780010_INSPECTIONS_20171231

{
E D:Drvrsron of Sorl and Water_Conservahon `°Operation
D Drvrsion of Soil and Water Conservatron -Compliance Inspection,
_ W
- Drvrsion of Water' ua1rE r Com' harice'Ins iectron s
y, 1? P a
13 Other Agency -Operation Review `
Routine OComplaint 0 Follow-up of DWQ ins ection 0 Follow-u of DSWC review 0 Other
Facility Number
Date of Inspection
Time of Inspection F1 24 hr. (hh:mm)
Permitted 13 Certified © Conditionally Certified 0 Registered 10 Not Operational Date Last Operated:
FarmName: ....... ............................................ County:.........fS.Cla'`................ .......................
.....�......-*----- //
Owner Name:.....�G3:Y'.r .�.-s...... _.._ .....tom C....... Phone No..................2-26........... �0.��............ ....................
/ y.................. C..... - a
facility Contact: h ��.......................................Title:.....C/n!��........'.'�L... .----------....... Phone No:........__.........................................
Mailing Address: ..... ..6............ 'S`6... ... � ��'2 c c1 ....N e- ..................... �.....
........ .......................................I......... f. ... ..........� .
Onsite Representative: .... L�. ...... Intel;rator:........ ......................::......................................................
..............................................................
.j
Certified Operator: ,,,,,Ce,C.E..! ...... Operator Certification Number:,,,,,,,,,,. ;,
Location of Farm:
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ J
Latitude Longitude
Swine Canacity POpulation
❑ Wean to Feeder-
❑ Fccderto Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
Z"
❑ Gilts
❑ Boars
Number of Lagoons
Holding Pon& / Solid Traps
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer _ I ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Subsurface Drains Present 11❑ Lagoon Area
No Liquid Waste Management
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_ ll' discharge is observed, was the conveyance ratan -made?
h. II' discharge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State
c. II'discharge is observed. what is the estimated (low in gal/tnin?
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 l Structure 2
Identifier: �%
Freeboard (inches): ......... (
1 /6/99
Structure 3 Structure 4 Structure 5
Spray Field Area
❑ Yes KNo
❑ Yes PI No
❑ Yes �No
❑ Yes Z1 No
❑ Yes Pj No
❑ Yes Po
❑ Yes No
Structure 6
Continued on back

f
i
Facility Number- - Datc of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes 9�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 9No
8. Does any pant of the waste management system other than waste structures require maintenance/improvement? ❑ Yes 4No
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings? 4 []Yes $LNo
Waste Application
10- Are there any buffers that need maintenance/improvement? ❑ Yes gNo
11. Is there evidence of over application? ❑ Ponding Nitrogen ❑ Yes D4,No
12- Crop type ........ Al ...... ............................
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes M"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
r3(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
KNo
19.
Does record keeping need improvement? (ic/ 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
KNo
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
KNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
rNO
�1o.violations or dehci iencies.'were noted during.tfiis:visi t. Ynti 4ill.re�ceive niY further .:.:
corresp63<idence;ab6U-this;visit.:::: :: ; ; : ; ::: ... .. ; .. .
Comtnentsefer to question #): Explain any YES answers and/or any recommendations orany
Use dicawin other comments ;
- _ .r.
�
gs,of facility to better explain situations. (use'additional pages as necessary)
6,11-4 4CI(1t ins t re- To fMploue- berptucc ��. �
far►%-t lNkS az oife-eratt ttec,--4- f- c I e'
a.-�
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: - Z7j - 11/6/99

MDivision of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 780010 Facility Status: Active
Inpsection Type: Compliance Inspection
Reason for Visit Routine County:
Date of Visit: 02/14/2017 Entry Time: 02:00 pm Flit Time: 3:0
Farm Name: Fain 5576
Owner. , Murphy -Brown LLC
Mailing Address: PO Box 487
Permit: AWS780010
Inactive Or Closed Date:
Robeson Region:
m Incident 0
Owner Email:
Phone:
Warsaw NC 28398
Denied Aocess
Fayetteville
910-296-1800
Physical Address: 749 McInnis Rd Maxton NC 28364
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34° 48' 55" Longitude: 79° 13' 27"
From Red Springs take 71 North and proceed 1.7 miles and turn right on SR 1321 and the farm entrance is on the left 0.8 mile.
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 Repmsentative(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: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number. 780010
Inspection Date: 02/14/17 Inppection 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 19.0a 46.00
Lagoon 7576
page: 2

Permit: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number. 780010
Inspection Date: 02/14/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discha & Stream impacts
Yos
No Na Ne
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑01111
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑0
❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
0011
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
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
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
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 101Y6110 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: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number. 780010
Inspection Date: 02/14/17 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Bay)
Crop Type 2
Com, Wheat, Soybeans
Crop Type 3
Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Coxvine
Soil Type 2
McColl
Soil Type 3
Norfolk
Soil Type 4
Wagram
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
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M ❑
❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ M ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Wl1P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ M ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

c '?
Permit: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number. 780010
Inspection Date: 02/14/17 Inppection Type: Compliance Inspection Reason For Visit: Routine
Records and Documents
Yea
No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
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?
❑
N ❑
❑
25. Is the facility out of compiiance with permit conditions related to sludge? If yes, check the
❑
01111
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
00
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yee
No Na He
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29, At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface 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 ❑ E ❑ ❑
CAMP?
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

t I*,
0 Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
780010 Facility Status:
Active Permit: AWS780010 ❑ Denied Access
Inppection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Robeson Region: Fayetteville
Date of Visit:
0311112015 EntryTime: 10:00 am
Exit Time: 10:30 am Incident #
Farm Name:
Farm 5576
Owner Email:
Owner:
Murphy -Brown LLC
Phone: [phone]
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
749 McInnis Rd
Maxton NC 28364
Facility Status:
Compliant Not Compliant
Integrator. Murphy -Brown LLC
Location of Farm:
Latitude: 34° 48' 55" Longitude: 79° IT 27"
From Red Springs take 71 North and proceed 1.7 miles and turn right on SR 1321 and the farm entrance is on the left 0.8 mile.
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: date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS780010
Owner - Facility : Murphy -Brown LLC
Facility Number:
780010
Inspection Date: 03/11/15
Inpsection Type: Compliance Inspection
Reason for Visit:
Routine
Regulated Operations
Design Capacity
Current promotions
Swine
FffSwine - 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 30.00
Lagoon 7576
page: 2

