830006_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental dual

0 Division of Water Resources
Division of Soil and Water Conservation
El Other Agency
Facility Number:
830006 Facility Status:
Active Permit: AWS830006
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County: Scotland Region:
Fayetteville
Date of visit; 02/15/2017 Entry Time: 02:00 pm Flit Time: 3:00 pm Incident #
Farm Name: Farm 5573 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 5549 Hasty Rd Laurinburg NC 28352
Facility Status: 0Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34° 39' 46"
On the southwest side of SR 1615 approx..1 mile north of its intersection with SR 1624, south of Johns, NC.
Question Areas:
Dischrge & Stream Impacts
Records and Documents
Waste Col, Stor, & Treat
Other issues
910-296-1800
Longitude: 79° 27' 44"
Waste Application
Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone
On -site representative Mike Cudd Phone
Primary Inspector. Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS830006 Owner - Facility : Murphy -Brown LLC Facility Number: 830006
Inspection Date: 02/15/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean 3,927
Total Design Capacity: 3,927
Total SSLW: 1,700,391
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00 39.00
Lagoon 7573
page: 2

Permit: AWS830006 Owner - Facility : Murphy -Brown LLC Facility Number: 830006
Inspection Date: 02/15/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑M
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ N
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ N
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
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 (Le./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
■ ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste Application
Yes No Na 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?
❑
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: AWS830006 Owner - Facility: Murphy -Brown LLC Facility Number: 830006
Inspection Date: 02/15/17 Inpsection Type: Compliance inspection Reason for Visit: Routine
Waste Application
Yee No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Coxville loam
Soil Type 2
Duplin sandy loam
Soil Type 3
Lynchburg loamy sand
Soil Type 4
Marlboro loamy sand, o to
2% slopes
Soil Type 5
McCall loam
Soil Type 6
Norfolk loamy sand, o to 2%
slopes
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ E ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ E ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑ ❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below,
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS830006 Owner - Facility : Murphy -Brown LLC Facility. Number: 830006
Inspection bate: 02/15/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No No No
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22, Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26, Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
N ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
E ❑
❑
(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
❑
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?
❑
E ❑
❑
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
830006
Facility
Status'. Active permit:
AWS830006
Denied Access
Inppection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Scotland
Region:
Fayetteville
Date of Visit:
03/11/2015 Entry Time:
03:30 pm Exit Time: 4:00 pm
Incident #
Farm Name:
Farm 5573
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
91D-296-1800
Mailing Address: PO Box 487
Physical Address: 5549 Hasty Rd
Warsaw NC 28398
Laurinburg NC 28352
Facility Status: E Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34' 39' 46" Longitude: 79" 27' 44"
On the southwest side of SR 1615 approx..1 mile north of its intersection with SR 1624, south of Johns, NC.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone
On -site representative Mike Cudd Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary inspector(s):
Inspection Summary:
page: 1

Permit: AWS830006 Owner - Facility : Murphy -Brown LLC Facility Number: 830006
Inspection Date: 03111J15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine -Farrow to Wean 3,927
Total Design Capacity: 3,927
Total SSLW: 1.700.391
Waste_ Structures Observed
Disignated
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00 31.00
Lagoon 7573
page: 2

Permit: AWS830006 Owner - Facility : Murphy -Brown LLC Facility Number: 830006
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na Ne
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ E
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
110
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
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?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑0
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ E ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/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: AWS830006 Owner - Facility : Murphy -Brown LLC Facility Number: 830006
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Cozville loam
Soil Type 2
Duplin sandy loam
Soil Type 3
Lynchburg loamy sand
Soil Type 4
Marlboro loamy sand, o to
2% slopes
Soil Type 5
McColl loam
Soil Type 6
Norfolk loamy sand, 4 to 2%
slopes
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ M ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ M ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ M ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑ ❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ M ❑ ❑
If yes, check the appropriate box below.
WU P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ E ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS830006 Owner - Facility : Murphy -Brown LLC Facility Number: 830006
Inspection Date: 03/11/15 1npsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na Ne
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
M ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■ ❑
❑
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,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
M ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon 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?
❑
M ❑
❑
page: 5

f
■ Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Outer Agency
Facility Number:
830006
Facility Status: Active Permit: AWS830006
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County: Scotland Region:
Fayetteville
Date of Visit:
0212612013 EntryTime: 11:00 am Exit Time: 11:30 am Incident #
Farm Name:
Farm 5573
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
5549 Hasty Rd
Laurinburg NC 28352
Facility Status:
Compliant ❑
Not Compliant Integrator: Murphy -Brown LLC
Location of Farm:
Latitude: 34' 39' 46" Longitude:
79' 27' 44"
On the southwest side of SR 1615 approx..1 mile north of its intersection with SR 1624, south of Johns, NC.
Question Areas:
Dischrge & Stream Impacts
Waste Col, Stor, & Treat Waste Application
Records and Documents
Other Issues
Certified Operator: Eric L Ferrell Operator Certification Number: 17634
Secondary OIC(s):
On -Site Representative(s)
24 hour contact name
On -site representative
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Records reviewed 2/6113
Site visit 2126/13
Name
Mike Cudd
Mike Cudd
Title
Phone
Phone:
Phone
Robert Marble Phone:
Date:
page: 1

Permit: AWSB30006 Owner -Facility: Murphy -Brown LLC Facility Number: 830006
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean 3.927
Total Design Capacity:
Total 55LW:
Waste Structures
Disignated observed
Type Identifier Closed Date Start Date Freeboard Freeboard
-agoon 1 19.00
-agoon 7573
page: 2

Permit: AWS830006 Owner - Facility : Murphy -Brown LLC Facility Number: 830006
Inspection Date: 02/26/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Dischargies & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
S ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
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 Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ e ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
E]
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: AWS830006 Owner - Facility : Murphy -Brown LLC Facility Number: 830006
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
coxvnlle
Soil Type 2
Duplin
Soil Type 3
Marlboro
Soil Type 4
Lynchburg
Soil Type 5
McColl
Soil Type 6
Norfolk
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15, Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure andlor operate per the irrigation design or wettable acre
❑
M ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
■ ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M ❑
❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ M ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ M ❑ ❑
If yes, check the appropriate box below.
WU P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21, Does record keeping need improvement?
❑ M ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS830006 Owner - Facility : Murphy -Brown LLC Facility Number:
830006
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yes No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24- Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25, Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
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?
❑
E ❑
❑
Other Issues
Yes
No Na No
2& Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑E
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Ouality 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 the drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below
Application Field
❑
Lagoon / Storage Pond
[]
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ 0 ❑ ❑
CAWM P?
33. Did the Reviewer/inspector fail to discuss review/inspection with on -site representative? ❑ 0 ❑
34. Does the facility require a follow-up visit by same agency? ❑ 0 ❑ ❑
page: 5

Type of Visit O 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: 2C6 1 Arrival Time: /� Departure Time: � County: � .2 f Region:
Farm Name: `�`• ( (?S%3� OOwnner Email•
Owner Name: t")., C_LC Phone:
Mailing Address:
Physical Address:
AA 4
Facility Contact: i ke C j Title: Phone No:
M
Onsite Representative: u Integrator: I' i wr 1 "'`` u-Q
Certified Operator: oo"_V L U,.,44tDr Operator Certification Number: 2 P_L(
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = 6 = it Longitude: = ° 0 f
1101 IN Design Current
Design Current
Design
Current
Swine _ Capacity Population
W,iL!L n try Capacity Population
Cattle .
Capacity
Population
❑ Wean to Finish
❑ Layer
❑Dai Cow
❑ Wean to Feeder
❑ Non -Layer
❑Dai Calf
❑ Feeder to Finish
Dai Heifer
❑ Farrow to Wean
ryDry'Poultry
❑ Dry Co",
Farrow to Feeder
'ers
El
to❑ Farrow to Finish 2Z O
❑
El Beef Stocker
El Gilts
❑ N on-Layers
❑Beef Feeder
El Boars
❑ Pullets
❑Beef Brood Co
z
❑ Turkeys_
Other
❑ Other
❑Turkey Puults
❑ Other
^
Idumbe� of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
P No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[�NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
b 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
P NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
P No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Wo
❑ NA
❑ NE
other than from a discharge'?
Page 1 of 3
12128104
Continued

