780012_INSPECTIONS_20171231

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
780012 Facility Status:
Inpsection Type:
Compliance Inspection
Reason for visit:
Routine
Date of visit:
02115l2017 Entry Time: 03:00 pm
Farm Name:
Farm 5572
Owner:
Murphy -Brown LLC
Active
Permit: AWS780012
inactive Or Closed Date:
County: Robeson Region:
Exit Tlme: 4:00 pm Incident #
Owner Emall:
Phone:
0 Denied Access
Fayetteville
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 1129 McRimmon Rd Maxton NC 28364
Facility Status: ECompliant ❑ Not Compliant Integrator Murphy -Brown LLC
Location of Farm: Latitude: 34° 36' 00" Longitude: 79° 22' 41"
From Rowland take 501 North at Raemon and turn Lt. on SR 1131 and proceed 2 miles and turn Lt. at the junction on SR 1102 _
and proceed 1.3 miles and turn Lt. on the dirt road (SR 1129) and the farm is 1 mile on the Lt.
Question Areas:
Dischrge & Stream Impacts Waste Col, Slor, & Treat Waste Application
r
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: AWS780012 Owner - Facility: Murphy -Brown LLC Facility Number: 780012
Inspection Date: 02/15/17 Inpsecton Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish 12,595
Total Design Capacity: 12,595
Total SSLW: 1,700,325
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
1
19.00
4&00
Lagoon
7572
19.00
page: 2

Permit: AWS780012 Owner - Facility : Murphy -Brown LLC Facility Number. 780012
Inspection Date: 02/15/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream tmoacts
Yes
No Ma 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?
❑
❑ N
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
00
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, 5torane $ Treatment
Yos
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 (l.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
■ ❑
❑
8_ Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
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 A li n
YYyoNa Ng
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenanoe or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 100/o/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

L-1
Permit: AWS780012 Owner - Facility : Murphy -Brown LLC Facility Number. 780012
Inspection Date: 02/15/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hey)
Crop Type 2
Cotton
Crop Type 3
Soybeans
Crop Type 4
Small Grain Overseed
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro loamy sand, o to
2% slopes
Soil Type 2
Pocalla loamy sand, o to 3%
slopes
Soil Type 3
Wagram loamy sand, o to
6% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
M ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
M ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
❑
❑
18. is there a lack of properly operating waste application equipment?
❑
❑
❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ ❑ ❑
If yes, check the appropriate box below.
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?
❑
page: 4

A
Permit:
AWS780012
Owner - Facility :
Murphy -Brown LLC
Facility Number:
780012
Inspection Date:
02115/17
Inpsection Type:
Compliance Inspection
Reason for Visit:
Routine
Records and Documents
Yea No Na Ne
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and V Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
M ❑
❑
23, If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑M
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
M ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
❑
❑
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 file drains exist at the facility?
❑
M ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑M
❑
❑
CAWMP?
33, Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
.0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
■ ❑
❑
page: 5

• Division of Water Resources
❑
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 780012 Facility Status: Active Permit: AWS780012 ❑ Denied Access
inpsection Type: Compliance Inspection inactive Or Closed Date:
Reason for Visit: Routine County: Robeson
Date of visit: 03/11/2015 Entry Time: 02:30 pm Exit Time: 3:00 pm
72
Region: Fayetteville
Incident#
Faun Name: Farm 55 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 1129 McRimmon Rd Maxton NC 28364
Facility Status: ■ Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
910-296-1800
Location of Faun: Latitude: 34' 36' 00" Longitude: 79' 22' 41"
From Rowland take 501 North at Raemon and turn Lt. on SR 1131 and proceed 2 miles and turn Lt. at the junction on SR 1102
and proceed 1.3 miles and turn Lt. on the dirt road (SR 1129) and the fans is 1 mile on the U.
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 Inspectorls):
Inspection Summary:
page: 1

Permit: AWS780012 Owner - Facility : Murphy -Brown LLC Facility Number: 780012
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
FffSwine - Farrow to Finish 1,200
Total Design Capacity: 1,200
Total SSLW: 1.700,400
Waste Structures
Disignated Observed
Type identifier Closed Date Start Date Freeboard Freeboard
Lagoon
1
19.00
35.00
Lagoon
7572
19.00
page: 2

Permit: AWS780012 Owner - Facility : Murphy -Brown LLC Facility Number: 780012
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na Ne
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na No
4. Is storage capacity less than adequate?
❑
■ ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e.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?
❑
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
❑ ❑ ❑
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: AWS780012 Owner - Facility : Murphy -Brown LLC Facility Number: 780012
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
cotton
Crop Type 3
soybeans
Crop Type 4
small Grain Overseed
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro loamy sand, it to
2% slopes
Soil Type 2
Pocalla loamy sand, a to 3%
slopes
Soil Type 3
Wagram loamy sand, 0 to
6% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
E ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
E ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
■ ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
N ❑
❑
Records and Documents
Yes
No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
N ❑ ❑
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?
❑
page: 4

Permit: AWS780012 Owner - Facility : Murphy -Brawn LLC Facility Number: 780012
Inspection Date: 03/11/15 Inssection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na Ne
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
[]
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
O ❑
❑
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?
❑
0 ❑
❑
25, Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
E ❑
❑
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?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
E ❑
❑
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

■ Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
780012 Facility Status:
Active Permit: AWS780012
❑ Denied Access
Inppection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Robeson Region:
Fayetteville
Date of Visit:
0311912014 Entry Time: 02:30 pm
Exit Time: 3:00 pm Incident fl
Farm Name:
Farm 5572
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
1129 McRimmon Rd
Maxton NC 28384
Facility Status:
0 Compliant ❑ Not Compliant
integrator. Murphy -Brown LLC
Location of Faun: Latitude: 34° 30 00" Longitude: 79° 22' 41"
From Rowland take 501 North at Raemon and turn Lt. on SR 1131 and proceed 2 miles and turn Lt. at the junction on SR 1102
and proceed 1.3 miles and turn Lt. on the dirt road (SR 1129) and the farm is 1 mile on the Ll,
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): 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 313114.
Site visit 3/19114.
page: 1

Permit: AWS780012 Owner - Facility : Murphy -Brawn LLC Facility Number: 780012
Inspection Date: 03/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine -Farrow to Finish
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00
Lagoon 7572 19.00
page: 2

Permit: AWS780012 Owner - Facility : Murphy -Brown LLC Facility Number: 780012
Inspection Date: 03/19/14 Inppection 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?
❑
❑
❑
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)
❑
110
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
■ ❑
❑
State other than from a discharge?
Waste Collection, Storage &_Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not property addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
■ ❑
❑
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 altematives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN a 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: AWS780012
Owner - Facility : Murphy -Brown LLC Facility Number: 780012
Inspection Date: 03/19/14
Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Overseed
Crop Type 3
Cotton
Crop Type 4
Soybeans
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro
Soil Type 2
Pocalla
Soil Type 3
Wagram
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
E ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
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?
❑
❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
■ ❑
❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS780012 Owner - Facility : Murphy -Brown LLC Facility Number: 780012
Inspection Date: 03/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na Ne
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDFS only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25, Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous toss assessment (PLAT) certification?
❑
E ❑
❑
Rifler Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30, Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
E ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
CAWMP?
33. Did the Reviewer/lnspector 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

t ' i
Division of Water Resources
El Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 780012 Facility Status: Active Permit: AWS780012
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Robeson }legion:
Date of Visit: 02/26/2013 Entry Time: 12:30 pm Exit Time: I= pm Incident #
Farm Name: Farm 5572 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 1129 McRimmon Rd Maxton NC 28364
Facility Status: ■ Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
❑ Denied Access
Fayetteville
910-296-1800
Location of Farm: Latitude: 34' 36' 00" Longitude: 79° 22' 41"
From Rowland take 501 North at Raemon and turn Lt. on SR 1131 and proceed 2 miles and turn Lt. at the junction on SR 1102
and proceed 1.3 miles and turn Lt. on the dirt road (SR 1129) and the farm is 1 mile on the Lt,
Question Areas:
Dischrge 8 Stream Impacts Waste Col, Stor, R Treat Waste Application
Records and Documents Other Issues
Certified Operator: Eric L Ferrell Operator Certification Number: 17534
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 Inspoctor(s):
Inspection Summary:
Records reviewed 218113
Site visit 2126/13
page: 1

y
Permit: AWS780012 Owner - Facility : Murphy -Brown LLC Facility Number: 780012
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
F#_ Swine - Farrow to Finish 1,200
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00
Lagoon 7572 19.00
page: 2

Permit: AWS780012 Owner - Facility : Murphy -Brown LLC Facility Number: 780012
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ ■
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 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 No No
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
■ ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste Aeplication
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ e ❑ ❑
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

f
Permit: AWS780012 Owner - Facility : Murphy -Brown LLC Facility Number: 780012
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Applicaillon
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Overseed
Crop Type 3
Cotton
Crop Type 4
Soybeans
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro
Soil Type 2
Pocalla
Soil Type 3
Wagram
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop andlor land application site need improvement?
❑ 0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑
❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ N ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ E ❑
❑
If yes, check the appropriate box below
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21, Does record keeping need improvement?
❑ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

4 .
Permit: AWS780012 Owner - Facility : Murphy -Brown LLC Facility Number: 780012
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
M ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
■ ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
ED
❑
If yes, check the appropriate box below.
Application Field ❑
Lagoon / Storage Pond ❑
Other ❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ 0 ❑ ❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with on -site representative? ❑ M ❑ ❑
34. Does the facility require a follow-up visit by same agency? ❑ M ❑ ❑
page: 5

i ype of visit: p t_:ompuance inspection l.J uperatnon Iceview V atructure r vaivanon u i ecnnicai Assistance
Reason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: j2;3o Departure Time: bl ,pp County: pry
Farm Name: 5S1 D—I L. I Cj 13 � Owner Email:
Owner Name: t,�{��(QCi� _ _ _ Phone:
Mailing Address:
Physical Address:
Facility Contact: M ty ( J Title:
Onsite Representative: k t 1
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Region:
Phone: ,�
Integrator: 1 ' ! u IU KA ND (tl n
Certification Number:
Certification Number: Y7 b3q
Longitude:
`Des
'gn C.urrent
Swine Capacity Pap.
Design�Current.
Wet Poultry Capactty�= Pop
„ Design Current
Cattle Capacity Pop_
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Farrow to Wean
11 4—_ Dairy Heifer
Design Current D Cow
1D . l;ouIt . Ca aci I;o Non -Dairy
Layers Beef Stocker
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Turkeys
Turkey Poults
Other I JMr-Tother
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 D WQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes ❑ No 0 NA ❑ NE
❑ Yes ❑ No [a NA ❑ NE
❑ Yes 0 No
❑ Yes P3 No
❑ Yes IR No
P NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

