780041_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Outer Agency
Faclitty Number: 780041 Facility Status: Active Permit. AWS78OD41
Inpsection Type. Compliance Inspection Inactive Or Closed Dale:
Reason for visit: Routine County. Robeson Region:
Date of visit: 02/13/2017 Entry Time: 08:00 am Exit Time: 9:00 am
Farm Name:
Farm 7690 & 7691
Owner.
Murphy -Brown LLC
Mailing Address:
PO Box 487
Physical Address:
1088 Ballance Farm Rd
Incident 0
Owner Email:
Phone:
Warsaw NC 28398
Saint Pauls NC 28384
❑ Denied Access
Fayetteville
910-296-1800
Facility Status: ■ Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34` 50' 09" Longitude: 78° 55' 05"
On the northeast side of SR 1906 approx. one mile north of its intersection with SR 1907, northeast of St. Pauls, NC.
Question Areas:
E Dischrge & Stream impacts M Waste Col, Slor, & Treat M Waste Application
M Records and Documents M Other Issues
Certified Operator:
James Brian McGugan
Operator Certification Number: 986752
Secondary OIC(s):
On -Site Representative(s):
Name
Title Phone
24 hour contact name
Mike Cudd
Phone
On -site representative
Mike Cudd
Phone
Primary Inspector.
Robert Marble
Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number: 780041
Inspection Date: 02/13/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Farrow to Wean 4,411
Total Design Capacity: 4,411
Total SSLW: 1,909,963
Waste Structures Observed
Disignated
Type identifier Closed Date Start Date Freeboard Freeboard
Lagoon
3121
19.50
Lagoon
3726
19.50
Lagoon
7690
27.00
Lagoon
7690-1
20.00
43.00
Lagoon
7691
19.50
Lagoon
7691-1
20.00
38.00
page: 2

Permit: AWS780041 Owner- Facility: Murphy -Brown LLC Facility Number: 780D41
Inspection Date: 02/13/17 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?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Water; of the State? (if yes, notify DWQ)
❑
❑
[]
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
01111
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Me
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 100/6/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number: 780041
Inspection Date: 02/13/17 Inssection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na N2
Crop Type 1
Coastal Bermuda Gress
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Norfolk loamy sand, 0 to 2%
slopes
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑0
❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
E ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
01111
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
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?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number. 780041
Inspection Date: 02/13/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na Ne
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(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?
❑
0 ❑
❑
Other issues
Yes
No Na Me
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?
❑
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 reviewfinspection with on -site representative?
❑0
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Division of Wafer Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 780041 Facility Status: Active Permit: AWS780041
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Robeson Region:
Date of Visit: 03/10/2015 Entry Time: 08:00 am Exit Time: 9:00 am Incident #
Farm Name: Farm 7690 & 7691 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 1088 Ballance Farm Rd Saint Pauls NC 28384
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34° 50' 09" Longitude: 78° 55' 05"
On the northeast side of SR 1906 approx. one mile north of its intersection with SR 1907, northeast of St. Pauls, NC.
Question Areas:
Dischrge & Stream Impacts
Records and Documents
Waste Col. Stor, & Treat Waste Application
Other Issues
❑ Denied Access
Fayetteville
910-296-1800
Certified Operator: James Brian McGugan Operator Certification Number: 986752
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone:
On -site representative Mike Cudd Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number: 780041
Inspection Date: 03/10/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
El Swine - Farrow to Wean 4,411
Total Design Capacity: 4,411
Total SSLW: 1,909,963
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
3121
19.50
Lagoon
3726
19.50
Lagoon
7690
27.00
Lagoon
7690-1
20.00
35.00
Lagoon
7691
19.50
Lagoon
7691-1
20.00
35.00
page: 2

Permit: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number: 780041
Inspection Date: 03/10/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yos
No Na No
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
11011
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?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection Storage & Treatment
Yes No Na Me
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 (Led large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
01111
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na NB
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number:
780041
Inspection Date: 03/10/15 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yes No No No
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Norfolk
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑
❑
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ 0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑
❑
Records and Documents
Yes
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
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: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number: 780041
Inspection Date: 03/10/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and V 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
❑
N ❑
❑
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?
❑
0 ❑
❑
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,
❑
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
❑
N ❑
❑
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

