780100_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

■ Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
780100
Facility Status: Active
Permit: AWS780100 [] Denied Access
Inppection Type:
Compliance inspection
Inactive Or Closed Date:
Reason for visit
Routine
County:
Robeson Region: Fayetteville
Date of Visit:
02/14/2017 Entry Time: 05:00 pm Exit Time: 6:00 pm Incident #
Farm name:
5703, 5704, & 5711
Owner Email:
Owner:
Murphy -Brown LLC
Phone: [phone]
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
1605 Montford Rd
Maxton NC 28364
Facility Status:
Compliant ❑
Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm:
Latitude:
34° 41' 51" Longihrde: 79' 19' 44"
Travel south from Maxton
approx 2 miles on NC 130 tum left on SR 1121 go approx. 112 mile tum right on farm road. Farm is
approx. 112 mile.
Question Areas:
Dischrge & Stream Impacts
Waste Col, Stor, & Treat
Waste Application
Records and Documents
Other issues
Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008
Secondary OIC(s):
OnSlte Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone:
On -site representative Mike Cudd Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Dale:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS780100 Owner - Facility: Murphy -Brown LLC Facility Number: 780100
Inspection Date: 02/14/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
�%mne arrow to Wean 7,200
Total Design Capacity: 7,200
Total SSLW: 3,117,600
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7703
19.00
70.00
Lagoon
7704
01/19/94
19.00
37.00
Lagoon
7711
26,00
%.00
page: 2

Permit: AWS780100 Owner - Facility : Murphy -Brown LLC Facility Number: 780100
Inspection Date: 02/14/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
01111
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection Storage & Treatment
Yes
No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
B. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
■ ❑
❑
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 aitematives 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 > 100ld10 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: AWS780100 Owner - Facility: Murphy -Brown LLC Facility Number. 780100
Inspection Date: 02/14/17 inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No No Me
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Com, wheat, Soybeans
Crop Type 3
Cotton
Crop Type 4
Small Grain Overseed
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro loamy sand, 0 to
2% slopes
SOLI Type 2
Lynchburg sandy loam
Soil Type 3
Rains sandy loam
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑0 ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ ■ ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ E ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑ E ❑ ❑
Records and Documents
Yes
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
1101111
20. Does the facility fail to have all components of the CAWMP readily available?
❑
■ ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS780100 Owner - Facility: Murphy -Brown LLC Facility Number: 780100
Inspection Date: 02/14/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No No Ne
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22, Did the facility fail to install and maintain a rain gauge?
❑
❑ ❑
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?
❑
E ❑ ❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑ ❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑ ❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑ ❑
Other Issues
Yes No Na 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?
ONE][]
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tie drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewrnspection with on -site representative?
❑
E ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
780100
Facility Status: Active
Permit: AWS780100 ❑ 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: 11:00 am Exit Time: 11:30 am Incident #
Farm Name:
5703, 5704, & 5711
Owner Email:
Owner:
Murphy -Brown LLC
Phone: [phone]
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
1605 Montford Rd
Maxton NC 28364
Facility Status:
Compliant ❑
Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm:
Latitude:
34° 41' 51" Longitude: 79' 19' 44"
Travel south from Maxton approx 2 miles on NC 130 turn left on SR 1121 go approx. 112 mile turn right on farm road. Farm is
approx. 112 mile.
Question Areas:
Disrhrge & Stream Impacts
Waste Col, Stor, & Treat
Waste Application
0 Records and Documents
Other Issues
Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone:
On -site representative Mike Cudd Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS780100 Owner - Facility : Murphy -Brown LLC Facility Number: 780100
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
[] Swine - Farrow to Wean 7,200
Total Design Capacity: 7,200
Total SSLW: 3,117,600
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7703
19,00
24,00
Lagoon
7704
01/19/94
19,00
25,00
Lagoon
7711
26.00
43-00
page: 2

Permit: AWS780100 Owner - Facility : Murphy -Brown LI_C Facility Number: 780100
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yea
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?
❑
❑ ■
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ O
❑
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)
❑
❑ E
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
■ ❑
❑
State other than from a discharge?
Waste Collection Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (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?
T Do any of the structures need maintenance or improvement?
❑
MEJ
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
E ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10, Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ ❑
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: AWS780100 Owner - Facility : Murphy -Brown LLC Facility Number: 780100
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
i Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Com, Wheat, Soybeans
Crop Type 3
cotton
Crop Type 4
Small Grain Overseed
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro loamy sand, 0 to
2% slopes
Soil Type 2
Lynchburg sandy loam
Soil Type 3
Rains sandy loam
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ 0 ❑ ❑
determination?
17. Does the facility lack adequate acreage for sand application?
1101113
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑ ❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
WLIP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
E]
If Other, please specify
21. Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS780100 Owner - Facility : Murphy -Brown LLC Facility Number: 780100
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Ne
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
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 surrey
❑
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 / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

U Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
780100 Facility Status:
Active Permit: AWS780100
❑ Denied Access
inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County: Robeson Region:
Fayetteville
Date of Visit:
03/19/2014 Entry Time: 10:00 am
Exit Time: 10:30 am Incident #
Farm Name:
5703, 5704, & 5711
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 1605 Montford Rd Maxton NC 28364
Facility Status: 0Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34' 41' 51" Longitude: 79° 19 44"
Travel south from Maxton approx 2 miles on NC 130 turn left on SR 1121 go approx. 112 mile turn right on farm road. Farm is
approx. 112 mile.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Michael L Cudd Operator Certification Number: 25233
Secondary OIC(s):
On -Site Representative(s): 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:
57031 = 25"
57041 = 25"
57111 = 54"
Records reviewed 2128/14.
Site visit 3/19/14.
page: 1

Permit: AWS780100 Owner - Facility : Murphy -Brown LLC Facility Number: 780100
Inspection Date: 03/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine -Farrow to Wean
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7703
19.00
Lagoon
7704
01 /19/94
19.00
Lagoon
T711
26.00
page: 2

Permit: AWS780100 Owner - Facility : Murphy -Brown LLC Facility Number: 780100
Inspection Date: 03/19/14 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)
❑
❑ E
❑
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 Collection. Storage & Treatment
Yes No Na Kg
4. Is storage capacity less than adequate?
❑
■ ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
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 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry slacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste ApAlication
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?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS780100
Owner - Facility : Murphy -Brown Li_C Facility Number: 780100
Inspection Date: 03/19/14
Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Overseed
Crop Type 3
Cotton
Crop Type 4
Conn, Wheat, Soybeans
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro
Soil Type 2
Lynchburg
Soil Type 3
Rains
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
E ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
N ❑
❑
Records and Documents
Yes
NQ Na NP
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?
❑ E ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS780100 Owner - Facility : Murphy -Brown LLC Facility Number: 780100
Inspection Date: 03/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
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?
❑
E ❑
❑
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?
❑
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
■ ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

0
El
Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number:
780100
Facility Status: Active Permit: AWS780100
Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Robeson Region:
Fayetteville
Date of Visit:
02/26/2013 Entry Time:
04:00 prn Exit Time: 4:30 pm Incident #
Faun Name:
5703, 5704, 8 5711
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address: 1605 Montford Rd Maxtan NC 28364
Facility Status: EMurphy-Brown LLC
Compliant Not Compliant Integrator:
Location of Farm: Latitude: 34' 41' 51" Longitude: 79° 19' 44"
Travel south from Manton approx 2 miles on NC 130 turn left on SR 1121 go approx. 112 mile turn right on farm road. Farm is
approx. 112 mile.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, R Treat Waste Application
Records and Documents Other Issues
Certified Operator: Harold E Whittaker Operator Certification Number: 25624
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone:
On -site representative Mike Cudd Phone
Primary Inspector Robert Marble Phone:
Inspector Signature: Date:
Secondary inspector(s)-
Inspection Summary:
Records reviewed 218113
Site visit 2126113
page: 1

Permit: AWS780100 Owner - Facility : Murphy -Brown LLC Facility Number: 780100
Inspection Date: 02/26/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
��nearrow to Wean 7,200
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
7703
19.00
Lagoon
7704
01 /19194
19-00
Lagoon
7711
26,00
page: 2

J
Permit: AWS780100 Owner - Facility : Murphy -Brown LLC Facility Number: 780100
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na Ne
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
0
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
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)
❑
110
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
[]
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS780100 Owner - Facility : Murphy -Brown LLC Facility Number: 780100
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No NaNe
Crop Type 1
Coastal Bermuda Grass
(Key)
Crop Type 2
Small Grain Overseed
Crop Type 3
cotton
Crop Type 4
Com, Wheat, Soybeans
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro
Soil Type 2
Lynchburg
Soil Type 3
Rains
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ N ❑
❑
Management Pian(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
[] E ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ E ❑
❑
Records and Documents
Yes No Na Ne
19, Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ E ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑
❑
If yes, check the appropriate box below
WU P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS780100 Owner - Facility : Murphy -Brown LLC Facility Number: 780100
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1"Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
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?
❑
❑
❑
If yes, check the appropriate box below.
Application Field ❑
Lagoon / Storage Pond ❑
Other ❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ 0 ❑ ❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ 0 ❑ ❑
34. Does the facility require a follow-up visit by same agency? ❑ 0 ❑ ❑
page: 5

