780085_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual
II

r
Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 780085 Facility Status: ActiVe Permit AWS780085
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Vistt Routine County: Robeson Region:
Date of Visit: 02117/2017 Entry Time: 08:00 am Exit Time: 9:00 am Incident 0
Farm Name: Farm 9413094 Owner Email: -
Owner. Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: Sr1762 213 Watts Dairy Rd Saint Pauls NC 28384
Facility Status: Compliant El Not Compliant Integrator Murphy -Brown LLC
Denied Access
Fayetteville
910-296-1800
Location of Farm: Latitude: 34° 4722" Longitude: 79° 00' 46"
95 south from fayeteville,right on 1006-left on 1762.1eft on 1761. farm on left.
Question Areas:
Dischrge 8 Stream Impacts
Records and Documents
Waste Col, Stor, & Treat Waste Application
Other Issues
Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone :
On -site representative Mike Cudd Phone
Primary Inspector. Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS780085 Owner - Facility : Murphy -Brown LLC Facility Number: 780085
Inspection Date: 02/17/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish 16,000
Total Design Capacity: 16,000
Total SSLW: 2,160,000
Waste Structures Observed
Dis ignated
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
3094-A
19•50
32.00
Lagoon
3094-B
25.60
56_00
Lagoon
A
19.50
Lagoon
B
25.60
page: 2

Permit: AWS780085 Owner - Facility : Murphy -Brown LLC Facility Number. 780085
Inspection Date: 02/17/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream impacts
vas No Na Ne
1. Is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
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)
❑
00
❑
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
❑
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 (Le./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yes No Na Na
10, Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN a 100/6/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS780085 Owner - Facility : Murphy -Brown LLC Facility Number. 780085
Inspection Date: 02/17/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yee No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Com, Wheat, Soybeans
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Coxville loam
Soil Type 2
Dunbar sandy loam
Soil Type 3
Goldsboro loamy sand, 0 to
2% slopes
SOIL Type 4
Lakeland sand, 0 to B%
slopes
SOIL Type 5
Lynchburg sandy loam
Soli Type 6
Rains sandy loam
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑E ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ 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?
❑
M ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

V
Permit: AWS780085 owner - Facility: Murphy -Brown LLC Facility Number. 780085
Inspection Date: 02/17/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■ ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑
N ❑
❑
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 (PLAT) certification?
❑
0 ❑
❑
Other Issues
You
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours andfor 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?
❑
E ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ ■ ❑ ❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ ❑ ❑
34. Does the facility require a follow-up visit by same agency? ❑ ■ ❑ ❑
page: 5

♦ a
Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
780085 Facility Status:
Active Permit: AWS780085
❑ Denied Access
Inppection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Robeson Region:
Fayetteville
Date of Visit:
03/11/2015 Entry Time: 10:30 am
Exit Timo: 11:00 am incident #
Farm Name:
Farm 9413094
Owner Finail:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: Sr1762 213 Watts Dairy Rd Saint Pauls NC 28384
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34' 47' 22" Longitude: 79' 00' 46"
95 south from fayeteville. right on 1006.1eft on 1762.1eft on 1761. farm on left.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone
On -site representative Mike Cudd Phone:
Primary Inspector:
Inspector Signature:
Secondary Inspector(s)-
Inspection Summary:
Robert Marble
Phone:
Date:
page- 1

J.
t
Permit: AWS780085 Owner - Facility : Murphy -Brown LLC Facility Number: 780085
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
=Ane eeder to Finish 16,000
Total Design Capacity: 16,000
Total SSLW: 2.160,000
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
3094-A
19.50
Lagoon
3094-8
25.60
Lagoon
A
19.50
29.00
Lagoon
B
25.60
39.00
page: 2

A ,
Permit: AWS780085 Owner - Facility : Murphy -Brown LLC Facility Number: 780085
Inspection Date: 03/11/15 inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No No No
1. Is any discharge observed from any part of the operation?
❑
■ ❑
❑
Discharge Originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ S
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
Noya NB
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (LeJ large
❑
■ ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
MEI
❑
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
❑
MEI
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
MEI
❑
maintenance or improvement?
Waste Application
Yes No No No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
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: AWS780085 Owner -Facility: Murphy -Brawn LLC Facility Number: 7B0085
Inspection Date: 03/11/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Cam, Wheat, Soybeans
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Coxville
Soil Type 2
Dunbar sandy loam
Soil Type 3
Goldsboro loamy sand, o to
2% slopes
SOLI Type 4
Lakeland sand, D to 6%
slopes
Soil Type 5
Lynchburg sandy loam
Soil Type 6
Rains sandy loam
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ M ❑ ❑
Management Plan{CAWMP}?
15. Does the receiving crop and/or land application site need improvement?
❑ M ❑ ❑
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ M ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑ ❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS780085 Owner - Facility: Murphy -Brown LLC Facility Number: 780085
Inspection pate: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
N ❑
❑
(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
❑
01111
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
N ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other issues
Yes No Na Ng
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
■ ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
■ ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility?
❑
N ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
N ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34, Does the facility require a follow-up visit by same agency?
❑
E ❑
❑
page: 5

0
Division of Wager Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
780085 Facility Status:
Active Permit: AWS780085
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
ReasonforVisit:
Routine
Coun Robeson Region:
Fayetteville
ty-
Date of Visit: 03120/2014 EntryTime: 11:00 am Exit Time: 12:00 pm
Farm Name:
Farm 94 13094
Owner:
Murphy -Brown LLC
Mailing Address:
PO Box 487
Physical Address:
Sri 762 213 Watts Dairy Rd
Incident#
Owner Emaii:
Phone:
Warsaw NC 28398
Saint Pauls NC 28384
910-296-1800
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34' 47' 22" Longitude: 79" 00' 46"
95 south from fayeteville. right on 1006.left on 1762,left an 1761, farm on left.
Question Areas:
Dischrge & Stream Impacts Waste Col, Star, & Treat Waste Application
Records and Documents Other issues
Certified Operator: Michael L Cudd Operator Certification Number: 25233
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone:
On -site representative Mike Cudd Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Lagoon levels:
30943A = 29"
30943E = 44"
Records reviewed 3/10114.
Site visit 3/20/14.
page: 1

Permit: AWS780085 Owner - Facilty : Murphy -Brown LLC Facility Number: 780085
Inspection Date: 03/20/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
3094-A
19.50
Lagoon
3094-8
25.60
Lagoon
A
19.50
Lagoon
B
25.60
page: 2

Permit: AWS780085 Owner - Facility : Murphy -Brown LLC Facility Number: 780085
Inspection Date: 03/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
■ ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 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)
❑
❑
❑
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
❑
M ❑
❑
State other than from a discharge?
Waste Coltecfion, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
■ ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
0 ❑
❑
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?
❑
0 ❑
❑
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
❑ ❑ ❑
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 n 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: AWS780085 Owner - Facility : Murphy -Brown LLC Facility Number:
780085
Inspection Date: 03/20/14 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Gress
(Hay)
Crop Type 2
Com, Wheat, Soybeans
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Coxville loam
Soil Type 2
Dunbar sandy loam
Soil Type 3
Goldsboro loamy sand, 0 to
2% slopes
Soil Type 4
Lakeland sand, 0 to 6%
slopes
Soil Type 5
Rains sandy loam
Soil Type 6 -
Lynchburg sandy loam
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ ❑ ❑
Management Plan(CAWMP)?
15, Does the receiving crop and/or land application site need improvement?
❑ ■ ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ E ❑ ❑
1 B. Is there a lack of properly operating waste application equipment?
❑ N ❑ ❑
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?
❑
❑ ❑
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?
❑
page: 4

Permit: AWS780085 Owner - Facility: Murphy -Brown LLC Facility !dumber: 780085
Inspection Date: 03/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Ne
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(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
❑
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?
❑
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
❑
Other Issues
Yes
No Na Ne
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑0
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon 1 Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
M ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