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 760041 Facility Status: Active Permit: AWS780041
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for visit: Routine County: Robeson Region:
Date of Visit: 03/18/2014 Entry Time: M30 pm Exit Time: 3:30 pm Incident #
Farm Name: Farm 7690 & 7691 Owner Email:
Owner: Murphy -Brown LLC Phone:
❑ Denied Access
Fayetteville
910-296-1600
Mailing Address: PO Sox 487 Warsaw NC 28398
Physical Address: 1088 Ballance Farm Rd Saint Pauls NC 28384
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34' 50' 09" Longitude: 78" 55' 05"
On the northeast side of SR 1906 approx. one mile north of its intersection with SR 1907, northeast of St. Pauls, NC.
Question Areas:
Dischrge & Stream Impacts
Records and Documents
Waste Cal, Stor, & Treat Waste Application
Otherissues
Certified Operator: Operator Certification Number:
Secondary OIC(s):
On -Site Representative(s):
24 hour contact name
On -site representative
Primary Inspector:
Inspector Signature:
Secondary Inspector(s)-
Inspection Summary:
Lagoon levels:
76901 = 35"
76911 = 30"
Records reviewed 2126/14.
Site visit 3/18114.
Name
Mike Cudd
Mike Cudd
Title
Phone :
Phone :
Phone
Robert Marble Phone:
Date:
page: 1

Permit: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number: 780041
Inspection pate: 03/18/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity
Current promotions
Swine
=,vine arrow to Wean
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
3121
19.50
Lagoon
3726
19.50
Lagoon
7690
27.00
Lagoon
7690-1
20.00
Lagoon
7691
19.50
Lagoon
7691-1
20.00
page: 2

Permit: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number: 780041
Inspection Date: 03/18/14 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?
❑
110
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■ ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
■ ❑
❑
State other than from a discharge?
Waste Collection Storage S Treatment
Yes No Na Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
E ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
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%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number: 780041
Inspection Date: 03/18/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Norfolk
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
E ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
M ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes No No Ne
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?
❑
M ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑E
❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS780041 Owner- Facility : Murphy -Brown LLC Facility Number: 780041
Inspection Date: 03/18/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22, Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■ ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
M ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
❑
❑
contact a regional Air Quality representative immediately.
30, Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
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
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
❑
0 ❑
❑
34, Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 780041 Facility Status: Active permit: AWS780041
❑ Denied Access
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for visit: Routine County: Robeson Region:
Fayetteville
Date of Visit: 02/26/2013 Entry Time: 09:00 am Exit Time: 9:30 am incident #
Farm Name: Farm 7690 & 7691 Owner Email:
Owner: Murphy -Brown LLC Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 1088 Ballance Farm Rd Saint Pauls NC 28384
Facility Status: Compliant ❑ Not Compliant Integrator Murphy -Brown LLC
Location of Farm: Latitude: 340 50' 09" Longitude:
78' 55' 05"
On the northeast side of SR 1906 approx. one mile north of its intersection with SR 1907, northeast of St. Paul$, NC.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: John S Cain Operator Certification Number:
23570
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone:
On -site representative Mike Cudd Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Records reviewed 216113
Site visit 2126113
page: 1

Permit: AWS780041 Owner- Facility : Murphy -Brown LLC Facility Number: 780041
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
10 Swine - Farrow to Wean 4,411
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
3121
19.50
Lagoon
3726
19.50
Lagoon
7690
27,00
Lagoon
769D-1
20,00
Lagoon
7691
19.50
Lagoon
7691-1
20.00
page: 2

