820005_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

M Division of Water Resources
❑
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 820005 Facility Status: Active
Permit: AWS820005
❑ Denied Access
Inpsection Type: Compliance inspection
Inactive Or Closed Date:
Reason for Visit: Routine County:
Sampson Region:
Fayetteville
Date of Visit: 09/22I2016 EntryTime: 10:00 am Exit Time: 11:00 am Incident #
Farm Name: Kilpatrick Farm 1, 2, 4 & 5 & Merritt Farm
Owner Email --
Owner: Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address: 1457 A K Bryan Rd Sr 1944
Magnolia NC 28453
Facility Status: Compliant ❑ Not Compliant Integrator:
Murphy -Brown LLC
Location of Farm: Latitude:
34' 52' 60" Longitude:
78' 09- 49"
1004 from Turkey. Left on 1943. Left on 1942. Farm on the left approx. 1 mile.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator, Michael Leon Norris
Operator Certification Number:
19861
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Michael Norris
Phone:
On -site representative Michael Norris
Phone:
Primary Inspector. Robert Marble
Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number: 820005
Inspection Date: 09/22/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Wean to Finish 18,419
Total Design Capacity: 18,419
Total SSLW: 2,118,185
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
KILPATRICK 1&5
26.50
32.00
Lagoon
KILPATRICK 2&4
27,00
99.00
Lagoon
MERRITT
27.00
29.Q0
0
page: 2

Permit: AWS820005 Owner- Facility : Murphy -Brown LLC Facility Number: 820005
Inspection Date: 09/22/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na Ne
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
11011
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na No
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
M, ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
S. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to rooted pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozeri 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: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number: 820005
Inspection Date: 09/22/16 Inppection 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
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
determination?
17. Does the facility lack adequate acreage for land application?
18_ Is there a lack of properly operating waste application equipment?
Records and Documents
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available?
If yes, check the appropriate box below.
WUP?
Checklists?
Design?
Maps?
Lease Agreements?
Other?
If Other, please specify
21. Does record keeping need improvement?
If yes, check the appropriate box below.
Waste Application?
Weekly Freeboard?
Waste Analysis?
Soil analysis?
Waste Transfers?
Autryvdle loamy sand, o to
6% slopes
Blanton sand, 0 to 6%
slopes
Foreston loamy sand
Norfolk loamy sand, 0 to 2%
slopes
Norfolk loamy sand, 2 to 6%
slopes
Wag ram loamy sand, 0 to
6% slopes
❑ M ❑ ❑
❑ M ❑ ❑
❑ M ❑ ❑
❑■❑❑
❑M❑❑
Yes
No Na No
❑ M ❑ ❑
page: 4

Permit: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number: 820005
Inspection Date: 09/22/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Weather code?
❑
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
N ❑
❑
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?
❑
M ❑
❑
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-compliani sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26_ Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na Ne
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? if yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30, Did the facility fail to notify regional DWQ of emergency -situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
E ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
E ❑
❑
CAWMP?
33_ Did the. Reviewerllnspector fail to discuss review/inspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
❑
❑
page: 5

Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number 820005 Facility Status: Active
Inpsection Type: Compliance Inspection
Permit: AWS820005
Inactive Or Closed Date:
Reason for Visit: Routine County: Sampson Region:
Date of Visit: 11/05/2015 Entry Time: 12:00 pm Exit Time: 1:00 pm
Farm Name: Kilpatrick Farm 1, 2, 4 & 5 & Merritt Farm
Owner: Murphy -Brown LLC
Incident to
Owner Email:
Phone:
❑ Denied Access
Fayetteville
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 1457 A K Bryan Rd Sr 1944 Magnolia NC 28453
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34' 52' 60" Longitude: 78' 09' 49"
1004 from Turkey. Lett on 1943. Left on 1942. Farm on the left approx. 1 mile.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Michael Leon Norris Operator Certification Number: 19861
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Michael Norris Phone:
On -site representative Michael Norris Phone:
Primary Inspector. Robert Marble Phone:
Inspector Signature: Date.
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number: 820005
Inspection Date: 11/05/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Wean to Finish 18,419
Total Design Capacity: 18,419
Total SSLW: 2.118,185
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
KILPATRICK 1&5
26.50
30.00
Lagoon
KILPATRICK 2&4
27.00
68.00
Lagoon
MERRITT
27.00
31.00
page: 2

Permit: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number: 820005
Inspection Date: 11/05/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
M ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
■ ❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
0 ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
■ ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
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?
Cl 01111
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: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number:
820005
Inspection Date: 11/05/15 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autryville loamy sand, 0 to
6% slopes
Soil Type 2
Blanton sand, 0 to 6%
slopes
Soil Type 3
Foreston loamy sand
Soil Type 4
Norfolk loamy sand, 0 to 2%
slopes
Soil -type 5
Norfolk loamy sand, 2 to 6%
slopes
Soil Type 6
Wagram loamy sand, 0 to
6% slopes
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ ■ ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ E ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ N ❑ ❑
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?
❑ ■ ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ E ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21, Does record keeping need improvement?
❑ N ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
page: 4

Permit: AWS820005 Owner - Facility: Murphy -Brown LLC Facility Number: 820005
Inspection Date: 11/05/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Weather code?
❑
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑N
❑
❑
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?
❑
E ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
E ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a 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 No No
28_ Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑ ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
❑ ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑ ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility?
❑
❑ ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon I Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑ ❑
❑
CAWMP?
33. Did the Reviewertinspector fail to discuss review/inspection with on -site representative?
❑
❑ ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
❑ ❑
❑
page: 5

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
820005 Facility Status: Active
Permit: AWS820005
Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine County:
Sampson Region:
Fayetteville
Date of Visit:
1211612014 EntryTime: 01 A5 pm Exit Time: 2:30 pm Incident #
Farm Name:
Kilpatrick Farm 1, 2, 4 & 5 & Merritt Farm
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
1457 A K Bryan Rd Sr 1944
Magnolia NC 28453
Facility Status:
Compliant ❑ Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm:
Latitude:
34' 52' 60" Longitude:
78' 09' 49'
1004 from Turkey. Left on 1943. Left on 1942. Farm on the left approx. 1 mile.
Question Areas:
Dischrge & Stream Impacts Waste Col, Slor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Tommy D Honrine Operator Certification Number: 18388
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Michael Norris Phone:
On -site representative Michael Norris Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Dale:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820005 Owner- Facility : Murphy -Brown LLC Facility Number: 820005
Inspection Date: 12A6/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Wean to Finish 18,419
Total Design Capacity: 18,419
Total SSLW: 2,118.185
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
KILPATRICK 1&5
26.50
30,00
Lagoon
KILPATRICK 2&4
27-00
108.00
Lagoon
MERRITT
27.00
45.00
page: 2

Permit: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number. 820005
Inspection Date: 12/16/14 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?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
EIN
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ ■
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (l.e.l large
Cl
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 tack 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
❑
ME][]
maintenance or improvement?
Waste Application
Yos 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?
❑ 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 manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

• * ,
Permit:
AWS820005
Owner - Facility :
Murphy -Brown LLC
Facility Number.
820005
Inspection Date:
12/16/14
Inpsection Type:
Compliance Inspection
Reason for Visit:
Routine
Waste Appllcatlon
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
AubWfle foamy sand, 0 to
6% slopes
Soil Type 2
Blanton sand, 0 to 6%
slopes
Soil Type 3
Foreston loamy sand
Soil Type 4
Norfolk loamy sand, 0 to 2%
slopes
Soil Type 5
Norfolk loamy sand, 2 to 6%
slopes
Soil Type 6
Wagram loamy sand, 0 to
6% slopes
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
❑
❑
16. Did the facility tail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
■ ❑
0
Records and Documents
Yes
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
❑
❑
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?
❑
M ❑
❑
If yes, check the appropriate box below.
Waste Application?
[]
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
page. 4