FaTility Number: q K - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No � NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ——
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 7cp ►/
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [10 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 Pg 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
P No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
V No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
P No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 10No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13, Soil Type(s):
14. Do the receiving crops 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?
[:]Yes
[� No
❑ NA
❑ Yes
No
❑ NA
❑ Yes
No
❑ NA
❑ Yes
No
❑ NA
❑ Yes P No ❑ NA
❑NE
❑ NE
❑NE
El NE
❑NE
❑NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ?g No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 53 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 P2 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes t9No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ONE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Fatifi Number: "l 8 - 1 Z., 1 Date of Ins eetion: ;- -D(�
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes M No [:]NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes E3 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 VPNA ❑ 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?
[:]Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
{� No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes M No
❑ Yes [ No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA FINE
Reviewer/inspector Signature: Date: %C/ A 3
Tr
Page 3 of 3 21412011

iype of visit: ! t_;ompuance inspection v operation xeview lV structure Lvatuanon V iecnnicai Assistance I
Reason for Visit: 0 Routine O Complaint (:) Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: Arrival Time: 1 J21 i Departure Time: p County: - pAio- j Region: P2-0
Farm Name: 557 2-1 (�i d7 ) Owner Email:
Owner Name: 4'V1 af—, Phone:
Mailing Address:
Physical Address:
Facility Contact: ! r r+f Title: Phone:
Onsite Renresentative: #� Integrator: /
Certified Operator: �" j wi}� q�4
Certification Number: oi.5(P
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design Current: .___ ;_
- =
Deslgn Current
Swine Ca acity Po . p _ p
Wet Poultry Capacity POP.
Cattle
Capacity Pop.
Wean to Finish
La ers
Nan -La ers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑Structure ❑Application Field ❑Other:
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 � No ❑ NA ❑ NE
❑ Yes [3 No
[:]Yes [3 No
[� NA ❑ NE
® NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑Yes ❑ No [� NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑Yes � No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑Yes 'V No ❑ NA ❑ NE
of the State other than from a discharge'?
Page I of 3 1/4/2011 Continued

Facility Number: 71& 1Date of Inspection: 3I7(� I i
1Waste C611ection & 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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Desi ed Freeboard (in) -
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
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
n Outside of Acceptable Crop Window n Evidence of Wind Drift n Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Q9 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records &_ Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes]
LP 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 C� No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [] Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes $ No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes rft No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: Date of Inspection:
24. Did tht facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No PPA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[PNo ❑ 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
0 No ❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No ❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No ❑ NA
❑ NE
(referComments r comments:'
tional recommendations or any otQs
P="
Use. drawinas
of facility o better egplain situations (useaaitionall pages necessary).
Owl�y
3 7
5�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 60
Date:
21412011

79)- G), 60v -
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 1f�} r�Arrival Time: Departure Time: �; County: _ [ 20 Region: A(`
Farm Name: �S I at �l 7679Owner Email:
Owner Name: U• /} Phone:
Mailing Address:
Physical Address:
/�j `'
Facility Contact: / " �/ i � _ _ Title: Phone No:
Onsite Representative. �1 Integrator:
Certified Operator: >"iV?7w '^ :L-4 _ ,Operator Certification Number: zb.-Iu
Sack -up Operator:
Sack -up Certification Number:
Location of Farm: Latitude: = 0 0 6 = Longitude: = ° = t = "
1 9
Dese� n CurreaE
g
., '`
D Gurrent�„ Design Current
ME
5wme Capacity Populatioif
Wet Poultry Capacity
❑ La er
Populahon�Cattle . Capacity Population
❑ DairyCow
❑ Wean to Finish
❑ Wean to Feeder
❑Non -La er
Dryl?oultry
"" `'
❑ DairyCalf
❑Dai Heifer
`.
° ❑ D Cow
5
❑ Feeder to Finishrz
❑ Farrow to Wean
❑ Farrow to Feeder
❑ La ers
Non -Dairy
2�
Farrow to Finish
avers
❑ Pullets
❑ Turkeys
El Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
-
❑ Gilts
❑ Boars
. ; .
-
❑ Other
El Turkey Points
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Pallo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[ONA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
ONA
❑ 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
[P No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Wo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

I
.+
Facility Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 1�No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: f
❑ NA ❑ NE
P NA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 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 ®1No ❑ 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 ONo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [ No El NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) i
4. Does any part of the waste management system other than the waste structures require ❑ Yes P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10- Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ONo ❑ 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 ibs ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of
Acceptable Crop Window El Evidence of/Wind
� Drift
'��,,❑� Application Outside of Area
12. Crop types) G ( l�/�1'�W2q `F[u.�7lr _—Sad. 7s� a� 6eaal i
13. Soil type(s) G0144tyV } Pocs 0 I w*4r?,1"
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
M No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
Eallo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
( tterex stn situations. uses as o>aal aoentlateons orComments reMMU uesuony; �Ea larn an Vil auswersr4nd/or an r ' P ( p g ry} asTnecessa :� --
IMMI-424"imm
e cc is re- i pu}Q� 42-e t f-
i
clr ie �i5,�+ Cffi L`le�e li-Vt(AI ,
Reviewerllnspector Name _ Phone: r733'3
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

i
Facility Number: Date of InspectionTlr 1
Re uired 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 No ❑ NA ❑ NE
the appropiiate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers !❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
99 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
f
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[0 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
1711 No
❑ NA
[I 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
[I NA
El NE
If yes, contact a regional Air Quality representative immediately
_ +
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
i 9 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
93 No
❑ NA
❑ NE
33,
Does facility require a follow-up visit by same agency?
❑ Yes
0 No
❑ NA
❑ NE
AdditionahCommed`ts and/or Drawings IV
H
Page 3 of 3 112128104