1 t
MDivision of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 780085 Facility Status: Active Permit: AWS780085
Inpsection Type: Compliance Inspection Inactive Or Ciosed Date:
Reason for Visit: Routine County: Robeson Region:
Date of Visit: 0212712013 Entry Time: 11:30 am Exit Time: 12:00 pm Incident #
Farm Name: Farm 9413094 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: SO762 213 Watts Dairy Rd Saint Pauls NC 28384
Facility Status: 0 Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34' 47' 22" Longitude: 79' 00' 46"
95 south from fayeteville.right on 1005.1eft on 1762.1eft on 1761. farm on left.
Question Areas:
Dischrge & Stream impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
❑ Denied Access
Fayetteville
910-296-1800
Certified Operator: John S Cain Operator Certification Number: 23570
Secondary 01C(s):
On -Site Represontative(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 2114113
Site visit 2/27/13
page: 1

Permit: AWS780085 Owner - Facility : Murphy -Brown LLC Facility Number: 780085
Inspection Date: 02/27/13 Inpsection Type: Compliance inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish 16,000
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
3094-A
19.50
Lagoon
3094-8
25.60
Lagoon
A
19.50
Lagoon
B
25.60
page: 2

Permit: AWS780085 Owner - Facility : Murphy -Brown LLC Facility Number: 780085
Inspection Date: 02/27/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■ ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le.l large
❑
M ❑
❑
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?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11, Is there evidence of incorrect application?
❑ 0 ❑ ❑
It 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: AWS780085 Owner - Facility : Murphy -Brown LLC Facility Number: 780085
Inspection Date: 02/27/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Gress
(Nay)
Crop Type 2
Small Grain Overseed
Crop Type 3
Com, Wheat, Soybeans
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Coxvilie
Soil Type 2
Dunbar sandy loam
Soil Type 3
Goldsboro
Soil Type 4
Lakeland
Soil Type 5
Rains
Soil Type 6
Lynchburg
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ M ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ 0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ ❑
❑
Records and Documents
Yes No No Ne
19, Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
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?
❑
M [] ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS780085 Owner - Facility : Murphy -Brown LLC Facility Number: 780085
Inspection Date: 02/27/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Ne
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26, Did the facility fail to provide documentation of an actively certified operator in charge?
❑
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,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon 1 Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/inspector fall to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Type of Visit: • Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up Q Referral O Emergency Q Other O Denied Access
Date of Visit: j� f� f L Arrival Timer Departure Time: �, Y T County: POBO.SOW Region: m
Farm Name: _ 3094-3 crarM q9I _ Owner Email:
Owner Name: �1 — iA W n, �.� ^� Phone:
Mailing Address:
Physical Address: �/�
Facility Contact: 1 !`� t__LLeid Title: Phone:
Onsite Representative: U
Certified Operator: p k r, "
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Certification Number:�T
Certification Number:
Longitude:
Design Current, Design Cu_`rrent Design Current
-.: , w
Swine Capacity Pop"" Wet Poultry C•apacity� Pope Cattle Capacity Pop.
Wean to Finish La er Dairy Cow
Wean to Feeder Non -Layer Dairy Calf
Feeder to Finish s Dairy Heifer
Farrow to Wean Design Curent-R ,', Dry Cow
Farrow to Feeder !W D . .P,nult, Ca ac�tPo Non -Dairy
Farrow to Finish Layers Beef Stocker
Non -Layers
Gilts'
Beef Feeder
Boars Beef Brood Cow
Turkeys
Other
Other Other
Pullets
Discharges and Stream Imuacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes E� No ❑ 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 ® NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)? T
d. Does the discharge bypass the waste management system? (if yes, notify DWQ) [] Yes ❑ No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA [:].NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page ] of 2/4/2011 Continued

FacilityNumber: - Date of Inspection: 2
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Struc e 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
3t
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan? (�
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste ApDlication
10. Are there any required buffers, setbacks, or compliance 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 Pq No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13, Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
❑ Yes
❑ Yes
No
yy
gj No
M,No
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
[:]Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA [3NE
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 0 NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Inspection: 3
'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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately_
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑Yes
❑No
❑NA
❑NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. Yes
rA Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
❑ No
❑ NA
❑ NE
❑ No
❑ NA
❑ NE
(—]No
❑NA
❑NE
❑No
[]NA
❑NE
Comments,(refer to question #)EapEain any YES answers and/or any additional.recommendations or auy Ether comments.
-7'001IMA drswuijslof facility tebetfer explain situations (use additional pa2es as necessary)
Reviewer/lnspector Name:
Reviewerllnspector Signature:
Page 3 of 3
Phone: I " 33r39W
Date: 3 a 1 JL
2/4a011

Type of Visit: 0 Compliance Inspection 0 Operation Review O Structure Evaluation p Technical Assistance
Pleason for Visit: 40 Routine O Complaint O Follow-up O Referral O Emergency Q Other p Denied Access
Date of Visit:-' Arrival Time: DepartureTime: County: 0139_$0IJ Region: 17ZQ
Farm Name: r_)9'+3 Cfkrm V) Owner Email:
Owner Name: lT ll.Wp—�jy�w� 4 LLC _ _ Phone:
Mailing Address:
Physical Address:
Facility Contact: t ✓NO ns Title: Phone:
94
Onsite Representative:
Certified Operator: Caton
Back-up Operator: / t i I� , e 04S
Location of Farm:
Latitude:
Integrator:
Certification Number: s2 3 S70
Certification Number: 995-9919
Longitude:
Design Current
Des " ..
ign.. Current
..
Design Current
Swine _" Capacity Pop.
WetPoultry Capacity Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
'"'- ys
Dai Heifer
Farrow to Wean
y Design
Current
D Cow
Farrow to Feeder
Dry` Quit . =r��Ca aci
P,o ,
Non-Dai
Farrow to Finish
Layers
Beef Stocker
Beef Feeder
Beef Brood Cow
Gilts
Non -Layers
Boars
Pullets
Turkeys
Other`
Turke Pouets
Other
Other
Dischar es and Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does 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 F
No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[:]Yes No
❑ Yes [ No
MNA ❑NE
MI NA ❑ NE
NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

• Facility Number: - S Date of Inspection:
i
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
00 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
V9 NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 1- S
Spillway?:
Designed Freeboard (in):
_
Observed freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
Y,
❑ 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
P No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[!p No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
rj No
Ir
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes V_v9 No ❑ NA ❑ NE
maintenance or improvement?
1 1. 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, eter
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
t 7. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
Yes No ❑ NA
❑ Yes No ❑ NA
[—]Yes
�] No
[] NA
❑ Yes
[ No
❑ NA
❑ Yes
[0 No
E3 NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
V No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
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 V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes IF
No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Qg No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

• Facility Number: - Date of Ins ection: jMu
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.
C] Failure to complete annual sludge survey FjFailure 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
�31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CA WIviP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No ❑ NA NE
Yes No DNA NE
Yes M No
[] Yes r_1 No
NA ❑ NE
[:]NA [—]NE
Yes P] No ❑ NA ❑ NE
Yes No
[:]Yes �] No
Yes ® No
�NA NE
NA NE
NA NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any:other comments'
use, drawings of facility to better explain situations (use additional pages as necessary).,M-M
S c4 'i S -+ co +14+. C-'j S/ I t/ I j 4
fec&-'4S reLl; e�„>-e-d q 11'{ 1 r r .
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: l jo-33-3
Date: .017/ 'l
214,12011

a
0"
IType of Visit • Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit *Routine O Complaint 0 Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: q (0 Arrival Time: fq�- Departure Time: County: /" Region:
Farm Name: %% — ! Owner Email:
Owner Name: ' 1atll�l{i�[%�t1 Phone:
Mailing Address:
Physical Address:
Facility Contact: I'1 r�V�l@' Title: Phone No:
Onsite Representative: (( Integrator: NU410L1_& Uly -
Certified Operator: Operator Certification Number: °� 3J (p
Back-up Operator: 11 Back-up Certification Number:
Location of Farm: Latitude: 0 0 0 6=61 Longitude: = o= 1 0 u
j
Design Current
Design Current
Design
C►urrent
swine
Capacity Population Wet Poultry
Capacity Population
Cattle 153—acit$a
Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Dairy Calf
FA Feeder to Finish
❑ Daia Heifer
❑ Farrow to Wean
Pout
- DryEtry
❑ D Cow
❑ Farrow to Feeder
❑ Non-Dai
❑ Farrow to Finish
❑ Layers
. ❑Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood CoLAJ
Turkeys
Other
❑Turke Poults
Structures:
❑ OtherI
JEJ 7
Other
umber of
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Wo
❑ 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 D WQ)
❑ 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
FA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
tpNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
M No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number:
Date of Inspection j p
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes KNo ❑ NA ❑ NE
a_ If yes, is waste level into the structural freeboard? ❑ Yes ❑ NoANA ❑ NE
Struct e 1 Struce 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes )h 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 E3 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 1p No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes M 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 QQNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes N No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes E3 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 Wiin`dowf ,❑_ -Evidence of Wind Drift El Application OOut�svi�dwore)
12. Crop type(s)C V1' /'1,r .
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
No
El NA
[I NE
No
❑ NA
❑ NE
Q§ No
❑ NA
❑ NE
�]No
El NA
ONE
Comments (refer to question # Explain any YES answers andlar any recommendations or any other comments.
Use drawings of facility to het#er explain situations. {use additional pages as necessary):
Reviewer/Inspector Name ®�` Phone:
Reviewer/Inspector Signature: Date: 110
Page 2 of 3
12128104 Continued