1 ,
Permit: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number:
820005
Inspection Date: 12/16/14 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yes No Na He
Weather code?
❑
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
[]
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
N ❑
❑
appropriate box(es) below:
Failure to complete annual sludge 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?
❑
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na Ne
28, Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
E ❑
❑
contact a regional Air Quality representative immediately.
30, Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
E ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
E ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon I Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
N ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 820005 Facility Status:
Inppection Type: Compliance Inspection
Reason for Visit: Routine
Date of Visit: 1211212013 Entry Time: 11:30 am
Farm Name: Kilpatrick Farm 1, 2, 4 & 5 & Merritt Farm
Active
Permit: AWS820005 Denied Access
Inactive Or Closed Date:
County: Sampson Region: Fayetteville
Exit Time: 12:30 pm Incident #
Owner Email:
Owner: Murphy -Brown LLC Phone: [phone]
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 1457 A K Bryan Rd Sr 1944 Magnolia NC 28453
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34' 52' 60" Longitude: 78' 09' 49"
1004 from Turkey. Left on 1943. Left on 1942. Farm on the left approx. 1 mile.
Question Areas:
Dischrge & Stream Impacts Waste Cal, Stor, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator: David Lee Edwards
Operator Certification Number: 989988
Secondary OIC(s):
On -Site Representative(s): Name
Title Phone
24 hour contact name Michael Norris
Phone:
On -site representative Michael Norris
Phone:
Primary Inspector: Robert Marble
Phone:
Inspector Signature:
Dale:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number: 820005
Inspection Date: 12/12/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Wean to Finish
Total Design Capacity:
Total SSLW:
Waste Structures Observed
Disignated
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
KILPATRICK 1&5
26.50
Lagoon
KILPATRICK 2&4
27.00
Lagoon
MERRITT
27.00
page: 2

Permit: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number: 820005
Inspection Date: 12/12/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
ELI
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
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 Ne
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.eJ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
[]
❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Apptication
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ .❑
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?
❑
Failufe to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
[]
page: 3

Permit: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number: 820005
Inspection Date: 12/12/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Com, Wheat, Soybeans
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Norfolk loamy sand, 0 to 2%
slopes
Soil Type 2
Norfolk loamy sand, 2 to 6%
slopes
Soil Type 3
Woodington loamy sand
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 andlor land application site need improvement?
❑
E ❑
❑
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?
❑
■ ❑
❑
Records and Documents
Yes
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS820005 Owner - Facility : Murphy -Brown LLC Facility Number: 820005
Inspection Date: 12/12/13 Inssection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fait to install and maintain a rain gauge?
❑
01111
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?
❑
❑
❑
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?
❑
N ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
E ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
N ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon 1 Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
E ❑
❑
page: 5

i ype of v [sit: W i.ompuance inspection v operation Keview t j structure r vaivanon l.! i ecnmcai Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
IF
Date of Visit: X-7 Arrival Time: Q 1 : oo Departure Time: at : 3 Countyx- 6V Region: Jrqft
Farm Name: L . C,k—Fzwfk,Me4/'d't4F r^ Owner Email:
Owner Name: QL CV r, , LLC Phone:
Mailing Address:
Physical Address:
Facility Contact:
Mr k Al. ,,L, Title:
Onsite Representative: G
Certified Operator: V` R
Phone:
Integrator: A
Certification Number: 319
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design
Current
Design Current Design Current
Swine
Capacity
Pop.
Wet Poultry C►►apacity Pop. Cattle Capacity Pop.
Finish
i
La er DaCow
Non -La er Dai Calf
Da' Heifer
Feeder
o Finish
�'L
o Wean
Design Current Caw
o Feeder
F
ll , P,oult . Ca aci P,o Non -Dairy
o Finish
La ers Beef Stocker
Non -La ers Beef Feeder
Pullets I Beef Brood Cow
Turkeys
Other Turkey Poults
NJ Other Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes P No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
RNA ❑ NE
NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes Ea No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes [A No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: jDate of Inspection: 7 �Z2
r
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑" No NA ❑ NE
Structure I f Structure 2 Structure 3 Structure 4
Identifier: t 2�
Spillway?:
Designed Freeboard (in):
r� �r
Observed Freeboard (in):
5. Are there any immediate threats to t e egrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Structure 5 Structure 6
❑ Yes T No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
T 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
T 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.
❑ Yes
[0 No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
rea
12. Crop TYP(s) �A
�
P e : -O
13. Soil Type(s): l 14-4 t �p
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[]RNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
W No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[] Yes,
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes A No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections ❑ Sludge Survey
22, Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility number: 3, Date of Inspection: -7 Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes QJ7No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Fla
llo ❑ NA ❑ NE
the appropriate box(es) below,
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34.'Does the facility require a follow-up visit by the same agency?
❑ Yes
�] No
❑ NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes ,P@ No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes A No ❑ NA ❑ NE
❑ Yes W No ❑ NA ❑ NE
❑ Yes No
❑ Yes No
[:]Yes No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any°additional"reco nmendahoiis or any'.other.;comments
Use drawings of facility to better explain situations use additional pages as necessar
y)-";
Reviewerllnspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 104od�-()
Date: LZ.
2/4/2011

Type of Visit: 0 Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: I to/T tv ti Arrival Time: Departure Time: County: Region:
Farm Named 1D0TM1'4FnfM ,itw-�1 _M Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: M ; k I&'f I S Title:
Onsite Representative: u
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: h
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current
Wet Poultry C►apaci#y Pop.
[Layer
Design
Cattle Capacity
Dairy Cow
C►nrrent
Pop.
Wean to Feeder
Non -La er
I I
I Dairy Calf
Feeder to Finish
I Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
Dr P,aultr. Ca aci P,o
Layers
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
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 IP No ❑ NA ❑ NE
Yes [:]No
❑ Yes ❑ No
NA ❑ NE
�J NA ❑ NE
❑ Yes
❑ No
(P NA
❑ NE
❑ Yes
*No
❑ NA
❑ NE
[] Yes
* No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

Facility Number: - Date of Inspection: I o Z4 11
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 �r Structure 2 2��/ Structure 3� Structure 4
Identifier: r
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
Structure 5
t No ❑ NA ❑ NE
❑ No MI NA [] NE
Structure 6
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
1# 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 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? ,
I L Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
' -'No
i
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved A
s4a OErw4JaSagLV�4'
a4.
12. Crop Type(s):
-S
-4-
13. Soil Type(s): 0 do 6 1 VJa
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
® No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
15D No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
fo No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
® No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ES No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and t" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes IQ No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 4No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Ins ection: p Z f 1 1
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 ONE
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 fast survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No [] NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility? if yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No
❑ Yes No
❑ Yes No
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes q
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 q No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other:coruments:
Use drawings of facility to better explain situations (use additional pages as necessary). Y"
�e s Twit
vl' t-t - oe, Io�zl/tl
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: p-`t'33� noo
Date: 1012411 C
21412011