Permit: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number:
780010
Inspection Date: 03/11/15 Inppection Type: Compliance Inspection Reason for Visit:
Routine
Discharges & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
❑
Cl
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 r'r Treatme
Yes No Na No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural Freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e.l 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?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS760010
Owner - Facility : Murphy -Brown LLC Facility Number: 780010
Inspection Date: 03/11/15
Inssection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No No Ne
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
Coxville
Soil Type 2
McColl
Soil Type 3
Norfolk
Soil Type 4
Wagram
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 andlor land application site need improvement?
D
M ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
M ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yips No No No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
M ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
[]
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
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: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number: 780010
Inspection Date: 03/11/15 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
❑
E ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
[]
E ❑
❑
25, Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
E ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a 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?
❑
N ❑
❑
Other issues
Yes
No No No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
N ❑
❑
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?
❑
N ❑
❑
(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
❑
E ❑
❑
CAWMP?
33, Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
❑
❑
page: 5

0
Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
780010 Facility Status:
Active permit: AWS780010
❑ Denied Access
Inppection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Robeson Region:
Fayetteville
Date of Visit: 03/19/2014 Entry Time: 09:00 am Exit Time: 9:30 am Incident #
Farm Name: Farm 5576 Owner Email:
Owner: Murphy -Brown LLC Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 749 McInnis Rd Maxton NC 28364
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude.• 34` 48' 55" Longitude: 79' 13' 27"
From Red Springs take 71 North and proceed 1.7 miles and turn right on SR 1321 and the farm entrance is on the left 0.8 mile.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Michael L Cudd Operator Certification Number: 25233
Secondary OIC{s}:
On -Site Representative(s)
24 hour contact name
On -site representative
Primary Inspector:
Inspector Signature:
Secondary Inspectorlsj:
Inspection Summary:
Records reviewed 2128/14.
Site visit 3119114.
Name
Mike Cudd
Mike Cudd
Title
Phone:
Phone:
Phone
Robert Marble Phone:
Date:
page: 1

Permit: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number: 780010
Inspection Date: 03/19/14 Inpsection Type: Compliance Inspection Reason For Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
rffSwine - Farrow to Wean
Total Design Capacity:
Total SSLW:
Waste StrUctUres
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00
Lagoon 7575
page: 2

Permit: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number: 780010
Inspection pate: 03/19/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No No Ne
1. Is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWO)
❑
❑ 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?
❑
01111
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No No Ne
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.eJ 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?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yes No No Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
C]
Application outside of application area?
❑
page: 3

Permit: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number: 780010
Inspection Date: 03/19/14 Inppection 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
coxviue
Soil Type 2
McColl
Soil Type 3
Norrolk
Soil Type 4
Wagram
Soil Type 5
Soil Type 6
114. 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 ❑
❑
II& 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?
❑
M ❑
❑
Records and Documents
Yes
No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
M ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
M ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number: 780010
Inspection Date: 03/19/14 tnpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Ne
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
[]
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
■ ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
[]
List structure(s) and date of first 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 Ne
28. Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility?
❑
01111
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?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

E Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
780010 Facility Status:
Inpsection Type:
Compliance Inspection
Reason for Visit:
Routine
Date of Visit:
02/26/2013 Entry Time: 05:30 pm
Farm Name:
Farm 5576
Owner:
Murphy -Brown LLC
Mailing Address:
PO Box 487
Active Permit: AWS780010 Denied Access
Inactive Or Closed Date:
County: Robeson Region: Fayetteville
Exit Time: 6:00 pm Incident #
Owner Email:
Phone: [phone]
Warsaw NC 28398
Physical Address: 749 McInnis Rd Maxton NC 28364
Facility Status: ■ Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34' 48' 55" Longitude: 79" 13' 27"
From Red Springs take 71 North and proceed 1.7 miles and turn right on SR 1321 and the farm entrance is on the left 0.8 mile.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator:
Secondary OIC(s):
John Samuel Cain
Operator Certification Number: 987304
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 28113
Site visit 2/26113
page: 1

r t
Permit: AWS780010 owner - Facility : Murphy -Brown LLC Facility Number: 780010
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean 3,927
Total Design Capacity:
Total SSLW:
Waste Structures
Disignafed Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
agoon 1 19.00
agoon 7576
page: 2

Permit: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number:
780010
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Discharges & Stream Impacts
Yes
No Na Ne
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
[]
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
[] 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)
Cl
❑ 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
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
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 (LeJ 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?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
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 > 100/6/10 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: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number: 780010
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes
No Na No
Crop Type 1
Coastal Bermuda Gress
(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
Coxville
Soil Type 2
McColl
Soil Type 3
Norfolk
Soil Type 4
wagram
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
[]
❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
❑
❑
Records and Documents
Yes
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
E ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
E ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
[]
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS780010 Owner - Facility : Murphy -Brown LLC Facility Number:
780010
Inspection Date: 02/26/13 Inppection 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?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
■ ❑
❑
(NPDES only)?
24. Did the facility fall 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
❑
N ❑
❑
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?
❑01111
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
a ❑
❑
Other Issues I
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
E ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i.e.. discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
■ ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
■ ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

0
Type of Visit 0 Compliance Inspection Q Operation Review U Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint 0 Follow up 0 Referral Q Emergency O Other El Denied Access
Date of Visit: Z 4�Arrival Time: �`.GDQW. Departure Time: County: lrJF:r-4W Region: F-42o
Farm Name: 65`96 —/ C75?(0 Owner Email:
Owner Name:C Phone:
Mailing Address:
Physical Address: -
Facility Contact: NI�1HK-/ Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
uC
Location of Farm: Latitude: E__1 o = I El u Longitude: ❑ ° = I = U
Design Current
Design Current
Design Current
Swine
Ca aci Po ulation
p ty p
Wet�Poult
,. ry
Capacity Population
Cattle
Capacity Population
❑ La er
❑ DairyCow
❑ Non -La er
❑ DairyCalf
Dairy El Heifer
_ .
Dry l'oilt_ry
❑ La ers
❑ Non -La ers
El Pullets
ElTurkeys
ElD Cow
❑
El Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Other
❑ Other
El Turkey Pou Its
❑ Other
Number of Structures:
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
D'escharQes & Stream Impacts
1. Is any discharge observed from any part of the operation?
El Yes
[9No
❑ NA
❑ NE
Discharge originated at: ❑Structure ❑Application Field El Other
a. Was the conveyance man-made?
❑Yes
❑ No
W NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
❑ No
P�NA
❑ Ni:
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 Yes
❑ No
OIVA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
P No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
WNo
❑ NA
❑ NE
other than from a discharge?
Pagel of 3
12/28/04
Continued.