Facility Number: 7 UNT 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 [I Checklists ❑Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes VNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ 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
rp No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
J5 No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P No
[INA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El
�No
❑ NA
[3 NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
0 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
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
f, No
❑ NA
❑ NE
Page 3 of 3 12128104

Type of visit 4P Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 10%001Departure Time: j/}6tD[ta County: RObeSOh Region:
Farm Name: 3CRLI Owner Email: /
Owner Name: r' ' U_rl",�q � 1N ��' Phone:
Mailing Address:
Physical Address:
Facility Contact: M 1wt0 t'15 Title:
it
Onsite Representative:
Certified Operator:
Back-up Operator: M" �e rt.i
Location of Farm:
r
Phone No: a
Integrator: ! v �✓pe�T LJ'''��''1 . ��
Operator Certification Number:
Back-up Certification Number: 7
Latitude: = o = d Longitude: = o = 1 = u
J
DestgnCurrent
Design, .Current
Design
C►urrent
Swine i
Wet Poultry
_Capacity Population
Cattle
Capacity
Population
:CagacityPopulaiion
❑ Wean to Finish
❑ La er
❑ DairyCow
❑ Wean to Feeder
❑Non -La er
❑ DairyCalf
Feeder to Finish'
❑ DairyHeifer
❑ Farrow to Wean
DryPo.ultry
'.
:._...
❑ D Cow
❑ Farrow to Feeder
�_
,z:- ..-;
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
on -La ers❑
Beef Feeder
PCIGilts
Boars
Pullets❑
❑ Beef Brood Co
❑ Turkeys
- -
Other
❑Turke Points
❑ Other
❑Other
Number of Structures:
Discharges & Stream Imaacts
I. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3- Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes $}No ❑ NA ❑ NE
❑ Yes
❑ No
NA
[INE
ElYes
ElNo
TNA
❑ NE
ID NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
[3 Yes
No
❑NA
El NE
Page I of 3 12/28/04 Continued

r
Facility Number: I&
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
PNo ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No VNA
❑ NE
Structur 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ,j o2 tt a;zg y
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No ❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ 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 I No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �SNo ❑ 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?
L_J Yes
fo
LJ NA
U NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
rrtt
Ig No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
Ejj�,, No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
CJ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Reviewer/Inspector Name Phone: O )33M
Reviewer/Inspector Signature: Date: Z 0
Page 2 of .i 1212dr/04 continued

1
Facility Number: Date of Inspection EPE
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ wup ❑ Checklists ❑ Design ❑ Maps ❑ Other
[]Yes I No ❑ NA ❑ NE
❑ Yes 01 No ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes iO 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
[PNo
❑ NA
❑ NE
❑ Yes
No
ElNA
ElNE
ElYes
No
❑ NA
❑ NE
❑ Yes
[r No
❑ NA
❑ NE
❑ Yes
F No
❑ NA
❑ NE
❑ Yes
VgNo
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
EpNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[� No
❑ NA
❑ NE
El Yes
[PNo
El NA
El NE
[]Yes
INNo
❑ NA
❑ NE
Addii Tonal C-05M meats and/or Drawings
H,,
Page 3 of 3 12128104

19 Division of Water Quality l
Frd�cility Number O Division of Soil and Water Conservation CB
- 0 Other Agency
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 16Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival'.rime: D Departure Time: County:
dV
Farm Name: ` t
Owner Name: {11�'►U �.LJ1' 'c _
Mailing Address:
Physical Address:
Owner Email:
Phone:
Region:
Facility Contact: M i MDY15 - Title: LA) Oq Phone No: U U (2-01
I i �/j�}
Onsite Representative: ! Integrator: I I
Certified Operator: 0Q.in Operator Certification Number:
Back-up Operator: 1 t t i i�C \ 1VIi'1�1j'1,'�7 Back-up Certification Number:
Location of Farm:
Swine
Latitude: = O = 6 Longitude: = ° 0 ` = „
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
❑ Wean to Finish
❑ Wean to Feeder
eeder to Finish
660
d
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy lAcifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
C. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: EE
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 1� No ❑ NA ❑ NE
❑ Yes ❑ No )] NA
❑ NE
❑ Yes ❑ No ® NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes &3No ❑ NA
❑ NE
❑ Yes A No ❑ NA
❑ NE
12128104 Continued

Facility Number: — S Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I cture 2 Structure 3 Structure 4
Identifier: Isu
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes XNo
❑ Yes KNo
Structure 5
El NA ❑NE
❑ NA ❑ NE
Structure 6
❑ Yes T<No ❑ NA ❑ NE
❑ Yes ANo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 8j No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes OjNo ❑ 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 Apalication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes P Vo ❑ NA ❑ NE
maintenance/improvement?
I t . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes M1' No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] 0 lbs ❑ Total Phosphorus [:]Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) —S W
13. Soil type(s) �' 1� h� 1 �'&jr6 t e l c4bha W-/,-J , J0& n-_rva'
14. Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
pJ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
NNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
�kqq
❑ NA
El NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
,No
24 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
J� No
❑ NA
❑ NE
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name=&JES Nro Phone:
Reviewer/Inspector Signature: Dater
12128104 Continued "

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes to
o ❑ NA El NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ yes ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement'? if yes, check the appropriate box below. ❑ Yes N No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 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 ' bNA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�Z 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
N NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
14 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
Wo
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss rcview/inspection with an on -site representative?
❑ Yes
'A No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[�Vo
El NA
❑ NE
Comments and/or
12128104

�y -K
Facility No. . ime In Time Out
Farm Name QY M q
Owner — 6
Operator 4 al
Back-up K
Integrator
Date
/)7— B
Site Rep}+^^+
No. vaQ e
No. O � G
COC Circle: G eral or NPDES
M
Design
Current
Design
Current
Wean - Feed
Farrow - Feed
Wean - Finish
Farrow - Finish
Feed - Finis
Gilts / Boars
Fafrow - can
Others
FREEBOARD: Design
Observed
Crop Yield �-
Rain Gauge
Soil Test Wettable Acres
Weekly Freeboard . Daily Rainfall
Spray/Freeboard Drop
Weather Codes
120 min Inspections
Waste Analysis: A
Date Nitrogen (N)
►1� zAe zS
Sludge Survey c
Calibration/GPM 1
Waste Tr ers
Rain Breake'P`--------,
PLAT
1-in Inspections.
�W, 0
Date Nitrogen (N)
•
Z.� 2
Pull/Field Soil Crop Pan Window
f \1
.�
w f

!'
ivision of Water Quality ,s1'
Facility Number O Division of Soil and Water Conservation
O Other Agency
Type of Visit G<o—mpliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit outine 0 Complaint O Follow up Q Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ��Arrival gTim. e: /Q . 3 O Departure Time: ,�� a County: b Region:
Farm Name: �� rw` r q Owner Email:
Owner Name: f D W A-5 GQ �� L n d°— Phone:
Mailing Address:
Physical Address:
Facility Contact: N, k e Am n u':` l Title: Phone No:
Onsite Representative: S`.�i-+.�� ^ Integrator: "
Certified Operator: �i� �— C '�-- Operator Certification Number: 4-,P__5 d7D
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: ❑ e ❑ I = Longitude: = o = = u
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
eeder to Finish1/&,V0o1/&'*V0
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non —Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream lmi2acts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ 2a Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes IQ No ❑ NA Cl NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
LM No
❑ NA
❑ NE
❑ Yes
CKNo
❑ NA
❑ NE
12128104 Continued