IM
Division of Water Quality
110EB-
lity Number 0 Division of Soil and Water Conservation
>L
0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: MI.
Arrival Thne: () OQC�...� Departure Time: 4 Y ► County: �'"7o^Farm Name: N/\ IOW l' [ Owner Email:
Owner Name: — Vt( U-C Phone:
Mailing Address:
Physical Address:
Facility Contact: Ni Y'Il 5 __ Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Region: �_
_Phone No:
Integrator•
Operator Certification Number:
Back-up Certification Number:
Latitude: ED o ❑ L = " Longitude: = o = I = u
Design Current
Design Current
Design
Current
Swine
Capacity Population
Wet Poultry Capacity Population C•a#tle
Capacity
Population
Wean to Finish 3 f Z5
❑ Layer
❑ DairyCow
Wean to Feeder
❑ Non -Layer
❑ DairyCalf
Feeder to Finish
El Dairy Heifer
Farrow to Wean
Dry Poultry ❑ D Cow
❑ Non -Dairy
❑ Layers
❑ Beef Stocker
❑ Farrow to Feeder
❑ Farrow to Finish
❑Non -La ers❑ Pullets ❑ Beef Feeder
El Beef Brood Cowl I
❑ Turkeys
PCGilts
Boars
Other
❑ TurkeyPoults
❑ Other Number of Structures:
❑ Other
Discharees & 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
[�j NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
[:`NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
�tacture 4
r-y
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 100SNo ❑ NA ❑ NE
❑ Yes ❑ NO-14 NA ❑ NE
Structure 5 Structure 6
❑ yes ]No ❑NA El 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 [ft. No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Ep 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 Dd No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes h No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �SNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift ElApication Ou ide f Area
12. Crop tyPe(s) l/BTv%. 4 .(VL7&',Cw s . aa4
13. Soil type(s) � —, �r, t wo
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
IP No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
99 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 t0 question,#) Eiplaln any YES answers and/or any;recommendathins or anv Other=comment&
Use drawings of facility to better explain situations. (use additional pages as necessary)k� +; f
Reviewer/Ins ector Name
P
�' " w x* t
.. - Phone:
�
Reviewer/Inspector Signature:
Date: 1 0 `Z.8 rf0
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection o! J I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [!�)No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design 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 �hNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes [ANo ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes 5allo ❑ 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 �;j No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[:]Yes
f§ 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
N 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
ZjNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings: -- �,"ry r
i
Page 3 of 3 12128104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 10 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: (t J 09 Arrival Time: Departure Time: County: Region:
Farm Name: !' S -07 Owner Email:
OwnerName: /�/ Gfie�%"�1� �� C.c.�� Phone:
Mailing Address:
Physical Address:
xC
Facility Contact: LL9J Title: Phone No:
Onsite Representative: N`� Integrator: u �/
Certified Operator: ou r �y Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [� e Longitude: = ° = ` K
Design . Current Design Current --Design Current
Swine Capaciq Popuiation�,„ _V4'et-Poultry Capacety. Populahori , '-Cattle "Cap ty P,opulafian
Wean to Finish
ID Wean to Feeder
175_1P—�
❑ Feeder to Finish
ElFarrow to Wean
ElFarrow to Feeder
ElFarrow to Finish
❑ Gilts
El Boars
Other.
❑ Other
❑ Layer 10 ❑ Dai Cow
❑ Non -Layer 11 ❑ Dairy Calf
Dry.Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkcx PouIts
❑ 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?
LHei
Cow
Beef Stocker
Beef Feeder
Beef Brood
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
P NA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
[3NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
F
❑ NA
❑ NE
❑ Yes
IRNo
❑ NA
❑ NE
12128104 Continued

1
Facility Number: —5_
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?
Simep,ire I S ct a Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes V No ❑ NA ❑ NE
❑ Yes ❑ No �p NA ❑ NE
Structure 5 Structure 6
❑ Yes [P No
❑ Yes [ No
❑ NA ❑ NE
❑ 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 MNo ❑ 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 P9 No ❑ NA ❑ NE
maintenance or improvement?
Waste Annlicatian
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 RNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
ElOutside of Acceptable C�ropj indow ❑ Evidence of Wind Drift❑ Applic tion Outside of Area
12. Crop type(s)W 6-g Q �i!
13. Soil type(s) IUD IT _ aQ 14, 4WZ-t '!.
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for laud application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
IONo
{�
❑ NA
❑ NE
No
❑ NA
❑ NE
No
❑ NA
❑ NE
No
❑ NA
❑ NE
] No
❑ NA
❑ NE
Comments (refer to question #: 'Explain any YES answers andlor any recommendations or any other comments'; "L
Use drawings of facility:,to better explain 'sitw tions. use additional pages as necessa '
Reviewer/inspector Name
f Phone: TO— 3 3-33cf)
Reviewer/Inspector Signature:
Date:
I2aSM4 ' Continued

Facility Number: Date of Inspection
Required Records & Documents
19, Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes EpNo ❑ NA ❑ NE
20, Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E�tNo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists El Design El Maps El Other
21 _ Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �4 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and P Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
IR No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
[I NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
o
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
1PNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[N No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
10 No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[�PNo
❑ 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
0 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
10 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
[5No
❑ NA
❑ NE
12129104

Division of Water Quality
Facility Number �� 0 Division of Soil and Water Conservation
0 Other Agenc
yy
Type of Visit 10 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: %�% _ I Arrival Time: ,� ,�L Departure Time: County: Region: �`
Farm Name: V' 1 oa} is t'w +�,Z15 g �rl4 j Owner Email:
Owner Name: — LLC- Phone:
Mailing Address:
Physical Address:
Facility Contact: [ V I t Ke Ngf>1S Title:
Onsite Representative: V
Certified Operator: d
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feede
Farrow to Finish
Boars
Other
❑ Other
Phone No:
Integrator: 11Af{1..J�MLJh
Operator Certification Number: a? 4"
Back-up Certification Number:
Latitude: E=1 o =1 ' ="
Longitude: = o =' = U
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
1q ❑ La er
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes: IgNo ❑ NA ❑ NE
❑ Yes
❑ No
IfNA
❑ NE
❑ Yes
❑ No
[P NA
❑ NE
❑ Yes
❑ No
0 NA
❑ NE
❑ Yes
o No
❑ NA
❑ NE
❑ Yes
ED No
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: S
Date of Inspection
Waste Collection & Treatment
4.. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No SNA ❑ NE
Structure 1 Structure Structure 3 Structure 4 Structure 5 Structure 6
Identifier: V S 0 `• In EUXTT
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Q
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
P No ❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
J�LNo ❑ 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
VPNo ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift El Application of Area
-~Outside
12. Crop type(s) Corn, whew 5&t1 � _. . (�"(&Mkda G.. , "&' G.S. Ows t
11 1 13. Soil type(s) �O OAt K a wo 11QIJ
--
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [RNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes W No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes E9 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes EpNo ❑ NA ❑ NE
❑ Yes JRNo ❑ NA ❑ NE
Reviewer/Inspector Name Phone: 3�
Reviewer/Inspector Signature: AllDate: �6 $
Page 2 of 3 12128104 Continued

r
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 `9 No ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EgNo ❑ 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
JP6No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[PNo
❑ 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
KjNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
V) No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
JP No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
1�5 No
❑ NA
❑ NE
Additional Gogh ents and/or I rawutgs:
f
Page 3 of 3 12128104

