260n 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE maintenance or improvement? Y, 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No [DNA ❑ 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,ipproved Area 12. Crop Type(s): fC4f' jM 60 C ff , 13. Soil Type(s): GvUs6nr4o A= 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE acres determination? 17. Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes No ❑ NA [] NE the appropriate box. ❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements []Other: 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste T fers ❑ Weather Code ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspecti s El Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? ❑Yes No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE Page 2 of 3 21412011 Continued Facili Number: I Date of Inspection: 21 24. Did & facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE 25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE the appropriate box(es) below. ❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels ❑ Non -compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? [:]Yes `r' 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 r ❑ 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 No 1P ❑ NA ❑ NE permit? (i.e., discharge, freeboard problems, over -application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE ❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: 32. Were any additional problems noted which cause non-compliance.of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE 34, Does the facility require a follow-up visit by the same agency? ❑ Yes o ❑ NA ❑ NE Comments (refer to question 9)- Explain any YES a additional recommendations or aay other°a. c" ommentsi ._ oality dasrnecessaiUseidrawtnjts�c f rpi'a. . ... Reviewer/Inspector Name: Y! I`Q Phone: Reviewer/Inspector Signature: Date: y Page 3 of 3 2/4,, l l R type of Visit: W Compliance inspection U Operation Keview U Structure Evaluation U Technical Assistance Reason for Visit: 40 Routine 0 Complaint 0 Follow-up O Referral O Emergency 0 Other Q Denied Access Date of Visit: a(� / Arrival Time: 02-' 3p Departure Time: 3 : County: '�f� Region: F� Farm Name: J I Owner Email: Owner Name: 1�2 {� Phone: Mailing Address: Physical Address: Facility Contact: Mk' � Onsite Representative: 1 Certified Operator: Back-up Operator: Location of Farm: Title: Phone: Latitude: Integrator: Certification Number: Certification Number: 1 Longitude: u- Design Current r Design Current .. Swine Capacity Pop. Wet Poultryapacity Pop. Cattle Design Current Capacity Pop. Wean to Finish La er D ' Cow Wean to Feeder Non -La er Da' Calf Feeder to Finish Farrow to Wean " �j' " Da' Heifer `� M '. Design Current Dry Cow Farrow to Feeder D P,oui . 'Ca' aci Po Non -Dairy Farrow to Finish I !)C)D La ers Beef Stocker Gilts Non -La ers Beef Feeder Boars 113eef Brood Cow Turke s Other Turkey Pouits Other Other Discharges and Stream Imuacts 1. Is any discharge observed from any part of the operation? ❑ Yes `42 No ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? ❑ Yes ❑ No 0 NA ❑ NE b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No r J NA ❑ NE c. What is the estimated volume that reached waters of the State (gallons)? d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ,r!�PNA ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE of the State other than from a discharge? Page I of 3 21417011 Condnued Facili_q Nudrber: - Date of Inspection: Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE a. if yes, is waste level into the structural freeboard? ❑ Yes 0 No �g NA ❑ NE Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 4) fl 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes P] 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 [�jNo ❑ 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 P No ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes jZNo ❑ 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 'TNo ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of ,Wind Drift ❑ Application �Outside 1 of Approved Area 12. Crop Type(s): �i�C'S `. ,tJ�!/Y�-t�� 01,Cc SS NO-141J_S D1_ bien1. ())herd � 6OU bee-o 13. Soil Type(s): Lod t)L&K_t cl: i)d+ L, 1 IL 14. Do the receiving crops differ from those designated in the CAW P? ❑ Yes [�No TRNo ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [;� No ❑ NA ❑ NE acres determination? 17. Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE Required Records & Documents 19, Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes PEJ No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Q5 No ❑ NA ❑ NE the appropriate box. ❑ WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other: 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �] No ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑NA ❑NE ❑ Weather Code ❑ Sludge Survey ❑ NA ❑ NE ❑ NA ❑ NE Page 2 of 3 21412011 Continued lFacility NufnberjDate of Inspection: / 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No [DNA ❑ 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 Q9 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 No ❑ NA ❑ NE permit? (i.e., discharge, freeboard problems, over -application) 31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE ❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? El Yes Tj No ❑ NA ❑ NE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE 34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE Comments (refer to question ft Explain any YES answers and/or any additional -recommendations or• any.,other com_faents Use drawings of facility to better ex Lain situations use additional pages as neces'sa ' k_ � 13 Reviewer/Inspector Name: Phone. `1(U 33 Reviewer/Inspector Signature: Page 3 of 3 Date: 21412011 0 S 9-/Z. -zo/O Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance Reason for Visit �outine O Complaint o Follow up O Referral O Emergency O Other ❑ Denied Access Date of Visit: ✓7 ZS-/!7 Arrival Time: % :ODAh.+ Departure Time: County: Qe��eso� Region: A2® Farm Name: _�7 9 fold at 7579Owner Email: Owner Name: /L/'tn✓i✓ G LG Phone: Mailing Address: Physical Address: Facility Contact: / 't t ke_ Oud a Title: 2_N,4f IHQA'?5 W Phone No: Onsite Representative: Integrator: Certified Operator: W � � k`Y Operator Certification Number: Z5 62 ,11 Back-up Operator: Location of Farm: Latitude: = o Back-up Certification Number: u Longitude: =0=6 = is Design Current Swine Capacity Population Design Current Design Current Wet Poultry Gapacity Population Cattle C+apacity Population ❑ Wean to Finish ill Layer I ❑ Dairy Cow El Dairy Calf ❑ Wean to Feeder I J[J Non -Layer ❑ Feeder to Finish El Dairy Heifer Dry Poultry El Dry Cow ii ElNon-Dairy ❑ Farrow to Wean El Farrow to Feeder ESFarrow to Finish /200 ElBeef Stocker n-La ers rWE]Layers llets El Turkeys Gilts ElBeef Feeder ❑ Beef Broad Cowl Boars Other ❑ Other ❑ Turkey Poults Number of Structures: 11IF10ther Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes E5No ❑ NA ❑ NE ❑ Yes ❑ No ® NA ❑ NE ❑ Yes ❑ No JRNA ❑ NE RNA ❑ NE ❑ Yes ❑ No ❑ Yes [X No ❑ NA ❑ NE ❑ Yes Q No ❑ NA ❑ NE Page I of 3 12128104 Continued Facility Number: "] — 00 Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): z �� 5. Are there any immediate threats to the integrity of any of the structures observed? (iel large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? ❑ Yes 0 No ❑ NA ❑ NE ❑ Yes UfNo ❑ NA ❑ NE Structure 5 Structure 6 ❑ Yes [�l No ❑ NA ❑ NE ❑ Yes VfNo ❑ NA ❑ NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes 0 No ❑ NA ❑ NE 8" Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes RfNo ❑ 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 [WNo ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes WNo ❑ NA ❑ NE maintenance/improvement? 11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Z No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area 12. Crop type(s) 13. Soil type(s) Gads bo,-o , 1, ke__ ,vd L y M" lou �5 j lgo rAl l< 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 10 No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes 51 No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes PF No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? ❑ Yes J9 No ❑ NA ❑ NE ❑ Yes 'P No ❑ NA ❑ NE Comments (refer to questron _) ExplaEn any YES;answers and/or;any;"r'ecomsriendatrons or any othe mments wtn s:of Incfac�h to be g ( p g� ry) Use dra 'g `y =tier ex lain situations use add�ao awl, a es as necessa :n te4 Reviewer/Inspector Name _ i eNe� j Rm Phone: 910 V33• 3300 Reviewer/Inspector Signature: Date: 41'497 — ZDIO Page 2 of 3 12128104 Continued Facility Number: 78 p9 Date of Inspection Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes PYNo ❑ NA ❑ NE the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps p ❑ Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes &No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes '0 No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes V3 No • ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 21No ❑ 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 (2 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 fail to notify the regional office of emergency situations as required by ❑ Yes VNo ❑ 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 LRNo ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes PNo ❑ 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 Reason for Visit 0 Routine O Complaint O Foliow up O Referral 0 Emergency 0 0ther ❑ Denied Access Date of Visit: Arrival Time: Departure Time: L.' County: Farm Name: Owner Email: Owner Name: ta Phone: _ Mailing Address: Physical Address: Facility Contact: !Y h CAP—[ i-v4t,c,1232: Title: L� Onsite Representative: Certified Operator: Back-up Operator: r v` r'"�� Region r,P`h000ne No• Integrator: IV , Lk- Operator Certification Number: Back-up Certification Number: Location of Farm: Latitude: El e E__1 ' = µ Longitude: 0 ° 0 + 0 it Design Current Design C•urrcnt Design Current Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population ❑ Wean to Finish 10 Layer ❑ Dairy Cow ❑ Wean to Feeder 10 Non -La er ❑ DairyCalf ❑ Feeder to Finish ❑ Dairy Heifer ❑ Farrow to Wean Dry Poultry ❑ Dry Cow ❑ Farrow to Feeder ❑ Non -Dairy Farrow to Finish 2, ❑ Layers ❑ Non -Layers ❑ Beef Stocker El Gilts ❑ Pullets ❑ Beef Feeder ❑ Boars El Beef Brood Cow - ❑Turke s Other ❑ Other ❑ Turkey Poults ElOther 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? ❑ Yes ?No ❑ NA ❑ NE ❑ Yes ❑ No MNA ❑ NE ❑ Yes ❑ No NA ❑ NE ❑ Yes ❑ No NA ❑ NE ❑ Yes o ❑ NA ElNE ElYes No ❑ NA ❑ NE Page I of 3 12128104 Continued L Facility Number: Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Strut ure I Structure 2 Structure 3 Structure 4 Identifier: ❑ Yes 0 No ❑ NA ❑ NE ❑ Yes ❑ No PNA ❑ NE Structure 5 Structure 6 Spillway?: Designed Freeboard (in): Observed Freeboard (in)- 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ONo ❑ NA ❑ NE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ONo ❑ NA ❑ NE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes *No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes iA No ❑ NA ❑ NE (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require [] Yes No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes t&No ❑ NA ❑ NE maintenance/improvement? IL Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes f*El No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Cr o Window ❑ EE1�vii�d��ence of Wind Drift ❑ Application Outside of Area 12. Crop type(s) 13. Soil type(s) NX4- k i Lti r mat Q ..-- 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes JpNo ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes T, No ❑ NA ❑ NE 16_ Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes P No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes IS No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes EPNo ❑ NA ❑ NE Comments (refer to question #): Explain any YES answers and/or any recommendations or any othercommentsr Use4rawings of facility to better explain situations. (nse additional pages as necessary): 7 Reviewer/inspecter Name Phone: Reviewer/Inspector Signature: Date: Page 2 of 3 12128104 Continued �A Facility Number: — Date of Inspection Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps p ❑ 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 f ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes W No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No VNA ❑ 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 P 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 o ❑ 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 concem? ❑ 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 El 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 0 No ❑ NA ❑ NE Page 3 of 3 12128104 Division of Water Quality EFaciiity Number ' O Division of Soil and Water Gonservation:E] — — — Q Other Agency Type of Visit 0 Compliance Inspection Q Operation Review O Structure Evaluation O Technical Assistance Reason for Visit Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access Date of Visit: Arrival Time: Departure Time: i2.'pp County: Kg&e0&1 Region: f_0 Farm Name: Foxm55 711 Owner Email: Owner Name: -Q!12 �ryt c 0 Phone: Mailing Address: Physical Address: c Facility Contact: M j_ �&M.0`V Title: Phone No: i( g 6Wp6 �Wh Onsite Representative: Irate rator: Certified Operator: Operator Certification Number: Back-up Operator: Back-up Certification Number: Location of Farm: Latitude: [__1 c = ` ❑ " Longitude: = c = { ❑ " DA i gn Current rDesigrig:Current Design Current SwineGapaty Population" Wet Poaltry Capacttyr Population Cattle Capacity Population ❑ Wean to Finish ❑ Layer ❑Dai Cow ❑ Wean to Feeder ❑ Non -Layer ❑Dai Calf ❑ Feeder to Finish Dairy Heifer ff ❑ Farrow to Wean Dry Poultry ❑ D Cow ❑ Farrow to Feeder ❑ Non -Dairy ❑ Layers Farrow to Finish 1310 ❑ Beef Stocker ❑ G i its ❑ Non -Layers ❑ Pullets ❑Beef Feeder ❑ Boars ❑ Beef Brood Co i .,.. ❑ Turkeys Other k ❑ Turkey Poults ❑ Other ❑ Other Number'of Structures: Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes r No ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made? ❑ Yes ❑ No T NA ❑ NE b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No TNA ❑ NE c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No [P NA ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes Ep No ❑ NA ❑ NE 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes IN No ❑ NA ❑ NE other than from a discharge? Page l of 3 12128104 Continued iJ Facility Number: — Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes MM No ❑ NA El NE a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No bg NA ❑ NE StruStructure��1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: 5579 1 Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ERNo ❑ 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 ]RNA ❑ 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 Klo ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes MNo ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 99 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 El Application Outside of Area �` p� 12. Crop type(s) &M� Al Q 1 LBS9t�f r S . l "'n j �M ' C'rz' 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes RNo ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes 10 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 NINo ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes ®No ❑ NA ❑ NE C mments (ref to.question #) Explain s>ry YES answers andLor�any recommendations or any other comments. Use drewuigs•of facility to Netter explarnIsituations. (use additlonalEpages as necessary): E er/Inspector Name 9� 3 -33m Phone:er/inspector Signature: Date: ,Page-, of .s ls1r61u4 c,annnuea Facility Number: — Date of Inspection Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes to No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 00 No ❑ NA ❑ NE the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes I.No El 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 P No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes JP No ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes V[No ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes P No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes WNo ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes GgNo ❑ 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 KNo ❑ 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 9 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 PNo ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes FINo ❑ NA ❑ NE s-., P .. w Additional Comments andlor Drawnx�m�' Page 3 of 3 12/2"4 0 Division of Water Quality 11.1 Facility Number—� 0 Division of Soil and Water Conservation 0 Other Agency 11 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: Arrival Time: Departure Time: County: Weser Region: Farm Name: _ f Orr SS i _. Owner Email: Owner Name: ("`��M eoWh Phone: Mailing Address: Physical Address: Facility Contact: �•� "�a ✓i 5 Title: Onsite Representative: Certified Operator: Back-up Operator: Location of Farm: Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Other ❑ Other Phone No: Integrator: Operator Certification Number: Back-up Certification Number: Latitude: [= o =1 0 Longitude: =o =1 = " Design Current Design Current Capacity Population Wet Poultry Capacity Population T. ❑_Layer T:::: I❑ Non -Layer Dry Poultry ❑ Layers ❑ Non -Layers ❑ Pullets ❑ Turkeys ❑ Turkey Poults ❑ Other Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made? Cattle Design Current Capacity Population.,,. ❑ Dairy Cow ❑ Dairy Calf ❑ Dairy Heifer ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stockei ❑ Beef Feeder ❑ Beef Brood Co 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 P No ❑ NA [:]'NE ❑ Yes ❑ No 01 NA ❑ NE ❑ Yes ❑ No [P NA ❑ NE A NA ❑ NE ❑ Yes ❑ No ❑ Yes No ❑ NA ❑ NE [:]Yes `{ No ❑ NA ❑ NE 12128104 Continued r`. Facility Number: — Date of Inspection '3 a9 O7 Waste Collection & Treatment EM 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes le No ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No y NA ❑ NE Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: 5�71Rl Spillway?: Designed Freeboard (in): Observed Freeboard (in): 3o N 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes r!�No ❑ NA ❑ NE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes [PNo ❑ 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 0No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 19 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 [3NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? ❑ Yes 19INo ❑ NA ❑ NE 11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes PANo ElNA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ElHeavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area 12. Crop type(s) 13. Soil type(s) W"d- 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 0 ❑ Yes ❑ Yes 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 17. Does the facility lack adequate acreage for land application? ❑ Yes 18. Is there a lack of properly operating waste application equipment? ❑ Yes "nNo El NA ❑NE No ❑ NA ❑ NE 1�3No❑ NA NE �No [I NA ❑NE �No [I NA El NE Comments (refer to question: Explain any YES answers and/or any recommendations or any other comments. Ilse drawings of facility to better explain situations. (use additional pages as necessary): AL Reviewer/inspector Name ��� �� Phone: /0 —3 Reviewer/Inspector Signature: Date: A % Page 2 of 3 112128104 C'onfinued Facility Number: — Date of Inspection ' f Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes P9No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes J9 No ❑ NA ❑ NE the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps [I Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 93 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 El No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes 0 No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes P No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes ® No ❑ NA [1 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 A] No [I 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 R] No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes ® No ❑ NA ❑ NE Additional:,Comrnents and/or. Drawings:, _...: Page 3 of 3 12128104