Facility Number: 70 Date of Inspection
{
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes j.No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Spillway?: IV aC-4
Designed Freeboard (in):
Observed Freeboard (in): �S 1
5_ Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes K No ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage. etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes 21 No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes [Z 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 ENNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 06 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or l0 Ibs [:]Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ 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
;K 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
[9No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
JZ No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name C �j*-- Phone: I1'f/3J' 33aa
Reviewer/Inspector Signature: Date: — a
IL/Za/V4 (,OAAn"ru

°1 Facility Number: Z,'_ 1p Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 19 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E,No ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [KNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P.No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
.A No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
M No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
DQ 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
JK 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
10 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
C0 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
21 No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

la vision of Water Quality
Fasali Nbmber0 Division of Soil and Water Conservation
�—
Q Other Agency
Type of Visit 6 ;7-o-utine
ply'ance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
g �7� Departure Time: County:il"'e�n Region:
Date of Visit: � � Arrival
Farm Name: r�Y 1 Ti 4 Owner Email:
Owner Name: f n Phone:
Mailing Address:
Physical Address:
Facility Contact: ` r {�/� 1 • bnS Title: j Phone No: [ D 6 1
Onsite Representative: ' r l I ICE V— \ t L 6n S Integrator: W A
Certified Operator: ~ 0 ky) C—P t i n Operator Certification Number: 5
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑ o ❑ 6 ❑ 4i Longitude: ❑ o ❑ 4 ❑ 6f
Design Currenf Design Current' Design 'Current
Swine w Capacity Populahan Wet Poultry Capacity Population Cattle CapactyPopulateon
,.
❑ Wean to Finish ❑ Layer
El Dairy Cow
El Wean to Feeder ❑ Non -Layer ❑Dai Calf
ceder to Finish (promo l I ❑ Daia Heifer
❑ Farrow to Wean ❑ D PoultryEl Dry Cow Farrow to Feeder r` Dry
. ❑Non-Dai
❑ Layers
❑ Farrow to Finish ❑ Beef Stocker
El Gilts ❑Non -Layers El Beef Feeder
El Boars
�'. El Pullets
El Beef Brood Cowl
-- - ❑ Turkeys ---
Other. k ❑Turke Points a
Ny .. -n _ r '' --
` ❑ Other : ❑ Other Num ire of Struct s
a
r�..—�'rM.+x�-'x«ip�.-_�..- --. _'�'".-:'moo:', *t .. _. ...._�_ _,. - ----� �, •,:m .^,»r.' .....m
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
ANo
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
❑ Yes
❑ No
k A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
,24;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
'QJ34A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
*o
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
"-No
ElNA
ElNE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: Date of Inspection
y
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? El yes ❑ Na q NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in)- 6
Observed Freeboard (in): Q y
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 34No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes XNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ';O-No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes oNo El 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 �Ta ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes >No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) -% ` � _ ! n f f ] ],, j ! {� I
13. Soil type(s) CpZv, , 11 e- t -RQ'. nS _ [ __u r) C1� �Y ! (Y S v �YD LU 1AItCy 1 1 � W, bGt Y
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes )�yo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement'? ❑ Yes �Wo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes X No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes &lo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? [:]Yes 11 No ❑ NA ❑ NE
Comments (refer to question #}: Explain any YES.answers and/or any recommendations or ady other comttents ,
Use drawings of facility to better explain situations. {use additional pages as necessary): ? J
Reviewer/inspector Name __ 1� � T1 ]� L �LO ---]Phone: �!jd V33 3 0
._ 0
Reviewer/Inspector Signature: Date:
Page 2 of 1 1217S/t?4 Continued

Facility Number:_7'� � 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 XNo ❑ NA ❑ NE
the appropiiate box. ❑ wup ❑ Cbecklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes )KNo ❑ 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? ❑ Yeso ❑ NA ❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ YesNo
❑ NA
❑ N E
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes 'W'No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes �Wo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes P14o
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes birNo
❑ 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 �ffNo
❑ NA
❑ NE
12128104

I
Facility No. I4� Time In c Time Out ` Date
Farm Name ' J0 j 3 C3�X nr1 -4 _Integrator �+"` -
13
Owner Site Rep ^ O�\ 0_t/YL"V1
Operator
No.
Back-up No. _
COC Circle: General or t�
Design
Current
Design
Current
Wean - Feed
Farrow - Feed
Wean - Finish
Farrow - Finish
Feed - Finish
Gilts 1 Boars
Farrow - Wean
Others
REEBOARD: �Desiggnn 1 t2, Observed
Judge Survey V Calibration/GPM '� 1
Crop Yield Waste Transfers
Rain Gauge b Rain Breaker
Soil Test �0__G � PLAT
Weekly Freeboard ("/ Daily Rainfall
Spray/Freeboard Drop {
Weather Codes 120 min Inspections
Waste Analysis: A /
Date Nitrogen (N)
0
Wettable Acres U
1-in Inspections �—
ML(L-, A,1,•r J(__ .
Date Nitrogen (N)
.a/11 •3 -: Lf.
Pull/Field
Soil
Crop
Pan
Window
Sa .,
71 n
G-A
`za; Y--, S
>1 v
o s 6 ey
LAM

f
ype of Visit �mpiiance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
eason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: �Gll•J County: ! Region: 17f�_ 19(
Farm Name: r'*1' �� _ Owner Email:
Owner Name: !'L1KJ Phone:
Mailing Address: , 00, ��7� � S / _ �Sr,�� NC •__��y.��
Physical Address:
Facility Contact: Title:
00,
Onsite Representative: .f4gW e__
Certified Operator: �
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = U = I =1 11 Longitude: = ° =' Q u
Design Current f4aesign
Current , - ! Design Current
Swine
Capacity P�Yopnlatibn Wet Poullhapacity
Populahan Cattle ° Capacity Population
Wean to Finish
❑
❑
Feeder to Finish
❑ Farrow to Wean
❑ Gilts
❑ Boars
Wean to Feeder
❑ Farrow to Feeder
❑ Farrow to Finish
Poults
❑ Layers
El Non -Layers
❑ Pullets
❑
DischartYes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field ❑ Other
a. Was the conveyance man-made?
❑ Layer El Dairy Cow
Dai Calf
❑ Dairy Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes RNO ❑ NA ❑ NE
❑ Yes R No ❑ NA ❑ NE
❑ Yes ®.No ❑ NA ❑ NE
❑ Yes ®,.No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes X-No ❑ NA ❑ NE
11/18/04 Continued
Poults
❑ Layers
El Non -Layers
❑ Pullets
❑
DischartYes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field ❑ Other
a. Was the conveyance man-made?
❑ Layer El Dairy Cow
Dai Calf
❑ Dairy Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes RNO ❑ NA ❑ NE
❑ Yes R No ❑ NA ❑ NE
❑ Yes ®.No ❑ NA ❑ NE
❑ Yes ®,.No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes X-No ❑ NA ❑ NE
11/18/04 Continued
DischartYes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field ❑ Other
a. Was the conveyance man-made?
❑ Layer El Dairy Cow
Dai Calf
❑ Dairy Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes RNO ❑ NA ❑ NE
❑ Yes R No ❑ NA ❑ NE
❑ Yes ®.No ❑ NA ❑ NE
❑ Yes ®,.No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes X-No ❑ NA ❑ NE
11/18/04 Continued
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes RNO ❑ NA ❑ NE
❑ Yes R No ❑ NA ❑ NE
❑ Yes ®.No ❑ NA ❑ NE
❑ Yes ®,.No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes X-No ❑ NA ❑ NE
11/18/04 Continued
11/18/04 Continued

I
Facility Number: Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
St ru ture 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, kepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes ;.No ❑ NA ❑ NE
❑ Yes Wo ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes (KNo ❑ NA ❑ NE
❑ Yes J.No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes KNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 19 No ❑ &A ❑ 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 C[ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ;kNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes (-No ElNA ElNE
❑ 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 Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑ Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
JZ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
R'No
❑ NA
❑ NE
: laur-any YE5>ansi
Reviewer/Inspector Name i yam. prv', Phone:7d
ReviewerlInspector Signature: Date: L
12128104 Continued