Division of Water Quality
Facility Number Q 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 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I YI '2 I Arrival Time: - Y�art' Departure Time: County: 5AYW 00
Farm Name: +l I A i L� IW1 �. �r s SWf f;WM Owner Email:
Owner Name: AA"i, 6 r0wh Phone:
Mailing Address:
Physical Address:
Region: F4ZO
Facility Contact: _P� k— f,6 W ►A Title: Phone No:
Onsite Representative: ey-ow to Integrator• _ ✓fro W h -
Certified Operator: 8r� w Operator Certification Number: -7 0 I� I
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
Back-up Certification Number:
Latitude: = 0 =' = Longitude: = o =' = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
1 ❑ Layer
„ • ❑ Non -La ei
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
"ge originated at: °"k Struc ` e El Application Field El Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity , Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
E]Dry Cow
E]Non-Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ©i,
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 El NA El NE
❑ Yes ❑ No YINA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No �NA
❑ NE
❑ Yes No ❑ NA
❑ NE
❑ Yes No ❑ NA
❑ NE
J
12128104 Continued

f
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?
v Strgcture l Structure 2 \ Structure.1 Structure 4
Identifier: K i S 2� Li
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Y r
❑ Yes M No ❑ NA ❑ NE
❑ Yes ❑ No' h NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [n No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes KkNo ❑ 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 h No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Wo [INA ❑ 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 X] 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 El NA [I NE
El Excessive Ponding El Hydraulic Overload El Frozen Ground El Heavy Metals (Cu, Zn, etc.) !!
❑ PAN ❑ PAN > I0% or 1 o lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop
-- Window ❑ Evidence of Wind
�?Drifl_ [I Application Outside of Area
��
12. Crop type(s) I�GL 4a( `5 ` qc6 Gras$ o4'y)
13. Soil type(s) Wao A"A0k ,
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
PpNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ 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):
. }�l�Y-r�i Rwm t.�►�c�w _ v �,�c�� .
Reviewer/Inspector Name Phone: % y3.3-1,70W
Reviewer/Inspector Signature: Date: fl!1
12128104 Continued

i
i
Facility Number. Date of Inspection �
Required Records & Documents I I
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ONo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps [I 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
[0 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
Et 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
09 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[9No
❑ 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
IgNo
❑ 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
[D No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[DNo
❑ NA
❑ NE
Comments and/or Drawings:
12128104

t
Type of Visit Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit Routine Q Complaint O Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Tby06 A_rriv{al Time:
--% SQ Departure Time: County: ;SA"P5o0
Farm Name: K I Qa- r,`� Farm I zla.L4, 5- s 1r 1err"+` Owner Email:
Owner Name: /' `gyp kU Phone:
Mailing Address: , �
Physical Address: 1 t.l la
Facility Contact: _ _ Title:
Onsite Representative: if
Certified Operator:
M Phon,,e No:
Integrator: _ f' �Pjr `y
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Region: jF­09-0
Latitude: [--]0 0' ❑ Longitude: I--]o =' = u
Design Current
Design Current
Design C►urrent
Swine C►apacity Population
Wet Poultry
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer I
Dairy Cow
❑ Wean to Feeder
JE1 Non -Layer
❑ Dairy Calf
® Feeder to Finish jIDOGD I
❑ Dairy Heifer
Farrow to Wean SQ 0
ry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
❑ Pullets
ElBeef Brood Cowl
❑ Turke s
Other
❑ Turkey Poults
❑ Other I
JE] Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[p NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
M 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
[PNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
09 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
tp No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
1212BI04
Continued

.- I t
Facility Number:
Date of Inspection f7 D6
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes lo XNA ❑ NE
S cture 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: k K rner�-+
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �� 9r
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes PNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 1PNo ❑ NA [INE
through a waste management or closure plan? lI
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 W 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?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
0 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)
Bat- mJa SM0.(t &Thin OU+Prsod
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
P9 No ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
P] No ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
W No ❑ NA
❑ NE
IT
Does the facility lack adequate acreage for land application? ❑ Yes
eg No ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
t� No ❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any -recommendations or any. other comments ; r:: b
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name I Phone: D 3 00
Reviewer/Inspector Signature: Date: o
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection /a
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 01 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 ❑ other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes F No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
JgNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[19 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
1P No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[ iNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
Jallo
❑ 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
[ONo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12128104

'J:') It Al s 3-- /-) = O l
Type of Visit 6 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 4 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Arrival Time: �U17 Departure Time: County: Region: Date of Visit: Vff 0
Farm Name:t tt]jYijL 14 40 /uerjwner Email:
Owner Name: me ceLtPhone: A
Mailing Address:
Physical Address: j
Facility Contact: /�' e- t rS Title:
Onsite Representative: AkcAx �y�lYr S
Certified Operator: ieoFLOL Q qcnte
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number: Y (Q G
Back-up Certification Number:
Location of Farm: Latitude: = o = 0 Longitude: = ° = I 0 0
tA.iiZ -. I 'Cryr�,I,.'-'Ac, ^i9b'j^+,��UrvL4p- .
rjai
4 nCurrent"^ Z"Design Current ..'t�Y �� d"A �.��.1���
ine C apty Population Wet Poultry Capacity Popula#on Cade- Capacity Population
Wean to Finish
REB,
❑ Layer
❑ DairyCow
Wean to Feeder
❑ Non -La et
❑ DairyCalf
aFeeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
/ ISO
Dry Poultry
❑ La ers
.
ElNon-Layers
El Pull ets
❑Beef
Turke s
El Turkey Poults
❑ DairyHeifer
❑ D Cow
❑ Non -Dairy
El Beef Stocker
❑ Beef Feeder
❑ Boars
O#her
❑ Brood Ca
Number of Structures:
❑ Other
I
10-0ther
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes E5No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made? ❑ Yes ❑ No LNA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No 2�NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)? I
rram�''''
d. Does discharge bypass the waste management system? (If yes, notify DWQ) El Yes ❑ No L'NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes KNo ❑ NA ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes &J90 ❑ NA ❑ NE
other than from a discharge?
12128104 Continued

Faciiity Number: iz
Date of Inspection �" 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
RNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No USNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: MCt•ri+Ir Y_.1 . 1 4;1 • ti
Spillway?: _ ,� kq I
Designed Freeboard (in): a0 11y• 5 1q
Observed Freeboard (in): W L k 3 J�l�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
QNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
ERNo ❑ 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
KNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
UR 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 El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
KNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
KNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus [:]Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Crrrr. — 4 tea+ rt .s ._r)a.0
13. Soil type(s) L11� I IJ&C40 4► A.,,
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
K.No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
XYes
*No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination , [] Yes FgNo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes 5� No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 0!�No ❑ NA ❑ NE
15- 1 co) r -at v44�6a 4.,V- �'VJJ5 41 arm yz
Reviewer/Inspector Name { �s r Phone:
Reviewer/Inspector Signature: Date: Z�
12128104 Continued

ti
Facility Number: —"CEDate of Inspection 5�
Required Records & Documents
19, Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes T�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 ❑ Checklisks- ❑ Desigtf ❑ Maps' ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes SNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
9 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
PSNo
❑ 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
Z] 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
N No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
2Q 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
KNo
❑ 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
[j4 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
KLNo
❑ NA
❑ NE
Addttronal Comments. and/or Drawings:.
12128104