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Oq'.00 Departure Time: Oy: r• County: ��/✓
Farm Name: 5 1 03-70 5,1 f 1-1 C7?11 7703 '770VoLer Email:
Owner Name: mi., Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: 0,)k�,_ i _ 1 -4 Title: Phone:
Onsite Representative: Integrator:
Certified Operator: 4� L;�4Certification Number: ZfO2jy
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
_
Swine - ..-
Wean to Finish
Wean to Feeder
Design Carrent
Capacity Pop.
Wet Pointry
Layer
I INon-Layer
Design
Capacity
I
I
Current
Pop.
Design Carrent
Cattle Capacity Pop.
airy Cow
airy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Soars
Othe
Other
7
Dr P,ou1
Layers
Non -Layers
Pullets
Turkeys
ITurkey Poults
Other
Ca aci
P,o
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Imnacts
I . Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[�3 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: - Date of Inspection: &a
3
Wjiste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
P No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
r"- NA
Iri
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a 0
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) r
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
_Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Od) No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approve Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those
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?
IT Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
D. NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes �j No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes P No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements []Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes [V No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 19
No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes G5 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

[Facility Number: jDateof Inspection:
24' Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes MA No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes P No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
❑ Yes 1 a No ❑ NA ❑ NE
24. 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.
T
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes [ No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility? If yes, check the appropriate box below.
Yes ❑ No
❑ NA ❑ NE
`® Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ NA ❑ NE
Comments (refer to question ft 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).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: Q/O -- y
Date: '2
21412011

L ype of v isir: V uompuance inspection L1 uperanon meveew u Ntrucrure r.vatuanon V i eenntcat Assistance
RI
eason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: / Z� Arrival Time: d: 3WDeparture Time: 04 County: Region: ';!
Farm Name: 5�03- Q S I J ��71 �, �703) Owner Email:
Owner Name: 9. AA ,,,A*V-1 Phone:
Mailing Address:
Physical Address:
i
Facility Contact: � �CA41 Title:
Onsite Representative: H
Certified Operator:Ah��
Back-up Operator:
Location of Farm:
Latitude:
Phone: , l
Integrator: M 7�Y� LLC
Certification Number:
Certification Number:
Longitude:
Designs Cur er nts� Design C�u nt
Design Current
Swine Gapac "Pop Wet Capacity"P P ;. Cattle
Capacity Pap.
-Poultry
Wean to Finish La er Dairy Cow
Wean to Feeder f
: Non -Laver Dairy Calf
Feeder to Finish `" - . Dairy Heifer
Farrow to Wean '' esign C.n irit3 -, D Cow
Farrow to Feeder D , �l?oult . FD
aaci Po x`, Non -Dairy
Farrow to Finish Layers " Beef Stocker
Gilts- Non -Layers Beef Feeder
Boars Pullets Beef Brood Cow
�Turkeys w.t
a. _
Other a Turke Poults
Other Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
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 0 No ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes [-]No
❑ Yes ❑ No
❑ Yes M No
❑ Yes � No
M NA ❑ NE
Q4 NA ❑ NE
NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facie Number: -
Date of Ins ection:
Waste Collection & Treatment �
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 6 Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No P9 NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ST7 0L
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �f �
5. Are there any immediate threats to the integrity of any of the structures observed? ElYes 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 Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
No
❑ Yes;.)
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, et
❑ PAN [] PAN > 10% or 10 lbs.
❑ Outside of Acceptable Crop Window
12. Crop Type(s):
13. Soil Type(s): G
14. Do the receiving crops differ from those
❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Evidence of Wind Drift ❑/
�(A-A s U-0"�s
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?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements
of Approved Area
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes rM
No
❑ Yes
No
Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes W No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tra6sfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes N No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [] Yes IN N
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
o ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

[Facility Number: - Date of Inspection: 7 'L
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No NA ❑ NE
Other Issues T
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately. 1P
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application) P,
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any:additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pates as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: 3 7 // 7==
2/4/2011

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: �: Ik Departure Time: �! County: RW� 4- " Region: r—' 1
Farm Name: 77o Owner Email
Owner Name: Phone:
Mailing Address:
Physical Address: /� /� j
Facility Contact: 1 ' � 1 CJ r Title: Phone No:
Onsite Representative: u Integrator: LtiK [.t-L_
Certified Operator:.— �Y"t`uW Operator Certification Number:af t
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = n = ' W Longitude: r—] o = ` = u
U,
`
:,III
�Destgn�;�Current
Design � Current Y Design Current
Swine
Capacity Population
Wet Poultry #Capacity�P p la�tton Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Daia Cow
❑ Wean to Feeder
❑Non -La er
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
Dry Poultry gyk r El Da Cow
— ❑ Non -Daffy
❑ Layers ❑ Beef Stocker
❑ Non -Layers ❑Beef Feeder
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑Pullets
ues
❑ Beef Brood Co
❑ Boars
❑ Turkeys
Other tl ;-
❑Turke Poults
., ..
❑ Other
❑ Other
Number of Structures
Discharges & Stream Impacts
1 _ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ia No ❑ NA ❑ NE
❑ Yes
❑ No
PNA
❑ NE
❑ Yes
❑ No
[�NA
❑ NE
❑ Yes
❑ No
OrNA
❑ NE
❑ Yes
[�DNo
❑ NA
❑ NE
❑ Yes
�3 No
❑ NA
❑ NE
Page 1 of 3 12.128104 Continued

Facility Number: r)— m Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No F
NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: G7 d 3
Spillway?. -
Designed Freeboard (in):
Observed Freeboard (in): 39t `
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
p No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
No
ClNA ElNE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the stnuctures need maintenance or improvement? ❑ Yes
P) No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
® No
El NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
f
9. Does any part of the waste management system other than the waste structures require ❑ Yes
,N No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
PNo
❑ NA ❑ NE
maintenance/improvement?
11, Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
PNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% cr l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outsidt- of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designate�t-fn the CAWMP?
❑ Yes
OlNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[0No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
P No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
V No
❑ NA
❑ NE
18, Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
Pi s I-eA,; 21�1/.
. 5,4t V",;'� Ce V11/11
Reviewer/inspector Name . y[ - Phone: jr33�
ReviewerlInspector Signature: Date: (
Page 2 of 3 12128104 Continued

Facility Number: — Date of inspection 17a/Lf 1
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ,9No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ ❑ Maps
Design
g p ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
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
P No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[29 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
n?U No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
91 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�No
ElNA
ElNE
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
I
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
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
Q9 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
99 No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

91.
Type of Visit (Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit & Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: -ZS-/O Arrival Time: Departure Time: 7%vOPIN County:
Farm Name: -6-7,9 3 1 . S7o V -1 -57,// - / Owner Email:
Owner Name: �' Btu L L C, Phone:
Mailing Address:
old #,Is -7-7// 1-703 � 7-70y )
Physical Address:
Region: '01-51ea
Facility Contact: /'r ; Ice- C4,c;,� Title: 1 NM '4fd1V4-3e4" Phone No:
Onsite Representative: Integrator: %1'�'&ZW /
Na►-o1l E. Wl'�4 -a%w ZS6aSf
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = I = l{ Longitude: 0 0 = 6 = {f
Swine
Design @urrent
Capacity Popula..tion
Design Current
&0111ulation
Wet try Capacity Population
Cattle
Design Current
16FPXc�!!7yAR9P-
❑ Wean to Finish
❑ La er
❑Dai Cow
❑ Wean to Feeder
on -Layer
❑Dai Calf
❑ Feeder to Finish
DairyHeifer
Farrow to Wean
7200
Dray Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
-erslles
❑eef Feeder
FO Boars
uGilts
❑ Beef Brood Ca
❑ Turkeys
Other.
❑ Other
❑ Turkey Poults
❑
Number of Structures:
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
2fNA
❑ NE
❑ Yes
❑ No
PY'NA
❑ NE
,DNA
❑ NE
❑ Yes
❑ No
❑ Yes
Q�No
❑ NA
❑ NE
❑ Yes
FePNo
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number:78 - /00
Date of Inspection 3-ems /O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a_ If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: 570.3 -1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 36 'Pe 33 � z710,
z
❑ Yes M No ❑ NA ❑ NE
❑ Yes &No ❑ NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
VINo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
PNo
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
)9 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
EgNo
❑ 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
ZNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
d No
❑ NA
❑ NE
maintenance/improvement?
1 1. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes W No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) mod-... (/s67_)F Sy�.tl�Cl'Gf..i i0. S .,� Co fatsn/� CarN_b,11n_t-s�47r.n/
13. Soil type(s) 6 01 J _ 6--o N c.f 6 Ra i N S ,+�
14. Do the receiving crops differ from those designated in the CAWMP? El Yes 2 1 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes F1 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes IM No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes Wo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes F1 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):
t
Reviewer/Inspector Name /�r�J t ve.�S Phone: 1/O, �L33. 3300
ReviewerAnspector Signature: iQ Date: -5k­ a7- Za�a�J
Page 2 of 3 12128104 Continued