-78 M. ©lz
Type of Visit Compliance Inspection 'Q Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: ! % o° k+'^ Departure Time: County: 9 6,e-&0A1
Farm Name: .� S 7 . / (ad id-1 757 Z ) Owner Email:
Owner Name: —A4 -B" t�.1 Aj , 4-LC Phone:
Mailing Address:
Physical Address:
Region: 10-:1e0
Facility Contact: M r te Cad Title: L NAf MQN�S-� Phone No:
Onsite Representative: Integrator: Af —.9ko- JA_1
Certified Operator: NQY° 1d F_' Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = = [� u Longitude: =1 o =, 0 u
Design Current
Design Current
Design
Current
SR�ne Capacity Population
Wet Poultry Capacity Population
Cattle Capacity
Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
❑ Wean to Feeder
❑ Non -La er
I
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
IESFarrow to Finish /Z O D
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
Other
❑
❑ Turkey Points
❑ Other
Nunn er of Structures:
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [A No ❑ NA ❑ NE
❑ Yes
❑ No
® NA
❑ NE
❑ Yes
❑ No
91 NA
❑ NE
[9NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
O No
❑ NA
❑ NE
Page 1 of 3
12128104 Continued

Facility Number: 78 —e> Z
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�5'7Z —/
❑ Yes No
❑ Yes No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[8 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
[RNo
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
$9 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[YNo
❑ 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
OlNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
V) No
❑ NA
❑ NE
maintenance/improvement?
11: Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes El'No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) T_Ze� lc �j-Fa,� i Sw.a i ! 6 ro N �O. S • / Say %NS , Cod N
13. Soil type(s) GoldS lbowo a k-gA..,
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes P1 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes R No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes & No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes ONo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 2 No ❑ NA ❑ NE
�Cnmments (refer to questton #) ti.xplain any YES answe'rs and/or any re�ommendabons or any other commea
Ilse drav►ings�of facility to better explam::situatiohs. (use additional pages Ns. necessar7. y):
r
�---
Reviewerllnspector Name c
--- - 9,10, P33,33o0
Wit/ S Phone:
y w
Reviewer/Inspector Signature:
Date: —D — ZOio
Page 2 of 3 I2/28/04 Continued

_ , , M
Facility Number: 78 —d/Z Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ff No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes EfNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n' El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes r® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
®'No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ff No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Ej No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
E'No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
R No
❑ NA
❑ NE
Otherlssues
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
0 Yes
&No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
X
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
ONo
❑ 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
Flo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
QVI No
❑ NA
❑ NE
Additeonal Coinmenfs 2d/or,�Drawings
Page 3 of 3 12128104

Type of Visit
0 Compliance Inspection O Operation Review
O Structure Evaluation
Q Technical Assistance
Reason for Visit Routine Q Complaint O Follow up O Referral O Emergency
Q Other ❑ Denied Access
DO of isi :
Time:Departure Time: 11County:
Region: 1—T
�
F�r �Me :
Owner Name:
r
Owner Email:
Phone:
* ' ` I' '� ►'�� u
Mailing Address:
Physical Address:
Facility Contact: t+� Title:
y
Onsite Representative: f ��
Certified Operator:
Back-up Operator:
Phone No: tic
Integrator:
Operator Certification Numher:
Back-up Certification Number: f
Location of Farm: Latitude: = o= d = Longitude: 0 0 [� a 0 6i
Design Current
~ De"sign, , C•urrent
Design C•arrent
Swine Capacity Population
Wet Poultry _`Capacity Popnlation
Cattle
Capacity Population
❑ Wean to Finish
❑ La er
❑ Dai Cow
❑ Wean to Feeder
❑Non -La er
❑ DairyCalf
❑ Feeder to Finish
❑ DairyHeifer
❑ Farrow to Wean
Dry�Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
Farrow to Finish
❑ Layers
El Beef Stocker
Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
:r; —
❑Turke s
Other
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures: ED
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
❑ No
❑ NA
❑ NE
other than from a discharge?
Page 7 of 3
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less a equate?
❑ Yes
19 No
[I NA
❑ NE
a. If yes, is waste level into the structural freeboard?
[-IYes/❑
No
_ANA
❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure
5
Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 08
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
MNo
❑ 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 1P No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ` No El ❑ 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 M No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes Q No ❑ NA ❑ NE
1 1 _ Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes F%No
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [--IPAN > 10% or ] 0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soi:
❑ Outside c
12_ Crop type(s)
13. Soil type(s)
❑ NA ❑ NE
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
IfNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
ElNA
ElNE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
ElYes
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
No
❑ NA
❑ NE
Comments (refer.to question #): Explain any YE&answers and/or any recommendations orb anyxother com[nepts
:...,. n
'Use drawings of facility to better explain situatious;_ (use additional pages as necessary) =,
Reviewer/Inspector Name
I Phone:
Reviewer/inspector Signature:
Page 2 of 3
Date:
5