Type of Visit *Compliance Inspection O Operation Review O Lagoon Evaluation ✓1
Reason for Visit *Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: % ���� TH e: %
Facility Number T 6' 6t ,S
0 Not Operational 0 Below Threshold
IV Permitted ® Certified E3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold- .....
Farm Name: rn e � r�;+ -f ..±e�n= County:
Owner Name: ---------------- ----------------.---. Phone No:
Mailing Address: • - P �._. t'� ,c .-7, S ...... .sr:as; W i-� `. 1[
Facility Contact:
Title:.._ .._. .................. _ _. _.. ._...—_.. Phone No:
Onsite Representative:
..... _—RfC' --- 1� I a �
Integrator: �► t�Y �3�. —
� r rs t.s �J
Certified Operator; ..-....
h , - .... j,w i o ►r
Operator Certification Number:
>_ ? 7 46 �
Location of Farm:
0) Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 0« Longitude • ° 96
Discharges & Stream Imoac#s
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min? H 1/1
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 ® 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- f� f
Freeboard (inches):
12112103 Continued

Facility Number: $2
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Aunlication
❑ Yes No
❑ Yes No
dyes ® No
❑ Yes ® No
❑ Yes ® No
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes © No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type ge_'-M� I4Q Row (21�4hw Coe'%j L k. +0 .5C'4
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 P No
b) Does the facility need a wettable acre determination? ❑ Yes Eb No
c) This facility is pended for a wettable acre determination? ❑ Yes 1P No
15. Does the receiving crop need improvement? ❑ Yes (M 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 atlor below ❑ Yes W No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes [A No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes Q 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 [ul No
Air Quality representative immediately.
_CO(refer to cluest,an #) Ezplaz�u airy YES avers and/or any recomtaendations or.any'other cosnmeuts
Use dravrtiigs of fac�ety to better - Iam stfuatsoas. ase"addit<onal as necessa ) �-.�.�...
�p _ _ f _ 1 F9 _ ®Field Copy ❑Final Notes�I
�.
8 s7 r, V s 7 a s3 b � 0— A � w„� � � p�', �.a -� ;d � w �, �. � � � i ,,� r'.+ t c,� o,-
A'
r"I u,,ctc-v ,I.Z CAS
P
ff h4vc S rcvtar_s-
AipL)14 1 mG TO C1�1Cs *+�T 1iCC� a� sC1 \ �Oy`apJ�
IJ
+��j<t
C1 �-`: ,.1 ..� � + d �( � Ci P a vtr � or � 1� `� 0. i!`� S U �J . •" � C. h Y ,'�T � V4� i �'
1t1� t < } i^ p W-- O -o t an G b P
1jGn7� hat �bv+..pcGJa0��1 �C.p1TG.S�S}O'�i{S �-.
��.Q � Mi S C �[d/t� Gtr^C
(� 1 {� i!
1
s/ i nG11G5 �OWW�4r' f C'dc' w e-e—+ J cpi �n C. 1 O Ss L1-4 ll Pi�t"� fin. e_
+n G t
7
Reviewer/Inspector Name ? 4 �-� ��
f
Reviewer/Inspector Signature: Date:
12112103 ✓ Continued

a �
Facility Number: q R _ S Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes ® No
❑ Yes E] No
❑ Yes m No
❑ Yes ® No
❑ Yes [�) No
❑ Yes ® No
❑ Yes ® No
❑ Yes No
❑ Yes No
® Yes ❑ No
❑ Yes [P No
❑ Yes O No
❑ Yes Q No
❑ Yes ® No
❑ Yes g] No
12112103

Type of Visit .6 Com ' ce Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Faci 'tv Number 7� (' S Date of Visit: Z 0 6 Time: O
rLCLNot Operational 0 Below Threshold
ermitted 0 Certified O Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: y t 1 P44 I ax ! M t ,,r ` 4 —�— County:
Owner Name:
Mailing Address: ~
Phone No:
Facility Contact: Title:
Onsite Representative: M �C 410 Yl� S Integrator:
�J
N
Certified Operator: �D WW �� `! d Operator Certification Number:
Location of Farm:
Phone No:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0• 6 Du Longitude 0'
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Ca ncity Po ulation
❑ Wean to Feeder I I ID Layer I I ❑ Da'
eeder to Finish ❑ Non -La er 1 10 Non -Dairy
[Traarrow to Wean 3.5 V
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number ofLagoons TO Subsurface Drains Present ❑ Lagoon Area JE1 Spray Field Area
Holding Ponds'LSolid Traps 10 No Liquid Waste Management S stem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c_ If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (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
Struc�tureI Structure 2 Structure 3 Structure 4
tuo
Identifier: �_ K P m
Freeboard (inches):
05103101
Structure 5
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes 2N!7�
El Ye
❑ Yes
❑ Yes o
Structure 6
Continued

Facility Number: L E— O Date of Inspection L e3
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding []PAN [:]Hydraulic Overload
12_ Crop type J 0 y lg h S (,✓�r �Yr+ . _ 1� lrn-i rr d q- �rr� �r �4 r •-e
13. Do the receiving crops differ with those designated in the 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?
I5. 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 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?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes 0
❑ Yes
❑ Yes 040
❑ Yes Io
❑ Yes
❑ Yes ��N0
❑ Yes
❑ Yes
�;N,
❑ Yes
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑
❑ No
Yes
❑ Yes
❑ Yes
❑ Yes
El Yes
,L.�,'No
No
❑ Yes
,L.�,
ldNo
❑ Yes
❑ Yes N
❑ Yes N
❑ Yes No
[] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visi
Commeuts`(refer to question #) Egplain any YE&answwers and/or, any tecommendatious or any oilier comments.
Use drawing of facility tobetter explain sitttatiotis. use additional pagesas necessary): El Field Copy -Final Notes
�: ;-. .
H
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: z
05103101 Continued

Type of Visit 0 Compliance Inspection Q Operation Review C) Lagoon Evaluation
Reason for Visit (� Routine () Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit: G1 Time: D O
rO Not Overational 0 Below Threshold
® Permitted ®'C/ertiiied 0 Conditionally Certified [l Registered Date Last Operated or Above Threshold:
Farm Name: 1�+ cy, rhrej M 1+ � 5 di M�N�i County: �Asort P;eo�
Owner Name: Phone No:
Mailing Address: n ,
Facility Contact: is e , crrs Title:
"I Onsite Representative: j �c � "'-r�S
Certified Operator: 1 " `,,,L,) AYnrr 'S
Location of Farm:
Phone No:
Integrator:
Operator Certification Number: It 1r%a
swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 04 u Longitude 0a 6 0
Design
Swine Ca acity
Eurrent
1?o ulation P,ouitry
Resign Current Design Cnrrent
Ca acity P.o ulation Cattle Ca aeity P,o ulation
Wean to Feeder
❑ La er
❑ Dai
.159 Feeder to Finish
1❑
❑Non -La er
❑ Non-Dai
[59 Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
�o
❑Other
Total Design Capacity
Total SSLW
Number of Lagoons l� ❑ Subsurface Drains Present ❑ Lagoon Area
Holding Ponds 1 Solid Traps ❑ No Liquid Waste Management System
❑ Spray Field Area
Discharves & Stream Impacts
I . Is any discharge observed from any part of the operation?
❑ Yes qQNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
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 EP 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 14.No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: K }cz M
Freeboard (inches): !�b
ga-
05103101 Continued