'acility*Number: Date of Inspection 2 f f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
1�No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
W NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
7'r
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[FINo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
0 No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes P
No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ElNA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) IR
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?
IL . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of
Acceptable Crop Window ❑l Evidence of /W�in�d Drift ❑ Application Outside off A're
12. Crop type(s) �-�C,LJ'r.`'� & Cl R7.�,/, 5i'il, t!W` k � i �,1 �
13. Soil type(s) 4x J 7
v
14. Do the receiving crops differ from those designated in the CAWMP?
[I Yes
PNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
KANo
El NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
R No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
`P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ER No
❑ NA
❑ NE
WE
�_v
Comments refer to,,question #) Eaplatn any YE5 answers�and/ar any recommendations or anv other comments.
Ilse drawings df2facilitystoibette,r` eiplam situations (use additional,pages as necessary). ' R
r P-ey�fyp-ep-rds rrev,`p4 21LS-1/I.
e714-- 0'5(' Co'dLCC7d -2,11 r
300
Reviewer/Inspector Name Phone: 3 `3
Reviewer/Inspector Signature: Date: 2 ZS !
Page l of of 1L/25/U4 [.onfrnuea

Facility Number: Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes g1No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [�j 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 �j 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 PNo ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Ep 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
R No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
PU 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
[p 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
[P No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
P No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[A No
❑ NA
❑ NE
Addittonal' Commeois andlor+Drsiviwgs,
Page 3 of 3 12128104

I ype of Visit: W Compuance inspection U operation Keview V structure Evatuation U 1ecnmcat Assistance
Reason for Visit: 40 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: F__1
Arrival Time: Departure Time: 4 KS� County:
Farm Name: r? I C�59b) Owner Email:
Owner Name: 14 LVQ hA4 — BiQ (f Phone:
Mailing Address:
Physical Address:
Facility Contact: A;
Onsite Representative:
Certified Operator:
Title:
Region:
Phone:
Integrator: "IA
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design�Current
Design CurrentF
Design Gurrent
Swine Capacity Pop:
Wet Poultry CapacttVP;,.op Cattle
Capacity Pap.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I
INon-Layer
I
Dairy Calf
Feeder to Finish1
Designe�Current _
I tim K. Ca aci . �P,o ,_ t
La ers
Dairy Heifer
Farrow to Wean
Dry Cow
Non -Da'
Farrow to Feeder
Farrow to Finish
Beef Stocker
Gilts
Non -La ers
Pullets
Turkeys
=
Beef Feeder
Boars
Beef Brood Cow
O e- '
thr ._....x_t�> �.::_.:
TurkeyPoults.
Other
Other
Discharges and Stream IMDacts
1. Is any discharge observed from any part of the operation?
❑ Yes
1PNo
❑ 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
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

Facili Number: jDate of Inspection: /Z
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 ❑ No � NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes F 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 to 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 ApDlication
10. Are there any required buffers, setbacks, or compliance altematives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CA
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes rv-q No
❑ Yes No
❑ Yes No
❑ Yes ® No
❑ Yes No
❑ Yes No
[:]Yes No
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below_ ❑ Yes V 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
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: IS - 10 Date of Inspection: L
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes fV No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Q3 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 oNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No 03 NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
CP 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?
❑ Yes
[�No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
f] No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
fo No
0 NA
❑ NE
Comments (refer to.question ft Explain any YES answers and/or. any additional recommendations or -an ,,other comments:
Use drawings of facility to better explain situations (use additional pages as necessary).
tS re�l�e�.►�ee� -8-11 f
31 g(rz�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: gl�jT�T�
Date: 31 19' 1 z
21412011

r- It
It ype of visit: o c.ompttance inspection v vperanon xeview v structure Evamanon V iecnntcal Assistance I
Reason for Visit. 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: L / Arrival Time: pS;3o Departure Time: County: ROBE-56YU Region: ­jO-D
Farm Name: 5 7�-rI7� — I (qS-rx,) Owner Email:
Owner Name: M tl�„/> ILC_ Phone:
Mailing Address:
Physical Address:
Facility Contact: M'I ze ab Title: Phone:
Onsite Representative: q Integrator: A4A'Anetl'-, &_
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current` Design Current
Design Current
Swine Capacity Pop. W.et Poultry .:, C•apacity Pop.
Cattle Capacity Pop.
Wean to Finish La er
DairyCow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
DairyHeifer
arrow to Wean
Design Current
D Cow
Farrow to Feeder
D .P,oult` . L Ca aci_ P,o P.
Non -Dairy
Farrow to Finish
2 aD
V La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
1pullets
Turke s
Beef Brood Cow
Other
Turke Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes N No ❑ NA ❑ NE
[:]Yes
[::]No
1P NA
❑ NE
[:]Yes
[::]No
j�JNA
❑ NE
d. Does the discharge bypass the waste management system? (if yes, notify DWQ) ❑ Yes ❑ No [ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[P No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[—]No
ONA
❑ NE
Structure 1— Structure 2 Structure 3 Structure 4
Identifier:
Structure 5
Structure 6
fj
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): C� q �'
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
q No
[DNA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
a Uttil s5L
4IX
t
12. Crop Type(s): (.�Q
13. Soil Type(s): V i� CG
If IF
14. Do the receiving crops differ from those designated in the CAWmlv
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
P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[j�No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[D No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
' No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes (4 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis 0 Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [ No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ONE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - be jDate of Inspection:
/
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
q No
❑ NA C] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
Pa No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
Comments (refer to question ft Explain any, YES: answers and
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes 01 No ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
❑ Yes PNo ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
No
❑ Yes
No
❑ Yes
No
nuns or. any
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Phone:
Date: /3
21412011

