830010_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quaff

• T r
M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 830010 Facility Status:
Inpsection Type: Compliance Inspection
Reason for Visit Routine
Date of visit: 0211612017 Entry Time: 0&00 am
Farm Name: Farm 5096
Active Permit AWS830010
Inactive Or Closed Date:
County: Scotland Region:
Exit Time: 9:00 am Incident #
Owner Email:
Owner- Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
❑ Denied Access
Fayetteville
910-296-1800
Physical Address: 18788 Old Lumberton Rd Laurinburg NC 28352
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34' 4T 06" Longitude: 79° 23' 25"
On the west side of SR 1369 at its intersection with SR 1438 west of the Laurinburg-Maxton Airport.
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($):
Name
Title Phone
24 hour contact name
Mike Cudd
Phone
On -site representative
Mike Cudd
Phone:
Primary Inspector.
Robert Marble
Phone:
Inspector Signature:
. Date:
Secondary Inspector(s):
Inspection Summary:
Lagoon Levels
50963-1 = 21"
50963-2 = 22"
50963-3 = 25"
50963-4 = 34"
50963-5 = 104"
page: 1

w
Permit: AWS830010 Owner - Facility : Murphy -Brown LLC Facility Number: 830010
Inspection Date: 02/16/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
$wine
[] Swine - Feeder to Finish 9,288
Total Design Capacity: 9,288
Total SSLW: 1,253,880
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
1
19.00
Lagoon
7096 (2-3)
Lagoon
70% (4-5)
Lagoon
7096-1
page: 2

Permit: AWS830010 Owner - Facitity : Murphy -Brown LLC Facility Number. 830010
Inspection Date: 02/16/17 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?
❑
Elm
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ m
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
❑ M
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
E ❑
❑ .
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes No Na Me
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑M
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[1
0 ❑
❑
maintenance or improvement?
Waste Application
Yes Ng Na Me
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ E ❑ ❑
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

4.
Permit: AWS830010 Owner - Facility: Murphy -Brown LLC Facility Number. 830010
Inspection Date: 02/16/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
WaLstE Application
Yen No No Ng
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Corn, wheat, soybeans
Crop Type 3
Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Lakeland sand, 0 to 10%
slopes
Soil Type 2
Marlboro loamy sand, o to
2% slopes
Soil Type 3
Wagram loamy sand, 0 to
2% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ ❑ ❑
18.. Is there a lack of properly operating waste application equipment?
❑ E ❑ ❑
Records and Documents
yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
■ ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

f
Permit: AWS830010 Owner - Facility: Murphy -Brown LLC Facility Number.
830010
Inspection Date: 02/16/17 Inpsecton Type: Compliance Inspection reason for Visit:
Routine
Records and Documents
Yes
No Na Re
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
N ❑
❑
(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?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No Na No
28. Did the facility fall to properly dispose of dead animals within 24 hours and/or document
❑
E ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
E ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon 1 Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewlnspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
E ❑
❑
page: 5

A IP
M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
830010 Facility Status: Active
Permit: AWS830010
❑ Denied Access
Inssection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine County:
Scotland Region:
Fayetteville
Date of Visit:
03/11/2015 Entry Time: 08:00 am Exit Time: 8:30 am Incident #
Faun Name:
Farm 5096
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
18788 Old Lumberton Rd
Laurinburg NC 28352
Facility Status:
Compliant ❑ Not Compliant Integrator:
Murphy -Brown LLC
Location of Farm:
Latitude:
34° 47' 06" Longitude:
79` 23' 25"
On the west side of SR 1369 at its intersection with SR 1438 west of the Laurinburg-Maxton Airport.
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
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Phone:
Date:
page: 1

Permit: AWS830010 Owner - Facility : Murphy -Brown LLC Facility Number: 830010
Inspection Hate: 03/11/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
El Swine - Feeder to Finish 9,288
Total Design Capacity: 9,288
Total SSLW: 1.253,880
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
1
19.00
Lagoon
7096 (2-3)
24.00
Lagoon
7096 (4-5)
36.00
Lagoon
7096-1
20.00
page: 2

Permit: AWS830010 Owner - Facility : Murphy -Brown LLC Facility Number: 830010
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?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ ■
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
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 NQ Na No
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Led large
❑
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?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS830010 Owner - Facility : Murphy -Brown LLC Facility Number: 830010
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No Na No
Crop Type 1 Coastal Bermuda Grass
(Hay)
Crop Type 2 Corn, Wheat, Soybeans
Crop Type 3 Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Lakeland
Soil Type 2
Marlboro
Soil Type 3
Wagram
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M ❑
❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
No
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑0
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS830010 Owner - Facility : Murphy -Brown LLC Facility Number:
830010
Inspection Date: 03/11/15 Inppection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yes No Na Ne
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
E ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
E ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
■ ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
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,
❑
N ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31, Do subsurface tile drains exist at the facility?
❑
0011
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 reviewlinspection with on -site representative?
❑
'❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
w ❑
❑
page: 5

r r
0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 830010 Facility Status:
Active Permit: AWS830010
❑ Denied Access
Inppection Type: Compliance Inspection
Inactive Or Closed Date:
Reason for visit: Routine
County: Scotland Region:
Fayetteville
Date of Visit: 0311912014 Entry Time: 04:30 pm
Exit Time: 5:00 pm Incident 0
Farm Name: Farm 5096
Owner Email:
Owner: Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address: 18788 Old Lumberton Rd
Laurinburg NC 25352
Facility Status: Compliant ❑ Not Compliant
Integrator. Murphy -Brown LLG
Location of Farm:
Latitude: 34° 47' 06" Longitude:
79' 23' 25"
On the west side of SR 1369 at its intersection with SR 1438 west of the Laurinburg-Maxton Airport.
Question Areas:
Dischrge & Stream Impacts Waste Col, Slor,
& Treat Waste Application
Records and Documents Other Issues
Certified Operator: Michael L Cudd
Operator Certification Number:
25233
Secondary OIC(s):
On -Site Representative(s): Name
Title Phone
24 hour contact name Mike Cudd
Phone:
On -site representative Mike Cudd
Phone
Primary Inspector: Robert Marble
Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection summary:
Lagoon levels:
50963-1 = 20"
50963-2 = 20"
50963-3 = 24"
50963-4 = 34"
50963-5 = 44"
Records reviewed 313114.
Site visit 3/19114.
page: 1

Permit: AWS830010 Owner - Facility : Murphy -Brown LLC Facility Number: 830010
Inspection Date: 03/19/14 Inssection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
El Swine - Feeder to Finish
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freaboard
Lagoon
1
19.00
Lagoon
7096(2-3)
Lagoon
7096(4-5)
Lagoon
7096-1
page: 2

Permit: AWS830010 Owner - Facility : Murphy -Brown LLC Facility Number: 83DO10
Inspection Date: 03/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ ■
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
110
❑
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)
❑
❑ N
❑
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
❑
E ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes Np 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 (Le.1 large
❑
E ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
[]
❑
❑
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
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS830010 Owner - Facility : Murphy -Brown LLC Facility Number: 830010
Inspection Date: 03/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Overseed
Crop Type 3
Corn, Wheat, Soybeans
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Lakeland
Soil Type 2
Marlboro
Soil Type 3
Wagram
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑ ❑
Management Plan(CAWMP)?
15, Does the receiving crop and/or land application site need improvement?
❑
❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑ ❑
Records and Documents
Yes
No Na 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.
WU P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
[l
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS830010 Owner - Facility : Murphy -Brown LLC Facility Number: 830010
Inspection Date: 03/19/14 Inpsection type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Ne
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Surrey
❑
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?
❑
01111
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 PDA 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 fall to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
N ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

0 Division of Water Resources
Division of Soil and Water Conservation
❑
Other Agency
Facility Number. 830010 Facility Status: Active Permit: AWS830010
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Scotland Region:
Date of Visit: 02/26/2013 Entry Time: 05:00 pm Exit Time: 6:30 pm Incident #
Farm Name: Farm 5096 Owner Email:
❑ Denied Access
Fayetteville
Owner: Murphy -Brown LLC
Phone: [phone]
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address: 18788 Old Lumberton Rd
Laurinburg NC 28352
Facility Status: Compliant ❑ Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm: Latitude:
34° 47' 06" Longitude: 79' 23' 25"
On the west side of SR 1369 at its intersection with SR 1438 west of the Laurinburg-Maxton Airport.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator: Harold E Whittaker Operator Certification Number: 25624
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone
On -site representative Mike Cudd Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Lagoon levels:
50963-1 = 21"
50963-2 = 28"
50963-3 = 24"
509634 = 32"
50963-5 = 110"
Records reviewed 2J8113
Site visit 2/26/13
page: 1