Facility Number: — Date of Inspection I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes to No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 0NA ❑ NE
Structure t Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: f
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 6 t I
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
j] 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
[V 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
N No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
[� No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
[ No
❑ NA ❑ NE
maintenance or improvement?
r
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No
❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[id No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
[J 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
[P No
❑ NA
❑ NE
Comments (refer,to question #): Explain any YES answers andlor any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
��'E'L9rd�S f'�vi Gj2�lf+ ,
S 4e, V [ Si T cm," r� 3/1
Reviewer/inspector Name ' Phone:-43�3-33ea
Reviewer/)nspector Signature: Date: .A L
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection A Z$ I t
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes qNo []NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [ No El NA ❑ NE
the appropirate box. {
El El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
(R No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[p No
❑ NA
❑ NE
24_
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26_
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[ No
❑ NA
❑ NE
27_
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[iNo
❑ 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
99 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
O 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
0 No
❑ NA
❑ NE
General Permit? (iel discharge- freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
�9 No
❑ NA
❑ NE
E
Page 3 of 3 12128104

i ype of visit: w t-ompuance inspection V uperanon neslew lJ Structure r,vaivation V i eenmcai Assistance
Reason for Visit: 0 Routine O Complaint p Follow-up O Referral O Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: L,CM�] Departure Time: /z�. County: Z&JP Region: - (]
Farm Name_ �j � ] �' Owner Email:
Owner Name: M(,N,QL— � .L -c Phone:
Mailing Address:
Physical Address:
Facility Contact: M, Title:
Onsite Representative:
Certified Operator:
Phone:
Integrator:
Certification Number: 251
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design
Swine Capacity
CU. en
Pop.
MIN
Wet Poultry
Design Current Design Currenwdo
Capacity Pop. Cattle Capacity Pop.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Dai Heifer
Design Current D Cow
Ca aci P,o Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
t ..
Feeder to Finish
Dr P�o_ul
Farrow to Wean
Farrow to Feeder
110
Farrow to Finish
�,�
Layers
Gilts
Non -La ers
IPUllets
Boars
Other
Other
Turkeys
Turkey Poultsp
Other
Discharges and Stream IMDacts
1. Is any discharge observed from any part of the operation?
[-]Yes
N No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
179 NA
❑ NE
b. Did the discharge reach waters of the State? (If ycs, notify DWQ)
❑ Yes
❑ No
MNA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any pan of the operation?
❑ Yes
1� No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3
21412011 Continued

Facilit Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[PNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
1?9 NA
❑ NE
Structure 1 Structure 2 Structure 3 Stricture 4
Structure 5
Structure 6
Identifier: �^
Spillway?:
Designed Freeboard (in):
1 i+
Observed Freeboard (in):LTi�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
$1 No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application'? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.
❑ PAN ❑ PAN > l0% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable
Crop Window � ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s) 1, »R.� [ �-��LS�°r'�kS ) �n,_ GR j oU{x;ead
13. Soil Type(s): k _eft fle, _4,4j,aL
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
IT Does the facility lack adequate acreage for land application?
18_ Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
[:]Yes (VNo ❑ NA ❑ NE
❑ Yes TNo ❑ NA ❑ NE
[] Yes
No
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
[:]Yes
® No
❑ NA
❑ NE
19_ Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[�j No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
[P No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design [—]Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement'? If yes, check the appropriate box below.
❑ Yes
11, 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

Faciti Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes V No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes P No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes 10 No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes [:]No
NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes Epo
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility`? If yes, check the appropriate box below.
❑ Yes No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No
❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes I rV No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or -any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
7P G'� 04 3
317IIL�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: 7
242

Type of Visit: 0 Compliance Inspection Z5 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: G /j Arrival Time: 11, Departure Time: County: Region:
Farm Name: ��� �j C r(Jr?3 f�J Owner Email:
Owner Name: r[ �jtp ,-t LLC Phone:
Mailing Address:
Physical Address:
Facility Contact: ( " ke G,4 Title: Phone:
Onsite Representative: u Integrator:
Certified Operator: �o- Certification Number: 24
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
r .Design Current
;Design Current
`A ��= Design Current
Swine `� ` 'iCapacity Pop.
Wet PoultryCapacity Pop.
Cattle �'' .Capacity Pop.
M.
,.
an to Finish
La er
Dai Cow
an to Feeder
Non -La er
Dai Calf
der to Finish
=
Dai Heifer
ow to Wean
j
Us* Current
D Cow
ow to Feeder
D . Paul ,.�, _. ,Ca aci Po ,
La ers
Non-Daiow
Beef Stocker
to Finish
IF
s
Non -La ers
Beef Feeder
rs
Pullets
Beef Brood Cow
_
Turkeys-
Uther
Turkey Puults
Other
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
[gNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
P�j NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
Ej NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
f�j NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
E§ No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Q No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: jDate of Inspection: a 1,94,
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[!�3 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
® NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3�5
5. Are there any immediate threats to the integrity of any of the structures observed?
[:]Yes
® No
[DNA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
`P No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
0 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
{v-9 No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® 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 Area
12. Crop Type(s): at9-
S� e -rri1S Cda,, , R._s-4,_J, sty. c4.,,,,, 1, ol-141
13. Soil Type(s): L t,
0
14. Do the receiving crops differ from those designated in the CAWMP?'
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
I I IV"t&,
❑ Yes [5g� No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA [] NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes [)a 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 N No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [�j No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes R9 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
DNA ❑NE
[] NA ❑ NE
Page 2 of 3 21412011 Continued

Fac'tli N umber: jDate of Inspection: /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [)j No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [3 No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes CP No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [—]Yes [0 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
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
[D Application Field ❑ Lagoon/Storage Pond ❑ Other.
32. Were any additional problems noted which cause non-compliance of the permit or CAW"?
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?
fer to question ff): Explain any YES answers and/or any
of faeiiity to better explain situations (use additional oaQ
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
as
❑ Yes M No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑Yes NNo ❑NA ❑NE
N Yes ❑ No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes [M No ❑ NA ❑ NE
❑ Yes [�j No ❑ NA ❑ NE
ons or any other comments.
Phone: q(,p
Date: �� f /3
21412011

vision of Water Qnality
9-3 M. O0 (1 ision of Soil and Water Conservation
Type of Visit
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
,,C,,ompliance
t ron�utine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: 3 aS-/D Arrival Time: 7;v0.¢ Departure Time: 7 :vo County: S�V#411OI
Farm Name: SS7.3 —/ I O/d # 7573 J Owner Email:
Owner Name: N-Bro w t L L C_ Phone:
Mailing Address:
Physical Address:
Region: 14:1XV
Facility Contact: C Title: LNAf Na Phone No:
le
Onsite Representative: Integrator: 'Z?fbi f1/
Certified Operator: f w� `0�k t� Operator Certification Number: z$� Z
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = = t ❑ a6 Longitude: = ° = 4 = «
Design Current
Swine Capacity Populat�r*on
Design Current
VNet Poultry Capacity Population
Design Current
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑Dai Cow
❑ Wean to Feeder
❑Non -La er
❑Dairy Calf
❑ Feeder to Finish
-
Dry Poultry _
❑ La ers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
❑ Dairy Heifer
❑ Dry Cow
ElNon-Dai
❑ Beef Stocker
❑Beef Feeder
❑Beef Brood Cow
Member of Structures:
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
1200
❑ Gilts
❑ Boars
_...r
Other -
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
b. Did the discharLe 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 OfNo ❑ NA ❑ NE
❑Yes
❑No
D9NA
El NE
❑ Yes
❑ No
�dNA
❑ NE
ONA
❑NE
❑Yes
❑No
❑ Yes
VNo
❑ NA
❑ NE
❑ Yes
5YNo
❑ NA
❑ NE
Page I of 3 12128104 Continued

- Facility Number: - a
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: SS73
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z 9
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 �fNo
❑ Yes RVNo
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes M No ❑ NA ❑ NE
❑ Yes 2INo ❑ 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 0 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes (H No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes V No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes PINo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �'No El NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window/ ❑ Evidence of Wind
\Drift ❑ Application Outside of Area
12. Crop type(s) Gv t—%,,
13_ Soil type(s) b>ue ��' nt t ccr( Ut II C M-a Y f lop,.p 1\ iI- C-D i4 L7 Nc�t I�•A+�� 1 7Jo r�'ai jL
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ® No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 0 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 [9 No
❑ Yes [�'No
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):
❑ NA ❑ NE
❑ NA ❑ NE
ReviewerAnspector :Name P'! c Re-1tIe-l-s Phone: 910, 51.33.3300
Reviewer/inspector Signature: Date: ` D % - ZO/4
Page 2 of 3 12128104 Continued