$-r/f1S q -- I z -- Z o 1 0
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 Time: %: d aA+►i Departure Time: 7:d8 ,., County:
Farm Name: SS76 ~/ 7S 742 Owner Email:
8
Owner Name: %u— rb" ^w ? LLL Phone:
Mailing Address:
Region: F/20
Physical Address: �y I
Facility Contact: � Title: LNA1 ALFA/4.724111f- Phone No:
Onsite Representative: Integrator: —,Erb v.Vj
Certified Operator: d.r.ter5G �u 4a N Operator Certification Number: /k3675Z
Back-up Operator:
. Back-up Certification Number:
Location of Farm: Latitude: =e = =" Longitude: = ° = 1 = u
Design Current
Design Current
Design Current
Swine C+apacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
10 Layer
I
❑ Dairy Cow
❑ Wean to Feeder
10 Non -Layer
I
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poulhy
❑ Dry Cow
❑ Farrow to Feeder
❑ La ers
❑ Non -Dairy
Farrow to Finish 200
/
❑Non -La ers
❑Beef Stocker
❑ Gilts
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ urke s
Other
urke Poultsr
E00ther
Number of Structures:
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
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
Pfl NA
❑ NE
❑ Yes
❑ No
02 NA
❑ NE
® NA
❑ NE
❑ Yes
❑ No
❑ Yes
EX No
❑ NA
❑ NE
❑ Yes 12 No ❑ NA ❑ NE
Page I of 3 12128104 Continued

Facility Number: 78 - 0/0
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: 5-5-76 '/
❑ Yes ® No
❑ Yes VfNo
Structure 5
❑ NA ❑ NE
El NA ❑NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 35-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E8 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 21 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 52 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 [PNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application ��qq
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes Yes 1No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes (A 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 El Evidence of Wind Drift El Application Outside of Area
L>
12. Croptype(s) et-^%K4 r ('0") t'
_504e-1 G"r'A/ (OVaesecd) art✓-W4etit -S'skea"✓_s
13. Soil type(s) COXVi 11-e- Col
l,_ //. AloY-6 //C , �a4YG A., �
14. Do the receiving crops differ from those designated in the CA W MP? ❑ Yes R1 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 0 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ® No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes ® No ❑ NA ❑ NE
18. Is there a.lack of properly operating waste application equipment? ❑ Yes [9No ❑ NA ❑ NE
Comments (refer to questtow Explain any VES:,answers and/or any recommendations=or any other comments :
Use drawings of facility to_better. explain situations. (use additional pages as necess
AL
T
Reviewer/inspector Name F_R,r c [:ti/t -s
Phone: 910r �'33 , 3300
ho
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12128104 Continued

Facility Number: 7b -0/0 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 QTNo ❑ NA ❑ NE
the appropriate box. ❑ W UP ❑ Checklists ❑ Desig
n ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 59 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
V9 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
ERNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
2TNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[9No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
WNo
❑ 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
[Rj 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
ONo
❑ 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
MNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
0 No
❑ NA
❑ NE
Page 3 of 3 12128104

V.
Type of Visit *Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral Q Emergency O Other ❑ Denied Access
Date of Visit: n Arrival Time: %=QOCw Departure Time: 2 ' County: ��►" Region: ' 9-6
Farm Name: ✓ r4 Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: G Integrator: AW
Certified Operator: James & ti Operator Certification Number:
Back-up Operator: l ""'uAnK—o"S Back-up Certification Number:
Location of Farm: Latitude: [= e =' = u Longitude: =1 ° u
Design Current
Design Current
Design Current
Swine Capacity Population
Wet Poultry
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑Dai CowII
❑ Wean to Feeder
❑ Non -Layer
❑Dai Calf
❑ Feeder to Finish
-"`
❑ Dai Heifer
❑ Farrow to Wean`'
Day Poultry
� � ,, „
❑ D Cow
❑ Farrow to Feeder
'
❑ Non-Dai
Kb Farrow to Finish ;LM
❑ La ers
❑ Non -Layers
❑ Beef Stocker
Gilts
❑Beef Feeder
El Boars
El Pullets
❑ Beef Brood Co
❑ Turkeys
Other,
❑ Other
U—Turkey Poults
10 Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
yNo
ElNA
ElNE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[4 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
pa NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
ETNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[3�No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
OffNo
❑ NA
❑ NE
other than from a discharge?
Page l of 3
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
J!� No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No P NA ❑ NE
Stru tune 1 Structure 2 Structure 3 Structure 4
Identifier:
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
No El NA El NE
T
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No ElNA ElNE
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?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop indow ❑ Evidence of Wind Drift El Application Outside
of Area
12. Crop type(s) 1�I�tOIQ SMlU>ol�
13. Soil type(s) ll 2&f Lj ' 44G' 111 f CO f I I L I 1 ' ( D t, _
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes]
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[N No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
'p No
❑ NA
❑ NE
J Reviewer/Inspector Name Phone: I
IReviewer/Inspector Signature: rn, fJ Date:
Pape 2 of 3
12128104 Continued

Facility Number: — Q Date of Inspection
Required Records & Documents I
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 1., No El NA El NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes LJ No ❑ NA ❑ NE
the appropriate box. ❑ WUP Cl Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes )n No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
Q5 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
[ ,NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Q9 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
69 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
CP NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
U9 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
0
❑ 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
[�yNo
❑ NA
ElNE
If yes, contact a regional Air Quality representative immediately
lC
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
P No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
�No
❑ NA
❑ NE
Page 3 of 3 12128104

t
Type of Visit 0 Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit 46 Routine 0 Complaint Q Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Farm
Arrival Time: O.`oOQ, .. Departure Time: : AO County: t^ Region: "
Farm Name: M 95-161 Owner Email:
Owner Name: � �_ pi^ot. jPi Phone:
Mailing Address:
Physical Address:
Facility Contact: _A - v - VkS Title: Phone No:
Onsite Representative: Integrator: !`liwp AfbU; in
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = d = " Longitude: 0 0 0 I = u
Design Current Design Current Design Current
Poultry Capacity Population Cattle Capsrity Population
Finish
rMe
❑ La er
❑ Dai Cow
Feeder
❑ Non -Layer
❑ DairyCalf
❑ Feeder to Finish
Dry Poultry
❑ DairyHeifer
❑ Farrow to Wean
❑ Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ La e rs
10 Farrow to Finish OD
11 Ir7
El Beef Stocker
❑Non -Layers
Gilts
❑Beef Feeder
❑ Pullets
El Boars
❑ Beef Brood Co
:,. ,... ❑ Turkeys
O#her El Turkey Poults
Number of Structures:
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Q9 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
P NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
q No
ElNA
ElNE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
y No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facih'ty Number: 1 f3— 10 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: 55-77k I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 33n
❑ Yes [PNo ❑ NA ❑ NE
❑ Yes ❑ No 1�3 NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[P No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
® No
❑ 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?
l l . 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 ❑ Evidencce of Wind Drift ❑ Application Outside of Area
12. Crop �e(s) &MuAa I Q�c..� 5w, + CAW liaJ
13. Soil type(s) k,� B
T
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
h}No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�9 No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
E9 No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
bg No
❑ NA ❑ NE
Comments (referao aquesnonx Epp .tn any YESanswers and/or any r ommendations ar any other comments.
. ..
Use drawings,'plaacihty to better eiplatn sit hatians�(use�additional pages,as,necessary):
Reviewer/Inspector Name ', Phone: MID 433 -3300
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continrted