Facility Number: ?g —/OZ� Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes L�No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ETNo ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E9 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
AW No
ElNA
ElNE
23_ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
EY No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�RNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�RNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
/a No
[:3NA
ElNE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
JA 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
QjPNo
❑ 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
�NNo
❑ NA
❑ NE
Page 3 of 3 12128104

I
Type of Visit 0 Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other ❑Denied Access
FRX
Date of Visit: �77 Arrival Time: i.r +Departure Time: p f�Qlr, County:bN Region:
Farm Name: _ ,. 7D 7 11 !iI4 1 . 52 1 1 ! Owner Email:
Owner Name: Phone:
Mailing Address: '
Physical Address:
Facility Contact:��P �S Title:
v
Onsite Representative:
Certified Operator:
Back-up Operator: ! ""
Phone No:
Integrator: L i/
Operator Certification Number: air —
Back-up Certification Number:Y1
Location of Farm: Latitude: = p 0 , = „ Longitude: ❑ ° = 6 = Lf
Design Current`
Design rn Design Current
Swine
Capacity Population ` Wet Poultry
Capacity PopuEat,ari Cattle Capacity Population
❑ Layer
ti ❑ DairyCow
6,1E] Non -Layer
❑ DairyCalf
a
❑Dai Heifer
t I' -
Dry Poultry
Af 4d. AK fi-.Lvl ❑ Dry Cow
°ta
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Other>;y
❑ Other
Number of Structures:
❑ Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean a�
Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars '
Discharses &Stream Impacts
❑ Layers
Discharses &Stream Impacts
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turke Pouits
❑ Other
1. Is any discharge observed from any part of the operation? ❑Yes �No ❑ NA ❑ NE
Discharge originated at: [I Structure El Application Field El Other
a. Was the conveyance man-made?
❑Yes
❑ No
�NA
r
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
El Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
❑Yes
❑ No
NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
El Yes
�No
NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
� No
❑ NA
❑ NE
other than from a discharge?
Page ! of 3
12/28/04
Continued

Facility Number: — Date of Inspection I LJ
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �1 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ® NA El NE
Stru ture I Struc ure 2 cture 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): q
Observed Freeboard (in): 37 i (r�17
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 kNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 0No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes �No 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 �No El NA ❑ NE
maintenance or improvement?
Waste ADnlieatiOn
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes rANo ❑ 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 Cro Window ❑ Evidence
_of`[Wind Drift ❑ Application Outside of Area
12. Crop types) �i ✓/,le V' "+ter`
13. Soil type(s) I_q u--Q r 516 .4,hS
14. Do the receiving crops differ ffom those designated in the CAWMP?
t5. 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
1�No
❑ NA
❑ NE
[� No
❑ NA
❑ NE
{" No
❑ NA
❑ NE
No
❑ NA
❑ NE
No
El NA
El 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 Phone: lO_c?oo
Reviewer/Inspector Signature:tam Date:
,rage L Of 3 l6/za/u4 Uunat"Ura

Facility Number: Date of Inspection
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 appropriate box.
❑ WUP El Checklists ❑Design ❑Maps El Other
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes W 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?
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
❑ No
ONA
❑ NE
❑ Yes
QgNo
❑ NA
❑ NE
❑ Yes
F No
❑ NA
❑ NE
❑ Yes
kd No
❑ NA
❑ NE
❑ Yes
❑ No
r%NA
❑ NE
❑ Yes LpNo ❑ NA ❑ NE
❑ Yes N No ❑ NA ❑ NE
❑ Yes
�a No
❑ NA
❑ NE
❑ Yes
A No
❑ NA
❑ NE
❑ Yes
N No
❑ NA
❑ NE
Page 3 of 3 12128104

J
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: "-'�� Departure Time: �i[� County: F1 Region:
Farm Name: 5rf Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Ake �(1LI%�7 _ Title:
Onsite Representative. 1f
Certified Operator:
Back-up Operator:
Phone:
Phone No:
Integrator: /'ll�hnl/l
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: o Longitude: = o
�Deston Current
Dcstgn Current llesign Current
Swine
;.
Capacityµ Population
Wet Poultry
Capau.ty Population Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Uai Cow
❑ Wean to Feeder
ElFeeder
❑ Non -Layer
❑Dai Calf
to Finish
h [] Dairy Heifer
Dry Poultry
El
Farrow to Feeder
ow to Wean �
El Farrow to Finish
❑ Gilts
❑
Discharges &Stream Impacts
1- Is any discharge observed from any part of the operation?
Discharges &Stream Impacts
1- Is any discharge observed from any part of the operation?
El Yes
rNo
❑ NA
❑ NE
Discharge originated at: ❑Structure El Application Field El Other
a. Was the conveyance man-made?
❑Yes
❑ No
NA
❑ NE
h. Did the dischar-e reach waters of the State'? (If yes. notify DWQ)
El 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? ([fyes, notify DWQ)
El Yes
❑ No
1PNA
❑ NE
2. Is there evidence cif a past discharge from any part of the operation?
El Yes
1PNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
`� No
❑ NA
❑ NE
other than from a discharge?
l
Page 1 of
12/28/04
Continued

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?
Structure I Structure 2 Structure 3 Structure 4
�j
identifier: 57031 � r 0 � .�� 1
Spillway?:
Designed Freeboard (in):
c?
Observed Freeboard (in): oc(g' ll 3
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 rp No ❑ NA ❑ NE
❑ Yes ❑ No 40 NA ❑ NE
Structure 5 Structure 6
❑ Yes `® No ❑ NA ❑ NE
❑ Yes P 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 M No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 0 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ®No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [4) No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1'No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination '?
❑ Yes
0 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
El Yes
IFNo
❑ NA
❑ NE
18, is there a lack of properly operating waste application equipment?
❑ Yes
1P No
❑ NA
❑ NE
vvm s oftfac�lity to better er lain situations. use additional�`a V
Comments {refer;to gnest�on##) � Xpla,n any YES answers and/or a�i yre�commendations or any other commenis.
Use�dra g p ( �p .gesAas£necessar;V}:
w
r Ise p M
Reviewer/Inspector lame t � � _ _ � . r �: ��� _�<: Phone:
Reviewerhnspector Signature: _ Date: 7
rage Z Of 3 1L11Z6104 c,onrrnuea

Facility Number: — 1CQ Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �p No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes �3 No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [�No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes V No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes PNo ❑ NA ❑ NE
25_ Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ONo ❑ NA ❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[RNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification'?
❑ Yes
IoNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
F] 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
19 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
tl No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
6 No
❑ NA
❑ NE
Additional.Comments and/or Drawings:. t.
Page 3 of 3 12128104

J
® Division of Water Quality
[Facility Number �� 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
p ss
Date of Visit: Arrival Time: voo 'D Departure Time: (0: 00 Q County: � Region: /TO
Farm Name: .-% � � � ( 1 o 3 D Owner Email:
I 1 1
Owner Name: 1 rlZ1.►r Phone:
,Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Title:
Phone No:
Integrator: M twpli-t'
Operator Certification Number:
Back-up Certification Number:
Latitude: = o =' = Longitude: = ° = , ="
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
arrow to Wean
a00
'l a
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers ---
El Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heife,
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cowl
Dumber of Structures: TI
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 53No El NA [I NE
❑ Yes
❑ No
P NA
❑ NE
❑ Yes
❑ No
F NA
❑ NE
Y NA
❑ NE
❑ Yes
❑ No
El Yes
� No
❑ NA
❑ NE
❑ Yes
1P No
❑ NA
❑ NE
12128104 Continued

facility�Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes )ONo El NA [-INE
a. If yes, is waste level inKul
a structural freeboard? El Yes El No P NA [I NE
Structure 1ture 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 5903 ( 57Ot{ ) I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [� No ❑ NA [I NE
(ie/ large trees, severe erosion, seepage, etc.) !
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes �ffNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes P No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the pen -nit? ❑ Yes §9 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 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes (9 No ❑ NA ❑ NE
maintenance/improvement?
I I . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [�,No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift El Application Outside of Area
12. Crop type(s) a.' (a+,)t S'.1 I � r� d[ . Ca7'rt` Vi , w _.,"r
13. Soil type(s) I2 k _
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1�1 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
M No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
(7F No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
1;allo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
L&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 flame
Re-viewer/Inspector Signature:
Phone: (Tfp
Date:
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists El Design El 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
PNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P] No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
PNo
❑ 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
;ANo
❑ 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
E 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
V1 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
K No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
1P No
❑ NA
❑ NE
Additional,Commenis and/or Drawings:
:.
Page 3 of 3 12128104