M S
Facility Number: Date of Inspection 7/.:2-/0?
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit rea ily available? ❑ Yes �INo ElNA ElNE
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 El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
P No
b NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
A
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
tNA
❑ 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
�io
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No [PNA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ANo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes No ElNA [INE
and report the mortality rates that were higher than normal? IP
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes INNo ❑ 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 ElNA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 19 No ❑ NA ❑ NE
Page 3 of 3 12128104

a
— � Division of Water Quality
=Facility Number 1 Q Division of Soil and Water Conservation
i —�-- 0 Other Agency
IType of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Q=,00 Departure Time: //f " County:
Farm Name:
(lwnPr Email!
Owner Name- h Phone:
Mailing Address:
Physical Address:
Facility Contact: rvtr 7�1 r�r.Tr�+,,S Title:
c+
Onsite Representative:
Certified Operator:
Back-up Operator:
Region:
Phone No:
Integrator: _ LV'Q!::1 gevw h
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o =, = Longitude: = c = I = u
Design
Current Design Current
Design
Current
°
Capacity
Population'_ Wet Poultry Capacity Population
Cattle Capacity
Population
an to Finish
❑ LaTer
❑Dai Cow
an to Feeder
rFOFarrow
❑ Non -La er
❑Dai Calf
der to Finish"~
"'
❑ Dai Heifer
;; to Wean
y°1�
❑ Drx Cow
❑ Farrow to Feeder
�D!
❑ Non
-Dairy
00 Farrow to Finish
JA00 ElLayers
ElBeef
Stocker
El Gilts
❑Non -Layers
❑ Beef Feeder
❑ Boars
=';7 El Pullets
❑ Beef Brood Co
...... ❑Turke s
O.
-y
❑ Turkey Pouets
❑ Other
KK` ❑ Other
re mbar of Structus:
.�.,�..;
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
ANo
ElNA
❑ NE
Discharge originated at: ElStructure ElApplication Field ElOther
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
Ep 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
ONA
❑ 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
❑ Yes
two
No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

i
Facility Number: a
0 -7 M
Date of Inspection
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 P
NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
e!
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes X No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes XNo ❑ 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 54 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El NA El NE
maintenance or improvement? ❑ Yes No
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ElNA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes PNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift% ❑ Application Outside of Area
f1 ' 12. Crop type(s) �e r (�da (Y 1 5*" - (;"'D W5.j
13. Soil type(s) P
vC
4 O[x$
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 P No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 1P No ❑ NA ❑ NE
C�omm nts (refer�to questtotis#)'° Eaplaut aay YES answers and/or any recommendations orany other comments.
�U es d� aw�,ua�rgs�of�fac�ity to befterjeaplam sii�tahoas. (use dd�ott na! pagesti„as necessary}
Reviewer/inspector Name r Phone: (TO 153`33M
Reviewer/Inspector Signature: Date: 4
Page 2 of 3 12128104 / 7 Continued

Facility Number: — a, Date of Inspection
Required Records & Documents 17
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 [P No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes [pa No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [:]Annual Certification
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and I" gain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
F No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[N No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[TNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
q5No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
[I NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
F] No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CA W M P?
❑ Yes
No
❑ 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
9No
❑ 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
JONo
❑ 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
JP No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
IRNo
❑ NA
❑ NE
Page 3 of 3 12178104

Facility Number
Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ORoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: I M00 � Departure Time: (3 '�D County:
Farm mr-m fla� _.. Owner Email:
Owner Name: + " 4p Phone: _
Mailing Address:
Physical Address:
Facility Contact:Title: Phone No:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Integrator• 1 - t�✓O�
Operator Certification Number:
Back-up Certification Number:
Region: F-40
Latitude: = o = 6 = « Longitude: = o = I = "
Design Current Design Current Design r
Swine Capaeity Population' : " ` Wet Poultry Capacity Population Cattle Capacii,a' f
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish (9- 0loop-
El
Gilts
❑ Boars
Other
❑ Other
❑ La er
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream impacts
. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
i7
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
m
❑ Yes R No ❑ NA ❑ NE
❑ Yes
❑ No
19 NA
❑ NE
❑ Yes
❑ No
59 NA
❑ NE
RNA
❑ NE
❑ Yes
❑ No
❑ Yes
ERNo
❑ NA
❑ NE
❑ Yes
[&No
❑ NA
❑ NE
12128104 Continued

FacilityNumber: "7 — (a-
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
t� 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:2� {
Spillway?:
Designed Freeboard (in):
�l
Observed Freeboard (in): 37
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
1P 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
U9No
[I 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
FNo
El NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
V].No
❑ NA [:3 NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
MNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
P No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
F] No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN [--IPAN > 10% or ] 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Appli�c(ation Outside of
Area
12. Crop type(s) I:A'A�/r�m �{�d �, I Pkal I �t2 �r1 6) it `0� r�
_
13. Soil type(s) PoL.._ W ct e>
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
q 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
KI 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
0 No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments
Use drawings of facility to better explain situations. (use additional pages as necessary.)::
Reviewerllnspector Name j i Phone: 3
D
Reviewer/Inspector Signature: MA jhdja Date:
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists []Design ❑Maps 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 [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
® No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
[:1 Yes
ff] No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[!W No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EP No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[N No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[�) No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33_
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or. Drawings:
Page 3 of 3 12128104