Facility Number:73 — Q Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes MNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes (K No ❑ NA ❑ N E
❑ 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 p3No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes f] No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
t9 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
09 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
M 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
h No
❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
JP 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
Q9 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
Page 3 of 3 12/28104

® Division of Water Quality
Facility Number O Division of Soil and Water Conservation
Q Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 3 D Arrival Time: ! ip ,� Departure Time: t��04 County: VIn Region: AW
Farm Name: _ ✓'� SJ 7 to f Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: ,,
Facility Contact: ! I F Y �tr� rv►o�'1S _ Title: Phone No:
Onsite Representative: Integrator: &—t-A3
I I
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 00 [=d 0[I Longitude: 00 0, 0 H
Swine
Wean to finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ g
r-La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Pouets
❑ 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 Stocker
❑ Beef Feeder
❑ Beef Brood Co
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)?
Number of Structures:
d. Does discharge bypass the waste management system? (Ifyes, 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?
J
❑ Yes [F No ❑ NA ❑ NE
❑ Yes
❑ No
IP NA
❑ NE
❑ Yes
❑ No
�] NA
❑ NE
❑ Yes
❑ No
1P NA
❑ NE
❑ Yes
�i No
❑ NA
❑ NE
❑ Yes
i;a No
❑ NA
❑ NE
12128104 Continued

Facility Number: — f Q Date of Inspection 3 3
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? El Yes (❑ No KI NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 551?� f
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
0 No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
P No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
® 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
Pd No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
??No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
;4 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) b�f �"' ►ut�(I Qt� ? �� IJTGt�\r� D(
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes}
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
0 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
1�1 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
19 No
❑ NA
❑ NE
.Comments (refer ta+questron,#): Explain any YES answers and/or any recommendations or any ohercom"rnents
Use.drawtngs of facility to better explain situations. (use addihbnal pages'as necessary):
Reviewer/Inspector Name — — — -- -- Phone: lO - 300
Reviewer/Inspector Signature: Date: -7
Page 2 of 3 12128104 Continued

Facility Number: — f 0 Date of Inspection O 6
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ISNo ❑ 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. ❑ WIJp ❑ Checklists ❑ Desig
n ❑Maps El 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 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes WNo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
f] No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
FQNo
❑ 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
rg No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[3 Yes
g] No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
In No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[P 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
P9 No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32_ Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

°f
Type of Visit ® Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 40 Routine O Complaint 0 Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: j e "r ov Region:
Farm Name: 0SyZ4,1_ COId CaveaWl Ct 757G Owner Email:
Owner Name: ,, 0Li Phone:
Mailing Address:
Physical Address:
iilola+
Facility Contact: i Title: Phone No:
Onsite Representative: Mf f[_ Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 0 ` =1 u Longitude: = ° =, 1=1 u
Design Current
d . Design Current
Design Current
nitrCaity Population
Cattle Capacityan
Mc,�Po,
to Finish
❑ La er
❑ Dai Cow
❑ Wean to Feeder
❑Non -La er
❑ Dai Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
x`
Dry Poultry =
❑ Dry Cow
❑ Farrow to Feeder
` `'`
❑ Non -Dairy
Farrow to Finish aOO
❑ La ers
❑Beef Stocker
❑ Gilts
❑Non -La ers
El Beef Feeder
Bo ars
❑ Pullets
El Beef Brood Co
El❑ Turkeys
Other :=x°
❑ Other
El Turkey Poults
❑Other
Number of Structures:
Discharecs & Stream Impacts
1. Is any discharge observed from any part of the operation'?
❑ Yes
X No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
❑ Yes
54No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
91 No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
pallo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA .
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: 71 — lQ Date of Inspection
+ Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ® No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes % No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 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 [3?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
[�PNo
❑ NA
❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
( No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[PNo
❑ NA
❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
q No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ]0 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) Z3 eV ort i._[4 i:L, j�Ha4 i .5MJ1 (a MI"^j ("'QVe- ►-S e ca( J
13.
Soil type(s) Wd► S . /VAC 11
,designated
14.
Do the receiving crops differ from those in the CAWMP? ❑ Yes
ONo ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
No ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
[A No ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
[;a No ❑ NA
❑ NE
Comments (refer to question#):. Explain any YES answers and/or any recommendations or anyaother comments - "
:Use drawings of facility to better explain situations.=(use additional pages'as<necessary}: 4
Reviewer/Inspector Name �� P L _1Z C U C_I S Phone-.( �f33 33a o
ReviewerAnspector Signature: ZA_4 �..� Date: fv ' /3 — ZOd (p
Page 2 of 3 12128104 Continued

Y
Facility Number: `7S — fQ Date of Inspection G 73-O
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes OfNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0 No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design ❑Maps [3 Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes V No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" 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 P No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
59No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
V 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
[RNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
WNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[ No
ElNA
ElNE
and report the mortality rates that were higher than normal?
30_
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
(WNo
❑ NA
❑ 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
[�ONo
❑ 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
fu No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
XNo
❑ NA
❑ NE
Additional Comments and/orl]rawings:,
Page 3 of 3 12128104