Permit: AWS830010 Owner - Facility : Murphy -Brown LLC Facility Number: 830010
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit Routine
Regulated Operations
Design Capacity
Current promotions
Swine
Swine - Feeder to Finish 9,288
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
1
19.00
Lagoon
7096 (2-3)
Lagoon
7096 (45)
Lagoon
70W1
page: 2

Permit: AWS830010 Owner - Facility : Murphy -Brown LLC Facility Number: 830010
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na Ne
1. Is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the Stale? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
[] M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
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.l large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
■ ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
e ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
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 manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS830010
Owner - Facility : Murphy -Brown LLC Facility Number: 830010
Inspection Date: 02/26/13
Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Ovcrseed
Crop Type 3
Corn, Wheat, soybeans
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Lakeland
Soil Type 2
Marlboro
Soil Type 3
Wagram
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑0
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M ❑
❑
Records and Documents
Yes No No No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ ■ ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 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?
❑ 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: AWS830010 Owner -Facility: Murphy -Brown LLC Facility Number: 830010
Inspection Date: 02/26/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
[l
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
E ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
■ ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
e ❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
N ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
N ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
■ ❑
❑
page: 5

i ype or visit: le t:ompuance inspection v uperatton xev►ew V structure Evamanon V Iecnnicai assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: off% j Arrival Time: 0 St90 Departure Time: o § ; County
Farm Name: {D 3 L. 9Q'1`D� 3) Owner Email:
Owner Name: u," i -1 Q)a w r% UC Phone:
Mailing Address:
Region: 1r?_1D
Physical Address:
Facility Contact: l z Title: Phone:
Onsite Representative: t Integrator: [ A (Z p C4 1 �](i)lzi 'O
Certified Operator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
ft-Iisign C*urrent DesignCurrent Design C+nrrent
SwineCapacity Pop.. Wet Poultry . CapacityPop. Cattle Capacity Pop.
are :F
Wean to Finish Layer Dairy Cow
Wean to Feeder
Non -La er
I Daja Calf
Feeder to Finish
11
Dairy Heifer
Design :xCurrent Dry Cow
Farrow to Wean
Farrow to Feeder
D , P,oul
Ca ac- --. Po ._ Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
10ther
Turkey Poults
OtherIff
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ WE
❑ Yes
❑ No
Oi NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[ No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

Facili Number: - Date of Inspection: .�(�,13
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
4!] NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): /1 D ii 3 4P 1-1l if 13
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
P 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
g No
❑ NA
0 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 [A No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ® No ❑ NA ❑ NE
maintenance or improvement? T'
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ WE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Ac/cleptableCrop Window ❑/Evidence of Wind Drift [:]Application Outside of Approved Area
i
12.CropType(s): LP-Ske-1 ��i(mina—la.fctSS��-{ax,�.5tn.�{ainu�J�rrC;Wf{�w6ar&t46S
13. Soil Type(s): o Pq r i bb Iro i WQ 62 rv-
14. Do the receiving crops differ from those designated in the CA P?
❑ Yes
VoNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
rMNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P0 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
R No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑NA ONE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: jDate of Inspection: alp 3
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes P No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [RNo ❑ 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 0 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No 0 NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes `l 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
No
❑ 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
�No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
V!?No
❑ NA
❑ NE
Comments (refer: to question #): Explain any YES answers and/or any additional recomutendattons or:; any other comments. t
Use. drawings of facility to better explain situations (use additional a es as necessa ��,� _
P g t 3')
Reviewer/Inspector Name:
Reviewer/Inspector Signatt
Page 3 of 3
Phone:
Date: -2 -2U/ i .
21412011

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 0 Denied Access
Date of Visit: 7— -r Arrival Time: Departure Time: County: StC' L*JD Region:
Farm Name: 6709 Owner Email:
Owner Name: — Ut Phone:
Mailing Address:
Physical Address: ]A i -
Facility Contact: N Title: Phone:
Onsite Representative:
Certified Operator:
Integrator: h
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Cu ent
Design
Current
Design Current
Swine
Capacity `-'Pope :Wct Poultry
Capacity
Pop.
Cattle Capacity Pop.
�'
Dai Cow
Dai Calf
z
Dai Heifer
w*:;
,�
Design
Cnrren_t
D Cow
,� „Dr, P,oul
Ca aci
P■o
Non -Dairy
} w, La ers
Beef Stocker
�' Non -Layers
Beef Feeder
Pullets
Beef Brood Cow
M Turkeys
_..
Other
i; TurkeyPoults
Other
Other
Wean to Finish
Wean to Feeder
Discharges
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
La er
Non -La er
and Stream Impact
i. is any discharge observed from any part of the operation?
Discharge originated at: ❑Structure ❑Application Field ❑Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes � No ❑ NA ❑ NE
❑ Yes
❑ No
� NA
❑ NE
❑ Yes
❑ No
� NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes No
❑ Yes No
j"� NA ❑ NE
�❑" NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 2/4/20I1 Continued

Facili Number: 03 - 10 jDate of Inspection:
2-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes No
(iNA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: �! _ 4 3
Spillway?:
Designed Freeboard (in):
Observed freeboard (in): �� � !i q Z�
Z2u
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 jq] 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
ONE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes i] No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes .M No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes 09 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
❑ Application Outside of Approved Area
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
12. Crop Type(s):41 �tn dU124
�&j +
$
13. Soil Type(s):
14. Do the receiving crops differ from those designated it the C P?
❑ Yes Fg 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
❑ Yes16 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes n No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes N] No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes 6 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[—]Yes Q 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 l] No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall []Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes h No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes t6 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

FacilityNumber: -io jDate of Inspection:
2
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
kNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[:]Yes
[—]No
P NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes M No ❑ NA ❑ NE
❑ Yes [P No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the pen7tit or CAWMP? ❑ Yes 1� No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments:
Use drawings. of facility to better explain situations (use additional pages as- necessarv). � ^ ,
2j ece,4S aw;wred
S>Ie de-4 r-
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
4Z3L'2�
31�(Zr
M
Phone:
Date: 3 Z
21412011

Type of Visit O Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 1, fi Departure Time: Q>; M M County: SST 1`I Region:
Farm Name: n J 0 j3 7� tOwner Email:
Owner Name: _ F''` elf! �u-1 �W S _ Phone:
Mailing Address:
Physical Address:
Facility Contact: !- t rucl Title:
N
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
,,
integrator: . AAWVp b{.�--1'YP W &A U c
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = a = I = u Longitude: = ° = 1
Cae act Po 'la 'on
epiy p w
Destgn Current Design Current
Vet PoultryCapai ttyPopulation Cattle �;= Capacity Population
ean to Finish
❑
La er
❑ Dai Cow
ean to Feeder
FFeeder
❑Non
-La er
❑ Dai Calf
fi■" Dai Heifer
❑ © Cow
_ __`:
Non -Dairy
❑Beef Stocker
❑Beef Feeder
❑ Beef Brood Co
to Finish
r'12i
❑
-
ry.._._.=
La ers
-Layers
ers
rrow to Wean
rrow to Feeder
row to Finish
ts
❑
Pullets
Turke s
kEEIBoars
❑Turke
Poultser
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
PNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
U NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
IANA
❑ 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
1� No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
1�No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Ycs P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes []No [A NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Freeboard (in):
7Observed
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No ❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
IM No ❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No ❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�No ❑ NA
El NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
CH 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 Are
12. Crop type(s) Q & 941 " � . � �, ©uvS� a
6'r h `�
_B
13. Soil type(s)
v
14. Do the receiving crops differ from those designated in the CAWMP?
El
No
❑ NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[jNo
❑ 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
UNo
[I NA
El NE
► IBC j��,�l5 rQ(�i C(�-!� /Z!_22�//( r
!j-�P
Reviewer/Inspector Name ^ Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: — � Date of Inspection 2s
Re uired 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. E] WUP ❑ Checklists ❑ Design
g ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 1� 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
[�j No
❑ NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
0 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P 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
[ 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
[P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Q�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
[ 3 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
�O No
❑ NA
❑ NE
E
Page 3 of 3 12128104

S q- /Z -ZolO
Mr__,11M ,:
Type of Visit erl5ompliance
inspection
O Operation Review O Structure Evaluation
Q Technical Assistance
Reason for Visit
uutine O Complaint
O Follow up O Referral O Emergency
O Other ❑ Denied Access
Date of Visit: Arrival Time: 7:4GA/�. Departure Time: 7: 40 �u County. Farm Name: .z SD d?4 —_3 l ��� # 70 9& Owner Email:
Owner Name: /i -03nr JNy L. f!-- L Phone:
Mailing Address:
Physical Address:
Region: AAW
n /
Facility Contact: g" C� t/02 Title: � �QN�c� Phone No:
Onsite Representative: Integrator: 1j4 Bltcf&1
54 Certified Operator: "t G s g ' /uc� K Q Operator Certification Number: / 675z
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = o = I =" Longitude: [� o [= i
SRine
Design Current
Capacity Population
Wet Poultry
Design Current
Capacity Population Cattle
Design Current
Capacity Population
❑ Wean to Finish
10 Layer
I
1 ❑ Dairy Cow
❑ Wean to Feeder
10 Non -Layer
I
❑ Dairy Calf
Feeder to Finish
92
❑ Dairy Heifer
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Dry Poultry
❑ Layers
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Non -Layers
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures:
❑ Gilts
❑ Pullets
❑ Turke s
❑ Turkey Points
I JE1 Other
❑ Boars
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 discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'?
❑ Yes [@No ❑ NA ❑ NE
❑ Yes
❑ No
[M NA
❑ NE
❑ Yes
❑ No
RNA
❑ NE
[WNA
❑ NE
❑ Yes
❑ No
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
19 No
❑ NA
❑ NE
Page 1 of 3
12128104 Continued