Permit: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number. 780041
Inspection Date: 02/26/13 Inpseclion Type: Compliance Inspection Reason for Visit: Routine
DischaTRes & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑0
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
Elm
❑
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
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na 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 (Led large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
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
❑
e ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ N ❑ ❑
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: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number: 780041
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No Na No
Crop Type 1 Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2 small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1 Norfolk
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
E ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
❑
❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below,
WU P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS780041 Owner - Facility : Murphy -Brown LLC Facility Number: 780041
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Crop yields?
120 Minute inspections?
Monthly and 1" Rainfall Inspections
Sludge Survey
22, Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
appropriate box(es) below:
Failure to complete annual sludge survey
Failure to develop a POA for sludge levels
Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorous loss assessment (PEAT) certification?
Other Issues
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 DWO of emergency situations as required by Permit?
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
If yes, check the appropriate box below.
Application Field
Lagoon 1 Storage Pond
Other
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
34. Does the facility require a follow-up visit by same agency?
Yes No No No
❑ M ❑ ❑
❑■❑❑
❑ M ❑ ❑
❑ M ❑ ❑
❑ N ❑ ❑
❑■❑❑
Yes No No No
❑■❑❑
❑ IN ❑ ❑
❑ ME] ❑
❑■❑❑
I■■ NONE
❑■❑[
❑ M ❑
page:

1
� t
Type of Visit: * Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time:County:�i�f
Farm Name: `j6gQ j ,(j j j6 aLLIn 7-1 _�rii ��`vner—�Em'ail�
Owner Name: M LlWOL4-4_—JQJV0r..J ti , LLC Phone:
Mailing Address:
Physical Address:
Facility Contact: Aev-� M oy,5 Title:
Onsite Representative:
11
Certified Operator: 3_0h G1.
Back-up Operator: A" k ice+ woo S
Location of Farm:
Region: �D
Phone:
Integrator: uc
Certification Number: A 3.27D
Certification Number:
Latitude: Longitude:
Design Current Design
Current
Design Current
Swine
ity Pop. Wet4Poultry7. Capacity
Pop.
Cattle Capacity Pap.
Wean to Finish
Wean to Feeder
Feeder to Finish_
La er
Non -La er
s _
Dai Cow
Dai Calf
DairyHeifer
Farrow to Wean
LIL111 Design
Current
Dry Cow
Farrow to Feeder
Farrow to Finish
Gilts
iD Poult `Ca paci_t7y=P,o
Layers
Non -Layers
Non -Dairy
Beef Stocker
Beef Feeder
Boars
Pullets
Turkeys
I 113eef Brood Cow
Other
Turkey Pouets
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2_ Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes RD No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
[� No
[:]Yes
[ No
NA ❑ NE
NA ❑ NE
NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

i
1
jFacWty Number: - Date of Inspection: L
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 Od NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 1690
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
1 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
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
7�
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
�j No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.))
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of AcceptableCropWindow __++ ❑/jEvidence of Wind Drift jj❑ Application Outside of Approved Area
12. Crop Type(s): ZA ` rt'htIK.tLl L7rz�SS l �lah r f�5 T��P : JA+. O'Wh DG V/'
13. Soil Type(s): -/ti
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [n No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:)Yes [�g 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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
❑ 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 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 [P No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

� . L
Facility Number: jDate of Inspection:141151(4
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 1# No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes M No ❑ NA ❑ NE
the appropriate box(es) below. LPU
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of fast survey indicating non-compliance:
25. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes] No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes 91
No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface file 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
Reviewer/inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone: [phone]cc)
Date: 7711
21412011

3 /z-7
(Type of Visit: ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: 4D Routine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: / Arrival Time: i Departure Time: County
Farm Name: - 1 00 A I llll"1 1 — j Owner Email:
Owner Name: — G f ` f) Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: MA2 &Idd' Title: Phone:
t
Onsite Representative: iIntegrator: fJV Ltd n
_r-
Certified Operator: �Q� o Ln Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design
Swine Capacity
Wean to Finish
Current
Pop.
Wet Poultry
La er
Dee gn
Cap cityCattle
i
Current
..
gn Current
EKC±cityPop.
Da' Cow
Wean to Feeder
Non -La er
Da' Calf
Feeder to Finish
"'`
DairyHeifer
Farrow to Wean
Design
Current
Cow
Farrow to Feeder
Dr. P.ouIt .
Ca aci
P,o
Non -Daily
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
J
Turkey Points
01 Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes [XNo ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No [M NA [] 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 the discharge bypass the waste management system? (If yes, notify DWQ) [:]Yes [:]No [RNA [] NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes Cg No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes [@ No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: - Zy Date of Inspection: - L -13
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes rL-,-U* No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 14 NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �] 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 PNo ❑ 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 Z] No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes f 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? TT
I I _ Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes to 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 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
Wo
❑ 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
Q5 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the 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 appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes 2!yNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �] No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: tj S - Date of Inspection: (, /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [)q No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes W 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 ;B No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No J!�p NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fait to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes 8 No ❑ NA ❑ NE
[—]Yes %�j No ❑ NA ❑ NE
❑ Yes n No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes (2 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes] No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ® No ❑ NA ❑ NE
Comments (refer to question # : Explain any YES answers:.and/or=any additional recommendations or,any other comments:
Use drawings of facility to better explain;situations:(nse additio>Ral:pages as necessary). ' , _ �`°`; „ '. M
j � s 4%j< C-tXC' z f&�(3
qL
ReviewerAnspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 4 1 `r -33 3-3 00
Date:113
21412011