Facility Number: 93 -awl Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes El No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 9No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 6 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
® No
❑ NA
❑ NE
23.
If selected. did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
®No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
O No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[A 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
[0 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
18 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
C4 No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

alAes *10349 9
vision of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit
15ommp�pliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
(31loutine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: 3— •SS.,, County: SG,>tl�.y� Region:
Farm Name: 055 7 3 i Owner Email:
Owner Name: !kly'pk-7 l3 ,%oJAl Phone:
Mailing Address:
Phvsical Address:
Facilitv Contact: Puw 1,4 'au!!:A 'r Title: FO"'''4 �i�_ Phone No:
Onsite Representative:
Certified Operator:
Back-up Operator:
Integrator: l K �v �L�r �.� &ZILJ. /V
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: =o =, = Longitude: 00 0A = ii
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -La Crs
❑ Pullets
❑ Turkevs
❑ Turkev Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Hcifet
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes L''J No ❑ NA ❑ NE
❑ Yes
❑ No
2 NNA
ElNE
ElYes
ElNo
B<
❑ NE
B A
El NE
❑ Yes
❑ No
❑ Yes
, ,,
El NA
El NE
❑ Yes
,L�"No
l�lvo
❑ NA
❑ NE
12128104 Continued

Facility Number: g,-3j— Q
Date of Inspection 3 •-l2 - 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: 55731
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
23"
5. Are there any immediate threats to the integrity of any of the structures observed?
(iel 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 ONo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes LT No ❑ NA ❑ NE
❑ Yes ONo ❑ 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 E3 o ❑ NA ❑ NE
8.
Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
[lio
❑ 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 ElE
Yes
�,�
� o
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10.
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
ETNo
❑ NA ❑ NE
maintenance/improvement?
I I.
is there evidence of incorrect application? if yes, check the appropriate box below. El Yes
�,/
F 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 types)ce.
13.
Soil type(s) V ., fr't D; i N L r, At dbam 114G C It Oet t3
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
�o
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
[ No
❑ NA ElNE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determYes
3ination?❑ o
❑ 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
2<o
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone: 1/0, q3.3. 3300
Reviewer/Inspector Signature: Gce,�� Date: 3'-/ - —Z�TO%
12128104 Continued

Facility Number: 193 - 06 Date of Inspection
Required Records_& Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below_ ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
❑ NE
General Permit? (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:
12128104

® Division of Water Quality
Facility Number o Q Division of Soil and Water Conservation
Other Agency
Type of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: cf Arrival Time: �Q Departure Time: rs•` � County: � Region:
Farm Name: M SS'�3 l Owner Email:
Owner Name: ' ` Phone:
Mailing Address:
Phvsical Address:
Facility Contact: AA "s"d0'-5 Title:
Onsite Representative: it
Certified Operator:
Back-up Operator:
Phone No:
Integrator: �tl
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = e = I E],1 Longitude: = ° = t
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
J ❑ Non -Laver
Dry Poultry
❑ Lavers
❑ Non -Layers
❑ Pullets
❑ T'urkevs
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy lleifei
❑ Dry Cow
❑ Non-Dairy
❑ 13cef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: E]
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)
Z. 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 M No ❑ NA ❑ NE
❑ Yes
❑ No
T NA
❑ NE
❑ Yes
❑ No
T NA
❑ NE
f NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection
Reguired Records &_Docume_nts
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA W MP readily available? If yes, check ❑ Yes No ❑ 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 [�No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Eallo
❑ 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
TNo
❑ NA
❑ NE
2T
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
$1No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
1B No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
F1 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
EA 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
P No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
�K No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency'?
❑ Yes
[ig No
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12128104

+'[Facility
Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[� No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:�3
Spillway? --
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
S No
❑ NA ❑ NI,
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
0 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
�gNo
❑ 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
El ❑ NA NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 lbs ❑ Totai 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) &m 5,m ©{!-P-( $sa¢.d
13. Soil type(s) AAM-1 eYVI G?CJ4 Ile. t'���'ivze •�
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
fo No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
❑ Yes
[P No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
T No
❑ NA
❑ NE
Comments (refer to question f: 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 Iv i Phone: ( f�
Reviewer/Inspector Signature: Date: 3
rage z of -1 "IZO v4 a,ununuea

U
® Division of Water Quality
�Facility�;�Number S 3 Q Division of Soil and Wry ater Conseation
- �� - 0 Other Agency
Type of Visit ® Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine O Complaint 0 Follow up O Referral O Emergency O Other [I Denied Access
Date of Visit: Arrival Time. Departure Time: %2; ZS County: Seo�la^�d Region: F�
Farm Name: #SS73 f eo Id Cam, f f 'S 47573 Owner Email:
Owner Name: /+'/[t kp �,. _ Cam'' �/ Phone:
Mailing Address:
Physical Address:
Facility Contact t+�rtit aNS Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator: � 4 ,gkaL Aj
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o F--] ' = Longitude: = o =' = "
Design Current .
Swine Capacity Population Wet Poultry
❑ Wean to Finish ❑ La er
1 ❑ Wean to Feeder ❑Non -La er
❑ Feeder to Finish a'
El Farrow to Wean':. Dry Poultry.
❑ Farrow to Feeder
}❑ La ers
Farrow to Finish IZOO
❑ Gilts ❑ Non -Layers
❑ Boars k ❑ Pullets
❑ Turkeys
Other ❑ Turkey Poults
❑ Other y ❑Other
Design C►urrent
Capacity Population
Design Current
Cattle Capacity Population
❑Dai Cow
❑Dai Calf
❑ DairyHeifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
="
-
Number of Structures:
Dise� & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes [9 No ❑ NA ❑ NE
❑ Yes
C�No
❑ NA
❑ NE
❑ Yes
[4 No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
P9 No
❑ Yes
WNo
❑ NA
❑ NE
❑ Yes Q?No ❑ NA ❑ NE
12128104 Continued

Facility Number: g3—Q Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 19No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes 0 No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 2-0 if
Observed Freeboard (in): 42. if
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E0 No ❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ElNA ❑ NE
through a waste management or closure plan? 91
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 y No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Wo ❑ 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 QffNo ❑ NA ❑ NE
maintenance/improvement?
1 I. Is there evidence of incorrect application'? If yes, check the appropriate box below. ❑ Yes [P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ElApplication Outside of Area
f 1
12. Croptype(s) (�edS�_ C G�� e /`/�f+e4�Gi .�n/ C Oywy et J
13. Soil type(s) /Y[ UYo bQ blo A coxy;112 vA-D, _ ,_ I&Go
I r / - if
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
CFNo
❑ 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
[jPNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment'?
❑ Yes
PNo
❑ NA
❑ NE
IComments (refer to question #f): 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 NameLl eve—(S Phone: 010) 1K.33—3.300
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

r
Facility Number: S3 - 0(e Date of Inspection
Reouired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes rp No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists ❑Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes M No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
N No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[A No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
0 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[51 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
� No
El NA
El NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
W No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
EP 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
Cfl 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
Page 3 of 3 12128104

r_._ .� __. _� � Division of Wafer Quality
==='Facilit—yer_ $ j l�% (p 0 Division of Soil and Water Coasenation
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: /Z ZO -0-51 Arriival 'Time: Departure Time: County: 574o+I4N,t
Farm Name: V 2757 3 / .---, 6) 1 d CYpy-bl 1 #/ -75Owner Email:
Owner Name: _ du,rp 1,,_ Phone:
Mailing Address:
Physical Address: T
Facility Contact: -Z-4 ," 1 1ri e_ V— Title:
Onsite Representative: _ �Te 1-1c, �V-
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Region: FRO
Phone No:
Integrator: AA VP4 "-q j Aj
Operator Certification Number:
Back-up Certification Number:
Latitude: = o ❑ , = Longitude: = o ❑ ,
Design Current Design- Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
20
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkev Poults
❑ Other
DiseharFes $ Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure El Application Field El Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy, Calf
❑ Dairy Fleifei
❑ Dr
y Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Coti
b. Did the discharge reach waters of the State? (If yes. notify DWQ)
c. What is the estimated volume that reached waters of -the State (gallons)?
Number of Structures: El
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
?. 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
M No
❑ NA
❑ NE
❑ Yes
[9 No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[K No
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
12128104 Continued