I
1
Facility Number: Date of Inspection Ugr
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes JSNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
DQ 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
X No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
5&No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
XNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWM P?
MYes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
X No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative`?
❑ Yes
M No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
)4 No
❑ NA
❑ NE
Additi6hal;,Cornments and/or. Drawings: '
A®4/ �r��1 Gl ��r�646 T be ril-.VD+le�.
12128104

0
[Type of Visit ® Compliance Inspection Q Operation Review O Lagoon Evaluation {
Reason for Visit • Routine O Complaint O Follow up Q Emergency Notification O Other 0 Denied Access
Facility Number 8 S Date of Visit: Tune: �r.>a
•- • - - - ..,.., -- 0 Not rational Q Below Threshold
M Permitted ® Certified L] Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: ..L- A #— m 9 -'yc _ .. County: ZE o_6 c s o o+ _ FP-b
Owner Name: 4 G -,. r 6 %arc �J Phone No: !->J .2 9 G / F ':' `>
Madmg Address: _ P b lae x 7-5-9 s Z/S'�F
Facility Contact:
Title:
Phone No:
Unite Representative: „---JD v Integ
�r j'1I cty - _� o w •-a
Certified Operator.-__-X_Q 6 n.{_ , S • ^ -- -----a k"-----_-S rz - Operator Certification Number: ik*d3 S 7 a
Location of Farm:
16 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude •
Mwhan & Stream
1. Is any discharge observed from any part of the operation? ❑ Yes IN 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? /fir
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 55 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 Strucnne 3 Structure 4 Structure 5 Structure 5
IdendfieT-
�� it
Freeboard (inches):
12/12M3 Continued

Facility Number: 7,f
Date of inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6_ Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWty
7. Do any of the structures need maintenancerimprovement?
S. Does any part of the waste management system other than waste structures require maintenancerimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffos that need maintenancertmprovement?
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
(� Yes ❑ No
❑ Yes [31 No
® Yes ❑ No
❑ Yes J2 No
❑ Yes ® No
❑ Yes $1 No
❑ Yes ® No
12. Crop type _ _ (,cill'�r.'F, Sa�.6��-.ems Cow.✓
13. Do the receiving crops differ with those designated in the Certified Animal Waste Manaaeament Plan (CAWMP)? ❑ Yes t] No
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
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
Air Quality representative immediately.
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes (P No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes M No
❑ Yes 6 No

i Facility Number: — ps� 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?
(ie/ WUP, 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?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection 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?
NPDES 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 rainbreakers 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 91 No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes U9 No
❑ Yes ® No
❑ Yes PO No
AYes ❑ No
❑ Yes No
❑ Yes No
❑ Yes U No
❑ Yes ® No
❑ Yes E§ No
l2/l2(03

IType of Visit 0 Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit 8 Routine Q Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: �!� Time: 07: SS
7 �
rO Not Operational Q Below Threshold
�irmitted C erti6ed 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ...
Farm Name: _ ._ Gr n.._... y _ County:. _ R ej e j.a!rx
Owner Name: o 's F C 1 .phone No: 9�0 - - �D
............. .. car..a..............c............r�r.Q �.r�.�....�..........� �..W....-------.... ._� .��.....------�----••-.
Mailing Address: _ P• 0� - �[2,�- _ `�,�m ! 0. C _!�% ��...NL -Z 91_/ S g
FacilitvContact: ....._..................._....W .............----------------- Title: ................... -............................. Phone No:
Onsite Representative: Integrator: _. WW ....W.......W__-W__--___--
Certified Operator:....... ............. .... , ,. .... ,,,,•,_. ..... _-.................. Operator Certification Number:
Location of Farm:
[Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' A 46 Longitude • 4 94
v
Wean. to Feeder
-
Layer
er to Finish
1 opp
Non -Layer
Farrow to Wean
-
Farrow to Feeder
= Other
Farrow to Finish
- ToW Di
Gilts
7
Boars
2
Discbames & Stream Impacts
1_ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
90
Dairy
Non-Dairy
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/rrrin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier.j.................... ........ ................ .......... ._..... ...................... ........ --...... ............... ......�._.._......
Freeboard (inches): y 7
12112103 Continued

Facility Number: i g — gar'
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
I5.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17.
Fail to have Certificate of Coverage & Genera! Permit or other Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ Ne
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
❑ No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
$C me (iifek to question #): Eirplatn'any YESy n ets and/or any recommend ns or any NO commegts
lUse'drawmgs nf-facility to better explain s! on�se addEtinnal pages as necessary), '. � ❑Field Copy ❑�Not,,
•=
Reviewer/Inspector Name }
_
Reviewer/inspector Signature: Date:
05103101 Continued

Type of Visit 0 Compliance Inspection Q Operation Review O Lagoon Evaluation
VV13
iReasonforVisit )(Routine JOComplaint O Follow up O Emergency Notification O Other ❑ Denied Access
- F Facility Number 8 Date of Visit: ? ?-O Tune: 8•'3d
O Not O erational O Below Threshold
®.Perrnitted M.Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: �rGwn 5 r c .......1 �_--------. County:
Owner Name: Phone No: _ /!7 " ��11i ` U(>
.N, t kng Address:.. !'..._. .. . r1...... QS,�...1 �_�la- � 21q3�T_S ----_
Facility Contact: ve...... A/,ar�.'rtr7Age
, .w..Title: j. Phone No:
Onsite Representative:........ �.... ...� .... _... c.--..� -------------------
Certified Operator:.. a.__.:,......[GtrC�.. . _ ....... ............ Operator Certification Nrrmber:, ,,,, ,,,,,,,, ,, •, , W�W.
Location of Farm:
EJAWNIne ❑ Poultry ❑ Cattle ❑ Horse Latitude a 4 " Longitude • 4 "
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes 2<0
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a_ If discharge is observed, was the conveyance man-made? ❑ Yes ENO
b. If discharge is observed, did it reacts Water of the State? (If yes, notify DWQ) [I Yes Blgo
c. if discharge is observed, what is the estimated now in eallmin? ---
d_ Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ONO
2. Is there evidence of past discharge from any part of the operation? ❑ Yes EWo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes Qio
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes Q-wo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: -•-•-••---- 1................... -2 ................. ... .............
... .............
Freeboard (inches):
12112103 Continued

' Facility Number: — Date of Inspections o c
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes (jj.Nt5
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes 91-No
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 maintenancelimprovement?
❑ Yes ❑.N6-
8. Does any part of the waste management system other than waste structures require maintenancermprovement?
❑ Yes ❑.Nor—
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes [}W
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes ❑ No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes ❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes ❑ No
b) Does the facility need a wettable acre determination?
❑ Yes ❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes ❑ No
I5. Does the receiving crop need improvement?
❑ Yes ❑ No
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 at/or below
❑ Yes ❑ 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 ❑ 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.
y_W
Field
IV''shed Fa"^ qs I( res ,11 of a camp%a,'?4 �ra� ?,n lie,'134 gr-,
Final Notes
NP,'91, 0 - . 411e9hag wus/P was i h a a/ >lc � '��/
r/ carry9
v� ��r'S ,<d�,n � flie,`g�6or also a11�9Pd f��f 1Ci+i+-, a', a% ndlC �Savr
a
Cetal e Far T1r F iJl�trr�Pi- OT �7d9 S
/0�'-04 5 re lci7!°, T @ COs,+ �ct i'n �
rlle Erik P T�� �o n�/o �,5 %3 r
GAar 6d �otd SCv••+ C/'eol.-,l ?jy 4era/1"dr, of
Over- heaver al&lrr, t4ccorrf',10 fa Mr. R,D,/,Br; h' AV--.r, how
/5-y cat4 IaM, 4!'G7` ed acres ava"Ia44 PG- w6e/P /����CaTi�el7� (�M�SIi'//�Pi I GiU/Is � -V
Reviewer/Ins r .,,
%� 11 r xc
Reviewer/Inspector `r � ! _E1�`;_E.` ..��`:"r4.�,_m�..:`.a�:�...���
ReviewedInspector Signature: Date:
12112103 Continued
r