a ype ui v Isir: p %-ompuance inspeenon l.! Vperanon xevtew U Ntructure t:vamanon U I ecttnical Assistance I
Reason for Visit: S Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency _0 Other 0 Denied Access
Date of Visit: z. Arrival Time: Departure Time: }� County: &DB Region:
Farm Name:' 14C " 1A 1-4 Owner Email:
Owner Name: i y0 Phone:
Mailing Address:
Physical Address:
Facility Contact: MI ke t� Title:
Onsite Representative: '
Certified Operator: jo— kA-
Back-up Operator:
Phone:
Integrator: 1•' I 6Otort
Certification Number: 17-55,70
Certification Number:
Location of Farm: Latitude: Longitude:
Swine
can to Finish
Design
Capacity
GCurrenE V
Pap �,t`"Wet Poultry
Layer
Design t Current ' °r t .. Design C•urrenE
Capacity' P,iip Cattle Capacity Pop.
Dairy Cow
can to Feeder
Feeder to Finish
Non -La er
Dairy Calf
Dairy Heifer
Farrow to Wean
Design Current " Cow
D
Farrow to Feeder
D . aPmoult ,
Ca ace_iNon-Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
FdiPullets
'- Beef Brood Cow
..
Turkeys
Othe
Turkey Poults
¢� °
Other
Other
Discharges and Stream Impacts
l . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes P No ❑ NA ❑ NE
❑ Yes ❑ No �p NA ❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ) ❑ Yes ❑ No [T NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes qNo
❑ Yes No
NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 21417011 Continued

Faeili Number: -I Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [�] No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ® NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 700 7b2�
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
(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 46 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
❑ Outside of Acceptable Crop Window,w //��❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 6q5 �lYw94 au.55 -rl' t,�71 �. 5ft ��, Ott Pe u&f
13. Soil Type(s):
LYl—
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes rp No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Ea 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? T
13
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
T�
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes No ❑ 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 IQ
No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Ins ection: 3�L /' 2
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [:]Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal? 1T
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)
3 L Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
El 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
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
11 No
TT
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
rM No
❑ NA
❑ NE
lUse Comments
facilftyeto! belt r expta n situations (use additional pages'asers and/or tneces- �� mendations or any other comments. �- I
V'f cej 44'
Ste �r`�r� � If�l12r
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: q10-4433 -33tV
Date: ?I t 2:1,Z-
21412011

Type of Visit • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrive[ Time: �
Departure Time: County: Region: H
r
Farm Name: Oo r /-G� t"l4V #* Owner Email:
Owner Name: UL _ Phone:
Mailing Address:
Physical Address:
Facility Contact: 1 ► X-C -I- Title: Phone No:
Onsite Representativ u Integrator:
49��9Certified Operator �� n 2,36p��Stor Certification Number:
Back-up Operator: 1�400,.�c Back-up Certification Number: r 03N?
Location of Farm: Latitude: = o = I = « Longitude: E=1 o ❑ i = "
Design Current
Swine Capacity Population
❑ an to Finish
❑ an to Feeder
_ � -xx?ca,
w ;DDesign Current
Wet Poultry 4Capacty Population
❑ Layer
❑ Non -Layer
Design Current
C►attle Capacity Population
❑Dai Cow
❑Dai Calf
❑ Feeder to Finish.,
❑Dairy Heifer
Farrow to Wean
1
Discharges & Stream Impacts
l . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
❑ No
r NA
❑ NE
❑ Yes
❑ No
1p NA
❑ NE
PPNA
❑ NE
❑ Yes
❑ No
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
IVNo
❑ NA
❑ NE
12128104 Continued