Facility Number: 83— 0 Date of Inspection iZ-2D-0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes %No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes 19 No ❑ NA ❑ NE
Structure t Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
OleDesigned Freeboard (in): Z 0
Observed Freeboard (in): 443
5_ Are there any immediate threats to the integrity of any of the structures observed'? ❑ Yes ES 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 NNo ❑ 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 (9No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ® No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ® No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN 7 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) fSe rtut,_d,j (GM,,eJA6U4 ) . ' U>, l- ►
13. Soil type(s) UkOlr
0
C Cc
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑ Yes
[A 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
[A No
❑ NA
❑ NE
Comments (refer to question #)r 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): ,
ReviewerAnspector Name r evds Phone�91G>� SAY/S`�%
Reviewer/Inspector Signature: Date: 20 -ZOOS
1L/Ldr/U4 [,onanuea

Facility Number: $ —d(0 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [4 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes M No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes W No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
IN 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
[RNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
N No
❑ NA
❑ NE
Other lssues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[2 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[YNo
❑ 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
W 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
D9 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
U No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
.P No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

Type of Visit 4D Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit *Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: Time: . a
Facility Number
10 .7at O erational Q Below Threshold
[3 Permitted ® Certified ❑ Conditionally Certified ❑ Registered Date Last Operated or above Threshold:
Farm Name: _ .. - are (/S C rA Lv1 C -. _ _ -- County: A::1
Owner Name: C ra r rn ( e Phone No: -q Ib
Mailing Address: (), a3Y. gS{. _ G-f �,� t
Facility Contact: 1%el l{ Title: Phone No:
OnsiteRepresentative: _ r_4� i�lc�h�P..,lo<,cl��� Intearator: gArrnI S
Certified Operator: %tr:, r-,n1A W1, i tk kcr Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Ca acitti Population Catde Ca achy Population
❑ Wean to Feeder ❑ Laver I I JE) Dairy
❑ Feeder to Finish JEI Non -Laver L ❑ Non -Dairy
❑ Farrow to '%Vcan
Farrow to Feeder ❑ Other
Farrow to Finish CZ) Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ILI Subsurface Drains Present ❑ Lagoon Area 10 5 rag Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management Svstem
Discharges S Stream Impacts
1. Is an-,- discharge observed from any par, of the operation? ❑Yes q No
Discharge originated at: ❑ Lagoon ❑ Sorav Field ❑ Other
2. if discharge is obsen'ed, 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 aallmin?
d. Does discharge bypass a lagoon system? (If ves. notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes S1 No
3. Were there anv adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes Q No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes `-i° No
Structure 1 Structure 2 Structure 3 Structure 4 Structure ; Structure 5
Identifier:
Freeboard (inches): ,2 1
05103101 ? 0 Continued

Facility Number: 83 — 6 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed`? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? Yes � No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
N 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
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
Ej No
16. Is there a lack of adequate waste application equipment?
❑ Yes
[;� No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
RNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design. maps, etc.)
❑ Yes
[&No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
14 No
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[0 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
21 No
(ie/ discharge, freeboard problems, over application)
23.
Did Revi ewer/] nspector 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
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): ❑ Field Copy ❑ Final Notes
G3
]?sec [o. ,ck r{p c �{ e�Q
rr
,M c 1`c�, � ' a
tr~' 3A —1. U
--c-, r d-j 4-
t
�r v SIL —1, a
"Oct
H,
Reviewer/Inspector Name i
T
Reviewer/[nspector Signature:
Date: o
05103101 Continued

Facility Number: 8 3 —(,
Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attar 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 p'ermanent/temporary cover?
❑ Yes ❑ No
❑ Yes QJ No
❑ Yes [�g No
❑ Yes [ No
❑ Yes [)a No
❑ Yes [R No
❑ Yes ❑ No
O5103101

Information contained in this database is from non agency sources and is considered unconfirmed.
Animal Operation Telephone Log
DWO Facility Number 83 06
Farm Name 17573
Caller's Name Rusty Collins
® Reporting O Complaint
Caller's Phone #
Access to Farm
Farm Accessible
From main road 10 Yes O No
Anintal Pouulation
Confined O Yes O No
Depop 10 Yes O Na
Feed Available O Yes O No
Mortality 10 Yes O No
Spray Availability
Pumping
Equipment 10 Yes O No
Available
Fields O Yes O No
.'person taking' call?(Larry Baxlev
Date 5/28/2003
Time 8.15
Control Number 12981
Region JFRO
La non Questions
Breached
O Yes O No
Inundated
10 Yes O No
Overtopped
O Yes ONO
Water on
0 Yes O No
Outside Wall
Dike Conditions
10 Yes O No
Freeboard l.cyel
Freeboard
Plan Due Date Date Plan Date Freeboard
Inches
(? equals blank) Received Level OK
Lagoons 18"
5/30/2003
1
Lagoon2
I�
Lagoon3
Lagoon4
Lagoons
C�
Lagoon6
Comments2

MAY. 30.2003 9-27RM CRRROLL'S FOODS NO.739 P.30
PLAN OF ACTION(Poa) FOR HIGH FREEBOARD AT ANIMAL FACILITIES
Facility Number: 83-6 County. Scotland
Facility Name: Farm 7573
Certified Operator Name: Operator Number J 5'6 2.
1. Current liquid level(s) In inches as measured from the current liquid level in the lagoon to the
lowest point on the top of the dam for lagoons without spillways; and from the current liquid level
in the lagoon to the bottom of the spillway for lagoons with spillways.
Lagoon 1 Lagoon 2 Lagoon 3 Lagoon 4 Lagoon 5
Lagoon Name/ID: 7573
Spillway ff or N): N
Level(inches); 18
2. Check all applicable items
liquid level is within the designed structural fraeboard elevations of one or more structures.
Five and 30 day Plans of Action are attached. Hydraulic and agronomic balances are
within acceptable ranges.
X Liquid level is within the 25 year 24 hour storm elevations for one or more structures. A
30 day Plan of Action Is attached. Agronomic balance is within acceptable range.
Waste is to be pumped and hauled to off sits locatlons. Bolume and PAN content of waste
to be pumped and hauled Is reflected in section III tables. Included within this plan is a list
of the proposed sites with related facility numbers, number of acres and recelving crop
information. Contact and secure approval from the QWQ prior to transfer of waste to a site
not covered in the facility's CAWMP.
Operation will be partially or fully depopulated.
`Attach a complete schedule with corresponding animal units and dates fro depopulation
'If animals are to be moved to another permitted facility, provide facility number, lagoon
freeboard levels and herd population for the receiving facility
3. Earliest possible date to begin {anti application of waste: 4, IAJO3
I hereby certify that I have reviewed the information llsted above and Included within the
attached Plan of Action, and to the best of my knowledge and ability, the Information is
accurate and correct.
r'n l Phone: 2 .S6 3 7
Facility Owner/Mana er rint)
Date: S lo-3
Faclil Owner/Manager (signature)

MAY.30.2003 9:27AM CARROLL'S FOODS NO.739 R.3I
PLAN OF ACTION (PDA) FOR HIGH FREEBOARD AT ANIMAL FACILITIE;
30 DAY DRAW DOWN PERIOD
I. TOTAL PAN TO BE LAND APPLIED PER WASTE STRUCTURE
1. Structure Name/identifier (ID) 7573
2. Current liquid volume in 25 yr.124 hr. storm storage $ structural freeboard
a. current liquid level according to marker 18,0 Inches
b. designed 25 yr.124 hr. storm 8 structural freeboard 19.0 inches
c. line b - line a (inches in red zone) = 1.0 Inches
d. top of dike surface area according to design
(area at below structural freehoard elevation) 271050 fig
e. line c/12 x line d x 7.48 gallonstO 168955 gallons
3. Projected volume of waste liquid produced during draw down period
f. temporary storage period according to structural design 180 days
g. volume of waste produced according to structural design 415248 fe
h. current herd # 12Q0 certified herd #1 1200
actual waste produced = current herd # x line g =
certified herd #
I. volume of wash water according to structural design
J. excess ralnfall over evaporation according to design
k. (limes h + i + 1) x 7.48 x 30 days/line f=
4. Total PAN to be land applied during draw down period
1. current waste analysis dated I 04/17/2003
m. ((lines e + k)l1000) x line I
REPEAT SECTION I FOR EACH WASTE STRUCTURE ON SITE.
(Click on the next Structure tab shown Wow)
415248 ft3
ft3
181291 jft3
77111B752 gallons
3.00 Ibs/1000 gal.
2663,1 lbs. PAN
PoA (30 Day) 2121/00