® Division of Water Quality
Facility Number 7 $ 70 0 Division of Sail and Water Conservation
Type of Visit ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I &-1 Z - O(P 1 Arrival Time: I /; s Departure Time: L % VS! County:
Farm Name: *57p3 ems. $ 7111 f ` pad Cara 1 'S 704
77J1 Owner Email:
Owner Name: f '' k�b� �. ���✓ Phone:
IF
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: _ 184- AiMutnd__S
Certified Operator:
Back-up Operator:
Phone No:
Integrator: 4 A/
Operator Certification Number:
Back-up Certification Number:
C20
Location of Farm: Latitude: = o = 6 = Longitude: = o =1 , = u
V'i • Design Current Design Current Design
Swine CapatyPopulation Wet Poultry Capa city Popnlation Cattle Capacity
Current
Population
❑ Wean to Finish
❑ Layer
❑ Non -Layer
❑ Da' Cow
Dairy Calf
s. DairyHeifer
Iny Poultry" ❑ D Cow
❑ Non -Dairy
Layers El Beef Stocker
❑Beef Feeder
lts
RE
d Co
Other
❑ Other
Number of 5truetures:
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
7ZQ (�
❑ Farrow to Finish
❑Gilts
❑ Boars
Discharges &Stream Impacts
1.
Region:
Is any discharge observed from any par[ of the operation?
El Yes
[A No
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
❑Yes
[g No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
[� No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑yes
14 No
❑ NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
[I Yes
®No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
®No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

IA
Facility Number: — Date of Inspection1&-yZ-006
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes []?No ❑ NA ❑ NE
the appropriate box. ❑ WDP ❑ Checklists ❑ ❑ Maps
Design
g p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [A No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crap 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
MNo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
O No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
IVNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[�No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
(P No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[?No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 L Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
Wo
❑ 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
PFNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
297No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3
12128104

J
Facility Number: - jU0
Date of Inspection --�2-
a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:".
Spillway?:
Designed Freeboard (in): ]9 y ZO �( 30
Observed Freeboard (in): f T 3 �r %13
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 [A No ❑ NA ❑ NE
❑ Yes E� No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes M No ❑ NA ❑ NE
❑ Yes [�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 [?No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ( No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [� No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) _ �Nc rf w .5w 6qVonJ, i.3Uc_ :FE!s
13. Soil type(s) Ly 2a
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes q No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [A No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination ? ❑ Yes [2 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[3 No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommepdations or any other comments
Use drawings of facility to.better explain situations. useaddtttonal pagesyas necessary): -�
Reviewer/Inspector Name 1 V } Phone: ` 10 *33 - 33D O
ReviewerfInspector Signature: Date: -- 2 7_CIU
rage -, of s I C/-,Wu4 c,onnnuea

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: �%� `7� Departure Time:
Farm Name: *� .67031 r7Q#1 0111 6014GI-robf-4 17-
County: RObeSer.i Region: M-0
Email:
Owner Name: /u LtV� _ _ B l�lns Phone:
Mailing Address:
Physical Address:
Facility Contact: w it es ~1r1 &Af= Title:
Onsite Representative: ­rtXVI_ ejr
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No.
Integrator: AkrF:dz� B 46Z
Operator Certification Number:
Back-up Certification Number:
Latitude: = = [ Longitude: = o =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
❑ Non-Layet
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: E]
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 N No ❑ NA ❑ NE
❑ Yes
[9 No
❑ NA
❑ NE
❑ Yes
[9No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
N No
❑ Yes
tR No
❑ NA
❑ NE
❑ Yes
�9 No
❑ NA
❑ NE
12128104 Continued

Facility Number: — jOp Date of Inspection
Waste Collection Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
rK No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
91 No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: �SS037
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): .31 33 ~ 4e 4.
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
DI 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
t0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No ❑ NA ❑ NE
maintenance/improvement?
1 I . Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind 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
[2 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
t@ No
❑ NA
❑ NE
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`-❑ Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Comments (refer to question #): Explain any 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 Namee,(S °y' Phone:
Reviewer/Inspector Signature: Date: [L — ZO —2pOS�
121-1 t" c.onunuea

Facility Number: —7 —fQD Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design
g El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [9No ❑ 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 Cade
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ;9 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [X No ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
U 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
[KNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
59 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
fA No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[3No
❑ 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
14 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
M No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[KNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
U No
❑ NA
❑ NE
Additional Comments and/or Drawings:.
12128104

I
F1 E.-`r.,.s� r ' a�...,s _-'-a'�. `%ii, vr.,.�cwr-- `�' •e.. ?��-�r� _. _ _ ... .=r'c... � � - ___ .....-_ .,. i - �'II
u .sl�:..a.n:. $•'. .s. --.+r - �: :c... z ,.-taa�-»_.z..-_.r_>. r—'........ _""- ... ... .. ., �- �,. -_ r. ,— x-.:� .:- _
Type of Visit 0 Compliance Inspection O operation Review O Lagoon Evaluation
Reason for Visit ®Routine O Complaint O Foliow up O Emergency Notification O Other ❑ Denied Access
Faeilin. Number g O O Date of Visit: )L WOITime:
• .�10 Not O erational 0 Below Threshold
® Permitted ® Certified 0 Conditionally Certified 13 Registered Date Last Operated or above Threshold:
i
Farm Name: ��,�{,,-, i S „7-lw f County: _
Owner lame: A i G Ps— 4",���'13 Phone No: ��0
r
�laiiing Address: !� CEO x �, t,�(SG •.i S {J,c . �9, 3 gr9,
Facility Contact: _iJ�� IC�P��e v.,bc.�cal� Title: Phone No:
Onsite Representative: `/_&,,-.-Jk F'Ui.eM Pir. 66, integrator:
C. C, f
Certified Operator: , Operator Certification Number: I O
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 6 a Longitude ' �•
Design Current Design Current Design Current
Swine Ca acitt Pa nlation Poultn Capacity Population Cattle Ca acitV Population
❑ Wean to Feeder 10 Laver I ❑ Dairy
❑ Feeder to Finish 10 Non -Laver L Non -Dairy
10 Farrow to Wean b
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons JU Subsurface Drains Present IILJ Lagoon area JL
Holding Ponds I Solid Traps JEJ No Liquid Waste Management System
Sprav Field Area 1
Discharges S- Stream Impacts
I . is anv discharge observed from any part of the operation?
-
El Yes
No
Discharge originated at: ❑ Lagoon ❑ Sprav Feld ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
❑ No
b. if discharge is obsen•ed, did it reach Water of the State? (If yes, notify DWQ)
❑ Yes
❑ No
c. if discharge is observed, what is the estimated flow in gallmin?
d_ Does discharge bypass a lagoon system? (If yes. notify DWQ)
❑ Yes
❑ No
2. is there evidence of past discharge from any part of the operation?
❑ Yes
No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
W No
Walte Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
QjNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: 2:101 TTIl CdA _ I I-04
Freeboard (inches): X3
05103101 l j `l
Continued

Facility Number: — pp
Date of Inspection —I—=i`���
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 ARolication
10. Are there any buffers that need maintenance/improvement?
I 1 _ Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop typei3fLn0D.E.
❑ Yes
No
❑ Yes
[N0
❑ Yes
No
❑ Yes
No
❑ Yes
(>_jNo
❑ Yes
n No
❑ Yes
P No
13. Do the receiving crops differ with those designated in tfic 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?
Reuuiryd Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ 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?
❑ Yes Q No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 0 No
❑ Yes El No
❑ Yes URNo
❑ Yes (N No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
(ie/ discharge, freeboard problems, over application) ❑ Yes 0 No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes `Q No
24. Does facility require a follow-up visit by same agency? ❑ Yes tQ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes JP No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Field Copy U Final Notes
4 " ,So i ( --J-,_,Jk-c.— t
kt' %-t,4 l c� �-,. �,,,e,lo two e ,r` �}o + � o rat w-rsl, l ri 4 �-w�c 103
— coo r- j d- L0d (--4 �4 6 d z
IReviewer/Ins pectorName��Wr'�T
Reviewer/Inspector Signature: Date: ]L2-0
05103101 Continued

y � v
Facility Number: S — 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 drill 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 permanenthemporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
O5103101

4, to
Type of Visit 0) Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facitity lumber o Date of Visit: isit: l 1 !(A 3 Time: L � : s
?\ot O erational 0 Below Threshold
® Permitted [2 Certified [] Conditionally Certified 0 Registered Date Last Operated or above Threshold:
Farm Name: _ 4 IF, a An "r . County: _
Owner Name: P ,-rrroUj LV a!I � � _f151.3 4-�11-1`hone No: S 1.0 1 � , "S%3}
Mailing Address: b . j10 k R 54 l/ W Sd'W
Facility Contact: Title: I _PJ AA Phone No: SA tV%
Onsite Representative: :.:LL CQ r--6 Integrator: Is
Certified Operator: n.. ! Operator Certification Number-
Location of Farm:
Swine ❑ Poultry ❑ cattle ❑ Horse Latitude ' 4 Longitude ' 1
Design Current Design Current Design Current
Swine Ca acilt Population Poultry Ca acitV Po ulation Cattle Callacitv Population
❑ NVean to Feeder 111 Laver ❑ Dairy
❑ Feeder to Finish I0 Non -Laver ❑ Non-Dairy
® Farrow to Wean ip D1
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons JLJ Subsurface Drains Present PLJ Lagoon Area JU Spray Field Area
Holding Ponds 1 Solid Traps ❑ No Liquid Waste Management Svstem
Discharoes & Stream JmRacts
l . is any discharge observed from any part of the operation? ❑Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discnarg. is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is obsen-ed, did it reach Water of the State? (if yes, notify DWQ) 0 yes ❑ No
c- if discharge is observed, what is the estimated flow in gaUrnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any pan of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure 1 S—tsruccttlurel2 Structure 3 Structure 4 Structure j Structure 6
Identifier: � 0 T� t f L.WJ ^ f' I I o t.6 +3-c4
Freeboard (inches):
05IV3101 Continued