Date of Inspection O
Facility Number: —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
ElNA
❑ NE
a. If yes, is waste level into the structural freeboard?
[]Yes
No
ONA
❑ NE
Sr tcture I Structure 2 Structure 3 Structure 4
tI 6 V
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes �No
El NA
[I NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
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.)
i
❑ 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. Croptype(s) P,&" A17 I
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
V No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�*o
❑ NA
❑ NE
I& Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
P No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application'?
❑ Yes
RNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
V No
❑ NA
❑ NE
Comrtzents (re..fer to question: Explain any YES.answers and/or any recommendations,or,�any other comments.>,
Use drawings of facility to better. ezplatn situations. (use additional pages as necessary).
Reviewer/Inspector Namep
,«wc Phone:
Reviewer/Inspector Signature: Date: [�
n. 17 -r2 1

Facility Number: Date of Inspection lO
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 [3 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 V 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
No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
f 5 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
1� No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ic/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
Page 3 of 3 1212&04

J
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit *,Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I S 1
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Arrival Time: Q�:AOQw• Departure Time: 07" County: qbk"� " Region: EeK
26 Owner Email:
W Phone:
Facility Contact: '' r,"-jW �^/y rnblt� Title: Phone No:
Onsite Representative: — -^ 14 Integrator:
Certified Operator:yy'S'i �p�/ Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [= e 0 l =di Longitude: = ° [--] f = "
Design
Current:;
. x Design Current
-
Design Current
Swine Capacity
Population"
3 ?�'et Pou ltry ,Cap ty Population
,Cattle
ea aci Po ulation
❑ Wean to Finish
❑ La er
El Dairy Cow
❑ Wean to Feeder
❑ Non -La er
❑ Dairy Calf
❑ Feeder to Finish
A Yli,
❑Dairy Heifer
arrow to Wean Dry Poultry ❑ D Cow
El Farrow to Feederon-
❑ Layers
airy
❑ Farrow to Finish ❑ Beef Stocker
❑ Gilts
ElNon-La Non -Layers
El Beef Feeder
❑ Boars
El s
❑ Beef Brood Co
Other
El Turkeys
❑ Turkey Poults
_
❑ Other
V, ❑ Other
1'
Num#�erof'Struetures:Cst
Dischames & Stream Imoacts
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
11PNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
tpNA
❑ 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
A
[:1NE
1 Is there evidence of a past discharge from any part of the operation?
ElYes
(1No
tNA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
16No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑NA ElNE
a. If yes, is waste level into the structural freeboard?
ElYesrNo
No
[ INA El NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 7� -C'7 6 ttu
.
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 33 36
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes &No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environments at,
notify DWQ
7. Do any of the structures need maintenance or improvement?
,Yes
❑ 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)
T
4. Does any part of the waste management system other than the waste structures require
0 Yes U§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 A No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 lbs [:]Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
❑ 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
lNo
❑ NA
❑ NE
3':answers and/or any recommendations
1. tJ&.f � "c- aelea'c o tt b4 l4S00 r S -
Reviewer/Inspector Name 1 / l Phone• 91PS7
Reviewer/inspector Signature: Date: 5
Page 2 of 3 12129104 Continued

Facility Number: Date of Inspection
Re wired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes P
No ❑ NA ElNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes MNo ❑ NA [I NE
the appropriate box. ElWUP El Checklists El Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes F 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
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No
❑ NA
❑ NE
27.
Did the facility fail to se re a phosphorus loss assessment (PLAT) certification?
❑ Yes
lNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
VpNo
❑ 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
rNo
❑ 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
Page 3 of 3 12128104