MY. 30.2003 9*27RM CARROLL'S FOODS
NO.739 P.32
II, TOTAL. POUNDS OF PAN STORED WITHIN STRUCTURAL FREEBOARD AND/OR 25 YR.124
HR. STORM STORAGE ELEVATIONS IN ALL WASTE STRUCTURES FOR FACILITY
1, Structure ID: 7573
line m =
2663.1 lb PAN
2. Structure ID:
line m
lb PAN
3. Structure ID:
lime m =
lb PAN
4, Structure ID:
life m =
Ib PAN
5. Structure ID:
line In =
lb PAN
6. Structure ID:
line m =
lb PAN
n_lines 1+2+3+4+5+6= 2663.1 lb PAN
Ili. TOTAL PAN BALANCE REMAINING FOR AVAILABLE CROPS DURING 30 DAY DRAW DOWp
PERIUD. DO NOT LIST FIM135 TO WHIC11 PAN CANNOT BE APPLIED DURING 11115.30 DAT PERIOD
o. tract # P. field # q. Crop r. acres a MMednIng IRR t. TOTAL. PAN U. &Xllcaban window`
9 PAN Wance BALANCE FOR
(IWaae) FIELD (Ibs,)
column r x a
646 1 Bermuda Past 12.10 120,00 1452.0 Mar -Oct
546 2 Bermuda Pest 11.80 120.00 1416.0 Mar -Oct
I,
w11011L bl{IFJ 1P11411I iy 4RFe11�%.P%AI Vac Nl Plr-^L %l VY gIJF1Ri0NN11 WK3W11 f11111!:J ua►c+ IUI =rail QW1V
receiving crops during 30 day draw down period.
v. Total PAN available for all fields (sum of column Q = 2868.0 Its, PAN
IV. FACILITY'S PoA OVERALL PAN BALANCE
w. Total PAN to be land applied (line n from section 11) = 2663,1 lb, PAN
PoA (30 Day) 2121100

MAY.30.2003 9-*27AM CARROLL'S FOODS NO.739 P.33
x. CroWs remaining PAN balance (line v from section IN) �
Y. Overall PAN balance (W - x)
2888.0 lb, PAN
-205 lb. PAN
tine y must show as a deficit, K line y does not show as a deficit, list oourse of action here including pump and
!haul, depopulation, herd reduction, etc. For pump & haul and herd reduction options. recalculate new PAN
:based on new information. If new fields are to be included as an option for lowering lagoon level, add these
,fields to the PAN balance table and recalculate the overall PAN balance. If animal waste is to be ha4led to
another permitted farility, provide Information regarding the herd population and lagoon freeboard levels at the
Irrigation onto existing spray fields will continue as weather and field conditions permit. Additional land is
available for pumping if needed.
POA (30 Day) 2/21100

r.-may � � des >.-�.•,.r� -�-.:-`,>�►!anresivu a[z�racer Ywu.as _z ",�;;` `�- �� .,•.r �,�•+ - -i- �. �'�* -
,.:?'rr' ��z '.5 �•�'�y"-�--� h�'� s'-a S3a °. ." �ai�.w - +r � -.i S � � 'e- - c" � r
Type of Visit ® Compliance Inspection O Operation Review () Lagoon Evaluation
Reason far Visit ® Routine C)Complaint Q Follow up O Emergency Notification Q Other ❑ Denied Access
Facilin'\umber 1 Date of Visit: � O o Time: ; o
1 18 Not O erational 0 Below Threshold
Ck Permitted ® Certified M Conditionally Certified E3 Registered Hate Last Operated or above Threshold:
Farm Name: C'e, CqER l Count-: S C1'.M eA,r.d,
Owner Name: GC f-' 'h �� tC _ � �� __ Phone No: '1 0 ` 2— 7-4 _S G 37-- _
Mailing Address: p, D , Q OX Q S % _ �w SG.�l il��
Facility Contact: (.j )4r4 ED l ILA Title: _ G-h4M Phone No:
Onsite Representative: integrator: _
Certified Operator: trt911C e d I r- Operator Certification Number: :a S / .14
Location of Farm-
�� IGlJ r�orLh -7,
S2 (C2'SL
]4 Swine ❑ poultry ❑ Cattie ❑ Horse Latitude a � Longitude ' �^
Design Current
Swine C'anacitt Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
TEE]
❑ Farrow is Wean
❑ Farrow to Feeder
® Farrow to Finish
1,100
❑ Gilts
❑ Boars
Design Current Design Current
Poulin Capacity Population Cattle Ca achy Population
DID Laver ❑ Dairy
❑ Non -Laver 1 1[3 Non -Dairy
❑ Other
Total Design Capacity
Total SSLVV
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon area ❑ S rav Field Area
Holding Ponds I Solid Traps JE3 No Liquid Waste Management Sl stem
Discharges S Stream impacts
I . Is anv discharge observed from any pan of the operation?
Discharge orizinated at: ❑ Lagoon ❑ Spray- Field ❑ Other
a. If discharge is observed, was the conyevance man-made?
b. If discharge is obsen-ed, did it reach Water of the State? (if yes, notif}r DWQ)
c. if discharge is observed, what is the estimated flow in aal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
?. Is there evidence of past discharge from any part of the operation?
3. Were there anv 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 1 Structure ? Structure 3 Structure Y Structure
Identifier:
Freeboard (incites):
05103101
❑ Yes
[P" No
❑Yes
El No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
® No
El Yes
®No
❑ Yes
[0 No
Structure b
2 f7
Continued

Facility Number: g3 -- 4, Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, ❑ Yes W No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes E� No
(1f 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 pan 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 [N 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
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
1X] No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes®
No
[b
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
K No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
9No
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.
Comments (refer to question € ): Explain any YES answers andlor any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): ❑ Field Copy ❑ Final Notes
CkA L,> 6 +ne_, .
Reviewer/Inspector Name �0, e.-
Reviewer/Inspector Signature: 14M Date: a
05103101 Continued

Facility lumber: TA— Date of Inspection �—��'
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond With no agitation?
27. .are there any dead animals not disposed of properly within 24 hours?
38_ 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. W'ere 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?
33. Do the flush tanks lack a submerged fill pipe or a permanent temporary cover?
is and/or
❑ Yes ®No
❑ Yes No
❑ Yes No
❑ Yes [3 No
❑ Yes © No
❑ Yes 117 No
❑ Yes 20 No
05103101

Type of Visit ® Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facilih Number ` Date of Visit: Time:
0 Not Oneratiunal O Be
® Permitted M Certified O Conditionally Certified © Registered Date Last Operated or Above Thres old:
cn7 yam/
Farm Name: %% % / County:
Owner Name: S + ' /7/!!/C Phone No:
Mailing Address: F. Q �i�/. _ ea 2f eo"/'
Facility Contact: CiS JO /.yf Title: Phone No:
Onsite Representative: //d Integrator: ' �
Certified Operator: Azp/ � �.�i� Operator Certification Number -
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 ` " Longitude
Design Current Design Current Design Current
awme [ a acity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
® Farrow to Finish 1
200
Q
❑ Gilts
Poultry Capacity Population Cattle Capacity Population
❑ La er ❑ Dairy
❑ Non -Layer ❑ Non-Dai
dy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons Q fi ❑Subsurface Drains Present ❑ La onn Area Area
5 ray Field
Holdin Ponds. / Solid Traps
g p 0 ❑ No Liquid Waste Management System
Dischargg5 S Stream 1_ moans
1. Is any discharge observed from any part of the operation? ❑ Yes XNo
Discharge originated at: ❑ Laizoon ❑ Spray Field ❑ Other
a. If discharge is obscrved, was the conveyance man-made? ❑ Yes KNo
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ) [] Yes �No
c. If discharge is obscrved, 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 *No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 71No
k\`aste Collection $ Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 6No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier;
Freeboard (inches): 6 /
05103101 Continued

Facility Number: S'3 —
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?
❑ Yes , No
❑ Yes OrNo
❑ Yes kNo
❑ Yes NNo
❑ Yes KNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes KNo
11. Is there evidence of over application? El Excessive Ponding El PAN ❑ Hydraulic Overload El Yes our
12. Crop type hu .t•
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 I�No
b) Does the facility need a wettable acre determination? ❑ Yes KNo
c) This facility is pended for a wettable acre determination? ❑ Yes KNo
15. Does the receiving crop need improvement? ❑ Yes P(No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
q No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
XNo
I &
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps etc.)
ElYes
ElNo
19.
Does record keeping need improvement? (i rri olio ceboard waste analysis & soil sam,p"Ie reports)
)s Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
;KNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
J�5No
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
(PqNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
�ffNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
A No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
meats r i _ Latn an YES answers artdlor an reco
p } Y or�anytb
Comments(refer,toto
S vusn . 4 � I�"
» '( dittpaalJpages asmme6pdatepas
better er
Use ilrawungsalyfae' plain s�tuahoas: use,ad spry) �. w opy ❑Final Notes
d Copy �.l Final
Qld c
ivrol� : Gorfr�wC" � �o �-s�/.s� .St c� v,�c. �,�+.� oj� �� .g•�s
Reviewer/Inspector Name �a'
Reviewer/Inspector Signature: Date: L34 o Z.
05103101 Continued