Facility Number: L� —Q/Q Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
El Yes
� No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
® No
❑ NA ❑ NE
Structur/P Structure Structurer Structur&
Structuro
Structure 6
Identifier: SD 9k
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z O Of 2U 26
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
UNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
PYNo
❑ 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
;0 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
19 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
ERNo
❑ 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 I 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ElApplication Outside of Area
12. Crop typeJ s) BtVAI M -L (/Ay) �• M • ,oUGVSecd, � Co f i.J _ t�.]Cticc. f — Spy be�NS
a? -•-
13. Soil type(s) /.glee- )a,v kla5 Va +w
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes '9No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
i 6_ Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ,!I No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes ,INo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
❑ Yes [RNo ❑ NA ❑ NE
Phone: [phone], 33 00
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12128104 Continued

Facility Number: 83 — &: D Date of Inspection
Required Records & Documents
.19. Did the facility fail to have Certificate of Coverage & Permit readily available? [:]Yes R No ❑ NA ❑ NE
20. Does the facility fail to have ail components of the CAWMP readily available? If yes, check ❑ Yes ONo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ CheckIists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes IRNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ I20 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �9 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
,® No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P9 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
ONO
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
0 No
❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
CgNo
❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
,M 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
15'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
R 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
jHNo
❑ NA ❑ NE
Page 3 of 3 12128104

/-
'7
Date of Visit: Arrival Time: Departure Time: �� County: 5efrl W Region:1W
Farm Name: 3 Owner Email:
Owner Name: t Fw C Phone:
Mailing Address:
Physical Address:
Facility Contact:` pvt opt Title:
u
Onsite Representative:
cm
Certified Operator: �. 02"E 'C u
Back-up Operator: M�k 4—,-''` -r's
Phone No:
Integrator:I1 .
0
Operator Certification Number: q&/� �5.a'
Back-up Certification Number: WZ I e 9
Location of Farm: Latitude: ❑ o ❑ d ❑ « Longitude: ❑ ° ❑ t ❑ u
Design Current
Design C►urrent
Design Current
Swinejjjj&apaciVj&opulation
Wet PouEtry'Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
❑Non -La er
�c =;;x"`
y"
Dry
❑ Dairy Calf
❑ Dairy Heifer
El Dry Cow
Feeder to Finish
❑ Farrow to Wean=`
❑ Farrow to Feeder
❑ La ers
❑ Non -Layers
El Pullets
❑ Turkeys
❑ Non -Dairy
❑ Beef Stocker
El Beef Feeder
❑ Beef Brood Cowl
-
❑ Farrow to Finish
❑ Gilts
El Boars
-
Other
❑ Turkey Poults`
..
❑ Otherz_
Other
.:
Numlier;:of,Structures:
Dischartres & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b- Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
Z. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
❑ No
❑ NA
❑ NE
other than from a discharge`?
Page I of 3
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0No ❑ NA ❑ NE
a_ If yes, is waste level into the structural freeboard? ❑ Yes ❑ No EiA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
OA
Observed Freeboard (in): 4
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 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 roNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ElNA ElNE
ElExcessive Ponding ❑ Hydraulic Overload [IFrozen Ground ElHeavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of jAcceptable Crop Window El Evidence of Wind Drift El Application Outside of Area
�r
12. Crop type(s) FC lrr�`Y� i �ilt�tlk r�filrS2ap�� Ct1, k,✓�,yllc�rs, f �`f7`�h. . f�
CfJ
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
PNo
El NA
El NE
No
❑ NA
❑ NE
No
❑ NA
❑ NE
F�No
El NA
❑NE
No
❑ NA
❑ NE
Comments F—eterivol(luestionT415:1111EXplain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
AL
Reviewer/inspector Name. y Phone: 9 io 33 3?oa
Reviewer/Inspector Signature: Ul 1.4 Date: _? O
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VM No ❑ NA ❑ NE
the appropriate box.
❑ WUP [I Checklists El Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes WNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Sail 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
JoNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
RNA
❑ 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
5JNA
[3 NE
Other Issues
jj
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[$qTo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
P
❑ 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
-M No
❑ NA
El 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
[INA
ElNE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[rNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
El Yes
�No
❑ NA
❑ NE
Additional Comments a &or brawings:.::
T
Page 3 of 3 12128104

J
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: I `f/./�-(p�J � Arrival Time: /O: Q Departure Time, County:
Farm Name: irr j09 6 3 Owner Email:
Owner Name: LrDwh Phone: _
Mailing Address:
Physical Address:
Region:
Facility Contact: _Annrvt,ol 5 Title: Phone No:
i
Onsite Representative: Integrator: &dL " _
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 00 [�' =if Longitude: =° El' 0
Design Current
Design Current Design Current
Swine
Capacity Population ". Wet Poul#ry
C•apacity Popu lation ;C•attle Capacity Population
❑ Wean to Finish
Layer
❑
❑ ❑Dai Cow
on -Layer ❑Dai Calf
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation`? ❑ Yes rNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure El Application Field El other
a. Was the conveyance man-made'? El Yes El No EP NA El NE
b. Did the discharge reach waters of the State? (If yes. notify DWQ) [I Yes ❑ No 1A NA El 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 El No )9NA El NE
2. Is there evidence of a past discharge from any part of the operation? El Yes No El NA El NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State El
No [I NA El NE
other than from a discharge?
Page 1 of 3 12/2"4 Continued

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 rNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 507b
Spillway?:
Designed Freeboard (in):
u
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes kDNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes fpNo ❑ 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 VNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes t9 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 1PNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes RNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application'? If yes, check the appropriate box below. ❑ Yes ElNo ❑ 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)/y►�,�,4��f
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
'k4No
❑ NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E ?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
10 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment'?
❑ Yes
r1 No
Cl NA
❑ NE
Comments (refei�to question #}. Explain any YES answers and/or any recommendations or any other comments
i
Use drawings of facility to better explain situations (use addehonal pages as necessary)
�. Mk
Reviewer/Inspector Name Phone`
Reviewer/Inspector Signature. Date: IL's
r"KC7 c (I/ J 1L/LU/VY s ws8"V

Facility Number:PT-70-1 Date of Inspection `5
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes ] No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps p ElOther
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes W No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
NNo
❑ NA
[--IN E
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
"19 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[A No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
19 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
19 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
Vill
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes W 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
Page 3 of 3 12128104

0foS 31 Ia12001 Svc
A Division of Water Quality
l ility Number 3 Z Division of Soil and Water Conservation
Q Other Agency
Type of Visit (0 Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ®Routine O Complaint 0 Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: 7: R wt Departure Time: b: j p County: SGDtIAAJd Region: /=;eO
Farm Name: C- L Owner Email:
Owner Name:. IU Phone:
Mailing Address:
Physical Address:
Facility Contact: 90. d,,A Bu4Ag6ttrNe 1_ Title: t-'d.rti r • _ ,,! Phone No:
Onsite Representative: Integrator: ►P+t11.44!s Beot,%
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = = = Longitude:[--] ° ❑ T =
Design Current
Design Current Design Current
Swine
Capacity Population Wet Poultry
Capacity Population Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
Layer
❑ Dairy Calf
59 Feeder to Finish1-792-9
1' ..1 _.�.,,,
"- D Dairy Heifer
❑ Farrow to Wean
<DryPoultry
�^ ❑ D Cow
❑ Farrow to Feeder
❑Non-Dai
El Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
El Pullets
x ❑ Beef Brood Cow
_ ❑ Turkeys
Other
❑ Turkey Poults
❑ Other
El Other
Number of Structures: �
Discharges & Stream Impacts
i _ Is any discharge observed from any part of the operation?
❑ Yes
IN No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
P+ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[0 No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (Ifyes, notify DWQ)
❑ Yes
10 No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
P No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: 3 — � - Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[F No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[A No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2 Z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
LNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
29 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
�j No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[1 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
f9 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[A No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [2PNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
l2. Crop type(s) b16 H . 5-o4411 ig,_n,v (0- S)
13. Soil type(s) WAs
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
IM No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
In No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
E5No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
IN No
❑ NA
❑ NE
"Comments (refer to_quesho.n o'- Explain any YES answers and/or any recommendations or any. otlser comments.
Use-drawmgsrof facelrty`td better explain situations. (use additional pages as necessary): T .
Reviewer/inspector Name R<< �iZearel Phone: 910. V33, 3330
Reviewer/inspector Signature: P,eo_ Date: Z — i3 ZO0�7-z
Page 2 of 3 12128104 Continued