Type of Visit (3rtompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 3-�%-D Arrival Time: irz%�S Departure Time: /Z: 3S County: Region: " u
r
Farm Name: 7l4 /� 7621 Owner Email:
Owner Name: i �� �lt�Ll IJ Phone:
Mailing Address:
Physical Address:
Facility Contact: Re� 1 p 'Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No: p
Integrator: rzrU Af
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude. • = 0 0 ` =" Longitude: = ° ❑ ` ❑ "
Lon
Design
Current
De°sign Current
Design Current
Swine Capacity
Population
Wet Poultry
Caacity Population
C►tittle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder ❑ Non -Laver
❑Dairy Calf
❑ Feeder to Finish
F:
❑ Dairy Heifer
Farrow to Wean ZDDO
Dry Poultry
El Dry Cow
❑ Non -Dairy
El Farrow to Finish
❑
❑ Beef Stocker
Non-LayersEl
❑ Beef Feeder
ElPullets
❑ Beef Brood Cow
--:
Other s�
❑ Turkeys
❑ TurkeyPoults
❑ Other
❑Other
Number of Structures:
® Farrow to Feeder
D D �
❑ Gilts
❑ Boars
Dischar:?es &Stream Impacts
1. Is any discharge observed from any part of the operation?
Dyes
i No
❑ NA
❑ NE
Discharge originated at_ ❑Structure El Application Field El Other
a. Was the conveyance man-made?
El 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? (Ifyes, notify DWQ)
❑yes
[n No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
®No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
[4 No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number:-7 $� [�L� Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ® No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: g/
Spillway?:
Designed Freeboard (in): 7
Observed Freeboard (in): 32 Ar 32
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
V No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
® No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[?fNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
EN 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
�fl 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
M No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop ❑ Evidence of Wind Drift ❑ Application Outside ofArea
/Window
12. Crop type(s) S"_AtKd G t' � . Mom/ j
13. Soil type(s) ^IO/-i
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
n No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ifl No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'?
❑ Yes
[jfl No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
A No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
)9 No
❑ NA ❑ NE
Comments refer to question #) Ex lain any YES:answers and/or an recommendations o%an other comments
( q P Y Y
Use drawings of facility to better explain- situations. (use additional pages as necessary)
..
_ham;
LZe"vii'ewerlinspector
er/Inspector Name �7_ Q�Q �� Phone: �y/4 . �3� - j3y�
Signature: Date: 3`3j— Zt�4g
Page l of f 12128104 Lanrrnuea

Ar I I
Facility Number: 7 — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 19No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes IF No ❑ NA ❑ NE
the appropriate box. ❑ WUP Cl Checklists ❑ Design El Maps El Other
21, Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes T No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stacking ❑ 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
`f' No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[� No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes P No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[P No
❑ NA
❑ NE
Other lssues
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
0 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
[3 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? (ic/ 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 -... - x
Page 3 of 3 12128104

Type of Visit • ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 4 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: -I �-4�] Arrival Time: -%:00 Departure Time: 7, Op County: Region:
Farm Name: / Owner Email:
Owner Name: ///ao 14V�Al Phone:
Mailing Address:
Physical Address:
Facility Contact: Q Title:
Onsite Representative: �a� B+•_.�ri�/�✓
Certified Operator:
Back-up Operator:
Phone No: p
Integrator: wA,'O"
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = 0 0 I =" Longitude: E] o E__1 ` = "
Design Current
MAMMOMMOM
Design Current
Design Current
Swine Capacity Population
Wet Poultry
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
❑ Wean to Feeder
❑ Non -Layer
❑ DairyCalf
Feeder to Finish
;� .
❑ Dairy Heifer
91 Farrow to Wean 7�OOD�,r
Dry Poultry
-
❑ Cow
DO Farrow to Feeder �Z>
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
El Pullets
❑ Beef Brood Co
❑ Turkeys
Other
❑ Other
❑ Turkey Poults
10 Other
Number of Structures: 1
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[A 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
INo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

r
Date of Inspection Z wp
Facility Number:'"? -
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
P9 No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
S Structure 6
Identifier: - t'O 9 0
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
14 No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s) ge.#_UA . j4(1t__ 6 k �G�a�� �... /��a. : w/ �"OY+.j,-S-e_�
13.
Soil type(s) z\ o A
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable 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
[?RNo
❑ NA
❑ NE
Comments (refer to question fl: Explain any YES answers andlor any recommendations or any
,(uother�comments
Use drawings of facility to better explain situations se additional pages as necessary)
Reviewer/Inspector Name ILy ',1 Phone: 910 V33, 33310
Reviewer/inspector Signature: Date: Z _/�f
Page 2 01 3 12128104 Continued