w
Facility Number: 7P — 5
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.) -
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste ADDlication
❑ Yes] No
❑ Yes �O No
❑ Yes No
❑ Yes No
❑ Yes 1� No
10. Are there any buffers that need maintenance/improvement? ❑ Yes [P No
11. Is there evidence of over application? ❑ Excessive�Ponding n ❑ PAN ❑ Hydraulic Overload ❑ Yes � No
12. Crop type Jh ej r S "U �C S !&( r �d1., W `_m" P el tcz..` rt ds
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 04 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? [AYes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes [2; No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[9 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
[0 No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[A No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22,
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[[ No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
.. _ Corkinents (refer to.qhn #)E=ln n5-'y
recommeedatrons or aiiy other comments. # , k
a
[3se drawings�of facdity to better ezplatn sttuahons "(nse addihonal pages as necessary) ❑Field Copy ❑ Final Notes'"
7,13
165 — Con�sn awe Wdt on �crrn u�a 5 u•ci/ . �; c� +� ��... Gc"�5 r��P f+'�c��
-�I�• g Y e��_
�' �Ce Siure- - o SprcacQ G�.� p� c��r►ms acatss 4tC �'el j_s , /1`�w�-� pte Qutils UsW_re.
e`n 4& sam q_ r i5v w/ no p+-Us madec5n MAV j CLet'+ f users ,
CCrT"e-
_xria�� Cl rC��n L'_'S �, ske� irk 4, &. ko--1 -�f ear r,' q �s
4 _3
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 Condnrted

e
Facility Number: �— 5 I Date of Inspection D Z
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
WA) aWLJ f , 41c small J- "M -41"S
❑ Yes ❑ No
❑ Yes No
❑ Yes ® No
❑ Yes 0 No
❑ Yes No
❑ Yes No
❑ Yes ❑ No
05103101

Facility Number Z Date of Visit: i% 9 d Time: ld�
Q Not Operational Q Below Threshold
® Permitted 0 Certified 0 Conditionally Certified 13 Registered , Date Last Operated or Above Threshold:
Farm Name: .... - e�� 1.. .1..f,.ee e`- . 1yZ"' X--.s 0 gonee County: , .OF
Owner Name: ..... ..... 1.���f�....!",'��.�..........._...................................... Phone No:.-1�
FacilityContact: ... ..._....... e. 0 /A#-*f L�..i Title:.............1.................................................. Phone No:............................ » ...».... .
Mailing Address:..
Onsite Representative:...._._ ./..�` .._.......!{lQ,�-��-it...... Integrator: .�c.r��ePi.+C_
Certified Operator: ....... „..... , � � ,per ✓................................. Operator Certification Num r•. _ _ .....
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 4 64 Longitude • �Du
Design Current
5 - nCanacits, Powdati&
Wean to Feeder
Feeder to Finish
19 Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
_Nttmbei-:af Lagoota; Subsurface Drains Present 1101,MoonArea 10 Spray Field Area
Holdiz}gPonds / 5olid 'Daps: ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes ,V No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes ANo
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
❑ Yes ,R No
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 ;allo
2. is there evidence of past discharge from any part of the operation?
❑ Yes IffNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes JqNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes XNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
/7
Identifier: ..._.....y� ............................ W................._..........._......................................_...........-----
............. -....... ._...._....
Freeboard (inches):
5100
Continued on back

Facility Number: P5 — = Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, j] yes ONO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes UNo
(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 FNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes RNo
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes ONO
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ,Yes ❑ No
12. Crop type
13_ Do the receiving crops differ with those designated in the Certified, Animal Waste Management Plan (CAWMP)? ❑ Yes ,Q 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?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) .�
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0.. g { Yo# ;Ye to�Y;4raedgflee[ces wire nQea
ctirresporideace abu f this visit:
❑ Yes IffNo
❑ Yes ®-No
❑ Yes RNo
❑ Yes )R No
❑ Yes JR No
❑ Yes IRNo
❑ Yes ONO
❑ Yes 19 No
❑ Yes JRNo
❑ Yes ®"No
❑ Yes IRINo
❑ Yes ONO
Cgtiunents (refer to question #) . Eikplain auy YES answers and/ar any re ornmew lions or?aay otlixr eoa
Use drawtugv of facility to better explain situations._(gse.additional;pages as aece ary)
�.
AN
.�
77
Reviewer/Inspector Name `
Reviewer/Inspector Signature: % ,� �� Date: A1,91a/ 5ADO

Facility Number: Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below [(Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes [�fNo
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes JM 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 Jallo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes JRNo
32. Do the flush tanks lack a submerged fill pipe or a permanentttemporary cover? EB Yes ❑ No
Additional omments an orDrawings: n -
5/00

® Division of Water Quality
Q Division of Soil -and Water Conservation
Q Other Agency LL
Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: �2 'rime: ¢':fib Printed on: 7/21/2000
'v
NNot Operational Q Below Threshold
'Permitted M Certified Cl Conditionally Certified © Registered Date bast Operated or Above Threshold: .................
Farm Name : ................................... ...........
-... .. ........ ...... . t...........................................
/�,%�E�����.. � �/ �r¢/1''�:..................... County: _.�,r�..
Owner Name:.......1..�<. ....,1- i�✓� Phone 1Vo pl T�.._�....!.......I......................
..................................... T d.. J......
Facility Contact: //>f �oo�ic'l.� Title: Phone No: ...................................................
.................................................... ..........................................................................
Mailing Address: �.�'.��� z......... l....... . � ./(��� ��� ...... Onsite Representative:.....//�_io���.................................... Integrator:.............
................
Certified Operator: _.....cf!,. „ �!i� �S '
....�............................................... Operator Certification Number:.......................
. ...................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ horse Latitude • 6 4i Longitude ' 4 «
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer I ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer I I0 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑Subsurface Drains Present 110 Lag--,n Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste ]Management System
Discharg-es & Stream Im acts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field []Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If dischart e 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 ; Structure 4 Structure 5
Identifier: ......_...r1.�� .............................3a........ ............ 1.......... ...................................................................................
Freeboard (inches):
5/00
❑ Yes �0a
❑ Yes NNo
❑ Yes k-No
❑ Yes No
El Yes No
❑ Yes No
[]Yes t No
Structure 6
Continued on back

r
Facility Number: eZ— late of Inspection 0 Printed on,• 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [:]Yes NO
seepage, etc.) NI
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 4-6was answered yes, and the situation poses an WKyes<W0
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes �kNo
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 �A 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 'Tp v/S fA•✓� ���
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes Pd No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes FNo
b) Does the facility need a wettable acre determination? ❑ Yes VQ No
c) This facility is pended for a wettable acre determination? ❑ Yes XNo
15- Does the receiving crop need improvement? ❑ Yes KNo
16. Is there a lack of adequate waste application equipment? ❑ Yes XNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes XNo
18. Does thpfacilita`il to have all rc6mponents of the Certified Animal Waste Management Plan readily available?
(ie/ W P, chec lists, des gn, maps, etc.) ✓ ' ❑ Yes E�No
19. Does record keeping need improvement'? (ie/ irrigation, free oard, waste analysis & soil sample reports) ❑ Yes _kNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 'tNo
21. Did the facility fail to have a actively certified operator in charge'? ❑ Yes P No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes P No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representaiive? ❑ Yes CTo
s
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 2jNo
.violations;or &fide di,,9 •were poted- during this visit.* • 'Y;ou will-teceiye iiti further.
rofris• ondenke: abbut: this :visit
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name
Reviewer/Inspector Signature: '-Se Date: 9 f9121-1ee> 5/00