Type of Visit ®Compliance Inspection Q Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit Q Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other ❑Denied Access
Date of Visit: Arrival Time: : DO Departure Time: County: 24".&1 Region: )�Po
Farm Name: _5.J�%&� - (aidCa Vyo10 p%(o _ Owner Email:
Owner Name: — _ Al", ,C� ✓ZrL A / _ Phone:
Mailing Address:
Physical Address:
Facility Contact: WV-s4 Title:
Onsite Representative: `.� eX� I Y- j3�
Certified Operator:
Back-up Operator:
Phone No:
Integrator: 1141.1.02" �✓
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o [= , [� 11 Longitude: ❑ ° = 4 ❑ it
rp[=' Design Current Design Current Design Current
Edean
Caplation Wet Poultry CapacityPopulation Cattle., Capcit:AFan to Finish ❑ La er ❑ Da' Cow
to Feeder ❑Non -La et ❑ Dai Calfder to Finish ❑ Dairy Heifei
Dry Poultry - J ❑ D Cow
x."
❑ La ers ElNon-Dairy
❑ N
❑ Pullets ❑ Beef Feeder
❑ Turkeys
❑ Beef Brood Co
Other
av ❑ Turke Pouets
❑ Other ❑Other Number of�Struc`tures:
El
❑ Beef Stocker
❑ Gilts on -La ers
Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
ZO
7.DO
&Stream Impacts
1.
Is any discharge observed from any part of the operation?
El Yes
[% No
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
El Yes
[9 No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
[XNo
❑ 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)
El Yes
09 No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑Yes
� No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
� No
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

a
Facility Number:
Date of Inspection lL
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
❑ Yes 19 No
❑ Yes %No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): Z d • S i�
Observed Freeboard (in): _34,
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes rf 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 UNo ❑ NA ❑ NE
8_ Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes P9 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 [ANo ❑ 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?
It. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Ig No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) genrm k'd cl` (4111, ) SA44116m flov (Ove
13. Soil type(s) A_'Ls /V0A McColl
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination: ❑ Yes ® No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
li
❑ Yes 1P No ❑ NA ❑ NE
❑ Yes PLNo ❑ NA ❑ NE
Phone: (`//DJ rK& —
Reviewer/Inspector Signature: Date: /2 — 19 -24)03-
12/28/04 Continued

Facility Number: "-7 — d 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 appropirate box.
❑ WUP El Checklists El Design [I Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
I�LNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[� No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[�gNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
W No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
CA 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?
El 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
M 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
M No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
R No
❑ NA
❑ NE
12128104

Type of Visit ® Compliance Inspection O Operation Review .0 Lagoon Evaluation
Reason far Visit 19Routine Q Complaint 0 Follow up O Emergency Notification Q Other ❑ Denied Access
Date of �•isit: tl Time;
Facility• Number "•=•� I �
loot O erational Below Threshold
EB Permitted ® Certified M Conditionaliv Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: _�' r (1,11 S--c;�-r� v�C County:
Owner Name: UC rro 's Phone No: �rj f O� -aTL. f
Alalittg Address: }4 L -I1? 3 ix
Facilitv Contact: M r Title: Phone No:
Onsite Representative: t4.rit Integrator: CeA s S
Certified Operator- Oe"CiL t. CA- Operator Certification Number: asti SS
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 9 " Longitude ' 1
Design Current
Swine ranacitt' Pnnnlatinn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow- to Feeder
® Farrow to Finish
:2,0'0
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Ca acity Population
❑ Laver ❑ Dairy
❑ Non -Laver ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons Subsurface Drains Present ❑ La oon Area ❑ S ray Field Area
Holding Ponds I Solid Traps 0 ❑ No Liquid Waste Management System
Discharges 8- Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is obsen ed, was the convevance man-made?
b_ If discharge is obsen'ed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed. what is the estimated flow in eallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
?. Is there e,.idence of past discharge from any part of the operation? El Yes kO No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes t�No
Wa a Collection & Treatment
4_ Is storage capacity (frecboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes Q No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier!
Freeboard (inches).
05103101 3 - - Continued

FacilityNumber: — 10 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 property addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ hydraulic Overload
12. Crop type QCf,m 1,Ar- -4- 9 ,n • Cnt rdi r, n .
❑ Yes [qNo
❑ Yes [@ No
❑ Yes N No
❑ Yes [RNo
❑ Yes [? No
❑ Yes qNo
❑ Yes qNo
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15_
Does the receiving crop need improvement?
❑ Yes
N No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
F No
Required Records & Documents
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?
(ic/ WUP, checklists, design, maps, etc.)
❑ Yes
[ No
19.
Does record keeping need improvement? (ic/ 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
[Q No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
54No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
1;9LNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
[5,No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes qNo
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to ,question #�zplarnlaay YES answers andlor anyrecomrnendatlons or any other comments.!:'
�c -,
ilse,drawmgs of factlrty to better explain srhratrons.,{use additional UAWpages as necessary)
d p �, �; 1 ❑ Field Copy ❑ !Fi!tes
i,) F� �.cr�� C3c-klti� tf.cxF-_
J111103 1-Z v .l fir. j. O k- S[n 4
ex c et:dQ tL PAAf b Y p w, ( &4o _ u� fir'
Reviewer/inspector Name
Reviewer/Inspector Signature: Date: o
05103101 Continued

Facility Number: Tg — 10 1 Date of Inspection O
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. 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 P No
❑ Yes R1 No
❑ Yes �9 No
❑ Yes No
❑ Yes ® No
❑ Yes [:]No
Additional'CoEnments`aiidlor Draiven _ =
r
T
05103101

F. i
II'247 7-
Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine Q Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Date of Visit: Time:
Facilih Number q
ro Not O erational 0 Below Threshold
® Permitted ® Certified © Conditionally Certified ❑ Reggistered Date Last Operated orAboveThreshold
Farm Name: C,GJ i b � �S �� Zvi C_ . Count•: 9 ]
7
Owner Name: l"S Phone No: V 'al (' - - L 3�-
llailing _address: 4 Z 4k 8 S a-Se-y �- _ _ -1g3 5 I?
Facility Contact: Title: ��� _ ,. Phone No: t D -
Onsite Representative: Integrator: —%r C ro
Certified Operator: _ Mcric_ _ _ my,-4-- _ Operator Certification Number: 2 `S 83-
Location of Farm-
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ' a Longitude ` ram• C�
Design Current
Swine C'anacity Ponulatinn
❑ 'Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrovy to Feeder
® Farrow to Finish
2 D
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Ca acid• Population
❑ Laver ❑ Dairy
❑ Non -Laver 1 10 Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ULJ Lagoon Area ❑ S rav Field Area
Holding Ponds / Solid Traps ❑ No Lig uid Waste Management System
Discharges 8- Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge orininated at: ❑ Lagoon ❑ Svrav Field ❑ Other
a. If discharge is observed, %+rag 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 oai/min?
d_ Does discharge bypass a lagoon system? (If yes, notiffi, 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 8 Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure
Identifier:
Freeboard (inches): 4-
05103101
❑ Yes 5� No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes Off No
❑ Yes ® No
Structure 6
Continued