Facility Number: 743— 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 ❑ 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
V No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
1P No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
MNo
❑ 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
JA 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
1� No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32,
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
&No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
PNo
❑ NA
❑ NE
Page 3 of 3 12128104

El
Type of Visit ®Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit 4P Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other ❑Denied Access
Date of Visit: Arrival Time: Di 3t7 . Departure Time: O: County: Region: /ERK
Farm Name: # ea 90 ' 1 7 (091 ' Owner Email:
Owner Name: A& k4k &Yo C f Phone:
Mailing Address:
Physical Address:
Facility Contact: !! pp Title
Onsite Representative: l+�crru d E>
Certified Operator:
Back-up Operator:
�yJPhone
/No:
Integrator: 12.4-a&Jn/ _
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = e 0 I ET
Longitude: =° 0 I= u
Design Current
Design Current
Design Current
Swine
Capacity Population
Wet Poaltry
Capaac�ity opuration
Cattle Capacity Population
❑ Layer
❑ DairyCow
❑ Non -Layer
❑Dai Calf
❑ DairyHeifer
Dry Poultry:
`. `-:.
❑ D Cow
❑ Layers
❑ Non -Dairy
❑ Beef Stocker
❑ Non -La ers
❑ Beef Feeder
❑ Pullets
❑ Beef Brood Cow
❑ Turkeys
Other
❑ TurkeyPoults
❑ Other
❑ Other
Number of Structures:
❑ Wean #o Finish
Feeder
Finish
Wean ObD
Feeder, � DOD
Finish
Discharges &Stream Impacts
I. Is any discharge observed from any part of the operation?
❑Yes
CRNo
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field ❑Other
a. Was the conveyance man-made?
El Yes
®No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? {If yes, notify DWQ}
El Yes
A] 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)
El Yes
®No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
®No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
JU No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

4
Facility Number: 7 - ! Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
L,&No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
® No
❑ NA ❑ NE
, 7L9/-/
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: 7 & %D — I 71&9h - I
Spillway?:
Designed Freeboard (in): ZO 4
Observed Freeboard (in): (p
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
2( 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
P No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[ No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
�i 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
[7No
❑ 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
[2fNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift El Application Outside of Area
12_ Crop type(s) i3e `kd �cd ( fire.,, l9 Yr � _ k�eti / S _au' J
l
Q V ueSt C-40( J
13. Soil type(s) �p
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[VNo
❑ 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
IN No ElNA ElNE
Im No ❑ NA ❑ NE
la No ❑ NA ❑ NE
[4No El NA El NE
Comments (refer -to question #): Explain any YES`'MiOi s and/or any recommendations or an o her com ents
Use'drawffigs,6f facility to better explain situations" (use a`ddrhonal pages as necessary):
Reviewer/Inspector Name i RL�j. S —_____ --- Phone: (910)
Reviewer/Inspector Signature: RAA Rea_ Date: 4,-OJ-Z©Q
Page 2 of 3 12128104 Continued

Facility Number: -7 Date of Inspection -W
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Dg 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 ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E4 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
(A No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Q§ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
1% No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
M No
❑ NA
El NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
TP No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
W 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
1P 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

.04
Type of Visit ®Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral Q Emergency O Other ❑Denied Access
Date of Visit: Arrival Time: Departure Time: County: JR
429SA& L_ Region: F�
Farm Name: _ 76o 90___/ 7& 91 Owner Email:
Owner Name: AG110 n 4 — u. Ln1 Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: -at LA 4 Q uwt ae tlJ�te
Certified Operator:
Back-up Operator:
N Phone No:
Integrator: 1VI t"y 011 a VZ i', ^j
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: ❑ e = ❑ it Longitude: = ° = 4 = 1i
Design Current
i� Design Current
(Design Current
Swine
Cap city Population
Wet PouEtar. � Cap ty Popnlatton
' Cattle Capacity Populati
[] La er
', ❑ Non-Layet
ltryMO.
Dry. Pftj
..
Other
❑ Other
'
Number of Structures?
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
�(� a
Farrow to Feeder
'Z OO'a
❑ Farrow to Finish
❑ Gilts
❑ Boars
Discharges & Stream Impacts
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
❑ Dairy Cow
❑ Dairy Calf
❑ Dai Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
1. is any discharge observed from any part of the operation?
❑Yes
®No
❑ NA
❑ NE
Discharge originated at: El Structure ❑Application Field El 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 by the waste management system? (If yes., notify DWQ)
El 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?
12/28/04
Cantiitued