Facility Number: F,7 — G Date of Inspection
Odor JKm
2& 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 property 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 bladc(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?
x1Yes ❑ No
❑ Yes ANO
❑ Yes NNo
❑ Yes ;E� No
❑ Yes KNo
❑ Yes V No
KYes ❑ No
05103101

]Diyisiou tiYaterQua#ty
O
DwrsiotQ of Soil and _Water Conservation
- O.Other Agency
Type of Visit �R 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 3 of Visit: ✓-,5-9-- Time: � Printed on: 7/21/2000
6
Operational O Below Threshold
Permitted [3 Certified Q Conditionally Certified E3 Registered Date Last Operated or Above Threshold: .........................
Farm Name: ! 5 73 County: �lGn........................
..................•............................................................................................... S Cc�............... .......................
OwnerName: C{3.O.Ll..S...................p.... �................ ......... Phone No:.......................................................................................
.............. r t...........
�t+S CO I�'1!��tl +' Phone No•
Facility Contact :................................ I'itle:............................. �..........................
MailingAddress: .................................................................................................................................................................................... ..........................
OnsiteRepresentative:--... .... ­­ ........................................................................................... Integrator :...........................................
...........................................
f f I I y a
Certified Operator: ..... ...`►'l6Lrrold................... {1�+�. ..... Operator Certification Number:..........................................
.......
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Norse Latitude ' & 66 Longitude 0 4 46
Swine.-
_ Design Current
Cmmiilty Population
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
aoO
Gilts
soars
Design Current Design . Currerit -.
Poultry Capacitv Population Cattle Population
❑ Layer I Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity /, ao 0
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, vvas the conveyance man-made?
Total SSL W
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. Ii' discharge is observed. what is the cstimated flow in gal/mina
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & -Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ..................
Freeboard (inches): 3s
5100
❑ Yes lg l No
❑ Yes o
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes o
❑ Yes P�L
Structure 6
Continued on back

Facility Number: 3— d(0 thate of inspection -ai-o 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.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes �No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes *No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes dNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes VNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes KNo
11, Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes $fNo
12. Crop type bermA4_,..1? 6rrd" Oucsaj
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes o
14. a) Does the facility lack adequate acreage for land application? ElYes 190
b) Does the facility need a wettable acre determination? ❑ Yes M&NO
c) This facility is pended for a wettable acre determination? ❑ Yes ❑'No
15. Does the receiving crop need improvement? ❑ Yes / `No
16. Is there a lack of adequate waste application equipment? ❑ Yes CIo
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
®No
/XNo
18,
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
�
(ie/ WUP, checklists, design, maps, etc_)
❑ Yes
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
E "No
20.
1s facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
gNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
No
• \�'i+lo
23.
Did Reviewer/[nspector fail to discuss review/inspection with on -site representative?
❑ Yes
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
Wo
Rio yi. ti¢ns oir deficiencies were noted dt><t°itig #his:visit: Yoi� will reeeiye Rio ui tier
e0 ?Kmdeirce: about this visi � `' ' : - -' . ::: ::
resj.
meats(rqtec to.question #): Explain any YES answers and/or any recommendations or _any oilier com' mets:
ravings of Wili_ to better explain situations. (use additional es as necessary)
t3: p� � s
dVJ AL
Reviewer/Inspector Name k—Ho d . 1iJKJS'/1-zzfa,,!
Reviewer/Inspector Signature: _r �� Date: ,
l_)^ 1 1 Y 5100

Facility Number: S3 — d Date of In%pection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below `Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ONO
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 0No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, trussing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes IVNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ()(No
5100

0.
4 Y ❑ Division of Soil and Water Conservation - Operation Review
❑ Division of Soil and Water Conservation - Compliance Inspection
Division of Water Quality - Compliance Inspection
Other Agency - Operation Review
Routine Q Complaint Q I-olloiv-upof MV 1 inspection 0 Follow-up of DS%%`C review Q Other
r
' Date of Inspectioil —
I'acilit}' Number F
Tiltic• oispectio2hr. (h:mm) g
[xPermitted Certified ❑ Conditionally Certified ❑ Registered ❑ Not O erational Date Last Operated:
Farm Name: ................... 'F��-3 Countv:..... Oat
!!v!!:1........................................................................................ �"'
c. J-q .. .............................................
Owner ,Name:. �RCILJ11S.... ��Sf A
e.`............... ............... I'honc \o: .........-...1�17 " c�%3 � 3ri�3`�
... --•-•.... ..............
Facility Contact: ...---... ritle....
,1:....tSt. Phone No:..---..--
................r..�......... c
ltaifippg Address: ........... .........lLLt7 ! ` !!r` ........St.. 'tla�.�i, ...................V......... ..... « / �..
__����..... .. ..........
Onsite Representative:.._....S.(.ry.1K, ..... ........................ Inte*gyrator:.......... --
Certified Operator: ................................................................................................................ Operator Certification Number: ........................................ ..
Location of Farm:
.................................•.--..---.............................---...---...-
Latitude 0 6 1 Longitude 0 : it
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder JE1 Layer FEJ
Dairy
El Feeder to Finish ❑ Non -Layer Non -Dairy
❑ Farrow to Wean
El Farrow to Feeder ❑Other
Farrow to Finish 1.2t o Total Design Capacity
Gilts
❑ Boars 'Total SSI,W
Number of Lagoons ❑ Subsurface Drains Present JJEI Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Impacts
I. is any discharge observed from any part of the operation (I I' yes, noffy DWQ)? Yes ❑ No
Discharge originated at: ❑ La2oon ❑ Spray field Other 17,6A �k
a. If discharge is obscrvcd, was the conceyancc Fnawaladc? ❑ Yes rV1No
h. 11' dischanuc is ohservcd. did it re.ic:h- ❑ Surface Waters ❑ Waters of the State ❑ Yes No
C. If dischar ,c: is observed- what is the estininicd flow in Lyal/thin'.' ///A
d. Docs discharge hypass a ia(�oon sys[cnl? ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes � No
3. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Yes No
Structure I Strucutrc 2 Structure 3 Structurr 4 Structure 5 Structure 6
Identifier:
l l
l-rcehuarcl (inches): .................................................................................................................
1/6/99 Continued on back

Facility Number: — L Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed`? (ic/ trees, severe erosion, El Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes X 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 maintcnancehinproyement? Yes ❑ No
8. Does any part of the waste mana(*cment system other than waste structures require maintenance/improvement? 9Yes [(No
9. Do any stuctures lack adequate, gauged markers with required top of clike, maximum and minimum
liquid level elevation markings? if .� L,,, .,, u�n ❑Yes No
bVaste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence ol' over application'? ❑ Pondin%g ❑ Nitrogen ❑ Yes No
12. Crop type ......... �.......... 5»......... .......1� ....................... } ).. �k
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP))?' ❑ Yes No
14. Does the facility lack wettable acreage for land application? �jfootpntr�C /L'Cc C YesNo
la Fe ' hca r r ,.�"
15. Does the receiving crop need improvement? Yes [I No
• . � AWL
16. Is there a lack of adequate waste application equipment? ❑ Yes V No
Required Records & Documents feu4n25 _96- 4 �� fe5i&?14 0
17. Fail to have Certificate of Coverage & encral Permit readily available95;&,t4a7�S. 1&5 15 El Yes No
-016, -� ,
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`? (ic/ irriga�n, freeboard, waste analysis & soil sample reports)
26. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a certified operator in responsible char.=e'?
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?
0: NA.violations;or deficient i�s.were noted clrtrin #tiffs. I'-ou w Lreceivia na further
:•:•eorrespaidence;a�oitt;tf�is'visi�.;•;•;•;•;•;•;•;•;•;•;-;•;•:•;-:�; ;�:•:•;•;•;•:•:•;•;•;•;•;•:•;�;•:•:•;•;
94 Yes ❑ No
❑ Yes VNo
❑ Yes 0 No
i Yes ❑ No
❑ Yes PO
❑ Yes r0
_.
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):;.
1. �is� �� i� �� � R rt� a Pryhle/m � �jee,•t r
-Ac-
-
�7Aw uov:, Alt,
Fil
,)-V_1n, .
Reviewer/Inspector Name
Reviewer/Inspector Signature: �Cl _ Date: 1~ 41 — ff 1 1 /6/99