r
Type of Visit ® Compliance inspection O Operation Review O Lagoon Evaluation
Reason for Visit (DRoutine O Complaint O Follow up O Emergency Notification O Other 0 Denied Access
Date of Visit: - 03 Time:rO r
Facility Number $'
Not Operational 0 Below Threshold
Permitted ® Certified 0 Conditionally Certified E3 Registered Date Last Operated or Above Threshold,
Farm Name: u Counh•: t7 bgSa2.
Owner ?Name: 1 Q C. _ Phone No � 1 � _� �(z=(mod 0 -
hlailinD Address: A A.- ja nC 'S rt _ 2g�5 Q_
FaCllitV Contact: er!4- aC�-K- Title: T {+n�e�.:�S?� S Phone No: f • A-t,
Onsite Representative: ar-, Integrator: o
Certified Operator: Zka , C_r.; a Operator Certification Number; 13
Location of Farm:
® Swine ❑ Pouttry ❑ Cattle ❑ Horse Latitude 0 �' �- Longitude ' �• OK
Design Current
Swipe Canarity Pnnnintinn
❑ Wean to Feeder
® Feeder to Finish
JL D 0
[] Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Ca acit7 Po Motion Cattle Ca achy Po Motion
❑ Laver JE3 Dairy
❑ Non -Laver ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons D . ' _ (J Subsurface Drains Present �LJ Lagoon Area JLJ Spray- Field_ Area
-Holding Ponds I Solid Traps - ❑ No Liquid Waste Management System -=
Discharges 8' Stream Impacts
1. is any discharge observed from any part of the operation?
Discharze originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in ealimin?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ)
?. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection 8' Treatment
4. Is storage capacity (freeboard plus storm storage) less titan adequate? ❑ SpiIlway A lk" 4_Spa air W
Structure 1 Structure 3 Structure 3 Structure 4 Structure S 7
Identifier: A=(j
Freeboard (inches):
❑ Yes W No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
® No
❑ Yes
No
Structure 6
OSIV3101 Continued

Facility Number:. —�
Date of Inspection
5. Are there anv 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 anv of the structures need maintenance/improvement?
8. Does any pan of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate. gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenanceiimprovement?
11- is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12- Crop type
13- Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAVI'MP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
I5. Does the receiving crop need improvement?
16. is there a lack of adequate waste application equipment?
Re aired Records S Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists. design. maps. etc.)
19. Does record keeping need improvement? (ie/ irrigation. freeboard, waste analysis & soil sample reports)
20. is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. rail to notify regional D,l"Q of emergency situations as required by General Permit?
(ie" discharge. freeboard problems, over application)
23. Did Reviewerdlnspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AW W?
❑ Yes ® No
❑ Yes P No
❑ Yes W No
❑ Yes - Ir - -
❑ Yes ERNo
❑ Yes Ba.No
❑ Yes 5P No
❑ Yes [R No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ERNo
❑ Yes M No
❑ Yes VNo
❑ Yes No
❑ Yes No
❑ Yes RN
❑ Yes [gNo
❑ Yes [Z No
❑ Yes ERNo
❑ Yes ERNo
❑ Yes Q'No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
y,,,;,;�wx.
Conam"enis (refry to gtrestion ` Eiplgin any�YES sttsweiis aadlor any recommend ttotts:or $av,afha commestts. '
Use drawinss of facdtty to better erplacn situattotis. (ase addt>znutil p g -
-� a °'� ❑ Field Copy ❑Final Notes
N
';Y`s`^=s'§i1
Lz oQ, CQ cp e, C� t
Reviewer/InspectorName
Reviewer/inspector Signature: Date: JJ as O
05IV3101 Condhued

Facility Number: - 25 1 Date of Inspection S`a
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
0510310I
❑ Yes [--]No
❑ Yes ® No
❑ Yes W No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes ❑ No

f
Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ID Routine Q Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
xacilitv Number Date of Visit: 10 QZ Time: f O
rO Not Operational 0 Below Threshold
® Permitted ® Certified 0 Conditionally Certified © Registered Date Last Operated or Above Threshold:
Farm Name: County: ,1Z1-& 41d
Owner Name: .�OGJ^/s e _ &�"x,;' Phone No:
Mailing Address: dr i3. �J % Gt1_�, /Y C
Facility Contact: �� Title: Phone No:
Onsite Representative: I ntegf ator: d 04 of fee X"
Certified Operator: ��`' ,�a1TC'_ Operator Certification Number: 3 5--76)
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' " Longitude •
Des i
Current. _
— Des' :' Curren! - = Current
=Swine Ca achy
Population
1?oultrr_. := Ca'acttv._ Pa tiiation _.cattle Cii act =:Po ulatton
❑ Layer Da ;; ❑
❑ Non -Laver '- ❑Non -Dairy
❑ Other
_ Total Des,gn"Capacit}
:. -Tata1 SSLW. -
Number of Lagiwiis
`" " ❑ Subsurface Drains Present ❑ La oon Area ❑ S rav Field Area
%Hbldung,Potrds / Sohd'Traps Fx-�
_ ❑ No Li uid Waste Management System
❑Wean to Feeder
Feeder to Finish
G
Gd'OD
Farrow to Wean
❑Farrow to Feeder
-W ❑Farrow to Finish
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes [K Na
Discharge originated at: ❑ Lagoon ❑Spray Field ❑Other
a. If discharge is observed, was the conveyance man-made? ❑Yes 51No
b. If discharge is obseryed, did it reach Water of the State? (If yes. notify DWQ) ❑ Yes allo
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) El Yes [&No
2. Is there evidence of past discharge from any part of the operation? ❑Yes ;Q No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑Yes R No
Waste Collection &Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? El Spillway El Yes �9 No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
05/03/01 Continued

Facility Number: ,p -- ?•. Date of Inspection
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes ONO
❑ Yes P9_No
❑ Yes F"No
❑ Yes , No
❑ Yes P'No
Waste Anolication
10. Are there any buffers that need maintenance/improvement? ❑ Yes �o
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN El Hydraulic Overload El Yes ?1�10
I2. Crop type -X rr zm.- ,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ YesNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acre determination? ❑ Yes [�No
c) This facility is pended for a wettable acre determination? El Yes �o
15. Does the receiving crop need improvement? ❑ Yes P54o
16. Is there a lack of adequate waste application equipment? ❑ Yes 0No
Reauired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes XNo
I & Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, c ec✓ts, des�maps c.) ❑Yes �No
19. Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes No
20. is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ YesSIN o
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes XNo
22_ Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes VNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ;KNo
24. Does facility require a follow-up visit by same agency? ❑ Yes J�l No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes JRNo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
and/or say retomtntndatmns or anv othtr oammenrs.
, YES Epany answeCorn`meats(reerto'questton #xissn rs -
Use drawtn of fa to better.explatn setttatto s { addttla©a1 pages as peeessary) 0 T _-� -
C!Iny ❑ Field C Fina! Notes s
onv
_.
.
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 continued

t
Facility Numn6er: — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28_ Is there any evidence of wind drift during land application? (i.e_ residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
05103101
Yes ❑ No
❑ Yes"O`7o
❑ Yes Flo
❑ Yes eMNo
❑ Yes $ No
❑ Yes t�;"No
r
❑ Yes No

Facility Number Date of Visit: �� Tune:
Q Not O erational Q Below Threshold
Permitted 13 Certified 0 Conditionally Certified [3 Registered Date Last Operated or bove Threshold:
Farm Name: ».! . W.. County:..... . � 0".. 9
'`
Owner Name:.. /�bta! . s _ ..1f . � ! A.L f� .r'�-. _......... Phone No:....... :46 _:. 1/V'0
Facility Contact: .46 Title: Phone No:
Mailing Address:.. �d .. Q........ ................ ............ .{N. S 1Y C --- i D
..
Onsite Representative:... ••� .. .. Integrator:
Certified Operator•. S.l..a....... •------------ Operator Certification Number:
_'....- -
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a 6 &4 Longitude • •
<-
:. Design ; '
Current DeSlgn Current
'.'Design . Currestt
Swi>Qe. " _ . - . _ • Ca ci ` ,
Po nlabou -. Poultry _Ca ci '. Pa elation Carrie
"
Ca -. Po Icon -:
Wean to Feeder
10 Layer I 1 ❑ Dairy
Feeder to Finish
❑Non -Layer ❑ Non -Dairy
Farrow to Wean
-
Farrow to Feeder
10 Other I.�
Farrow to Finish
Tdtai °Design Capacity
-
Gilts
Boars
.
-"Total SSLWzq
Number of Lagoons
Subsurface Drains Present Lagoon Area . ❑Spray Field Area
.. ;,.
' -Iio ;Ponds / Solid T
ldutg raps.
:: ' ❑ No Liquid Waste Management System
=
�.r.
Discharges & Stream Impacts
1. Is any discharge observed from any pan of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is 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
If discharge is observed. what is the estimated flow in gal/rnin?
d. Does discharge bypass a lagoon system? (If yes, notify DW Q) ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes �No
S cture I Swure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ........r............
Freeboard (inches):
S/DO Continued on back