Facility Number:, — Date of Inspection �I�Z9-OS
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 [A No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: --7-42!3Q - 7 f!p 9 1 _
Spillway?:
Designed Freeboard (in): _ '2 0
Observed Freeboard (in): 7W 7
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes N No ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes ® No ❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes [9 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 N No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [VNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) t:�> s . A o__ C ".. / a r a a e_ ) _ SIMrx // A vial
13. Soil type(s) ND A
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
(9 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
❑ NE
to:quest�on ##) Explatnfady YES.answersRand/or.a�}
Reviewer/inspector Name � '�'C eK i �' t`S ^ ` . Phone: �1O�
iw '4 .k t' ":ti'"'u4 'G' h .
Reviewer/Inspector Signature: Date: I/- Z9 -195
12128104 Continued

Facility Number: 7 — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes tK No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes to No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes fig No ❑ NA ❑ NE
/�— �P_/L
❑ Waste Application El Weekly Freeboard ❑Waste Analysis ❑Soil Analysis El Waste Transfers nual 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
00 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Q9 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[9No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[KNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
IN No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
�d 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
CM 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
55 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
U No
❑ NA
❑ NE
' A''ddrtionai Comments'and/or`Dr:awirr gs -_i.
12128104

Type of visit O Compliance Inspection O Operation Review O Lagoon Evaluation I
for Visit 9 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Tune:
— • — .�� O Not Operational O Below Threshold
® Permitted ® Certified ❑ Conditionally Certified 0 Registered Date -Last Operated or Above Threshold:
Farm Nance: _�trr� #/ -- f -- -- .. �G County: me: C l2 D
Owner Name: G _ ��i.• k �i3 r w a ' Phone No: �! " �9 L &` 0 0 W
Mading Address: , P a a o x - "? S 9----- �(2 b c- !� % /l N G P YS.F
Facility Contact: . _ . _ _ Title:.
Onsite Representative: v h.rp r A 1 o _
r" r 5 s
Certified Operator: - -
.-------- o.- ►�?, _, -..N-•--
Location of Farm:
Phone No:
Integrator. --
Operator Certification Number: d ,3 7 0
w
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �' �" Longitude �• ��"
•Cmzent
Swine.Caaac;iv, ]Pennhitinn . .,Poalttr
Wean to Feeder
Feeder to Finish
Farrow to Wean
oCv'
Farrow to Feeder
2 0 U
Farrow to Finish
Gilts
Boars
Ilesga Ctirimt
xPopolatiotr CatBe .
�. Other
Total Desip,,.Capadty
k,
Discharges & Stream Imaacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a_ If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min? _ M//I
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes [5 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier: — % A —_ . - - �-
t� 1r
Freeboard (inches): `7
12112103 continued

Facility.Numher: 79 -- Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures tack adequate, gauged markets 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? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Ae r r►a •��� ez r c
❑ Yes [g No
❑ Yes ® No
to Yes ❑ No
❑ Yes 53 No
❑ Yes (g No
❑ Yes M No
❑ Yes ® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAVWMP)? ❑ Yes No
14, a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acne determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes WNo
15. Does the receiving crop need improvement? ❑ Yes EWNo
16. Is there a lack of adequate waste application equipment? ❑ Yes ® No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below [j Yes W No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? Yes j31 No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ® No
Air Quality representative immediately.

Facility Number: Date of Inspection
Required Records & Documents.
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ief VV JP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25_ Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems, over application)
27. Did Reviewer/Impector fail to discuss reviewCmspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
LAMES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbr Bakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes 50 No
❑ Yes ® No
❑ Yes CO No
❑ Yes ® No
❑ Yes M No
❑ Yes ® No
❑ Yes [I No
Yes ❑ No
[:]Yes j9 No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes 9 No
09 Yes ❑ No
❑ Yes ❑ No
12112103