Facility Number: g — 1 O 0 Date of Inspection
5. Arc 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? El Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes No
12. Crop type RonA- . r� U%J< he 47-
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes rM No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15.
Does the receiving crop need improvement?
❑ Yes
0 No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
+No
Reguired
Records& Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
PNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
5No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[�4 No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
�O No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
WNo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
U1 No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
�9 No
25_
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[3No
13
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
❑ Field Copy ❑ Final Notes
C oc +kJ - t,'+M6r #+ l "y4k'r— - Tm l qLP-ran
�r•Y. i ll <A oft & OL k e-t\ a (A 14 rt 4- btu �. ►. Q Fi�-�o r`•
Fa.r---N ir 4 °+ `cam t.rc c� tic v.�d�- �c�.� �qpp_-J
{-Y�G,,r,S•�vrc�(} �-�7 cwr�.��k�'Fa✓.,rrrti {� �'� (I �: h.c,.1 w�-45 l c�4 o.r,,., use C.rs',r.��c
O&Z . �M� � (� ' an�� ��A �.sca Ps+�r•�� �P l���Q �On d�l� a�'�`�.s�ze.�Picn�-
Reviewer/Inspector Name'' �*
Reviewer/InspectorSignature 1[ji A,/[_ Date:
05103101 v Continued

Facility lumber: - ( o0l Date of Inspection -3—
Odor Issues
26_ Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid ievel of lagoon or storage pond with no agitation?
27_ Are there any dead animals not disposed of properly within 24 hours?
28. Is there am- 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 systcm intake not located near the liquid surface of the lagoon?
;0. Were anv major maintcnance problems with the ventilation fan(s) noted? (i.c. broken fan belts. missing or
or broken fan blade(s). inoperable shutters. etc.)
3 I _ Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover?
and/or
❑ Yes 4 No
❑ Yes No
❑ Yes No
❑ Yes [S No
❑ Yes W No
[] Yes [P No
❑ Yes T No
05103101

Type of Visit & Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit *Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
(late of Visit: Time:
rOFacility Number "7 D
Not Operational Below Threshold
Permitted ® Certified O Conditionally Certified © Registered Date Last Operated or above Threshold:
Farm Name: �.yies.. 71, County: �a s
Owner Name: Tk �x'6/ 7C . Phone No: 3 - -
Mailing Address: [� �%%• 7 ? / . gos. �� /V
Facility Contact: /�� Title: Phone NNo/:� / • -
Onsite Representative: i��`Xt S_ _ Integrator:G-
Certified Operator- �.✓ Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' " Longitude a 0 0"
Swine
'Design Current
C'snanih• Pnnnlatinn
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
OD
2 "0
❑ Farrow to Feeder
❑ Farrow to Finish
Gilts
❑ soars
Uestgn `Current
Poultry `Ca achy � Pa tilation Cattle
❑ Laver ❑ Dairy
❑ Non -Laver ❑Non -Dui
❑ Other
-Total Design Capacity
Total SSLW
Gui
v :Fiona
Number ,of Lagoons ; ` ❑ Subsurface Drains Present ❑ La oon Area 10 S rav Field Area
Holding fronds / Solid-Tiraps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discbarge is obsen ed. 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 obsen-ed. what is the estimated flow in gal/min?
d_ Does discharge bypass a lagoon system? (If ves, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): � A,
05103101
❑ Yes KNo
❑ Yes KNo
❑ Yes R No
❑ Yes KNo
❑ Yes MNo
❑ Yes KNo
❑ Yes o
Structure 6
Continued

Facility Dumber: -7— Ago
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 maintenancelimprovement?
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 Ievel
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hvdraulic Overload
12. Crop type 16.0 0111 1# 1.Titrit�/e 1-ZAA*) 1
❑ Yes *No
❑ Yes KNo
❑ Yes X[No
cKYes ❑ No
❑ Yes P?No
❑ Yes No
❑ Yes No
13. Do the receiving crops differ with those designated in the Cerdhed Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
KNo
b) Does the facility need a wettable acre determination?
❑ Yes
NNo
c) This facility is pended for a wettable acre determination?
❑ Yes
RNo
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
X[No
Required Records & Documents
17- Fail to have Certificate of Coverage & General Permit or other Permit readily available?
)<Yes
�& No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WU� heck�l s, desi�.)
❑ Yes
t No
s/ ✓
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
i iNo
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 anv additional problems noted which cause noncompliance of the Certified A'41MP?
❑ Yes
No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer_to_ques#ioa #j: -:Explain any YES answers and/or.any recommendations or any other comments. _
[Ise tirawiii s of fni lffi to better explain situations ,(psi additional pages as netessary):
g :.:. ❑Field Cor±v ❑ Final Note
/"% /U�Q ca � F�S.e' r�,�✓�``/./�1 ,�r�` •S'•-��f��%o� ��/.��fnx-
�` „5, // S/. �c�i� sx Af 0 Keo4 �
/��/sue.✓
/Lp��
�s ftfs�/� af �h .•�f gs��/'�rilX� /�.. ,.�.�diwl� �2i!' G •`.
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: y 4 Z
05103101 Continued

Facility- lumber: %? -lao Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes , , No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes PNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt. ❑ Yes E[No
roads.. building structure, and/or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e, broken fan belts, missing or
or broken fan blade(s), inoperable shutters. etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover? ❑ Yes ❑ No
05103101

IType of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit ®Routine O Complaint O Follow up O Emergency Notification O Other
❑ Denied Access
ility 78 �{j{) ,Y`M} ` Tom` � Date of Visit: S-ZG-Zilol Time: Printed on: 6/52007
FacNum6e
H l O Nat O erational O Below Threshold
O Permitted MCertified O Conditionally Certified D Registered Date Last Operated or Above Threshold_
Farm Name: Farvat#1'7711............. ....... ..... County: R.ob.C19JUL------------------- -------------- FRO .........
Owner Name:._-__--_-_-_._____-_--_--- Car_ttallsyltaL►r._._._._._._.__ Phone No: 9�Q-143-�3�--------------------_. --- --
MaifingAddress: PQ&x.856............................ ....... Wureaw.NC............................. -........... .............. .._. .........
Facility Contact: 1K►Y,'V1 C0Ujwk- .............._- .-- ....Title: EA.E,MO ......................... Phone No: ...
Onsite Representative: Rusty CnAinsIntegrator.
Certified Operator ,]'may ................
1� ................... Qxmdjne ......................................... Operator Certifies#ion Number: 1.7.6,50........................_...
Location of Farm:
Travel south from Maxton approx 2 miles on NC 130; turn left on SR 1121; go approx. 112 mile; turn right on farm road. Fa +
is appro3.112 mile.
®Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude E34 : • -l2 � -31 Longitude � 79 '• • 19 55 µ
-
Destgn::....Current :
Design Curtent:`
__ _ - —
... .
Design Current , ;,
S»�ne Ca acitv,:Pti ulatloe ::
foul
o.. Cattk.
.
.. .
Ga ac' Po ulation -::
❑ Wean to Feeder
ID Layer
ij
Dairy
❑ Feeder to Finish
[INon-layer
:::
❑ Non -Dairy
® Farrow to Wean
2400
:.......
.,
❑ Farrow to Feeder
❑ Other
-
❑ Farrow to Finish
-
Total Design Capacity..
2,400
❑ Gilts
Total: SSLW
1,039,200
❑ Boars
g Sp _
Number. of Lagoons 3 ® Subsurface Drams Present ❑ oon Area rsv Field Area
Holding Pond% / Solid liips ❑ No Liquid Waste Management System
Discharges & Stream Impacts
I . Is any discharge obstn ed fforn any part of the oration? ❑ Yes % No
Discharge originated at: ❑ Lagoon ❑ Spray Field 0 Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes IN No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimawd floxv in gal/min?
d- Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
[:]Yes Ij No
❑Yes 51No
❑ Yes 9 No
3. Were there any adverse impacts or potential adverse impact,, to the Waters of the State other than from a discharge? ❑ Yes N No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes CK No
Structure 1 Structure 2 Structure 3 Structure 4 Stntcture 5 Structure 6
Identifier: ........................... .......................... .......................... .................................................... ...........................
Freeboard (inches): ........... .38...---...... ............... ........................... .............................:.