9 ;4
Facility Number: — 7
5` I Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes O(No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes �No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the strictures need maintenancelimprovement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes/No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over plic 'on? ❑ Excessive Ponding $PAN ❑ Hydraulic Overload AYes ❑ No
12. Crop type h A4 A."
13. Do the receiving crops differ with those des(nated in tLe Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Yi4►IaiiQtgs;ei deficiencies i re noted dingy t�s;v}sit: X'4 %td t�eb0iyetrio Wtbgr ;
cotri esporidence about this visit` • • • . • • • •
Use'drawrnga of facility to,better ezpllata sitnatiorrs. (use addrhonal pages as iierc�sary}
_ - _ _ r �.- _ _.
D Z` h �P7 As, ater n, w
dlr"f 4y 8� 3. ((a Ibr. over a„- f i/.
/ Z , Zd
1 yd.,4 13,
r j r r I
plyA&!� beo, C ,2G� -6 fAec_ I e coYn'Glkecti" 5ac��Ba�
❑ Yes No .
❑ Yes No
❑ YesJ`No
❑ YesNo
❑ Yes ( No
❑ Yes IANo
❑ Yes No
❑ Yes ❑ YesJNo
No
❑ Yes No
❑ Yes No
❑ Yes `�] No
❑ Yes 0 No
❑ Yes OtNo
❑ Yes tNo
A.
Reviewer/Inspector Name `` ` d = _
Reviewer/Inspector Signature: _ V Date:
5/00

G�
I+aeility Number: — Date of Inspection y' Printed on, 10/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ky
es ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ITo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
\
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ;la
32. Do the (lush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑.No
I-Adoitional'CommentsandlerDrawings:_
5100

}
- _
-- [3 Division of Soil and; Water Conseirvafon- O erataoii Renew
s E L
r] Division of Sotl and -Water Conservation Compliance Luspection{
_M Division of Water Qualtty Conipliatnee Inspection
R L= pe`rabvie`
on Rew,. :�
C Other Agency O
_
® Routine 0 Complaint 0 Follow-up of DW ins ection 0 Follow-up of DSWC review O Other
Facility Number S Date of Inspection
Time of Inspection :mod 24 hr. (hh:mm)
0 Permitted 13 Certified Q Conditionally Certified © Registered 10 Not O erational Date Last Operated:
Farm Name .A,Q.►+ 6 County:.......... �Eto.✓..........................................
......................../-................/..................._................._........
OwnerName: ldv<4✓ s �/ L�i>. �?1. ....... .. Phone No. - ............................................. ................................................ ....................................................................
Facility Contact:....../ti,...........,1/5................ Title:....................... ......---...........------...... Phone No:...................................................
Mailing Address: ......1. ...�:... G .:Da. T. t?....?r....za'.' � r1..l.1Y... ......�r � ( ................................................... .........................
Onsite Representative :.... 6;7 f. .............. 12-a ................................................. Integrator:.. ��?Gcl � .....� LsiaCG�.Jr1
....
1
Certified Operator:_,,,,��%. G, 2)"r. i ..___... .._... Operator Certification iVumber:
..........................................
Location of Farm:
Latitude • 4 •= Longitude • _ «
- Design Current.-:-;- Design Current, ;_ Design - Ciirrent.
Swine Capacity Po ulation =°Poultry ;"-c `achy Pa 0 ulafion Cattle Capacity .,Population
❑ Wean to Feeder
® Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
yREayDairy
er
on-Layer •,._: ❑ Non -Dairy
❑ Other
Total DesiCapaq .
- •:TotaLSSM
.m Number of Lagoons,.: ❑ Suent bsurface Drains Pres❑ Lagoon Area
Holding Ponds / Solid Traps No Li uid Waste Management System
_.. _..r._ ❑ 9 g Y
] Spray Field Are
Vischamgs & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes ONo
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/tnin?
d: D(w,, discharge bypass a lagoon system? (Il'yes, notify DWQ) ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure ] Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ��77
Freeboard(inches): �� ........... .............'�................................................................................................................
...............P..."�./� ...............-.... ...
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, ❑ Yes fikNo
seepage, etc.)
3/23/99 Continued on back

Facility Number: ]Y — �j` Date of Inspection
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ YesANo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes XNo
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes XNo
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes )KNo
12.
Crop type
13,
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes )KNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes No
b) Does the facility need a wettable acre determination?
❑ Yes 99 No
c) This "facility is pended for a wettable acre determination?
❑ Yes A No
15.
Does the receiving crop need improvement?
❑ Yes Wo
16.
Is there a lack of adequate waste application equipment?
❑ Yes �To
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes ANo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
0 WUP -checklists, design, maps, etc.)
Yes ❑ No
19.
Does record keeping need improvement? (i Imgation, reeboard, waste analysis & soil sample reports)
RYes ❑ No
20,
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes XNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes R No
22_
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
❑ Yes ANo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes No
24_
Does facility require a follow-up visit by same agency?
❑ Yes No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes VkNo
Li;Rio yiolA,*Qds;oir- deficiencies were n Ced d ring #his;visit; Yo.ww311 reeeiye q furthgr ;
;cones oridence.about this visit: :
Cotninents (refer to question #) =Expliinrany YE5 answers and/or any recommendations or anyother comments�� - —
Use draw�ng5 of facility to better explajn situations (use•additional pa` es as necessary}—
. 1-. - - - a ..f':�.:4-a-- i •-i--' .. ..,+�% ...�•'i,�__'L� _ - - _ c.,'�--i.--•cam
_-g &
!� A'.Q,d /lGflr4�' �i�GcY=� /�G�� f%viG.c�/J��c� 7a� �CGc•/1 ��.cJ
Reviewer/inspector Name
ector Sinature: ri!
Reviewer/Insp g Date:

Facility Number: -7y — Date of ImspectionFa-
Odor "J9
Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor below ,Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ` CW.,No
roads, building structure, and/or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes [[No
g
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters; etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ YesIo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ffNO
i! orta i `omn en!! an or: rawings = -
1.
I Ki
°A
Id
. ...._ .v.. :�L.;. -.. ., .. x d.�,'...su.-. ., �. ..i'.. .. •Y,T�Ej..sYi•.w'Si.1 .4'..

Facility Number Date of Inspection
Time of Inspection F�!�24 hr. (hh:mm)
Permitted [3 Certified Q Conditionally Certified © Registered [3 Not Operational Date Last Operated:
Farm Name. lJ.r i�. ...... t'M�.. ..... CountV:..........��F�� �... _.... . . .....................
.... ................ .............
Owner Name:.........r v..u1%!�....�...............a a.rQ..l..�.a .......... Phone No: 7-16 ..� .......................................
.......
Facility Contact: s..1 f..(M �. ? !'Ik—....... Titic: ------ Ali,/ .............1 Phone No: ..................... . ............................
Mailing Address: ............................................
Onsite Representative:
Certified Operator:
Location of Farm:
Integrator:
.................... Operator Certification Number:
.................................... .............................................................. ................................................................................................... ....................................................................... .
Latitude ���� �s Longitude
- Design Cnrrent Design Cuieent' x rDesignCurrent
YCapacity='IPo
ulation
❑ Wean to Feeder
ceder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Poultry Capacity Po elation.' tattle Ca "are ` Y'Po Julation
-t ❑ Layer :' ❑Dairy -
Non -Layer Non -Dairy
_..
❑ Other
a Total Design Cpacity
,•. -_
Total SSL�
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance than -made'? ❑ Yes ❑ No
h. If discharge is observed, did it reach Water of the State? (If ycs, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed. what is the estimated flow in gallmin'?
d. Does discharge bypass a la oan system? If yes, notify DW ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway AYes ❑ No
Structure I Structure 2 Structure 3 Structure d Structure 5 Structure 6
Identifier: H
57-
Freeboard(inches): .........1J......... ............................................................................................................................ .......................... • ..-.
5. Are there any im threats to into it -of the structures observed? (ie/ trees, severe erosion, [] Yes ❑ No
a
3/23/99 seepage, etc.) Continued on back