Facility Number: 1p Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes V) 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 Wo
(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
P No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
�3No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
IM No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
No
12. Crop type 9 es.,, — A c g- f,,_c..lt
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
CR No
16. Is there a lack of adequate waste application equipment?
❑ Yes
5D No
Reuuired Records & Documents
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
W No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
Q No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
R No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
[�j No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel 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
P No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
N No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer -to .questiiin `Explain any YES,!flIIswee s sndlOr,anyrecommeadat�Qnsor any other comments�y i
r
�Use;drawings of facility to better c plaralsituations (use,additionid pages•as necessary): ❑ Field Copv ❑ Final Notes
�.. ,
O r'c r �
C, C.n r AQ o -E— _F6_r_ .., LS. UAA
Reviewer/Inspector Name-
Reviewer/Inspector Signature: - ti, rw— Date: C
05103101 Continued

Facility \umber: Date of Inspection o �
Odor Issues
26, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atfor 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. ' ere any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s). inoperable shutters. etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32_ Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover?
❑ Yes W No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes [5� No
❑ Yes No
❑ Yes No
❑ Yes "UNo
05103101

Type of Visit ® 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 Date of visit: " Time: d
Not Operational 0 Below Threshold
N Permitted ® Certified [3Conditionally Certified D Registered Date Last Operated or Above Threshold:
Farm Name: _ �i4�z _�/7f _79- County: _-AZZ9 T iJ
Owner Name: /� �� _ Phone No: -41
Mailing Address: G l 7f/ .
Facility Contact: lij (�?a �i4s- Title: Phone No:
Onsite Representative: /�� Integrator:�z iS
Certified Operator: AAA fall Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �' 0 u Longitude
'Design : Garrettt Disign 'Carrent. Desrgn Current
Swine - _ _ _.
Ca acity Po Matron `�� =Pou ltry Ca achy=Fo ulation Cattir ; _ �.Ca acrtv_=.Po ula�on
❑ Wean to Feeder ':= ❑ Layer _P
DairyFeeder to Finish ❑av
Non-Ler Non -Dairy
❑ Farrow to Wean = `
❑ Farrow to Feeder - ❑ Other 7_
�FarrOW to Finish 2lyd 2a4) _ Tots1 Destgl�_Cgnik }
❑ Gilts _
[] Boars - m Tots!-SSLW -
Nomber,af Lagoons ❑ Subsurface Drains Present IF] Lagoon Area 10 S rav Field Area =
- - 1
'Hoidtiig Ponds I:Solyd;Traps "I No ; w �] No Li uid Waste Mana etnent System ki
Discharges & 5tream Imaacts
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 ves, 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 S
Identifier:
Freeboard (inches): 3k,
05103101
❑ Yes R No
❑ Yes 2 No
❑ Yes K'No
❑ Yes tRNo
❑ Yes , No
❑ Yes 5;�No
❑ Yes ,E•No
Structure 6
Continued

Facility Number: 78 — f 0 Date of Inspection !�—J
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 ADDlication
❑ Yes
OfNo
❑ Yes
�;No
❑ Yes
;N No
❑ Yes
X No
❑ Yes
ECNo
10. Are there any buffers that need maintenance/improvement? ❑ Yes e'6 No
IL is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes 11No
12. Crop type ; ti�llr �19 Sisv� 4�P�1�
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ONO
14. a) Does the facility lack adequate acreage for land application? ❑ Yes JONo
b) Does the facility need a wettable acre determination? ❑ Yes ANo
c) This facility is pended for a wettable acre determination? ❑ Yes IN No
15. Does the receiving crop need improvement? ❑ Yes tgNo
16. Is there a lack of adequate waste application equipment? ❑ Yes 10rNo
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
�jNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps .)
✓
❑ Yes
® No
19.
✓e ✓ c✓
ac
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soils ple reports)
❑ Yes
ff No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
91 No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
DR:No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application) ❑ Yes f 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 PNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes RNo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
essary)r ati
❑Final Notes '
Use d wan�gof facihtyy ob{etter ezplatnAstti $ttons. (use additional pagesilkas; el Copyen
lP?a CZ/•�,tDd — oat/ •t'T �O.cdS r
Reviewer/Inspector Name uF.
Reviewer/Inspector Signature: 2 Date: le Z
05103101 Continued

r
Facility Number: 7 — Q Date of Inspection DZ
Odor Issues
25. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes IqNo
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �ffNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, Cl Yes (allo
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 PNo
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 P No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes OT10
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? V Yes ❑ No
Additional- Comments and/or Drawings;
05103101
05103101

r
- � D og of Soil and Water Conservation :Operdtia Review 7 -=
r t '
�'-"�� � � - a of Soil and.- Water Canser�on � Campliainee Inspeciian�.� x � � ,,.,,
Routine O Complaint O Follow-ue of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection 1
Time of Inspection 24 hr. (hh:mm}
Permitted [3 Certified [3 Conditionally Certified El Registered 0 Not rational Date Last Operated: yyyyyy\\\\\\ ,,�Q`_ ff���
Farm Name: f,, �(1` tl ....1`... __ .....
........._..?��l!Y........................................................
County........... �_`��../........
Owner Name:....(....:.r�t�X`��.�L...��...........�b�Gf,S�..... ................ Phone No:..............2i ...` a 7" 0..................................
Facility Contact: ..... eJc........�A.......................... Title:...-........1........._. Phone No:
Mailing Address: .... D....... 1pr prat".) A.... 1_'5tP. Q �' Q ` �� y, a 3 c
Onsite Representative: ,�r ,5 .......... ( �`--• Integrator ........
Certified Operator: .......... . ........................................ ........................................... .. .............. Operator Certification Number:
Location of Farm:
Latitude =• =' " Longitude =' =° =Li
°_ Design Current
-Design Current Design Current.
_._.
Swine...:, .. W:__Ca'aci
;Po'-Wation.:;Poultry.
Ca aci _.Po illation Cattle .-...Ga aci Po`ulabon.�;:
❑ Wean to Feeder
'' ❑ Layer
q= ❑Dairy
-
❑ Feeder to Finish
❑Non -Layer
== ❑Non -Dairy
w ❑ Farrow to Wean
—
[],Farrow to Feeder
❑Other
Farrow to Finish
K Total DeS1gIl Capaclty�
❑ Gilts
❑ Boars
`M1
_ ,
:Total SSLW. '•
c
Number of: Dons ❑Subsurface
�$
Drains Present ❑ Lagoon Area ❑ Spray Field Area *
r,
Holding Ponds hSolid Traps= '- ❑ 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. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (Il' 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):
❑ Yes J No
❑ Yes A No
❑ Yes �No
❑ Yes
qNo
❑ Yes
qNo
❑ Yes
WNo
❑ Yes RNo
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes X-No
seepage, etc.)
3/23/99 Continued on back