F acWty Number: 78 —100
Date of Inspection 5-26-2001 Printed on: 6152001
5. Are there any immediate threats to the integrity of any of the structures observed'? (ic:/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancefimprovement?
8. Does any part of the waste management system other than waste structures require maintenancefmiprovement?
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?
1 i. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Coastal Bermuda (Graze) Cotton Soybeans Wheat
❑ Yes 0 No
[]Yes C& No
❑ Yes ® No
❑ Yes H No
❑ Yes N No
❑ Yes CK No
❑ Yes M No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? 0 Yes ® No
14. a) Does the facility lack adequate acreage for land application? El Yes H No
b) Does the facility need a wettable acre determination?] Yes No
c) 'This facility is pended for a wettable acre deternrina6on'r Yes No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Re uimd Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ 1A1JP, 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 I2e6ewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
[I Yes H No
fl Yes CR No
C] Yes X No
❑ Yes 04 No
❑ Yes 19 No
❑ Yes No
❑ Yes ® No
❑ Yes CK No
Yes H No
] Yes ® No
25. Were any additional problems noted which cause noncompliance of the Certified AW1v1P? ❑ Yes E$ No
N No violations or deficiencies were noted during this visit. You wi0 receive no further correspondence about this visit.
arm is well maintained and operated.
Reviewer/inspector Name .iol n;Ha ail S!` rm n: .
Reviewer/Inspector Signature:
❑ Field Copy D Final Notes
Date: r'

J
snsry atonDryiton oSodae Water Coe_2OOther
.-..
hype of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ioutine Q Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: 2 -0% Time: � printed on: 7/21/2000
30
O Not Operational O Below Threshold
X�Q O
Permitted 13 Certifie • ' Certified © Registered Date Last Operated or Above Threshold:
- 7 - 7 D / d
Farm Name:....................................................................
/ %69 �.County: -....
. ....,1.. ............ �1............-.-........... CPSdn
c Phone No: Owner Name ........... �......................
. ...... ..�... s /J/f
Facility Contact: ..t ti .......... y��............... T .. "Title:.... 1.r... l L..... i:........................ Phone No:................................................
MailingAddress:.............................................•----..................................
Onsite Representative: ----•---• --------------- Integrator:
Certified Operator ............... ............. Operator Certification Number:
Location 'of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 49 Longitude • 6 64
Design Current
- CapadtyPopulation
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Design Current- Desigp .. Cbr_rent
Paul try Ca aei Po elation Cattle CAR&dty Po cation
❑ Layer I ❑ Dairy
❑ Non -Layer I I I[] Non -Dairy
❑ Other
Total Design Capacity
Total SSL W
Y
c rber of i agouios Subsurface Drains Present Lag-m Area ❑ Spray Field Area
-110 ' ' Pdnds; /. Sol_iid Traps -; ❑ No Liquid Waste Management System
Discharges & Stream Impacts
I - Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon El Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the Operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & "Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 22
Structure 3 Structure 4
Identifier:......7.74).3........... ......... 7.7...aX......
........ Zzff.1-....... ........... I.................
Freeboard (inches): qv Vv
30
5/00
Structure 5
❑ Yes )No
❑ Yes No
❑ Yes o
❑ Yes No
❑ Yes , \ o
❑ Yes No
❑ Yes XN0
Structure 6
Continued on Lack

.. 77?_ /to
Facility Number: 7 — Date of Inspection Z6 fJ 7/21/2000
Printed on:
5. Are there any immediate threats to the integrity of any of the structures observed'? (ie/ trees, severe erosion, ❑ Yes [��N0
seepage, etc.) 9\
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 maintenancefimprovement?
S. Does any part of the waste management system other than waste structures require maintenancetimprovement?
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?
12. Crop type
13. Do the receiving crops differ with
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? (ic/ 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?
yiglat�iOttis;ejr. di fcie»cio$ vt re hOfpd-du�'ing this•visiC - Y;oir wiil-tece'iye ijd iuiTth&
irorrespoiidence: about this visit. • : ::::.::.:.::::::::
❑ Yes qNo
❑ Yes �INo
❑ Yes iNo
❑ Yes tNo
o
❑ Yes
❑ Yes U(Iqo
[]Yes 4No
❑ Yes WO
❑ Yes kNO
❑ Yes )(No
❑ Yes XNo
❑ Yes No
El Yes o
(:]Yes
ANo
❑ Yes
qrNo
❑ Yes
)�No
❑ Yes

r -79 3a
Facility Number: 7` r Date of Inspection `Z d Printed on: 7/21/2000
Odor Issues 2 S ` I do
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
o
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
o
Ir
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
Pfo
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yesa�o
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
�es
[I No
AdditionalComments an or,Drawings: - - _ __ . _ .. 7.
J
5100

Permitted © Certified ❑ Conditionally Certified E3 Registered C
Farm Name: /./"..,.s ........... 7 .. 7..'.1J ............................................
Owner Name:...... It .ir.i..... s..... ),::;Uk �C.
Facility Contact:
Mailing Address:
Onsite Representative:
Certified Operator:
Location of Farm:
Phone No:................. i1...^ ...._.
..............
(.r(Q ................... Phone No: ............. ............... -....... ..............
NO
.,...................Z. �
Operator Certification Number: ................................ . ... ....
Latitude ' 6 '1 Longitude ' =' =GC
w Design Current Design Current w ; Design Current
Swene _ -, :Ca"aci 'Po elation ,•PoultiT Ca aci _ Po.uation -Cattle Ca ac:. Po�iilation =
El
❑ Layer 1 ❑ Dairy
❑ Non -Layer 2` ❑ Non -Dairy
Z
Ny
r ❑ Other
F
_.F Total Design Capacity s ZQI�
Total SS
❑ Boars LW'
umbe =Nr of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
H
o --
Ponds /-Solid Tra -
_
g_ ps = : ❑ No Liquid Waste Management System
Wean to Feeder
Feeder to Finish
arrow to Wean
❑ Farrow to Feeder
Farrow to Finish
❑ Gilts
Discharaes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: Lagoon ❑ Spray Field ❑ Other
O-
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: Ar
Freeboard (inched..2.......:........................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes �No
seepage, etc.)
3/23/99 Continued on back
Yes ❑ No
❑ Yes fifA 0o
❑ Yes No
❑ Yes ❑ No
❑ Yes FfNo
❑ Yes O-No
❑ Yes gNo
Structure 6
Discharaes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: Lagoon ❑ Spray Field ❑ Other
O-
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: Ar
Freeboard (inched..2.......:........................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes �No
seepage, etc.)
3/23/99 Continued on back
Yes ❑ No
❑ Yes fifA 0o
❑ Yes No
❑ Yes ❑ No
❑ Yes FfNo
❑ Yes O-No
❑ Yes gNo
Structure 6

Facility Number: —/Z�7 Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
VINo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
MNo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11, Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
❑ No
12. Crap type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Reauired Records & Documents
IT. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20_
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
Rio yiolhiions:oi dgf cieneie* vt re noted ftrift thjs:visit; • Y60 wili•1 ecviye iio t`urther
- cartes dense: Abu' f this visit. ::: :
H etHP� /!�r`"cec� �7as'�c i ti d�� a,�c� cor�Il`�.cr� i'��S�{ ��Z•�QD n•�---- �'
ismr, r�►�`%`pa�� w�, t� ivu •�d a�, u n kko.ti r4 �rt -�� le� ae
{L)Q5 J-1-le,
.l4cas ��4CI�PCJ GC I� r fK l orons e�p�rc �e,,��
Pti g cvctS �cey ce 4CtC/�/lAC ;" ��GC' p�cticesJ f ed °X ""T e Three
/d kjwbt.o� -�s4 lw, r4Ja�s4e. .ealS fh�le-k
1j
jVajoj� e� J.,+ 61_j �Xri�./
r. �
I�P e Cb,,nC Q- _`r;jeWr[&..Z ad,)
/Mr. .S�
%P rrea a' -AP- laDior-,f [.> Prc �Lr� Oive amc C4D� QKd nbY��u ME �i�ie� Af"e4 5
Reviewer/Inspector Name,
Reviewer/Inspector Signature: Date: S--

el
a a ��� -Q DaviSiiin of Sotl and Water Conservagon�' Operation Review°rKs� Qt"
W - vision of Soil and:Water Consetvabon .Compliance Inspechon rt _ '= b
Drnsron of Water Quality. -. Compliance ftiq Lon
enc O erahon.Reveew
Q Routine Q Complaint 0 Follow-up of DW2 inspection Q Follow-up of DSWC review 41POther
Facility Number Date of Inspection]
Time of Inspection 0' 24 hr. (hh:mm)
Permitted Certified Conditionallyy rCertified [3 Registered [3 Not Operational Date Last Operated:
FarmName. ........................... + WL-.... + / �.!..... County:...............................................................
........TT...... __ .....I ..................`` ry
Owner Name: ................ tCYt2. S ....�-!{ ..f l�!Tr . Phone No ..... .a.iz.........�.¢..............
jjy...... ..... ... r... ..............
... 1
Facility Contact: ...1..3......�J !''6 ............. Title: ........................................ Phone No. ..................................
Mailing Address: ..................1 9..`...... 60 05%........ ........................... ...........1�%r. .wt / G ........ �3%3
Onsite Representative: �;�.L.f Cf Ct......... .. ............. Integrator:...yl /^1/-.........�. Q�
............. ........ 1 �#�U
Certified Operator:...............j� .I1.%1.fOperator Certification Number :..........................................
1.]:-....(..:'.......1..�-�.....................
Location of Farm:
Latitude C� • 1 [�" . Longitude 0 a E--]' 0-
Design Current Design Current Design :;Cuireitt
,Swine Capacity Population Poultry Capacity Population Cattle :.:Ca 'aeity " Po ulation
❑ Wean to Feeder JE1 Layer ❑Dairy
❑ Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
Farrow to Wean
Farrow to Feeder Other
❑ Farrow to Finish Total Desi Ca aci 60
Gilts
❑
� P .ty<
❑ Boars Total "SSL.W
M Number of Lagoons Subsurface Drains Present JjMt2goonArea ❑ Spray Field Area ; j
Holding Ponds / Solid Traps No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? [Yes ❑ No
Discharge orig inated at: []Lagoon ❑ Spray Field Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes U(No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ)
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): ..................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
Yes ❑ No
Co #hued on back