Facility Number: S3 - j Z Date of Inspection 12 -13-07
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes R9 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 ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [I5 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
%No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
N No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
I No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0A No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[5No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[9 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ONo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
0 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
f� 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
N 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
91 No
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12128104

W Division of Water Quality
Facility Number g J�p O Division of Soil and Water Conservation
O Other Agency
Type of Visit i Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up O Referral 0 Emergency 0 Other_ J❑ Denied Access
Date of Visit: b Arrivai Time: 6= �O r� Departure Time: 17.00 rti County: ``� Region:
goFarm Name:js Owner Email:
Owner Name: Phone:
Mailing Address:
Phvsical Address:
Facility Contact: t ` r' 6 „ Title: Phone No:
Ll
Onsite Representative: Integrator: U.✓�A, ,
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 O =' F__] " Longitude: = ° =' = "
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feede
Farrow to Finish
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
EJ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
ElTurke 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
Cattle Capacity
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [PNo ❑ NA ❑ NE
❑ Yes
❑ No
ipNA
❑ NE
❑ Yes
❑ No
1P NA
❑ NE
T NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
El Yes
No
El NA
❑NE
12128104 Continued

" Facility Number: —
Date of Inspection 3 �}
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: 0 g1 b 3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3q a
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 Wo ❑ NA ❑ NE
❑Yes ❑No 0NA El NE
Structure 5 Structure 6
❑ Yes %J No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes A 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
maintenance or improvement? ❑Yes No El NA [I NE
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes J4 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application'? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift ❑, JApplication Outside of Area j �_
12. Crop type(s) &,yh ,� C�� I , sme Q 6} , QAi9x , Collor . C9{-� w ; � baae1S
13. Soil type(s) 04 d,g"d r /1%��, �b6-YV
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 [N No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes W No ❑ NA ❑ NE
Comments (refer to question ff): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name
Reviewer/Inspector Signature:
PaL,e 2 of 3
Phone: �9
Date:
ar rr
I
Continued

Facility Number: vj - Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes P No ❑ NA ❑ NE
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 19 No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Desig
n ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes IN 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
18 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
91 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
it 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
01 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
El Yes
,,��qq
JA 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
9 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
5d No
❑ NA
❑ NE
Page 3 of 3 12128104

u
Type of Visit B Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up O Referral O Emergency O Other ❑Denied Access
Date of Visit: l0 `/3- rp Arrival Time: Departure Time: Z ; �County: SGgX&/4 Region:
Farm Name: W DSO 3 go Id C,-,m I l `s TO Owner Email:
Owner Name: /lilu�n�I— _ Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: AikL Am4mr-c
Certified Operator:
Back-up Operator:
Phone No: Q
Integrator: u..49/ �<2rc✓it/
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o = ` = Longitude: = o = 1 = u
Design Current Design Current':;; Design Current
Swine Capacity Population Wet Poultry,Capacity Population yCattle Capacity Population
EE01FaF
to Finish ❑ La er❑ Dai Cow
to Feeder ❑Non -La er❑Dai Calfr to Finish ``' ❑ Dai Heifer
to Wean ❑ D Cow
Dry Poulw to Feeder Non-Daiw to Finish R❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl I
Numberof(Structures:
❑ La ers
❑ Non -Lay ers
❑ Pullets
� ❑Turke s
❑Turke Points
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Od 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
W No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
VgNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
4 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
0 No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: g3 — j0
Date of Inspection1,6-1-2-:24
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): ZO
Observed Freeboard (in): s/ rr
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 [M No
❑ NA ❑ NE
❑ Yes No
❑ NA ❑ NE
Structure 5
Structure 6
❑ NA ❑ NE
❑ Yes No
❑ Yes [� No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[ No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
PA No
ElNA
❑ NE
maintenance or improvement?
Waste A olication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑Yes
M No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes [M No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs El 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) C_a44o ^j C —t j (��, .ig� Scv� _ 8U'�lc� �0. C a �� 4 /l �vni�/ (0 ucvScc�
13. Soil type(s) 4Va1..47 1_4k e_ra nr d 1HI S11,641yp
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ❑ No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑ No ❑ NA ❑ NE
El Yes El No ❑NA ❑NE
Comments,(refer to question #): Explain any YES answers and/or any recommendations or any other comments $ ' .
Use drawings of facility to better explain situations. (use additional pages as -necessary): y;
w
Reviewer/inspector Name 'G r trc
Phone: /O)#M -3300
Reviewer/Inspector Signature:
Date: 6 -13 — Zoo &C
Page 2 of 3 12128104 Continued

Facility Number:
Facility of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [A No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 1� No ❑ NA ❑ NE
the appropriate box. ❑ wup ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [21No ❑ 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 f�j No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �ffNo ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
1� No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[4 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
1� No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
CWNo
❑ 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
Q@ 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
T 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
[�j No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
P9 No
❑ NA
❑ NE
Page 3 of 3 12128104

® Division of Water Qaality
Facility Numijeol 83 /� Q Division of Soil and Water Conservation
- 0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: /Z -24 -Q I Arrival Time: Departure Time: County: aiv
Farm Name: 059963 ' # 70 Owner Email:
Owner Name: Ind h 1. Phone:
Mailing Address:
Physical Address:
Facility Contact: .A r ` Title:
Onsite Representative: r
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Region: F-R-0
Phone No:
Integrator: �� 9yo L.f8z
Operator Certification Number:
Back-up Certification Number:
Latitude: = 0 0 ` = Longitude: ❑ ° ❑ ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Lavery
— Non-Layet -
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ 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 Heifer
❑
Pa Cow
❑
Non -Dairy
❑
Beef Stockei
❑
Beef Feeder
❑
Beef Brood Cow
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:
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 U No ❑ NA ❑ NE
❑ Yes
T$No
❑ NA
❑ NE
❑ Yes .JONo
❑ NA
❑ NE
❑ NA
❑ NE
[--]Yes
N No
❑ Yes
®No
❑ NA
❑ NE
❑ Yes
N No
❑ NA
❑ NE
12128104 Continued

Facility Number: Ig 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
N No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): } ZO
Observed Freeboard (in): 7
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[9 No
❑ NA
❑ NE
(ieI large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
W 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
[M No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [Z 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 J�iNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes N No ❑ NA ❑ NE
maintenance/improvement?
l l . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes (X No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] 0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soiltype(s) Wa$ L.-akc— la^id Maivlbev
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ER No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
10 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination[:] Yes
ER No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
M No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Reviewer/Inspector Name �� i2 k Re-d S 2'4­-,-,!A Phone:/S,// ax.73Q
Reviewer/Inspector Signature: Date: /Z —ZP —Z4DS
12128104 Condnued

y +
Facility Number: Date of Inspection 21O -D
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes N No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 50 No ❑ NA ❑ NE
the appropirate box.
❑ WUP [I Checklists El Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [9 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
[ANo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes.
D9 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
ER 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
[9 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/]nspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[2 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[K No
❑ NA
❑ NE
12128104

(Type of Visit m Compliance Inspection O Operation Review O L-agoon Evaluation
Reason for Visit b Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: i - 9- Time;
Facility Number 3 1 0'
Not erational O Below Threshold
G Permitted ® Certified © Conditionally Certified E3 Registered Date Last Operated or Above Threshold: ----- _. .. �._W.
Farm Name: - arroil'� 4"Q.. >g^ .- Z..��. County:Gu _aw ....._
Owner Name: C a Y r u .. rr o o aQs ...T '±c........................ Phone No: _.... +...4. ..._a ......-..
Mailing Address: Q D........... ,
Facility Contact: _. ...--- ------- Title: ... ..... ........... Phone No:
Onsite Representative: _ _ _ ........................ Integrator:
Certified Operator: _ _ Operator Cerdfiication
Location of Farm:
to Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ' it Longitude • ' 94
Discharges &, Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at. ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ 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: ........... � 2 -3
................ _............... -- ---- ..........._................-l--...................
44
_ ....._ ...Q.....................
- ................ -...
`
Freeboard (inches): /�i I Sc, d seK a
KiJf
44Al : l, S
12112103
Continued

r
Facility Number: 3 — O
Date of Inspection — `%-
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? -
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [--]No
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22_
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
❑ No
(iel 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
13 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to=questiap #I) E$plain any YES answers and/or any recommendations oror any�othe c utments.E' r
WWI* 3 Y
drawuigs of facility to better• explain situations (use addihoaal'; pages as necessary) Copy ❑Final Notes
AUse ; : .� ®Field
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 v Continued