® Division of Water Quality
Facility Number Z O Division of Soil and Water Conservation
- �-- 0 Other Agency ✓
Type of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: ;QO Departure Time: %; County: 06CSdN Region: F%Z0
Farm Name: # SS7Z/ 1'Old Ca"11_'S '"'757Z Owner Email:
Owner Name: �' r(�-Or" ., _- pYDWAI Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: /Yt'r 1L ANdUhAtS
Certified Operator:
Back-up Operator:
Title:
Phone No:
Integrator
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = 0 0 L 0is Longitude: = o = 6 0 1f
Swine
❑ Wean to Finish
❑ Wean to Feeder
Design Current
Capacity Popes on
Wet Poultry
❑ I a er
on -Layer
Design
Capacity
Design Current
C*urrentMeg
Population Cattapacity Population
❑Dai Cow
❑Dai Calf
❑Dai Heifer
❑ Feeder to Finish
❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
Farrow to Finish
1200
❑ La ers
❑ Beef Stocker
on -Layers
❑ Beef Feeder
F[IE]Gilts
Boars
❑ Pullets
❑ Beef Brood Co
R �
❑ Turkeys
Other
���.�
❑Turke Poults
Number of Structures:
i L
❑ Other ❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'?
❑ Yes
0 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
j?No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
R 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
g No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[50 No
❑ NA
❑ NE
3- Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
PNo
❑ NA
❑ NE
other than from a discharge'?
Page I of 3
12128104
Continued

Facility Number: 7— / 2-1 Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[]Yes
[%No
❑ NA
❑ NE
a If yes, is waste level into the structural freeboard?
❑ Yes
E)?No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
•i
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[KNo
❑ 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
[jNo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[O 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
TNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
JNo
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [ VNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) � - L/ 6AUeirS�G�ot!
13. Soil type(s) Poca L L/�,
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 191 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
1PNo El NA ❑NE
C No ❑ NA ❑ NE
[NNo ❑ NA ❑ NE
[O No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any,other epind is '
x
`Use drawings 617facility to better explain situations: (use'hdditional pages .as necessary):
Reviewer/inspector Name I 1<1 Gat�<..[- j Phone(9/w�.3.3 —3347D
Reviewer/inspector Signature: Date: 6 —13 —Z-004
Page 2 of 3 12128104 Continued

'4
Facility Number: 7 -j Z Date of Inspection / -O
i
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [YNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes P No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [O 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
[P No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'?
❑ Yes
�8 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[� No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Wo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Q�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
r
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
UNo
❑ 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
[$j No
❑ NA
❑ NE
Additional Comuieats'andlor Drawings
Page 3 of 3 12128104

® Division of Water Qaality '
acility Number $ �_ (-�II�IIMIIII -Z O Division of Soil and Water Ca�nservation
ll!
Q Otber 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: Arrival Time: Departure Time: County: Rt) 69,4jj &Z Region: F-k-0
FarmName: ,. # 5_S % Z 1 �O 1d Ceayu i Is it 7 S7 -. ) Owner Email:
Owner Name:
Mailing Address:
Phvsical Address:
Phone:
Facility Contact: em , 1 V Title: ,�/ Phone No: n
Onsite Representative: .1 e.y-w � V-- e- Y /N Integrator: 46e x t. O 601JAZ
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Back-up Certification Number:
Latitude: = e = f = Longitude: = o = I =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
1 1❑ Layer
E] Non-Layet - - -
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
urkey Poults
❑ Other
Disebarges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
Design Current'
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dix 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? (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 ofthe State
other than from a discharge?
L\
❑ Yes C2 No ❑ NA ❑ NE
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
19 No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[9 No
❑ Yes
®No
❑ NA
❑ NE
❑ Yes
�Z No
❑ NA
❑ NE
12128104 Continued

J t
Facility Number: _7 -- + Z Date of Inspection 2a-
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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: _
Designed Freeboard (in):
Observed Freeboard (in): _ 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
fRNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[X 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
[A No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
�K 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
jNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
RNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
19 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift❑ Application Outside of
Area
12. Crop type(s) E CrlZt _ 41- ) _ SMC116K-1/
in1 C. uey t-C`
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E9 No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[A No
❑ 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
N No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
0 No
❑ NA ❑ NE
Reviewer/Inspector NameZ� F Phone: 9�171 7ti /5 ly/
Reviewer/Inspector Signature: Date: f4-2O - 2dOS
12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [V No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes M No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes (A No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that Were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
19 No
❑ NA
❑ NE
❑ Yes
1W No
❑ NA
❑ NE
❑ Yes
U No
❑ NA
❑ NE
❑ Yes
IN No
❑ NA
❑ NE
❑ Yes
00 No
❑ NA
❑ NE ,
❑Yes
®No
El NA
El NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ®,No ❑ NA ❑ NE
❑ Yes
ERNo
❑ NA
❑ NE
❑ Yes
Callo
❑ NA
❑ NE
El Yes
®No
El NA
❑NE
❑ Yes
® No
❑ NA
❑ NE
i1d`dit una!'Commeats and/or'Drawings ' "41
q
<
12129104

IM
FI
-----ivision of Waeracility Number $ I Z� Division of So- and Water Conservation L
� Other Agency
Type of Visit 410 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint ® Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 5 2 IO Arrival Time: Departure Time: 3 : 00 County: t2o 6eso.1 Region:
Farm Name: -1S'9 2 Owner Email:
FRO
Owner Name: G a rra tl FOOct S. _ .7yl C.. Phone: 910 - 24 3 - 35 31
Mailing Address: V70 9ex - 1 Qose_ 14 i it � G ZBYS>R
Physical Address: _ -489 (sR 1l2,11)
Facility Contact: 3err'V Try +*Y-r Title: .P,thone No: 710-276- ` 6,
Onsite Representative: 4�er �.l�ti.� � .�srr,t 7" r.er- Integrator: N�ys-Q�`� � &_O c6t
Certified Operator: �A.CO1d +Gl 1r-�� Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: CEO E ` Longitude: ®° ZZ
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Layer I
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
® Farrow to Finish 1 ZOO
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Discharp,es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: �s
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 J9 No ❑ NA ❑ NE
❑ Yes
❑ No
M NA
❑ NE
❑ Yes
❑ No
N NA
❑ NE
®NA.
El NE
El Yes
❑No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
IR No
❑ NA
❑ NE
12128104 Continued