Faclity Number: g — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
IL Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes ❑ No
12, Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? �j, a ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? i v� ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? (�_ ❑ Yes ❑ No
15. Does the receiving crop need improvement? diU� O►�Vl r❑ Yes ❑ No
Id-
a.
16. is there a lack of adequate waste application equipment? V 1 o Cot" ❑ Yes ❑ No
RtirLuircd Records & Documents
IT Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes ❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Gel WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard. waste analysis & soil sample reports)
❑ Yes
❑ No
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems: over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -rile 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
V: �4,6- iglati0iis'oi- deficiencies �jtere p ted diWing this:visit.,- Yoix ;wIR4- eeive Rio #wither.
corresp oridence' about this visit. : ::: :: : : :::: .. ' .... .
Cotnrttents(refer to`questron #): Explain any 'YES answers and/or any-recommendattons:or any other comments: r^ -
r _ ' _. c-
:Use drawings of facihty,to betteir explain srtuahons n
{use:addettoal pages as necessary)_:
C
`
d� rt o+o o d vi
pry,:►, - I� -p a� Nit. 544
A,A P'� � �.Q -fit,,, IMS t� , _�,�►m �D t+� s�.
Reviewer/Inspector Name _ &(`OtA j :
Reviewer/inspector Signature: Date: �g— �O

IffRoutine 0 Complaint 0 Follow-up of DWO inspection 0 Follow-up of DSWC review 0 Other
Facility Number Qp Date of Inspection
Time of Inspection E� 24 hr. (hh:mm)
Permitted © Certified [3 Conditionally Certified © Registered 13 Not O erational Date �Last Operated:
Farm Name:...................._...1......1..�......_................................................_.._...... County:..........Kf�.�.���..............................
.
Owner Name: G ��{?. (....r_.� � �C._•-_..... phone No. 2 7G.��...........................
JJJ.... ' ...................- ..........
Facility Contact: ... � �5.......�1� .............................. Title:... ....... .. r............_. Phone No: ...........................................
Mailing Address: !`Gi W l°.......... q Q t f....C----------------......
OnsiteRepresentative: P ..........��... ................... ....... ............................... Integrator: .............. ....... ............... .......... .......... _....
---...............
Certified Operator.*...,_Pe_............... CJ....................... Operator Certification Number•.._.__._..
........................ • •,••
Location of Farm:
Latitude 0 6 •4 Longitude • 6 44
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated au ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance ►nan-made? ❑ Yes No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes rKNo
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (I1' yes, notify DWQ) El Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 4 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
No
Waste Collection & Treatment P
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes �NG
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ti
Freeboard (inches):
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes o
seepage, etc.)
3123/99 Continued on back

Facility Number: ']f — /Q27 Date of inspection z
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑Yes
kNo
(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
o
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
tNO
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
4No
11. Is there evidence of over application? ❑ Exces 've Pon ing PAN
❑ Yes
�Q No
/
12. Crop type LG '1 (^6 Lis �
\
13. Do the receiving crops differ with those desi aced in the Ce ' fed Animal Waste M agement Plan (CAWMP)?
[I Yes
o
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
[No
b) Does the facility need a wettable acre determination?
❑ Yeso
c) This facility is pended for a wettable acre determination?
❑ Yeso
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there'a lack of adequate waste application equipment?
❑ Yes
KR0
II
Required Records & Documents
IT. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
Iro
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
PNo
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?
ElYes
o
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
/VrNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
z3vo
24. Does facility require a follow-up visit by same agency?
❑ Yes
_A�No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
Al
�'VQ yiolal�itjnjs e#' 00f d6nr ie�s •were h "eo dr"ih' Ols"visit: • Y;o will •)['e�iye 40 WOO .. .
cories�orideirrce: abotiti this visit: ....................................
14' �e IZf�i e z Q[
Reviewer/Inspector Name 5 LZ
= f "... A
Reviewer/Inspector Signature: Date. old

r
Facility Number: % — jdD Date of inspection-
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes 5�10
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
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
LI

- (]-bi- on of Soil an'd Water Con"sei=vation - Operation Review -
=r -
(] Division of Soil and Water; Conservation - Compliance Inspection -
t
Divislion of Water Quality='Corriphance lnspeetion
Other, Agency - Operation Review:
[JEkRoutine 0 Complaint Q Follo-w-up of DWQ inspection Q hollow -up of DSLVC revicw Q Other J
Facility Number p(J Date of Inspection
Time of inspection 24 hr. (hh:mm)
Permitted ❑ Certified 0 Conditionally Certified © Registered 113 Not Operational] Date Last Operated:
Farm Name: ...... � _. .7.�L...................... ------..................... Cuunty:....... t'.......................... ..........
..
Owner Nante: C Phane No:-._........Z f�................ j................................._.. �a..` ....Q(.c�'.................................
Facility Contact: ...e.......... 5�7..... Title:
...._�vi�r......1....................... I'hune No:..............r
Mailing Address: 5 .... ...... ..... a r �7K
D..(.......�f.............-./..................s-`....c............................Z..............
Onsite Representative: Lis SS Integrator: ....................`.....,,,,........................................
.................................................................................................1.
Certified Operator: .be 'IiS Operator Certification Number: .......................................... ......-............ .......... .................
Location of Farm:
............. ................................................................................................................................................................................................................................... ......................
....
Latitude ` 4 •4 Longitude ' 4 «
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population.
❑ Wean to Feeder 10 Layer ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer 10 Non -Dairy
Farrow to Wean 7200
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity 7z-0
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons 1 13 ❑ Subsurface Drains Present ❑ Lagoon Area ID Spray Field Area
Holding Ponds / Solid Traps JE3 No Liquid Waste (Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'! ❑ Yes No
b. If discharge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State ❑ Yesf o
c. if discharge is observed. what is the estimated flow in gal/min? 1
d. Does discharge hypass a lagoon system? ❑ Yes 9No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any 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? ❑ Yes io
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 ✓
Identifier:
Frcehoard (inches): ...........
..................................................... ..... I................... -..,................................ ............................ ........ ....................................
1/6/99 Continued on back

f
Facility Number: 7gr --/ 6V I 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/improvernent?
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
Waste application
10. Are there any buffers that need maintenance/improvcrnent?
-zy-q
❑ Yes I No
11. Is there evidence of over application'? ❑ Ponding ❑ Nitrogen
Q aa
12. Crop type ....i�tprt"`r kd ra�G s,>i ....gy..........................................................................
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. Does the facility lack wettable acreage for land application'? (footprint)
15. Does the receiving crop need improvement'?
16, Is there a lack of adequate waste application equipment?
Required Records & Documents
IT Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement'? (ie/ irriga(ion, 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 certified operator in responsible charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems, over application)
❑ Yes A No
❑ Yes No
❑ Yes Pq No
❑ Yes (ldNo
❑ Yes OfNo
❑ Yes P No
Yes
❑ Yes P�No
❑ Yes ENO
❑ Yes ONO
❑ Yes 0, No
❑ Yes No
❑ Yes ►� No
❑ Yes No
[]Yes ONO
❑ Yes OfNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes Vf No
24_ Does facility require a follow-up visit by same agency? ❑ Yes f,No
0. NA.vio)a'tions _tir. deficiencies .were'noted during this: visit:. Ynu vviil.rezeive nil further .:.: _
eorresb6 ideii4ce: abbtif this :visit ............:. . .: • : • : • : • :. . .
co,
unents (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):
M.: A4ew--- Svn L.-s fit
e �- a AecJ C A 4J M P 46 5 ,, Q, j b s 4,, `
Co r/.. 4- 4, /lea owe- ; r` 0 C Q f a, ,p 'k
/11 1 �i j- added
(� _ /
f tI SG Sac,lr��/�ti5 he/ectt -� �j� /did �T Irl",r74T; �- '5os-
�aer,41 I j- r-1 e loa,CS 9aara% q` l� �.�ctt end, i
ReviewerAnspector Name
Reviewer/Inspector Signature: Date: 3-2q--
9 ! /6/99