Facility Number: — D Date of Inspection ? —C
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 o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes �Ido
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes P0+I0
11. Is there evidence over application? ❑ ExcessivR Ponding ❑ PAN e ❑ Yes gNo
i I
12. Crop type 1 J6'r V►.�t� joL. hn-._j / J;I, . (57 r a: , /-)1! e r S r -_ moo(
13. Do the receiving crops differ with those designadein the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
No
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15. Does the receiving crop need improvement?
`Yes
16. Is there'a Iack of adequate waste application equipment?
❑ Yes
[[No
Reauired Records & Documents
IT. Fail to have Certificate of Coverage & General 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 gNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes RfNo
20: Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑
Yes JdNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ANo
24. Does facility require a follow-up visit by same agency? ❑ Yes XNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ONo
�Vo violntigris:eT deficiencies ware pQted dining #his:visit; Yoi� will ceeeiye Rio futtblw
ooires66fideuce: ahouti this visit: -:::...:::..:::..::...:::...::::..:: .
f -, &lc l�Er N� elf �/ f Te let / haS' t`t?'^Ir kwettck ea y &AYiaT �4Jr�i�S V4- /7ePd5 `
�7 � 5'P�y e�i - �—r'vhT ��Na ct8'�. -4•-i � I � � 60 ��S Qre� G't ��
ReviewerMspector Name F' = ^ Al-M�*`_
SP Y z'.!'A�..,..__�....a'sY.,L.s=__
Reviewer/Inspector Signature. 41 Date: 2

f-
Facility Number: Date ofinspection
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
0
r
28_
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
o
Ir
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
RNo
31 _
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
P<Na
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
[]No
3/23/99

'I.-
0 Division of Soil and Water Conservation ❑ Other Agency
t ,
�Division of Water Quality;;�777 EERIE -
A
10
Routine 0 Complaint 0 Follow-up cif DNVQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection
Facility Number O
Time of Inspection I q,V0 24 hr. (bh:mm)
© Registered Certified 13 Applied for Permit t ,Permitted 13 Not O erational Date Last Operated:.,-.,_,.-,-•-•- ..„ ._-•
..
Farah Name: ................................ . ��L?�Sra�'1........
!� �...----��--------�........................................ County:...........c..�........... .......................
Owner Name: ............. Grf.a.JP5.........,.......�........................... Phone No:..........f., ................
j,
Facility Contact:............./.. ------ Title: ........ Phone No: _. .
p n 1
Mailing Address:........... P..:.�f.........hG"' .C�r........F5- a ........................................ ........�/.��4�'t,�y......./V ............................ 0��3
10
Onsite Representative / Irate Integrator: ................ `-5 S C,
p ....L.-... 1.4-..1................................ g n .--..11.."'"._... .......2;< .
Certified Operator..............c r G J �.-- I[..4................................ Operator Certification Number ................................... ....
Location of Farm:
Latitude �• �' ��� Longitude �• ��
j;Design Current ;.£Design } Current
�<Capacity Population `:Poultry - xCapacaty>Population x�
xF ,.
❑ Wean to Feeder
,,-";
❑ Feeder to Finish
❑ Farrow to Wean
'?
❑ Farrow to Feeder
Farrow to Finish
qo
1Q0 o
❑ Gilts
❑ Boars
❑ Layer
❑ Non -Layer
❑ OtherY
a•+�tal De5t0E
,
LLagoons 1 Holditig Ponds ❑ Subsurface Drains Present
�` ❑ No Liquid Waste Managemet
Genera
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field 90ther
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?
Design' Current
le w "'1 ':Capacity,- Populatton�'
Non-Dairy1
Mgc««� <
'e
apacty
mod
ASSLK
Lagoon Area
❑ Spray Field Area
5. Does any part of the waste management system (other than lagoonsmolding 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 0 No
Ayes ❑ No
❑ Yes XNo
❑ Yes )V No
NIA6W4jl,
P(Yes ❑ No
❑ Yes P(No
❑ Yes *No
f$Yes ❑ No
❑ Yes JWNo
❑ Yes ANo
Continued on back

Facility Number: 93 — YD
8. Are there lagoons or storage ponds on site which need to be properly closed'?
Structures (Lagoons,Ilolding Ponds, Flush fits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure ? Structure 3 Structure 4
El Yes N No
%Yes ❑ No
Structure 5 Structure 6
Identifier:
Freeboardft................................................................................................................................................................
I0. Is seepage observed from any of the structures? ❑ Yeti KNo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes A No
12. Do any of the structures need maintenance/improvement? XYes ❑ No
(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 ADDliCati0
❑ Yes XNo
14. Is there physical evidence of over application? ❑ Yes XNo
(If in excess of WMP, or runoff enteniny, wa rs of the State, notify DWQ)
15. Crop type ... ..............................
....�- ......... ............. .......s...........v-
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes No
18. Does the receiving crop need improvement? ❑ Yes No
19.
Is there a lack of available waste application equipment?
❑ Yes
No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
No
21.
Did Reviewer/[nspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
22.
Does record keeping need improvement?
Yes
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste :Management Plan readily available?
❑ Yes
�No
24.
Were any additional problems noted which cause noncompliance of the -Certified AWNIP?
❑ Yes
Ji No
25-
Were any additional problems noted which cause noncompliance of the Permit"
❑ Yes
9 No
0 No violation's or deficiencies.were-note'd during this.visit.- .You.will receive no further
correspondence about this. visit. -
Comments fExplain(reeany ]r ES =answers and/or ainv recomtnendatii,ons:or any, other comments #v
I):!" rawings of facility -6 better"explaimshu' ations:- {use add�itoual pages'as nece5s:iry}:'' Y=
Lr file-
bg
�a
-rile
two
AMV /Le 7/25/97 T
Reviewer/Inspector Name �r0
Reviewer/Inspector Signature: Date: ? — 99
L

Facility Number: --- Date of Inspection: --9
Additi6nal.ments and/bi.
r /
r /
� + J
4/30/97