10 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection Z DU
Time of Inspection 24 hr. (hh:mm)
Permitted [3 Certified [] Conditionally Certified 0 Registered 113 Not Operational Date Last 70perted•
Farm Name: Gfl�
._.........4..Z:Ez3............................................................................. County:......5........................................._........................
OwnerName:...._.�t.0 0.�.��� !...:at C� Phone No. z71v..�d 6..............................--
�...... ..... ....... ..........
Facility Contact: �� S Title:..1—. Phone
:........................-----.........................r.�.................... No: _..................................
Mailing Address: ...... P�....�.....�...'c� �........... Jr.( ........................................... ....... �t rsa cv� ... ...................................... 2 (-3 ` T
Onsite Representative:..... ,...... ............... Integrator:
Certified Operator:................................................................................................................ Operator Certification Number: .............................. ...........
Location of Farm:
Latitude • 4 " Longitude • 4 "
Design Current Design Current Design Current
'Plyne Ca aPotilation CapacityPo ulationCattle - '
--7:Po-ulation -�°
❑ Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer - ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
Farrow to Finish ZDD Total DeSiga Capacity ` Z,
Gilts _ = - _
❑ Boars Tota1SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑Lagoon Area Spray Field Area L`
- Bolding Ponds /'Solid Traps_; ❑ No Liquid Waste Management System �3
..
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed. was the conveyance man-made? ❑ Yes o
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? (Il' yes, notil'y DWQ) ❑ Yes ONO
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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 7 rr
Freeboard(inched: 3.................. .................................... .................. ................. .................................... ............. ... ................ ........................... I............
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes F
No
seepage, etc.)
3/23/99 Continued on back

Facility Number-g5 — O Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑Yes
� No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintcnance/improvement?
❑ Yes
[ No
S. Does any part of the waste management system other than waste structures require maintenancetimprovement?
❑ Yes
> No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
ONO
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
ONO
11. Is there evidence of over application? ❑ Excessive riding ❑ PAN
❑ Yes
XNo
12. Crop typeRd
13. Do the receiving crops differ with thos esignated ' the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
gNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
WNo
b) Does the facility need a wettable acre determination?
❑ Yes
;'No
c) This facility is pended for a wettable acre determination?
❑ Yes
jj[No
15. Does the receiving crop need improvement?
❑ Yes
gjNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
JANo
Required Records & Documents
IT. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
M—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
KNo
20_ Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
0 No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
VtNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
No
23, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24. Does facility require a follow-up visit by same agency?
❑ Yes
RoNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
id —No
: 0-yi01ja0d1is o - dgficiettctieg orb rioter dtrr:irig this:visit; - Y'op will-t�eegiye trio ru>ftf - ...
icorresnoridence about this 'visit` ................
:

• Facility Number: J; — Date of Inspection 16, - Z -UU
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 O'No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes �No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes )No
30. Were any major maintenance problems with the ventilation fan(s) noted? (Le, broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes P(No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes �Io
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
10 Routine O Complaint O Follow-up of DWO inspection O Follow-up of DSWC review O Other I
Facility Number
Date of inspection
Time of Inspection j j 24 hr. (hh:mm) I
© Registered 00 Certified E3 Applied for Permit 9ermitted [3 Not O erational Date Last Operated:
Farm Name. W 7.5 73.. ........................................................ County:....y I,%.�l ................ .......
.................
n f f t -�—
Owner Name:...h..�.cc. d/.L.l.... .....-.1.. 0.. ..... lC.�.................................... Phone No: Z 3�. C/................................... _.
FacilityContact: Z..es,�!.. Title: n tJ .. Phone No: ...................................
Mailing Address: Po �r-a'j e r ��
............. ..................................Gv C ...........................
�5
OnsiteRepresentative:.._4..es _4�6t/1 S ....................................................... Integrator:................---...................................................................
Certified Operator;............................................................................................................... Operator Certification Number :.........................................
Location of Farm:
Latitude 0 4 « Longitude ' ' 0"
-.
f D&igni Current: Design Curren Design' Cut rent;
`
Svnne;:' CapacityX Population Poultry Capacity Poulafion Cattle ,. Capacity Populahoa
❑ Wean to Feeder
❑ Layer ' ❑ Dairy
❑ Feeder to Finish
10 Non -Layer ❑ Non -Dairy —
:` ❑ Farrow to Wean
❑ Farrow Feeder
Fr
❑Other
to
IM Farrow to Finish
DD Total Design Capacity
❑ Gilts
4
[I Boars
.w TotaUSSLW
Neunbe}rt►f Lagoons / Holdmg Ponds ❑ Subsurface Drains Present Lagoon Area ID Field Are
-.
31
F,k y ❑ No Liquid Waste Management stem '
,.w
,
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes No
2. 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 Surface Water? (1f 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
3. Is there evidence of past discharge from any part of the operation? ❑ Yes 0 No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes XkNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes 19 No
maintenance/improvement?
6- Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ( N0
7. Did the facility fail to have a certified operator in responsible charge? El Yes rrVNo
7/25/97

Facility Number: — (o
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes �No
Structures,(Lagoons.Holding Ponds, Flush Pits..etc
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes 9No
Structure I Structure ? Structure 3 Structure 4 Structure. 5 Structure 6
Identifier:
Freeboard(ft): ............................................................................................................................- ........... ..........
10. Is seepage observed from any of the structures'? ❑ Yes No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes J No
12. Do any of the structures need maintenance/improvement? ❑ Yes '�\ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes KNo
Waste Application
14. Is there physical evidence of over application? ❑ Yes ONO
(If in excess of MP, or runo ente aters of the State, notify DWQ)
15. Crop type � ..... .. .-................................................................................................................................................ ........
16. Do the receiving crops differ wi those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes JNo
17. Does the facility have a lack of adequate acreage for land application? El Yes ""RI No
18. Does the receiving crop need improvement? ❑ Yes No
19. Is there a lack of available waste application equipment? ❑ Yes No
20. Does facility require a follow-up visit by same agency? ❑ Yes '�No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes �INo
22. Does record keeping need improvement? ❑ Yes �No
For Certified or Permitted Facilities Only,
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes A No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes �NO
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes PJ�No
No.violatio-is•ar. deficiencies.were noted -during this.visit..You;will Feceiveno t ri er
cofrespundence about this:visit.
sdm� C'6.u,oe�fj�i d7t-
�r�tuda.- i`.—
7/25/97
8
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: M- z1�qO

0 DSWC Animal Teedlot 00er0i6ii-_ eview-,.'..
Animal Feedlot OiDera ion Site inspection
Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection V-277��
Time of Inspection /Z ' 24 hr. (hh.-mm)
Total Time (in fraction of hours
Farm Status: [I Registered El Applied for Permit (ex:1.25 for I hr 15 min)) Spent on Review
El Certified XPermitted or Inspection includes travel and processin
0 Not Operational Date Last Operated:
Farm Name: --...-75 73 ... County:
Land Owner Name: ........ Phone No: .... . ....
Facility Conctact: ---- — _- Phone No:
rc:LL� t—
Mailina Address: .... .. 2- 9;39V
F� .... . ..... . . ..... . . .... . ..... ..... . . .....
Onsite Representative: ............. . . ..... Integrator:
Certified Operator: .. . . .... ...................... Operator Certification Number:
Location of Form:
Latitude & 4 44 Longitude 0
Type of Operation and Design Capacity
'-A "Design"-:'_
rv,
Ine n- _0_U r
'I tio 0 ua t"`Pdpulation
0 Wean to Feeder Ll Uyer Dai
El Feeder to Finish [I Non-Lry
MST
ayer :�E D Non-Da'ry
0-Farrow to Wean
Farrow to
Feeder e­s'ig'n',- Capacity_4
0
1 4 1 .:. MV, O"L�
Farrow to Finish 12-co
❑ Other . . . ... ...
Ponds u u da b�sce Drains Present
j
WWAll
Lagoon ❑AM 0 Spray kid Area J
General
I . Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Lagoon 0 Spray field El 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
4/30/97 maintenance/improvement?
❑ Yes No
❑ Yes No
[I Yes [I No
El Yes [I No
[:]Yes [I No
❑ Yes No
❑ Yes No
❑ Yes 0
Continued on back