r. '
V
Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint 0 FDllow up O Emergency Notification Q Other ❑ Denied Access
Facility lumber Date of Visit i Time: I 'I "
10 Not Operational 0 Below Threshold
® Permitted ® Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: — ___ )G r!'Qfk{ S �t��d i.n l_ f County-: S'CY t-�GV-'
Owner Name: _ Czlr'o S -f: r-.,.. #t- `--CI i G _ Phone No: , I!�
Mailing _address: p B cur V E6, L) c;.L_CG _ f'' C '
Facilit%' Contact: C46, f� Me LL e,,., In C dg rr- _. Title:
Onsite Representative:
Certified Operator: _. , ]3 I.v. C, 1)v f6'
Location of Farm:
Phone No:
Integrator: .__ C. e. rrt-Y, {t 1C
Operator Certification Number: 1 7:?- 1p.S U
.9 Swine ❑ Poultry ❑ Cattle ❑Horse Latitude ' �� 0` Longitude ' •
Design Current Design Current Design Current
Swine Ca acit`• Po elation Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Laver I I JEI Dairy
® Feeder to Finish xg,
❑ Non -Laver I 1 10 Non-Dair
❑ Farrow to R°ean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons I h I JLJ Subsurface Drains Present JILJ Lagoon Area !LJ Sprav Field area
Holding Ponds /Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. is anv discharge observed from any part of the operation?
Discharge orie-inated at: ❑ Lagoon ❑ Snray Field ❑ Other
a. If discharge is obsen-ed, was the conveyance man-made?
b. If discharge is observed, did it reach I ater of the State? (If yes, notify DWQ)
c. if discharge is observed. what is the estimated flow in eal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collmdon & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
❑ Yes
[19 No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
® No
❑ Yes
Q No
Structure 6
Freeboard (inches):
05103101 ? Continued

Facility Number: — 10 Date of Inspection r "
5. Are there any immediate threats to the integrity of any of the structures observed!? (iel trees, severe erosion, [] Yes [ANo
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 M 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 C%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 Q No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes FQ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN []Hydraulic Overload ❑ Yes C3 No
12. Crop type arirf-r^t.A-e %A-- 2r,. (',EiM UI^ PGA- +- So
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
r
15. Does the receiving crop need improvement? ❑ Yes ® No
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21, Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ❑ No
❑ Yes 29 No
❑ Yes ® No
❑ Yes CO No
❑ Yes M No
❑ Yes [91 No
❑ Yes ® No
❑ Yes No
❑ Yes] No
❑ Yes V No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments refer to re°stion EiQ111111111111`iin any YES answerand/or;an recommendahons or an a`ther com'� pine ts.
T
Ilse drawings of faNdity to better ezpla n situations. (use addtttonal pages as necessary): ❑Field Copv ❑Final Notes
Sot i S G,-r%p (e I n r } l a'103
�^^ (3MP f-&, 'o A or 1,
�• i (6- e-en1 ��.x.tQ v� p o rk � i ., 6r-a, + hn 6 c a. o 03 0 k. S('A CR
app(i (." rn re 6t>-4- �� n �: C t`N �� �, 5 't� azd 3 b ,1- I'1A tJCrA a
tr v�4l�G S irS rip � r�- F� c�cl i .� nA-re. FJo o;C,
Reviewer/Inspector Name. , ti
Reviewer/Inspector Signature: r Date: d
05103101 t �- Continued

Facility Number: $ 3 - •,b Date of Inspection
Odor lSSueS
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the Iiquid 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 petmanenthemporary cover?
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes ® No
❑ Yes No
❑ Yes ® No
❑ Yes ❑ No
O5103101

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ® Routine 0 Complaint O Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Faciliry Number 1 0 I Date OfViSit: �g is 3 Time:
-- Not O erational Below Threshold
Permitted ® Certified © Conditionally Certified ©Registered Date Last Operated or Above Threshold:
r
Farm Name: ("Ca-roCounty: -*[yHe, -d
Owner Name: Cr r_r'e.Q% # T-og G Phone No. It 0 —.2 4-G. � S�� Zi
Mailing Address: _tica'a. o AC.
Facility Contact: Title: i k M Phone No:
OnSite Representative: cc>tkIntegrator- eprYs i 4// a
Certified Operator: iZ u a i' r Co R i Operator Certification Number: .2
Location of Farm:
P9 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
Design Current
Swine Capacity Po ulatiot
❑ Wean to Feeder
® Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
El Gilts
❑ Boars
Number of Lagoons
Holding Ponds I Solid Traps
Design Current Design Current
Poultry Capacity Po ulation Cattle Capacity Population
❑ Laver I FQ Da'a I I --d
❑ Non -Laver Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
JLJ Subsurface Drains Present U J Lagoon Area JU Spray Field Area
❑ No Liquid Waste Management Svstem
Discharses 8 Stream Impacts
1. is anv discharge observed from any part of the operation?
Discharge originated ar. ❑ Lagoon ❑ Spray Feld ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in aallmin?
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 a llection 8- Treatment
4_ is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): pl- 1 ri t q
03103101 k.,d & Pi-� nO L2 r
❑Yes 0No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
® No
❑ Yes
EN No
❑ Yes
® No
Structure 6
Continued

Facility Number: 23 — t p Date of Inspection r/ 7
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes allo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes ❑ No
(!f 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 R No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? Cl Yes 91 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 [5d No
12_ Crop type (z e.T nn i.1Q 9-- + R14.4
13. Do the receiving crops differ with those designated -in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
O No
b) Does the facility need a wettable acre determination?
❑ Yes
'o
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?
Cl Yes
No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ 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
(3No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
51 No
22_
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
[1 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.
0
Gamments (refer to question #fj ExEdaplain a:zyiYES�answers,�and/or+anyf recommendahoas:.or a©y_,athencomments,11
�. - p tlpiTa �r ,. - 4 ls
Use drawings
of�facilrty to better explain situations: (use addrhona! pagmas necessary) ❑ Field Copy ❑ Final Note,
' -
Reviewer/Inspector Name ' "
Reviewerhnspector Signature: el4j& Date: 0
05103101 Continued

Facility Number: g' — E17 Date of Inspection EZ D"
Odor Issues
26_ Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. is there am- evidence of wind drift during land application? (i.e_ residue on neighboring vegetation. asphalt.
roads, building structure. and/or public property)
'19. is the land application spray system intake not located near the liquid surface of the lagoon?
30. XVere any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missine 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 permanentitemporary cover?
❑ Yes N No
❑ Ycs [,-&I No
❑ Yes ES No
❑ Yes W No
❑ Yes E No
❑ Y'es 15� No
❑ Yes fQ No
05103101

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit *Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number
Date of Visit: Time:
Not O erational Below Threshold
Permitted E Certified 13Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: �'/¢�; �/� 9� // Counq:
Owner Name: �.�:� ��/� ad i_ Phone No: �� 9,3— �3r
Mailing Address: AJgr
Facility Contact: ,O'k S Title: Phone No:
Onsite Representative: 4s, ~ —� Integrator• I '/X�Ir! / �
Certified Operator: _ 1c&ocl ....12,�s Operator Certification Number.af�f�
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude n � �u Longitude 0 '
Design
Current
Design
CurrenE Design Current
_
Swine Ca acih
Population
Pogltry, 1, _Ca acity
t
P,o ulatiop Cattle Ca acity P.o ulation
Wean to Feeder
❑ I a er
❑ Dairy
eeder to Finish .2
Ki"
k❑ Non -Layer
❑ Other
S°
❑ Non -pair
to WeanFow
to Feeder
Total Design Caliactty ;17
T,otal°SSLV1'
❑ Fow to Finish
❑ Gilts
❑ 130 rs
Number olLagoons
❑ Subsurface Drains Present ❑ La oon Area
❑ S rov Field Area
❑ No Li uid Waste Management S ystem
Holding Ponds / Solid Traps _n--
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier: Freeboard (inches): Itq 1,9 34) 52
p
05103101 Continued

Facility Number: U — d I Date of Inspection C�
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste A ligl cL, ation
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop hype A.06 0.14�14
❑ Yes PTNo
❑ Yes VNo
❑ Yes Wo
❑ Yes P'No
❑ Yes �RNo
Cl Yes QRNO
❑ Yes RNO
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes RNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
P?No
b) Does the facility need a wettable acre determination?
❑ Yes
ONo
c) This facility is pended for a wettable acre determination?
❑ Yes
KNo
15.
Does the receiving crop need improvement?
❑ Yes
KNo
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
�9 No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps etc.)
❑ Yes
JR] No
19.
Does record keeping need improvement? (ie/ irrighion, freeboard, waste analysis & soil sample reports)
❑ Yes
OLNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
RNo
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
N No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
tRNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
VNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Commeuyfs, {refer to gn�tion #f) Ezpiarn anyYES answersrandla,r�,any rernmmenda4onsor�any other,�comraeats. I '
'xs
Use"dr�a� ngs of faci�t��to better e�plam s�tuat�ons (use atidrieonal�pages as necessary):- ❑Field Copy ❑Final Notes
3 _:� ;, �,,,,,
X S — •✓h',«� /I�ib^� F �'!�" .aS�' o`.� bit'iG�
w
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
O5103101 Continued