1
Facility Number: 4 8— Date of Inspection S Z6 0
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: l
Spillway?: no
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
RNo ❑ 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?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
❑ No ❑ NA [K 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 Drifi ❑ Application Outside of Area
12. Crop type(s)
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
® NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
® NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination': ❑ Yes
❑ No
❑ NA
® NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
® NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
[9NE
jA6
-b J i SGt)Ss work vr, d is e-
4 F
�i e3 atao
SerV 1 GQ rva d
Tvel cA.-ec" it-9- 'I•,+ei�Nr A-y Of'it,,P
` o�..�, �; ; ,rq 0--k�
_&c " 't"� w a f>+e-w o-A-.� " ..
was
s�,e r. by t w Q d u c-IV4
4
b Q.e,&.
Reviewer/Inspector Name, A _ g�r� H e � ,,, .; Phone: 910 - Y �, - ! _All
Reviewer/Inspector
Signature:
Date: SVZb(O S
12128104 Continued

. Facility Number: :4 a — tZ Date of Inspection S Z4 0
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 El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ® NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
[3NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'?
❑ Yes
❑ No
❑ NA
0 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
ONE
26_
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
© NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
10 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
[9NE
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
09 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
ANo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
Additional:Cammenisaud/or:Draviings: f:' t �A
r a 5 ;13 va l ,,sa f-4-4-w4r -C� c ea,r. w+- ti-e 4 ; ►,,.e L-L_- 01 -fi-t Y
bC"t,+ ,, -, a,.. �t-C-ssa-c- / P) V `,s — G(.aa•� opt'
a«vw.0 ta4-Cad 5d as . .Sola4r-
e •„� �; .-� .tip �1�s b s.�� „�. �#.1 -� d
_Mq. ]D Prw, was 061.. tL j i r. r� S P d +'� Se 4o ar+�
`3
0. c l CP%AQ 0,( - -e S e, ee l '{ .� r ears cL 0.
QjV" 114 V, l S '1 vl 0--K ` j , �° . ~n'L co— S'CZ v C+" bti
wa-rS- wN,,,j - [�-�c P S ac4,- .� -r--� Y%,ax- f +,a, -,, -irt�rea v-oA� s .
12128104

Type of Visit Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit ® Routine 0 Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: D� Time:10
Z
Not Operational Q Below Threshold
Permitted ® Certified [3 Conditionally Certified © Registered Date Last Operated or
Above Threshold:
Farm Name: /`-r9a.ei4� 75�� County: Fd �tsd.J
,sly-/d� Owner Name: _ 1++� �. -t ��/C r Phone No:
Mailing Address:
le
Facility Contact: Title:
Onsite Representative: kx �.�if
Certified Operator: A4gg 1
Location of Farm:
Phone No:
ell
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' �• 0" Longitude 0
_ r
❑ Wean to Feeder
El Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Cogent =� _ Design
T
;.Ca acitr--= Po ulatwa e : Pouttn -Ca apYti
:"f: ❑ Layer -
❑ Non -Laver
Current Desrgo �w Cnrr_ent
:;Po notion - ;Caine Ca spur. `Po ulatmn V
❑ Dairy
[] Non-Dairy R
_
' ❑ Other
Farrow to Finish
1A40d
Tt>ftal Design CapaCxh'
❑ Gilts
❑Boars
- Total-SSiW.
_ Number of Lagoons :Q ❑ Subsurface Drains Present ❑ Lagoon Area ❑ S rav Field Area
-Al ldtag-Poads'I Sold Traps , 7 ❑ No Liquid Waste Management Svstem
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 by a lagoon system? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes No
❑ Yes KfNo
❑ Yes X-No
❑ Yes ONo
❑ Yes PRt1Vo
❑ Yes )KNo
❑ Yes A No
Structure 6
Identifier:
Freeboard (inches):
05103101 Continued

Facility Number: ]? — /Z
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ YeS WNo
❑ Yes .K No
❑ Yes KNo
❑ Yes Wo
❑ Yes )XNo
Waste Application
10- Are there any buffers that need maintenance/improvement? ❑ Yes C& No
11. is there evidence of over application? / ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes 14 No
12. Crop type-
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes IgNo
b) Does the facility need a wettable acre determination? ❑ Yes JRNo
c) This facility is pended for a wettable acre determination? ❑ Yes A No
15. Does the receiving crop need improvement? ❑ Yes 9 No
16. Is there a lack of adequate waste application equipment? ❑ Yes $7No
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?
(ie/ WUP checklists, design, maw etc.) L/ ./
❑ Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
El No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
KNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
)KNo
(iel discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comtueats (refer to questiou #) Eiiplain any..YIESa� swersandlor_any reeo�umendatiaas ar auv other comments:
Use drawings of facdity to better e=Pisizt sttoatic; s -( a addiiianni pages as ae ry) ❑ Field Copv ❑ Final Notes -
�,,t �o �
/����//���o� Ga�''Srl�%�' �ifl�ifGt���lv��� r�"'� �,t,t1��7.✓
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: Z
05103101 - Continued

Facility lumber: — 2 Date of Inspection /� d
Odor Issues
26, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below `es El No
liquid level of lagoon or storage pond With no agitation? " ��
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes %No
28. is there any evidence of wind drift during land application? (i.e_ residue on neighboring vegetation, asphalt, ❑ Yes XNo
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 PKNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters. etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Yes ❑ No
05103101