Facility Number .....
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes 'U�No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes o
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes o
Structures (Lagoons and/or Holding Ponds}
9. Is storage capacity (freeboard plus storm storage) Iess than adequate?
❑ Yes `�No
Freeboard (ff): Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
L1
10. Is seepage observed from any of the structures?
❑ Yes PNo
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes U�No
12. Do any of the structures need maintenance/improvement?
1
❑ Yes 'K 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 JRNo
Waste Application
14. Is there physical evidence of over application?
❑ Yes P�kNo
(If in excess of WMP, or runoffentering waters of the State, notify DWQ)
]f
15. Crop type .. ................. ......... ...... _ ._...._ ............. _ ....
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes h�No
18. Does the receiving crop need improvement?
❑ Yes MNo
19. Is there a lack of available waste application equipment?
❑ Yes 1A No
20. Does facility require a follow-up visit by same agency?
❑ Yes )9Vo
2 t. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes XNo
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes "XNo
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes No
24. Does record keeping need improvement?
❑ Yes ANo
Comments (refer to question t) 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):
�arlw 15 Luc�� w•a�n- ;htA -d ;-►. Cah j�a�c.
P e
1
*9' �""7w ,b,%�f/ ,•'Y.,.-_.".". `y - ^4szborM' t '2i�_e`K'3.`v f".
Reviewer/Inspector Name '. "� - ' � �• . _ ...m ... �-.<,«�,, ....,,�� f �,...
ReAewer/InspectorSignature: o. Date:
cc: Division of Water Quality water Quality Section, Facility Assessment Unit 4/30/97

ow
State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Carroll's Foods, Inc.
116 James Street
Laurinburg, NC 28352
Dear Sir:
e0
1DEHNR
DIVISION OF WATER QUALITY
July 25, 1996
SUBJECT
Compliance Inspection
Swine Farms
Hoke, Scotland and Richmond Counties
On July 2, 1996, an inspection of several animal operations was performed by the
Fayetteville Regional Office (FRO). Please find enclosed a copy of our Compliance Inspection
Report for your information. It is the opinion of this office that these facilities are in compliance
with 15A NCAC 2H, Part .0217, and that Animal Waste Management is being properly performed.
Should you have any questions regarding this matter, feel free to contact me at (910) 486-
1541 ext. 325.
Sincerely,
Ricky Revels
Environmental Technician IV
Enclosure
cc: Facility Compliance Group
Wachovia Building, Suite 714, Fayetteville �T�ak FAX [phone]
North Carolina 28301-5043 lj � ;* C An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541RIOURNERIONW-Fas50% recycled/10% post -consumer paper

Facility Number: a 3 - 0
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
Date: 7- Z -`i
Time: 11' 05r
G&neral Information:
Farm Name: 0 -1S 7 3 County: s'� �/a .,.. d
Owner Name: Came/ l 'S F a d_r _ -7-ivc- Phone No: (910 z 9 3 - 343
On Site Representative: ! L .,v c_ Integrator: Ca Iry i1 s �o ai
Mailing Address: PO Dr--a..Jw SSG
ln1a�rs.Lw r N c. Z939 8
Physical Addressg ocation: take- 401 5"4-L n.d -t..N ie:et , o=,_fib-4!�-, red .
C SR 1 �. 1 S � �`� o �}l1 ��,L ��`�� A.+ N 4 f � S•fe � Ti� ���c•ucr��
Latitude: I 1 Longitude: I 1
Qperation Description: (based on design characteristics)
T)Se of Swine No. of Animals Type of Poultry No. of Animals Type of Cattle No. of Animals
Sow i Zoo F%wsi, 0 Layer ❑ Dairy
❑ Nursery ❑ Non -Layer © Beef
❑ Feeder
OtherTjpe of livestock.: Number of Animals:
Number of Lagoons: 1 (include in the Drawings and Observations the freeboard of each lagoon)
Facilily Inspection:
Lagoon
Is lagoon(s) freeboard less than Ifoot + 25 year 24 hour storm storage?: Z, 7 Yes ❑
Is seepage observed from the lagoon?:
Is erosion observed?:
Is any discharge observed?
❑ Man-made C 1 Not Man-made
Cover Crop
Does the facility need more acreage for spraying?:
Does the cover crop teed improvement?:
( list the crops which need improvement)
Crop type:-- Oe -L—J a.-- ffK., " d Acreage:
Setback Criteria
Is a dwelling located within 200 feet of waste application?
Is a well located within 100 feet of waste application?
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream?
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream?
AOI -- January 17,1996
Yes ❑
Yes ❑
Yes ❑
No 13,11'
No M",
No C"
No &'
Yes ❑ No C'
Yes ❑ No C"
Yes ❑ No I9�
Yes ❑ No
Yes ❑ No L'
Yes ❑ No 2"�

Maintenance
Does the facility maintenance deed improvement? Yes ❑ No ar"
Is there evidence of pit discharge from any part of the operation? Yes ❑ No
Does record keeping need improvement? Yes a No Ur
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes ❑ No B-�
cam'¢ ,000gZ4
Explain any. Yes answers:
Signature: �� ��- �
cc. Facility Assessment Unit
Drawings or _Observations:
Date: -710 z/ ? 4-
Use Attachments if Needed
cad 14_
-- .
AOI — January 17,19%

Site Requires Immediate Attention: N D
Facility No. S 3 -
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 7,4Of , 1995
Time: /O : /0
Farm Name/Owner: C a r-ro f i 's tic ,-75 7 3
Mailing Address: 9 h&5'& Rd ,
County: _ 5c'o flamd
Integrator:
On Site Representative:_
Physical Address/Location:
o al -q/C. .
C zS3j'Z
Phone:
Phone: (WO) M74a - d 91M
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: / 9(ofr Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: ° 39, y-kF " Longitude: -79 ° 27' 37 "
Circle Yes or No
Does the Animal Waste Lagoon a sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Ye or No Actual Freeboard: -3 Ft. O Inches
Was any seepage observed from the lMor
n(s)? Yes or N� Was any erosion observed? Yes or N9
Is adequate land available for spray? No Is the cover crop adequate? Yes or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings'? &0or No
100 Feet from Wells? a or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or N®
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or(9
Is animal waste discharged into water of oa state by man-made ditch, flushing system, or other
similar man-made devices? Yes o N 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)? Yes or No
Additional Comments: RC'50 secre_ol !
Inspector Name
-/ )- _
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

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101 00 '00 00:00 021 P03
NORTH CAROL3NA DEPARTMENT OF F=LTH & NATURAL RRSOQRCSS
DIV13I0OR OF INVIRONNEWAL MANAGHPIENT
Fayetteville Regional Office
Animal Operation Compliance Inspection Form
d,;�w>;�;:;�����,"«« .��.+:+d��;�y'sir"a"r�w "a'k ""'.K,ewx+:s�w:e,sw��'a"s:asw��'"K�:x
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All questions answered /negatively will be discussed in sufficient detail in
the Comments Section to enable the deemed peraittee to perform the appropriate
corrections:
SECTION I
Animal _Oper_atian Tsrae:
Horses, cattle, swine poultry, or sheep
EA© . i.
1. Does the number and type of animal meet or exceed
the (.0217) criteria? (Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
poultry (30,000 birds With liquid waste
system) ]
2. Does this facility meet criteria for
Animal Operation RMISTRATIM
3_ Are animals confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a CKRTrFrED ANIMAL
WASTE MAMGEMW PLAN?
S. Does this facility maintain waste management
records (Volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover crop)?
6. Does this facility meet the SCS minimum
setback criteria for neighboring houses,
wells, etc?

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CTI III
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S ' to management
1. Is animal waste stockpiled or lagoon
construction within 100 ft. of a USGS
Map Blue Line Stream?
2. Is animal waste land applied or spray
irrigated within 25 ft, of a USGS Hap
Blue Line Stream?
3. Does this facility have adequate acreage
on which to apply the waste?
4. Does the land application site have a
cover crop in accordance with the
CRRTMCATI2j_
5. Is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar man-made devices?
6. Does the animal waste management at this
farm adhere to Best Management Practices
(B14P) of the approved CPLTIFICaTZON?
7. Does animal waste lagoon have -sufficient
freeboard? How much? (Approximately - 7
8. Is the general condition of this CAFO facility,
including management and operation,
satisfactory?
ORCTION IV
Comments
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