r- ...
E3 Division of Soil and Water Conservation ❑ Other Agency
0 Division of Water Quality
10 Routine O Complaint O Fellow -up of DAVO inspection O Follow-uts of DSWC review O Other 1
Date of Inspection:•
Facility Number
Time of Inspection %30 2.4 hr. (hh:mm)
D Registered M Certified 9f Applied for Permit [3Permitted
13 Not Operational Date Last Operated:....
�j
Farm Name: #
AVJ
County .............. I.....................
1
Owner Name: ................................. -----..5 ZGD .1-ri�
.....................................................................
... Phone No: quo-a93-33...................
---....................................
Facility Contact: // �I S&. .. Title:
Phone No: '
Mailing Address: ........ i..:�:.......... ek...... .......���................................
........�"�S�tt��, ...�.G-..... ........... ...............
r
Onsite Representative: .......... GC.!9 t 1........
... Integrator: ............... Qvzwls
................................................
Certified Operator ;............... �S,.......... .............. .................... Operator Certification Number:......................
Location of Farm:
Latitude E «
' Design CI �­ '.
S Twine °
-Capacity" Population
❑ Wean to Feeder
x ❑ Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Longitude 4
Resign Current D
Poultry "' Capacity` "Populaiion C&d Z 4C1
❑ Layer ❑ Dairyx
❑ Non -Layer I❑ Non -Dairy
-❑.:
Other
Total Design Capacity^, '
Total SSLW4"
J E
c
C
ctyPaiilahon
t r;
.2 L),.0
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes P[No
2. Is any discharge observed from any part of the operation? ❑ Yes ANo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, watt the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/i m provetnent?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes
M No
❑ Yes
[4No
AJ 4
❑ Yes
EXNo
❑ Yes
U[No
❑ Yes
MNo
❑ Yes
]K No
❑ Yes
09 No
❑ Yes
XNo
Continued
on back

Facility Numher: q p
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures 41,a irons 11olding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I
Identi fier:
Freeboard (ft): ..............7,1
Structure 2 Structure 3 Structure 4
10. Is seepage observed from any of the structures'?
11. Is erosion, or any other threats to the integrity of any of the structures observed'?
❑ Yes ONO
❑ Yes ONO
Structure 5 Structure 6
....................................................................................
❑ Yes P'No
❑ Yeti A No
12.. Do any of the structures need maintenance/improvement?
Xyes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers"
❑ Yes
KNo
-Vkaste Application
14. Is there physical evidence of over application?
❑ Yes
No
(If in excess of WMP, or runoff entering waters of the State. notify DWQ)
15. Crop type ....... C.pl�.......... s....... .........................
r2
.........
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan— i (A�'4 Mp)'?
❑Yes
No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
R[No
18. Does the receiving crop need improvement?
❑ Yes
21 No
19. ,Is there a lack of available waste application equipment? s
❑ Yes
R[ No
20. Does facility require a follow-up visit by same agency?
❑ Yes
J( No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
KNo
22. Does record keeping need improvement?
❑ Yes
W No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes XNo
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 0 No
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes ❑ No
0 No.vio'lations or deficiencies were noted during this. visit. You.will receive no further
correspondence about this visit.
Comments (refer to question- ft Explain any VES answers and/or a'fiv recommendations or any other comments x
9�
Use drawings of facility to,better explain situations, (rise additional pages as necessary):
Aa 7J'ua ' 6;
C F�6 . 195i;>) CA, s
C c�, 4,D «fS�
AJo SO— S�
7/25/97
0
Reviewer/Inspector Name ' =1!
Reviewer/Inspector Signature:
Date:

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
is Routine O Complaint O Follow-un of 1DW1.) insr►ection O Follow-uo of DSWC review Q Other I
Date of Inspection 1/40•25'�
Facility Number DO
Time of Inspection Q: 3Z) 24 hr. (hh:mm}
© Registered X, Certified D Applied for Permit 0 Permitted 13Not O crational Date Last Operated: .............
Farm Name: .... CaLC.t?.1.(..........Z...�.I. ................... County:.....apGS...............................................
f� !} .........._.... ..... / �/
Owner Name:.....4 ��!Cf'�l...l.l. ..... ..F..g.g; Phone No.- 4. ` 4 .Yqm................ I ............. I...........
Facility Contact: ... 5......5 ..... .... Title:..f& l........ ., ..... Phone No: 0.�w-�,_,�:................
x......................
Mailing Address: Q n....y a
. ............. ............ .................................................. .. ..................
Onsite Representative...L.e:5...-5-Az j... ......................... __.... grator:.....L.r / s
Certified Operator............................................................................... .............. Operator Certification Number .........................................
Location of Farm:
C
C
Latitude Longitude �• ��°'
gnu Current'; 9Design Current;'
❑ Wean to Feeder ❑ Layer 110 Dairy
y ❑ Feeder to Finish ❑ Non -Layer 1=10 Non-Dairy
Farrow to Wean Z T db
❑Farrow to Feeder ❑ Other
El
Farrow to Finish t Total Design Capacity$ Z tJ�W
❑ Gilts tt m ari
❑ BoarstTi' 6VSSLW < . u
oldmg Ponds ❑ Subsurface Drains Present JJU Lagoon Area
-�
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon [ISpray Field [IOther
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface: Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6_ Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25197
Spray Field Area
c V ,
❑ Yes o
❑ Yes JI(No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
Wo
❑ Yes
4 No
❑ Yes
PNo
❑ Yes " No
❑ Yes % No
Continued on back

Facility Number: — /&f)
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons.Holding Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1
Identifier:
Freeboard (ft): .........1.2-............
Structure 2 Structure 3
.........................................................
Structure 4
■ 1Z
❑ Yes XNo
Structure. 5 Structure 6
10. Is seepage observed from any of the structures? ❑ Yes No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
ElYes
YNo
12. Do any of the structures need maintenance/improvement?
❑ Yes
A] No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
,(J No
v
Waste Application
1
14. Is there physical evidence of over application?
❑ Yes
o
(If in excess of WMP, or runoff entering w ters of the State, notify DWQ)
15. Crop type ........ lPr.f` .l'L4 ........��..5............ ... ....................................................-.......................................I.....-............
16. Do the receiving crops differ with thos designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
o
17. Does the facility have a lack of adequate acreage for land application?
El Yes
tNo
18. Does the receiving crop need improvement?
❑ Yeso
19. Is there a lack of available waste application equipment?
❑ Yes
o
20. Does facility require a follow-up visit by same agency?
❑ Yes
o
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
�No
22. Does record keeping need improvement?
❑ Yes
JNo
For Certified or Permitted„ Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
)�No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
VNO
25- Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
❑ No
No.violationsor deficiencies. were noted during this:visit:- Yon:will receive no fdriher-
: correspondence about this. visit'.,.'-'.
�iti5 IS aweva r�('t�, CQ+�S��-Tl�br` rS �hgB�n ,
�� 1I'rjqq�o►.� W� [1 6� �'T�'"�f°� �r' GvI�,J �c.3�� I�
J
7/25/97
Re-v iewerAnspector ]Same ] �. ,;:: • ._ .:}
Re,triewer/Inspector Signature: „� Date: `Z 7

Type of Visit • Compliance inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint 0 Foliuw up O Emergency Notification O Other ❑ Denied Access
Facility Number 78 /pp of Visit: Time:
t� NotOperational 0 Below Threshold
�erm'tted G ertified Q Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: , .Z l lL`aL__ _ County: % n z ! o ,.. ... 1z�-12 O
Owner Name: _[a r-, ......a.l _ „ Phone No:
-Mailing Address:
Ma-rf" M a� 6a� ier
Facility Contact: J4°£_-_------- Title: _ Phone No:
Onsite Representative: _ 3e _ Z _ , :=�7 14 i er Integrator: C « l i
Certified Operator: x c.sLji ns. Operator Certification Number. 1 qG Sv
Location of Farm:
SFSrwine ❑ Poultry 0 Cattle ❑ Norse Latitude • u Longitude �• ��
DisclLrges & Stream Im acts
1. Is any discharge observed from any part of the operation?
❑ Yes M 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 SaUmin?
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 X No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): 1 S
12112103 Condnued

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No/
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
❑ 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 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
❑ Yes
❑ No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
1 I . 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
15. 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.
Field Copy ❑ Final Notes
CJ'VQ STg7T ✓rsFt� FO/, GS G r,s,/it , f 'ol+or'A4icTrrOh O�•r4 '004s5erl &0",
9
farW",' .Sod a.. &V"4'
Al r .
lC�tf S f.,
4 #T
74 440- p:v Sloq °1e k4j,, Q-,-ai-,� 1-4-,
7 i�
br.��.�
+•t f�C
.S l^pr fi
S ("Ofa� f ,
`-'r 3 G �'Sfr J
1 s4
� �
�u,eaq
4hd
Latta l�ea�
lct�na,j
IGVL�S
�or �'a.�
'71703
��..� r7 '�oy Cap --) 4.5 ��<<,1 M r, T ,'cr �d p /re, s e
Cw4LvQ o r,cr
F'r 4 4�"f 1(-'n) A)L,,,,6tr ror 4.'r .7 /,,.7 A4..i. jiw,it
Reviewerlhq?ector Name -ff
Reviewer/Inspector Signature:
free6-p,,a Jev.lj
Date: ' 7 -
12112103 Continued

Facility Number: g i &o I Date of Inspection p a
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?
(it/ 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 ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
12112103