Facility Number: ,7 -- Date of Inspection zS
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
VYes ❑ No
❑ Yes PNo
❑ Yes. P-No
❑ Yes �fNo
❑ Yes PtNo
❑ Yes [�No
PrYes /❑ No
0510310,1

Type of Visit jo Compliance Inspection O Operation Review O Lagoon Evaluation
(Reason for Visit $ Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Z `o Time:
O Not Operational Q Below Threshold
Overmitted © Certified 13 Conditionally Certified © Registered Date Last Operated or Ab vy Thres ld•
Farm Name: ! i�
-�7 County:
/- ......ye �........................................ ...................
_.
Owner Name: ........... CcEx:ro .. 113 ............. 5 ........ Phone No: ..............
j� k � ,�f�
Facility Contact: .../�- ar/1.L. ............ Tale L+• X' fif................... Phone No
MailingAddress:...-------•.............................................................................................................................. .....................
Onsite Representative: ..................... ..................................................................................... Integrator:............................................
Certified Operator: (tit t�«T_........._... Operator Certification Number:
... ...................7.--------------•- •........
Location•of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude • ��
Design Cui refit 'Design Current Design - Current
Capacity PopulationCapacityn eSwine Pouy Po latioCa aci °°Po idatiioe r
❑ Wean to Feeder ❑ Layer ❑ Dairy -
ff
Feeder to Finish ❑ Non -Layer ❑Non -Dairy
Farrow to Wean -
❑
Other Farrow to Feeder =
❑ Farrow to Finish Total Des' _ ..:
❑tilts =CaPa_ci
t
Boars TAW ISSI W _
Nuiaaber of Lagoons_::. -: ❑Subsurface Drains Present Lagoon Area ❑ Spray Field Area
-_ _ ..
Holdrng Ponds] Sohd Traps'` ❑ No Liquid Waste Management System
Discharges & Stream Impack5
1. Is any discharge observed from any part of the operation?
❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes VNa
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 gai/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ANO
2. Is there evidence of past discharge from any part of the operation'? ❑ Yes [ANo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 414o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes �No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .................................... .... ...................... .......... .....................................--......................................---..............................................
.................
Freeboard (inches): �' Z ' Z ' Z 13 1
5100 Continued on back

Facility Number: rg Date of Inspection 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 F 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 ONO
(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
ONO
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes
� No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
ONO
_Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
ANo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
12. Crop type �jLeo- 12 W_r,5 60d
)P(No
13. Do the receiving crops differ with those designat din th 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
zzNo
15. Does the receiving crop need improvement?
❑ Yes
S`No
16. Is there a lack of adequate waste application equipment?
❑ Yes
X No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
® No
' \
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oc/ WUP, checklists, design, maps, etc.)
❑ Yes
20 No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
ANo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
P No
21. Did the facility fail to have a 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 j No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes No
24. Does facility require a follow-up visit by same agency?
❑ Yes No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes No
Yiol;aiigM,or defcie[tcie were i►gfed dung this:visit; Yo1l will reeeipe tj<o further
• ...9
0- dence� about: this visit: - ..:... .... - . - - - - . - • . • • • - , - - .. . - . • ...... .
Comments (r%r to:question'#} Explain any YES answers and/or any_iecomimendations or any other comments
Use drawtngsR:uf facility to better cS[plam Atuabous {iise additiooai:pages
�j .""�r1L� �LQq/]!1 So�1 ���oFzal
N.
Reviewer/Inspector Name J +1lt i..J_XerW
t_
yz
Reviewerlinspector Signature: Date: 5)w

�• Facility Number: g3 — v Date of Inspection 1-5--.Zyw Printed on: 1/9/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ❑ Yes No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes J No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes Q�No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes eN0
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? &/Yes ❑ No
5100

Routine 0 Complaint 0 Follow-u of DWQ ins ection 0 Follow-up of DSWC review 0 Other
Facility Number t7 Date of Inspection Z7—d7
Time of Inspection ![(aJ 24 hr. (hh:mm)
Permitted 0 Certified 0 Conditionally Certified 0 Registered 10 Not Operational I Date Last
/Operated:
FarmName: ........�...7...a...l .................................................................................... County:............. .............................
Owner Name:.... �t l E'D....�`...f....... 1 �1 f... .................... Phone No: ........�..12_ .G.................. I ............ .......
Facility Contact: ...L.e.r5 ........5 dal..l.I..r7....................... Title: /........... Phone No:...................................................
Mailing Address: .....F....... !!`ct.,.-v ..............f...(ly. ......�Ti6
Onsite Representative: ....................... . .................................. . .............................................. Integrator:.-----.... ......
_.... .
Certified Operator: ..... „11................................... ..If.... �.................. Operator Certification Number:
�'�}................I.......................
Location of Farm: /
...........................................................................................................................................................................................................................................
....... ... _ ............................ ......... ....... --_..
Latitude Longitude 0 • �' �"
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes O(No
Discharge originated at: ❑ Lagoon ElSpray Field ElOther
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (Il' 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
❑ Yes No
❑ Yes No
❑ Yes J�No
[]Yes KNO
❑ Yes KNo
❑ Yes No
Structure 5 Structure
Identifier: Al
/ /j.� / � � , G
Freeboard (inches): 4 e .................. r o f.....
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes No
Continued on back
R1L►M05i

Facility Number: -j;�3 — /Q 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
WNO
(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
4No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
R10
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
RNo
Waste Application
10. Are there any buffers that need main tenance/improvement?
❑ Yes
ij No
11. Is there evidence of over application? ❑ Ex essive Po ding �AN
YesZasdlft
12. Crop type 'e� Q r•-Q z ,t? eXe
13. Do the receiving crops differ with 4tose deig4ated in L 46rtified Animal ante anagement Plan (CAWMP)?
❑ Yes
*No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
,P No
b) Does the facility need a wettable acre determination?
❑ Yes
Rlo
c) This facility is pended for a wettable acre determination?
❑ Yes] No
15. Does the receiving crop need improvement?
❑ Yes
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
�(No
Required Records & Documents
IT. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
ONO
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
P No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
ATM
20_ Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
14'No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
A No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
4No
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
10 No
24. Does facility require a follow-up visit by same agency?
❑ Yes
WNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
EtrNo
IM?10 yiol��icjttjs or dgf cieincips -Wig re oteo jl rw xig tbis:visit • You Wdi•tee�iye o' further
corresporicieitce about this visit ..::...:.......: ...:............. .
Gaja7r,. (0-1 .kv ar'e_ 9ef�,� �//C� es�l�5/rm�k7` v� �ra�sr aX� 7��' AL
tl�nn
(� opcY f ccarz(s',
s6 'O rROI' Z9Ver 1ic4`F�ds4
M �pP v U
Reviewer/Inspector Name " �`i° R ;''
Reviewer/Inspector Signature. Date: -? y�

Facility Number: �3 — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes #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 10�o
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ YesAlo<
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No

Division of Soil and Water Conservation [3 Other Agency L�
Division of Water Quality .x
1G Routine O Complaint O Fellow -up of DWO inspection O Follow-up of DSWC review O Other
Date of Inspection l
Facility Number 0
Time of Inspection 24 hr. (hh:mm)
13 Registered istered Certified ©A lied for Permit Applied d Permitted 10 Not O eratinnal Date Last Operated:
Farm Name: ........ ......%o. �z..Ill................C........................ County:...... 1 /..----•----..............................
3
OwnerNatne:..... .�..L ±....5...........�d5. �i t C.......................... Phone No: ........
.....��.3.7.`...........................................
ff, ' �/
Facility Contact: ....>1.(....... ............................ Title:.. ,....mt.................. Phone No: ...1:�......
�J ....... ......2)L......6&
Mailing Address:...... o. 7..�%..D..... .� ....... -.i ! . Y�ier. R .......il!+!.! ...........z.SF ..
Onsite Representative :..-----l-.s .. 5:6Integrator:........................
............{......................................................................................................................
Certified Operator:............................................................................................................... Operator Certification Number;
Location of Farm:
0
Latitude a 4 " Longitude • 6 46
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? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? Of yes, notify DWQ) ❑ Yes ❑ No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ElYes No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ONo
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes No
7/25197

Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagpons.Holding PpAns. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
0 Yes No
El Yes ANO
Structure 5 Structure 6
Identifier: :
;'VI .............. * .................................. ............ * ........... " ........... ...... * ....... ........ ....
Freeboard (ft): ......1 e .... ........ ..... .............. /?"* . ....... ........ If."' A.....----- ........
.............. ....... ... ............................................................
10. Is seepage observed from any of the structures? El Yes P(NO
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes VjrNo
12, Do any of the structures need maintenance/improvement? JKYes 0 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 WNo
Waste ApRlication
14. Is there physical evidence of over application? El Yes 9No
(If in excess of WNW, or runoffenten% waters of the State, notify DWQ)
15. Crop type kr�CL_/
........................ ...... T-7.pf.�.c - — -_--_-__-__- - ................ ................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWIVIR)? 0 Yes No
17. Does the facility have a lack of adequate acreage for land application? El Yes No
18. Does the receiving crop need improvement? ❑ Yes No
19. Is there a lack of available waste application equipment? ❑ Yes O.No
20. Does facility require a follow-up visit by same agency? 0 Yes �No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? 0 Yes RNo
22. Does record keeping need improvement? 0 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? 0 Yes KNo
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? 0 Yes RkNo
25, Were any additional problems noted which cause noncompliance of the Permit? El Yes NrNo
No.violaifiohs, -or'deficie'nc'ie's'w'e'r'e-'no't'ed-d'ur'iiig thisvjsW YoU'-W'iH it ceii've,nio'Airilieri'.*,
Otr&pOildekt EiVoid this'visit'.- .... ................
Alee W A C").n k" U e 7� el I
erv5;an_ ha_cJx,1a1Oe_ �Xa�
5pr-a-1 'celV 0�-e cam w�
" , "q/ 7/11� _1
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: /) '14A 1 14, Date:

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.NQtr,_� or
�-a
June 26, 1998
UL 2 3 1998
Carroll's Foods Inc
7096 FAYE7TEVIL E
18788 Old Lumberton Hwy. RE(3. Ur=r;C
Laurinburg NC 28352
Dear Carroll's Foods Inc:
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT ANo NATURAL RESOURCES
Subject: Reissuance of Certificate of Coverage
No.AWS830010
7096
Swine Waste Collection, Treatment, Storage and
Application System
Scotland County
The Division of Water Quality modified the Swine Waste Operation General Permit originally issued to
this facility on June 23, 1997. In accordance with the issuance of the revised General- Permit, we are
forwarding this Certificate of Coverage (COC) to Carroll's Foods Inc, authorizing the operation of the
subject animal waste collection, treatment, storage and land application system in accordance with
General Permit AWG100000. This approval shall consist of the operation of this system including, but
not limited to, the management of animal waste from the 7096, located in Scotland County, with an
animal capacity of no greater than 9288 Feeder to Finish and the application to land as specified in the
Certified Animal Waste Management Plan (CAWMP).
The COC shall be effective from the date of issuance until April 30, 2003, and shall hereby void
COC No AWS830010 dated June 23, 1997. The COC shall hereby incorporate by reference any specific
conditions of the previous COC issued to this facility. The purpose of this COC is to allow coverage
under the revised General Permit. Please review the revised General Permit (enclosed) and pay
particular attention to Condition I1.10 regarding tree removal from lagoon embankments, Condition III.1
regarding inspection frequency of the waste treatment, storage and collection system and Condition I11.6
regarding notification requirements for system failures, spills and emergencies. Pursuant to this COC,
you are authorized and required to operate the system in conformity with the conditions and limitations
as specified in the General Permit, the facility's CAWMP, and this COC, with no discharge of wastes to
surface waters. An adequate system for collecting and maintaining the required monitoring data and
operational information must be established for this farm. Any increase in waste production greater than
the certified design capacity or increase in number of stocked animals above the number authorized by
this COC will require a modification to the CAWMP and this COC and shall be completed prior to
actual increase in either wastewater flow or number of animals.
Please be advised that any violation of the terms and conditions specified in this COC, the
General Permit or the CAWMP may result in the revocation of this COC, or penalties in accordance
with NCGS 143-215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive
relief.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Certificate of Coverage AWS830010
7096
Page 2
Upon notification by the Division of this COC's expiration, you shall apply for its renewal. This
request shall be made within 30 days of notification by the Division.
This COC is not automatically transferable. A name/ownership change application must be
submitted to the DWQ prior to a name change or change in ownership:
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the
right to apply for an individual non -discharge permit by contacting, the engineer listed below for
information on this process. Unless such a request is made within 30 days, this COC shall be final and
binding.
The subject farm is located in the Fayetteville Regional Office. The Regional Office Water
Quality Staff may be reached at [phone]. If you need additional information concerning this
COC or the General Permit, please contact Sue Homewood at [phone] ext. 502.
Si erely,
for A. Preston Howard, Jr., P.E.
cc: (Certificate of Coverage only for all cc's)
Scotland County Health Department
Fayetteville Regional Office, Water Quality Section
Scotland County Soil and Water Conservation District
Permit File

}
❑DSWC Animal Feedlot Operatton Review a
�, k � �,� WQ�An�mal Feedlot�Operatlon 51fePInspectton , �, ` � �� t',; �� � - � ;•
..• ���.-� :m� � . ,..,�w"�l . , -'�`.�ct_w�m.*. �.��: § � -y,�� � �, v�.s .. •�. ^"s,` 61 ��"' � ,E �e w.° rah � fiF t.,
Rp Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
I Facility Number I
Date of Inspection
Time of Inspection 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status. ❑ Registered Applied for Permit (ex:L25 for 1 hr 15 min)) Spent on Review
❑ Certified RPermitted or Inspection includes travel and processing)
❑ Not
�Operational Date` Last Operated:...__.._. ...... _.. ..... ............... __ . _ ..— .. ..... �. _ ....
Farm Name: _. L L�70410. _ ._ .. ....... _ _ County: SCo�G _....._.. _ .
Land Owner Name�I!r!^ei_ `..s...._ Phone No:
FacilityConctact: Lei .. Title: Phone No:
Mailing Address: .._��r �J (o ! �'�ti�,`��k 7. e 2e3!�'
.................. f
Onsite Representative:. . _._. Integrator•n�a
Certified Operator:.......... _ .......... _ .----......._....... .......... _...... _....__.._ _....... Operator Certification Number: . _ . _........._ ..
—0
Lmanon or rarm: Iq a
QJ&).Q� _..SL -- — .... ... _.. ._.L. -.__1 !7 � �,.....lastd_ ..... ... S.-R_._!d1_. —_ .... ... Q
.fir► n . :_Mg n. r mot:: _.. _...._ .. —.....
_...._ ..... .. _ --... _ ... — . W- .. .. _ ..
a
Latitude 0 4 K Longitude • 4 4.
Type of Operation and Design Capacity
� ':: ,� e ,- �-. 'r�' ;s �:. �s^=r,�.:" -�, _.
Des�gn Grrentw , x Design: Current UesiguCurrent�
r x gigc5 S' ..�a'.rvk' wnY9� 'v t
Sw�ue Poultry ,4--Ca aci Po iilat�on �# Caftie: Ca aci <nPo nlat,o;:
_Ca ace �,Po nlatfon m
. ❑Wean to Feeder La ❑ Dairy
eeder to Finish Z Q ❑Non La erx
❑ Non Da
Farrow to Weanw Farrow to Feeders" " TotalDe5tgtt CCl apaky a �z
.,s
Farrow to Finish ' K
��Tota! SSLW d
❑Other � �rs€�� �"`}� ,w,tF�� " a� � � ;ate nr X { ».�� a»•
Numbe af�Lagoons H !d g Ponds' ❑ Subsurface Drains Present
F
s z Lagoon Area Spray Fie reap
❑ !d A
G nei it
I. Are there any buffers that need maintenance/improvement? ❑ Yes (�No
2. Is any discharge observed from any part of the operation? ❑ Yes / *o
Discharge originated at: ❑ Lagoon [ISpray field ElOther /
a. If discharge is observe, was the conveyance man-made? ❑ Yes ❑ No
b- If discharge is obsen-ed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d_ Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
3, Is there evidence of past discharge from any part of the operation? ❑ Yes )qNo
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes No
5. Does any part of the waste management system (other than lagoons holding ponds) require ❑ Yes No
maintenance/improvement?
4/30197 Continued on back