0 w
Division of Soil and Water Conservation -Operation R ;
0 ivision of Soil and Water Conservation -Compliance Inspection
�s
Division of Water Quality - Compliance Inspection a
Other Agency - Operation Reviews`
III Routine 0 Complaint 0 Follow-up of DNVQ inspection 0 Follow-up of DS%VC review 0 Other 1
LFacility Number - �5 Date of Inspection zZ -'1 '_71 J I - I-ime of inspection ` Q 24 hr. (hh:mm)
Aermitted 13 Certified Q Conditionally Certified © Registered JE3 Not Operational Date Last Operated:
rrvL 9a Count6�ESo7��
Farm Name: ...... L. .. .. (4.. `......
Owner Name Qi�1 /� S C�-i` D i t't-a--- Phone No: Z �� ,V
............................................... 1...
Facility Contact:
.._..... �..+
_..L.a..�.�+'��...._..�a-3.Lh.S.............. I'rtle:.....Gr't:lJ.......}-�......................... Phone No:
MailingAddress: .....P6...[.2......... .;?l...........................................................arS J „' V.. .......... ..Ll.?..
%%��._. ......
Onsite Representative:.....o f✓ +1 . Q.tJ[. ..................................... Integrator: ...... ........... ....................... ......................................... .....
Certified O erator: Operator Certification Number:
p .. ........5...............
C �...... T�.......... ......................�......�.
Location of Farm:
Latitude ' 6 At Longitude ' 4 64 .
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
Feeder -to Finish 000 ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder 10 Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ soars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps 10 No Liquid Waste Management System
Discharges & Stream i_ mpacts
1. is any discharge observed from any part of the operation (If yes, notify DWQ)? ❑ Yes j'No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, -was the conveyance man-made'? ❑ Yes ONO
h. li' discharge is observed, did it reach: ❑ Surface Waters ❑ Waters of the State ❑ Yes�No
c. if discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? ❑ Yes gtNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes KNo
3. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes ONO
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? []Yes Kj No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Frcchuard(inches): ................................. .................................... .......................... —...__--
1/6/99 Continued on back

Paitity Number: 7;K — ?5-� I Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? � Yes {gNo
(If any of questions 4-6 was answered yes, and the situation poses an �`
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any pact of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings? ElYes JR(No
Waste Aoolication
10. Are there any buffers that need maintenance/improvement? ❑ Yes )KNo
11. Is there evidence of over applica ion" ❑/Ponding ❑ Nitrogen ❑ Yes �No
12. Cropt �^ .... ... 1(.1�aS..... lA� .................... / ctl hl
YID.. ........ .............. I..............
13. Do the receiving crops differ w th those designated in th Certified Animal Waste anagement Plan (CAWMP)? ❑ Yes XNO
14. Does the facility lack wettable acreage for land application? (footprint) ❑ Yes jNo
15. Does the receiving crop need improvement? ❑ Yes WNo
16. Is there a lack of adequate waste application equipment? ❑ Yes -fo
Renuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes XNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes WO
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes 0,No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes P<No
21. Did the facility fail to have a certified operator in responsible charge?
❑ Yes ANo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes gNO
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ YesP(No
24. Does facility require a follow-up visit by same agency?
❑ Yes �'No
4.vlo)atlOflS Ot c#efiClencjes .w.ere noted duirlll tftlS:vls. You wj .receive no tt riper
•correspgtidenre:abotit'this visit.:-:-; :.,-:-,•..: ..:..... .: :. . . .. ... .. ....
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
rrn� i5 C_omiw a Imti� tierear-
b,k.5 4 5e� Inore, 5ra55 es
dveralt , ,5 54e f5 �1- O_Od shafe.
f
Q� recards
Reviewer/Inspector Name
Reviewer/Inspector Signature: - _&::31 A4_ _ _ Date: t_ Zz ` a I I/6/99

7
VW_ >v
0 Division of Soil and Water Conservation ❑ Ottter Agency
,Division of Water Quality
to Routine O Complaint O Follow-uu of DWO inspection. O Follow-up of DSWC review O Other
Date of inspection®
Facility Number
Time of Inspection -'00 24 hr. (hh:mm)
D Registered Certified © Applied for Permit INPermitted 0 Not O eratiotial Date
pLast Operated:
Farm Name: Fc ^!�..-....! _.......... County:....................IP06esigv�_.............................
...... ............................................................
Owner Name: �f pT t� r .. Phone No: QI 0..-`%6..� ....��.�..............
°......... 5............................................ ° h�i........._........... .............~..
Facility Contact :............ ..eQ../jf ......t&r4&L......., ..... Phone No:
Q. D, Box 497 kl
Mailing Address:..................................I........ a .sa-ui
Onsite Representative:................ �r...................r eM Rrxun S C,-( C/.g�M�I., l�ta
............„L........-- ...... - ..._....... ImegTatar:............... .......... �Certified Operator;..............G. .....n�"cation Nm:..----.......-...._..........pi... Location of Farm:
Latitude =0[ it Longitude 0• =' =11
x Design, Current pesign Current <� w Design ; "Current
'�Capacity�-Population
Poultry;. ;Capacity. Population a Capacity yPopulatign
FCattle
❑ Wean to Feeder
❑ Layer ❑ Dairy
Feeder to Finish plDO O�PO
.4 ❑Non -Layer ❑Non -Dairy
36,.✓+&
❑Farrow to Wean
i ❑ Farrow to Feeder S
❑Other�`;'x F'
f ❑Farrow to Finish�4
r TUtal Dt>stgn Capacit 6
Gilts
Boars
SSLW
vV�wp.. ... ... :.. ....
--Total
w+'f-...;.E�Y, ti. 4ar._;a...ve .. �..s `Fbe. n �xu�.�:,2 ?t. :Sa.rV�s`:• -.k—R .<Y '"��+.
F: Lagoon Area spray Fietd Area
Number of Lagoons / Holding Ponds ®5 ❑Subsurface Drains Present ❑
❑ No Liquid Waste Management System
si"Itz
z,sa`" f
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes )@ No
2. Is any discharge observed from any part of the operation? ❑ Yes XNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes )VNo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑Yes XNo
c. If discharge is observed, what is the estimated flow in gal/min? MIA
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes Pd No'
3. Is there evidence of past discharge from any part of the operation? ❑ Yes J( No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes XNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require N1 Yes ❑ No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 0 No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes KNo
7/25/97
Continued on back

Facility Number: — 7
8. Are there lagoons or storage ponds on site which need to be property closed?
Structures (Lagoons,11olding Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
Identifier: �� l �a aa�t....................:....... ....... ..... ..................
............
....��........ ........ ii
Freeboard(ft):..............�................... t�....................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed'?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers'
NVaste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State. notify DWQ)
❑ Yes 9No
Yes ❑ No
Structure. 5 Structure 6
................................... .............................
.................................................................
Cl Yes XNo
15. Crop type ....... :.............. ........-..A ...... alR ... - !� ..Q..... ............................................................
lb. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW,MP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/inspector fail to discuss reviewlinspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit''
0 No.violatioiisor. deficieineies were noted during this.visit. You.will receive no ftirtlier
correspondence about this. visit'.-'-'.
Q Yes No
Yes
❑ No
❑ Yes
XNo
❑ Yes
KNo
PEI Yes
❑ No
❑ Yes
,� No
XYes
❑ No
❑ Yes
JX No
❑ Yes
X No
❑ Yes
XNo
❑ Yes
fl No
Yes
❑ No
❑ Yes
No
❑ Yes
No
Comments -(refer to question #): Explain any: t'ES an's"veers aitd/or anv; recommeiedaiions oar any niher comments I 1 ' 4,
Use draweags of fattltty, tti better explain situations: (use addittonal`pages`as necesn ). n w:
rU14
A7CO7-A
16. `aa, cAwO1e CJ 06a_xto n� ot,�"vo
1- ; CAWVp
c4WO710 g�j
f _ �aiiiian�u� . 7125/97 d
Reviewer/inspector Name
Reviewer/Inspector Signature:_ �, �� � Date: 6

Facility Number:Date of Inspection:
Addition`a1.Comments and/or Drawings
!j b., s 4
4/3 U/9 7