11
[late of Visit: Tirnt: E= Printed on: 7/21/2000
Facility Number
I=iot Operational Q Below Threshold
© Permitted ❑ Certified (3 Conditionally Certified ❑ Registered Date Last Operated r Above Threshold: .......................•
Farm Name. ! 57 ?i ........... County:......ry..................................
Owner Name: r?"7JI/ S / r�.6G�! f} -C Phone No:
........ ........................r.............................................................
//��i
Facility Contact: t'�...QkL' j...... Title:.. .Phone No :............................................_...•
.......
!Mailing Address:
Onsite Representative: ........................ ................................................................ -­ Integrator:............................................
Certified Operator:..... 4 -� .. _ a.. ............................ Operator Certification Number:
Location 'of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 6 66 Longitude • 6 fit
.• =r gii Current
"'..�� - -, . _ .-.----..-_ -•� fians�rifv - Poanlafin
Wean to Feeder
Feeder to Finish
Faaow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Design Cnrrent Design Ctun
Poidtry Ca ci Popnlation Cattle Ca Piipyd
❑ Layer ❑ Dairy
❑ Non -Layer ❑Non -Dairy
Other -
Total -Design"Cbpacity.-` 2
Total kW.
Discharges & Stream Impacts
l . Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach Water of the State? (if yes, notify DWQ)
c. li'discharge is observed. what is the estirnated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: .................................................................... ............. I....
Freeboard (inches): !!i `�3 �e ,K grans zj GK,r Sf
5100 II
❑ Yes XNo
❑ Yes 010
❑ Yes [ No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes P(No
Structure 6
Continued on back

�i
Facility Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (fireeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
----......._................................................
Freeboard (inches): t�[� !�r'S�.....................................................................
......................................... ............ -
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes P(No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes *0
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ANo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes KNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes �No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes E -No
12. Crop type ��Dr-.,�fr. Sit,, l:
13.
Do the receiving crops differ with dose designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
VNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
0(1No
b) Does the facility need a wettable acre determination?
❑ Yes
)6o
c) This facility is pended for a wettable acre determination?
❑ Yes
ONO
15.
Does the receiving crop need improvement?
( f Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
99(No
17.
Are rock outcrops present?
❑ Yes
R(No
18.
Is there a water supply well within 250 feet of the sprayfield boundary? ❑ Unknown
❑ Yes
P!�A10
❑ On -site ❑ Off -site
Required
Records & Documents
19.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
0 No
20.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
�(
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
) J No
\
21 _
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
o
22.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
23.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
o
24.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
ONO
(ie/ discharge, freeboard problems, over application)
25.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
26.
Does facility require a follow-up visit by same agency?
❑ Yes
#"No
27.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
0 No
Odor Issues
28.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
D&Mes
P(No
liquid level of lagoon or storage pond with no agitation?
29.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
*D10
01/01/01
Continued

Facility Number: ��_^ Date of Inspection Printed on: 1/4/2001
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes r
o
32. 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 o
33. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: J - 5D--a,
01/0I/01

z
jo Routine Q Complaint 0 Follow-up of DWQ ins ection Q Follow-up of DSWC review 0 Other
Facility Number ® Z Date of Inspection Time of InspectionFFM
24 hr. (hh:mm)
Permitted 0 Certified [3 Conditionally Certified ❑ Registered 113 Not Operational Date Last Operated:
Farm Name : ................ /................................._.........................._............... County- ...........�64e
.............. nn Jj ] ................ ....
Owner Name:.....-L s....... . �.. f.... ........... Phone No:.......... ..�.� .... _..............� . .
Facility Contact:....E?...... .. ............................. Title: .... Phone No: .................
MailingAddress: _... 6.....L��'`�.�........... � ...11�..t. .. ... .! v ................... �� ` [! ..... ............................. ..... ..........................
Int Onsite Representative:...........................�__..//..... .................. ...............................
�es' C! rator:... _.... �.............. .�
Certified Operator:..-.� , ►�+ . ,.] . �................ . C l'! .LrlS....................... Operator Certification Number:
Location of Farm:
Latitude Longitude •
De itgn Current _.
Di - _ , es gn urrent Cnrrea#
.`twine - Capacity'- Poii'lation Poultry Ca achy Po PWat,on CattEe
-- p . - . •,Capar�tp=Populattoo
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
Z 4-2)
❑ Gilts
❑ Boars
21 4z
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): .......��..
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes No
❑ Yes tNo
❑ Yes ' No
❑ Yes �1 No
❑ Yes No
❑ Yes PdNo
Structure 6
❑ Yes �,�To
Continued on ' back

Facility Number: 7 — Z Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
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
12. Crop type
❑ Yes �No
❑ Yes kNQ
❑ Yes No
❑ Yes ONO
❑ Yes ® No
❑ Yes gNo
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes )4 No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes WNo
b) Does the facility need a wettable acre determination? ❑ Yes �((No
c) This facility is pended for a wettable acre determination? ❑ Yes ONO
15. Does the receiving crop need improvement? ❑ Yes ONO
16. Is there'a lack of adequate waste application equipment?
Renuired Records & Documents
17.- Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20: Is facility not in compliance with any applicable setback criteria in effect at the time.of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes V_
❑ Yes 0 No
❑ Yes k3No
❑ Yes )qNo
❑ Yes No
❑ Yes a
❑ Yes ko
❑ Yes gNo
❑ Yes ,gNo
❑ Yes $N0

Facility Number: Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ 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 R(No
2$_ Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes AkNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes P(No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes MO
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No