Facility Number:..._ .....„ -- ..
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ((No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes ANo
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes O(No
�S_truct►tres (Lagoons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes ANo
Freeboard (ft): Structure Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
10. Is seepage observed from any of the structures? ❑ Yes JKNo
11, Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes No
12. Do any of the structures need maintenance/improvement? P(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 fiqNo
Waste Annlication
14.
Is there physical evidence of over application?
❑ Yes
ONo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
6 �_... �.. �
15.
Crop type ........ erwl. ---•.._....
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
KNo
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
ANo
18.
Does the receiving crop need improvement?
❑ Yes
A No
19.
Is there a Iack of available waste application equipment?
❑ Yes
PkNo
20.
Does facility require a follow-up visit by same agency?
❑ Yes
ANo
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
;E(No
For
Certified Facilities Qn v_
22.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
KNo
23.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
RjNo
24.
Does record keeping need improvement?
❑ Yes
V(No
Comments (refer to question:#) `Explain any YES answers aiid/ar any recommendations br any other comments:
Use drav�nngs _of facility to betterexplatn situations (use additional pages as necessary
- Iz. Lawyoe s kaue, beer, C'eLoar ked +-k� af-c- i r'JJ-gyp e'5j6bl;5L 4
0. dege�t�-'tUe Couer o►•. ipa,w�s 4rauv�a! i�goans. r
yod 5Ji4afe o--.eLrt ea ;a,%ce-.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: 1 -q
cc: Division of Water Quality, Obter Quality Section, Facftity Assessment Unit 4/30197

State of North Carolina
Department of Environment,
Health and Natural Resources 1 X"W'A 0
Fayetteville Regional Office
James B. Hunt, Jr., Governor � E H N R
Jonathan B. Howes, Secretary
DIVISION OF WATER QUALITY
July 25, 1996
Carroll's Foods, Inc.
116 James Street
Laurinburg, NC 28352
SUBJECT: Compliance Inspection
Swine Farms
Hoke, Scotland and Richmond Counties
Dear Sir:
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 N101
FAX [phone]
North Carolina 28301-5043 An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/10% post -consumer paper

Facility Number: S2 l 0-
Division of Environmental Management
Animal Feedlot Operations Site visitation Record
Date: 7- z - -1 �.
Time: 13 �S
ficnml forma
Farm Name: C L F 7 0 1Co County:
Owner Name: C o�v-* v (l 's F-6 od s T--jc.. Phone No: l 9i0.) z 7& — a7 z 7
On Site Representative: _ A -I LaN c. Integrator: CaVVo 11' SL rooct�s
Mailing Address: /87sg old l w,b�.-�••� �w
L 1 ,/� �,,.,,L,au•+...bK. NG Z'935Z �l b �/
Physical Address&=ation: , 4—,4 v -tc,k-e- 7T Bu . rn$T szNJ r f tfec YL e-d
144 - -fwr..r
cf �a•.atir� S QL. -0�Cs 4-__ L4A s�cn+y eta s<ro..d s�•r 5'uy��vo: �c� aervss
o..+,lo d�.+ V�c_1 4zeeccl s l--ct ct+ _Q.•Y— Kerr le--Q+. s.�•-d Fo�c k..p�
_ Latitude: 1 _ 1 Longitude:
L►w,d V-;race.e..d
Qperation Description: (based on design characteristics)
Type of Swine No. of Animals Type of Poultry No. of Animals Type of Cattle No. of AnimaLs
O Sow ❑ Layer O Dairy
O Nursery _ ❑ Non -Layer O Beef
Bleeder 8560 P; �I
OrherType of Livestock- Number of Animals_
Number of Lagoons: (include in the Drawings and Observations the fimeboard of each lagoon)
Facility a ti ' �
Lagoon
Is Iagoon(s) freeboard less than I.foot + 25 year 24 hour storm storage?: Yes ❑ No csrll�
Is seepage observed from the lagoon?: Yes 0 No 3
/11
Is emsicn Observed?:
Is any discharge observed?
❑ Man-made Q Not Man-made
Cover Crop
Does the facility need more acreage for spraying?:
Does the cover crop need improvement?:
( list the crops which need iisprovement)
Crop type: C.04sI t!!! 4 I-- -A 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 ❑ No CY'
Yes ❑ No CT'
Yes ❑ No aK
Yes ❑ No 3"'
Yes ❑ No ar'
Yes ❑ No a",
Yes ❑ No C�
Yes ❑ No L9�

Maintenance
Does the facility maintenance need improvement? Yes Q No
Is there evidence of past discharge from any part of the operation? Yes O No
Does record keeping need improvement? Yes ❑No
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes M/No
Explain any Yes answers:fa�P,c Ct
Signature:_ R:� R-�...�� _ --- _ Date: 7lo z/ 9 G
cc: Facility Assessment Unit Use Anadiments if Needed
DrawingS Qr Observations:
r nr•.:tr -"
- 'r. ar t�.
:.I�
�+f •ii .,r
1 44 •=
AOI — January 17,19%

Site Requires Immediate Attention:
Facility No. 83
No
- ro
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
� h DATE: 731_I `} , 1995
Time: 1 `- . 0 S
(,PLF)
Farm Name/Owner: C cxv- r-o ! I' s # 7 0 9& c a rk o ff s Food Z v c.
'Mailing Address: / 57 g 8 Ord I -a m be- -i.I llw!g Lau #-1-A b.4 = Nc z 8 3 5z
County:
-Integrator: Phone:
On Site Representative: _ Phone: _(9/©� z 7 fo �- Z� z7
Physical Address/Location: :54 / �33 lycz,,, ,� rukC.
Type of Operation: Swine Poultry Cattle
Design Capacity: g,soo � 4-fr4 Number of Animals on Site: F. 500
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 34 0 4�-7' 07 " Longitude:-2-7- ° 23 ' Z'7 •
Circle Yes or No
Does the Animal Waste Lagoon have sufficie
(approximately 1 Foot + 7 inches) (e or No
Was any seepage observed from the lagoon(s)?
Is adequate land available for spray? es r N
Crop(s) being utilized:s�
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? �or No
100 Feet from Wells?�r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o�
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes o�
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o� 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:_ eve <s� [aspo�lS oivc a �' wL..G6. 1`s use _W%_ wayl�.rx.�i.rr I
a
nt freeboard of I Foot + 25 year 24 hour storm event
Actual Freeboard: 3 Ft. o Inches
Yes o�1�Vas any erosion observed? Yes or®
Is the cover crop adequate? �or No
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.

101 00 100 00:00
021 P02
/1/, o S R,-,
DIVISION OF ENVIRONMENTAL MANACEMENT
November 4, 1994
SUBJECT: Compliance Inspection
SCojs County
Dear � +�1 ( 4 S
On , , an inspection of your animal operation was performed by the
Fayetteville Regional Office (PRO). Please find enclosed a copy of our
Compliance Inspection Report for your information. It is the opinion of this
office that this facility is in compliance with 15A NCAC 2x, 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 [phone].
Sincerely,
Enclosure
cc: Facility Compliance Group

rArr7
»u
�Vt _ �i'+'•ham
�-
tap
,
Iffy
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0.09
IS
104`-
�
p
I I Y UN � S
„ M leas
},� t
a ' 4 U
n LU
F
Scotland County' oLM
4.
This southern border county was ! ' ""a ;
estabished in 1899. Laurinburg is the
county seat of Scotland County, named �\ /
so for Scotland in the British Isles from
which many of the early settlers of the
region came.
. t1kV611,11 �, k V�v
/..Mtn
101

EARTH CAROLIPM DEPARTMMT OF ENVIROKKERT, HEALTH & MATUR LT. RESOURCES
Fayetteville Regional Office
Animal Operation Compliance Inspection Form
:..:.er.Yx+..»:ax..iait4• A4+F .- -..... .5?�C KY�0.YBAW KiK 'Ax:K'
-
.�
3 ^' ii f�i{L7 Ws..w.ww�>o-. ...,o.
4➢•e6i6 xawr.0��
A� �.
•"�Ox'�':�'�a.+dd rat .��
Ltd• ..�.
1' F
909
R..,e:�..~�a�
y -r w
�:wMN an.a.ow ; .nxnex•x.xw•
wM��.�a�L.�..+...�.� Nr.1wKw:'h�T.?.E.
.rt�C�.•...... 4�'x n nw.a...v �..�:,}.,.�:
Id w r mN -
- -- --- _
All questions answered negatively will be discussed in sufficient detail In
the Comments Section to enable the deemed Permittee to perform the appropriate
corrections:
SEMIGH I
An-iP;a-0P.0;za-tJ n T
Horses, cattle, Swine
�dZoi*- i'a
poultry, or sheep
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 RMLT RATION?
3_ Are animals confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a CERTIFIED ANTML
WAST8 MANAGMUMV P ?
5. 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?

lei 00 '00 00:00
� 1a
fit.
S=31CM III
C014MI.ri
z I x
LLQ10 Site lianaaement
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
CESM-MCM-M
S. 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 .caste management at this
farm adhere to Best Management Practices
(BMP) of the approved CWTIFI ATION?
7. Does animal waste lagoon have •sufficien - a�
freeboard? How much? (Approximately )
8. Is the general condition of this CAFO facility,
including management and operation,
satisfactory?
SECTION IV
Comments
O—k--r— or w1%"41L s