Facility Number: Z — Date of Inspection; Z
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor 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 PPdo
28_ Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes M 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 J2 No
3 t. Do the animals feed storage bins fail to have appropriate cover? [:]Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? 5}Yes ❑ No
kdditionaLCommOnts an or sawiin - W
•= - -
3/23/99

f
1 Division of Soil and Water.Conservation Operation Review
© Division of Soil and '4rater Conservation -=:Compliance Inspection
_ ivision of Water Quality' Compfeance Inspection �r
— -
_ _ .Other Agency Operation Review
p -
_.. _ - -
IM_Routine 0 Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Q Date of Inspection
Time of Inspection FF9 24 hr. (hh:mm)
Permitted © Certified © Conditionally Certified 13,registered JE3 Not O erational Date Last Operated:
Farm Name: QL.. f -.-Z r rr`I ....... County:.....
...��...........................
........... ......... ...............
-......
Owner Name:.......... .!cif. .................. ...0 .WLI.. 1 Gc r"�'ls... Phone No:.........-....-......... .......................
�' �
Facility Contact: . -..- .l.-....a.e ...... /,"•Q............................
!% 5............... Title:c... ho a No:.........:......-...........................-....
Mailing Address:......D...!1...�....!.....1..``... ..........................
Onsite Representative:..... lid cZ e 1 k Y i''1 ..... Integrator:.........
.......................
Certified Operator...... r"„G,..1!.G!!1GL' ..... 1rY`, .......................... Operator Certification Number: ...........
Location of Farm:
Latitude • 4 — Longitude • 4 46
,Design Current = ' Design: _ ' Currerit; Design Current
Swine Capacity Population = Poultry Capacity Population Cattle Capacity Population "-
❑ Wean to Feeder ❑Layer ❑ Dairy:A.-
Feeder to Finish ❑ Non -Layer I ❑ Non -Dairy
Farrow to Wean Q
" ❑ Farrow to Feeder ❑ Other I I ,
❑Farrow to Finish Total Design Capacity z % f
❑ Gilts _
❑Boars _ .Total=55LW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area Io Spray Field Area
HoldiagPonds 7 Solid Traps ID No Liquid Waste Management System
DischaLrges & Stream Impacts
Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (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 Stry2re 2 44eruc u _3 Structure 4 Structure
Identifier:
Freeboard(inches): ........./ �................... .........................:3...."................................................... .............................
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes 0KNo
❑ Yes VNo
❑ Yes No
❑ Yes OfNo
❑ Yes KNo
❑ Yes �No
❑ Yes JqNo
Structure 6
❑ Yes No
Continued on back

r !
Facility Number: — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
6Yes
closure plan?
❑ 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 maintenaricelimprovement?
❑ Yes WNO
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes V�o
Waste application
10. Are there any buffers that need maintenance/improvement?
❑ Yes ,Aj No
11. Is there evidence of over appl- ation? ❑ xcessive Ponding ❑ PAN
❑ Yes ANo
12_ Crop type !il �oqi
13. Do the receiving crops fer with those signated n the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes A 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 XNo
15. Does the receiving crop need improvement?
❑ Yes 9No
16. Is there a lack of adequate waste application equipment?
❑ Yes '"No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes 1KNo
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 ANo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes JQNo
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 ONo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?`
(ie/ discharge, freeboard problems, over application)
❑ Yes R14No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes VNo
24. Does facility require a follow-up visit by same agency?
❑ Yes RNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes )No
O ViO�a�10RS Or deeCleliCiLS veeTe pijie(i a>rki`iil9 . . . . S .... .. .e . . . iio further ; ;
COTFCSDOII�eIICe �WLt�TLS VlSlt_'.'. .'..'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'. .'.'.'. .
Eomments':(tefer to -question #); Explain _dhy. YES answers a id/or anyreeommendations-or any-other:comments.
..
Use drawings of facility.to better explain situations. (use additionalpages`as necessary):
AL
5 a,re wef� 1'.AOd .
Reviewer/Inspector Name
sz
Reviewer/Inspector Signature: Date:
3/23/99

FaciEity Number: 2 — Q 57-- 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 AYes ❑ 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 -gNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes IkNo
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 KNo
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 VNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 15�No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? xy,es ❑ No
3/23/99

-.�. wM—
U Devision of Soil and Water Conservation ❑ Other Agency
� cy
Division of Water Quality
Routine O Com faint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection
Facility
NumberZ
Time of Inspection 24 hr. (hh:mm)
0 Registered Oertified C3 Applij for Permit �ermitted 0 Not O erational Date Last Operated
Farm Name: �C,(... rA'i ,� iG./� �.. T ¢ County:.... .............
L�
Owner Name: .... .._..........f- ................Q> -m- .... Phone No 2.:... 2l /(, ,.......
Facility Contact:�Q-t't�'..�....... •-.L.� %e S.� ....... Title:..L �7......... _.:.. ... Phone No:... ................................................
Mailing Address:.. ..1� :...+.....1........�...9..........................................I............... ...........� ..../Tl.�/�.../ .�� - ��
xl&
OnsiteRepreSentative:-- g
................................................................ Integrator...
Certified Operator k --- -.-..... (,�.7. /1r.� s.................................. Operator Certification Number •.........................................
Location of Farm:
Latitude • 0' " Longitude 4 46
Design
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
127, //
❑ Gilts
❑ Boars
Design Current ° 3
tale �(",aiiacity �Pnniilatinn
`RJ6 x
DesI.ign Capacity z 7/
Total SSLw,
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes o
2. Is any discharge observed from any part of the operation? ❑ Yes o
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes XNo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes 14No
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 4No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes �No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes Al� No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes li 'No
mai ntenancelimprovement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes J1 No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes dGo
7/25/97

Facility Number. -- Q
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes ONO
Structures (Lagoons Holding Ponds, Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes ONO
Structure t StntcZe 2 Structure 3 Structure 4
Identifier: Miffr�
Structure 5 Structure 6
>F2 .! j........_ .........................................
Freeboard (ft). .........��� ............ s 1. ............................
.......................--............................................--------..._
............. ...................................................
......------. - ...........................
10. Is seepage observed from any of the structures?
❑ Yes ;%No
IL . Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes P No
12. Do any of the structures need maintenance/improvement?
❑ Yes ET 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 ``-`t No
Waste Application
14. Is there physical evidence of over application? ❑ Yes 1�No
(If in excess of or run f ente ' g wa a State n tfy DWQ}
15. Crop type �. ?u.ur .. /.�1..4 ..... a!�5 ... �"�e�..... ............. . ......................................
16. Do the receiving crops differ w those designated in the Animal Waste Management an (AWMP)? ❑ Yes 4No
IT Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
No'viailations' -Ok deficiencies:were"noted-iiuriug this:visit. You:will irefieive-no-f&iher _ -
correspQndence A obi this;
❑ Yes FkNo
❑ Yes AO No
❑ Yes RNo
❑ Yes �No
❑ Yes VNo
❑ Yes K No
❑ Yes 4 No
❑ Yes KNo
❑ Yes J�LNo
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:

❑ DSWC Animal Feedlot Operation Rggeview
x �� "� DWQ Anunal Feedlot Operation Site Inspechoa .� :-� ,
10 Routine O Complaint O Follow-up of DWQ inspection O Follow-u of DSNVC review O Other
FacilityNnmber
Date of Inspection r-.r- 79
Z .�
Time of Inspection �Jo 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status, 91 Registered ❑ Applied for Permit (ex:1.25 for 1 hr 15 min)) Spent on Review u
❑ Certified ❑ Permitted I or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated: . _... ,.... _ _ _. _ ._ . -... _ -._.. .. .. .. _ _ ._.......
Farm Name., Ilzc County.
Land Owner Name:.. -,, ��►+._ _. .... Phone No:
/ L
Facility Conctact: _ ,�r� Title: _/. _... ... _ ....� .. _ Phone No:.. _ ,. .._....�..... .... ...
Mailing Address:
0--_
Onsite Representative:... ....!�! integrator:'`
Certified Operator:_.._................................-..,......,..,.........-,.._.............._........�...._.... Operator Certification Number: �O �
Location of Farm:
fl
Q
Latitude Longitude �• �� ���
Type of Operation and Design Capacity
Design Ctirrent °Des�ga Cie ent ` De �gn Cur ent
Swine 'Ca acity Po ulateon Cattle Ca a+aci `Fa"uahon
�,., n .Ca aci Po elation}'Y
❑Wean to Feeder Lava Dairy
Feeder to Finish ❑ Non -Laver Non
Farrow to Wean
[71Farrow to Feeder �'TotalDesign Capae�tyI�
Arl Farrow to Finish �� -;
...... .....
tif
SSEft
XIM
,'❑ Other S r a .` t m.. "'w �^'
ME -Number of Lagoons'f HpEding Ponds ❑ Subsurface Drains Present
R "� xc La oon Area ❑ Spray Field Area
eral
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
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
4/30197 maintenanc&- improvement?
❑ Yes k No
❑ Yes WNo
❑ Yes (WNo
❑ Yes 19jNo
❑ Yes
tWNo
❑ Yes
N'No
❑ Yes
KrNo
❑ Yes
fi�No
Continued on back

Facility Number:... ....�
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes CffNo
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes %No
8. Are there lagoons or storage ponds on site which need to be properly closed? L'Yes ❑ No
Structures (11aggons and/or Holding. Pond,
9. Is storage capacity (freeboard plus storm storage) less than adequate? > ❑ es JV o
iifO' (
Freeboard (ft): Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Stru pure V
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste AFplication
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type�'F!!�ryti
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
ForCerrified Facilities
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes Mlo
Yes ❑ No
Yes ❑ No
❑ Yes %SNo
❑ Yes '"No
❑ Yes )KNo
❑ Yes )@ No
❑ Yes ;!ZNo
Yes El No
❑ Yes ANo
❑ Yes V No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Comments {refer to'question`; Explain'apy YES answers'andlor any recommendations or any,other cemments
Use'drawnngssof facility to better lat ezpn: situations (use addthonal pages as necessary)�N
,;� (l dl/pl/.e1�✓ -4A-6r b c..�v .46..�.,vr.. e�ar�,a.�� Q
--,��ow:• it a cc_cc,r,r�� ...�>� ,�•��--*����E.r a/ �-'r-�.s•��.
rA-).��f,�,.,_ •f.. r,•..�� �✓ r�� .vim✓,".sKv.'._V0W_"
Reviewer/Inspector Name -1�„� 'sa''_•'.
Reviewer/Inspector Signature: ��.✓Date: _ f .7 — Z%
cc. Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

Site Requires Immediate Attention: NO
Facility No. Sz - S
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: us /! , 1"5
Time: 14: 34
Farm Namejowner: k ! Q',Lf-1c_K/��FisrlS
Mailing Address: R+_ I-, _ ,Bo-x 367 NC z S� .. .
County; �.+� A 5 a n! _
Integrator: Phone:
On Site Representative: Gab-!, Ray i s e-" . _ „ _ - Phone: C 91 a.) 53 Z - �,' do z
Physical Addressllocation: _ SA .L7 44 _
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: 11 36, 1 Number of Animals on Site: 1/, aoo
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 0 Longitude• 0 ,
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) 6�or No Actual Freeboard: ? Ft. 15� Inches
Was any seepage observed from the lMr
s)? Yes or® Was any erosion observed? Yes orQo
Is adequate land available for spray? No Is the cover crop adequate?®or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? (J e r No
100 Feet from Wells? for No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or lP
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or(O
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes ordP If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? <YV or No
Additional Comments:
_ Ric- ky
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.

r
Site Requires Immediate Atten 'an: k-
Facility No. - 6l
DIVISION OF ENVIRONMENTAL MANAGEN ENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 1995
Time: 13 0
Faun Narnc/Owner:
Mailing Address: 1'kl
County: S W
1U t r\A
K �-
SoVJ
)AN
'J
\'AA) wk(3w)l'kfA , V.C.
Integrator: FA V-A 5 1IQ C- Phone: 1-go 0 - 7_8�- 2.11 q
y
On Site Representative: Ll-Xc3 COS' p N Phone: �1D - S3�„- L
Physical AddresslLocation: 'Z-S R t ct'- 4, RIj"° _ Z vw 1cs (".wm ; A-t -
o S21g43
Type of Operation: Swine Poultry cattle
Design Capacity: _ 14 n 0 Number of Animals on Site: 1400
DEEM Certification Number: ACE DEM Certification Number. ACNEW
Latitude: Longitude:•
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) es o No Actual Freeboard: Wit. O Inches
Was any seepage observed from the lagoon(s)? Yes or 9was any erosion observed? Yes o No
Is adequate land available for splay? es No Is the cover crop adequate? Yes r No
Crop(s) being utilized: rr 40I&OVA(VU5
Does ft facility mcet SCS minimurn setback criteria? 200 Feet 6m Dwellings' e or No
100 Feet from Wells? &ee or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or T�o
Is animal waste land applied or spray irrigated within 25 Fect of a USGS Map Blue Line.) Yes No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spiny irrigated on specific acreage with cover crop)?� No
Additional Comments:
- Nx\. b 0
Inspector Name
cc: Facility Assessment Unit Use Attachments if Needed.

Site Requires Immediate Attention: kL
Facility No. �S - <.I
DIVISION OF ENVIRONMENTAL MANAGEAMNYT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: '� 5� , 1995
Time: 13 p
Farm Name/Owner:--A
Mailing Address:
County: S
SoN
WV IGW)IAA , V.C. 1�453
Integrator: 'V:AV-V\ 5 VQ C-, _Phone: PM - M - 2_l i q
On Site Representative: N Phone:.'t) - c33Z„- L16V
Physical Address/Location: t ck q P Z v\,v k s Cn o m; vtit -
�Sc SC kg43
Type of Operation: Swine Poultry Cattle
Design Capacity: 0 Number of Animals on Site: _ � D 0
DEM Certification Number: ACE DEM Certification Number. ACNEW
Latitude: Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) es No Actual Freeboard: J k1t. O Inches
Was any seepage observed from the lagoon(s)? Yes or @5was any erosion observed? Yes org
Is adequate land available for spray? es No Is the cover crop adequate?(Yes No
Crop(s) being utilized: tiu �,E— Q & Atwtc5
Does the facility mt-et SCS mir&num setback criteria? 200 Feet from Dwellings7CLLes)or
100 Feet from Wells? Ge or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or (;
Is animal waste land applied or spray irrigated within 25 Feu of a USGS Map Blue Line?
No
Yes No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage 1with cover crop)?�r No
Additional Comments: _ 1k5Ve'26'yo,
09,
Ins Name
Pa
rr• F9r4liry oetrsxrr -"t TInit Use Attachments if Needed.