830014_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

Date of Visit: Arrival Arrival Time: �; Departure Time: County: � Region:"t7
Farm Name: / f7 I - , Gi � jSOh � _ Owner Email:
Owner Name: TV'—
V— r 6i is', Phone:
Mailing Address:
Physical Address:
Facility Contact: �Title: Phone:
Onsite Representative: Integrator:
v
Certified Operator: Certification Number: � %3
Back-up Operator: Certification Number:
Location of Farm: Latitude:
Longitude:
Swine
Design'
Capacity
Current
,Pap.
Wet Poultry
Design
Capacity
Current
Pap:.
3h!°i
Design Current
Cattle Opacity Pop.
Wean to Finish
11
Layer
Dai Caw
Wean to Feeder
I'Non-Layer
Dr Poult .
Layers ers
I
Design
Ca aci
Current
1?0 .
Calf
Dairy Heifer
t
Feeder to Finish
Zd
'50r-?
7
Farrow to Wean
Farrow to Feeder
D Cow
Non -Dairy
Beef Stocker
Farrow to Finish
Gilts
Boars
Ottrer
€°
p:N
Non -Layers ers
Beef Feeder
Pullets
Beef Brood Cow
-
Turkeys
Turkey Poults
Other
f—iOther
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 DWR)
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 DWR)
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
❑NE
❑ Yes ❑ No NA [] NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412015 Continued

lFacifity Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard S
(in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc_)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® No ❑ NA
❑ NE
waste management or closure plan?
l
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA 0 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 Q No ❑ NA ❑ NE
maintenance or improvement?
Waste Aaalication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
� No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Cv4 ,p14 �is'
13. Soil. Type(s): � K_f"1ek,41_<V11
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
y
❑ 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
[)d No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
1� No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �] N
El Waste Application ❑ Weekly Freeboard El Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield El120 Minute Inspections ❑ Monthly and I" Rainfall Inspecti s
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
o ❑NA []NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA []NE
Page 2 of 3 21412015 Continued

r
IFacili Number: Date of Ins eetion:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑Yes No ❑NA ❑NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑Yes
�No
❑NA
❑NE
❑Yes
�No
❑NA
❑NE
❑Yes
No
❑NA
❑NE
❑ Yes
No
❑ NA
❑ NE
Phone:
Date:
21412015

t ype or visit: ✓lam Compliance Inspection V operation Keview V Structure Evaluation V 'Technical Assistance
Reason for Visit: 00 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: ,g9r ] County; 4W2'.4 / legion:
Farm Name: e�1!'j�J�+Y/h Owner Email:
Owner Name: �� rr - 6y— h Phone:
Mailing Address:
Physical Address:
Facility Contact: �y r l >, h �4�i Title:
Onsite Representative:
Certified Operator: y
Back-up Operator:
Location of Farm: Latitude:
Phone:
Integrator: /4
Certification Number:
Certification Number:
Longitude:
Design Current
Design
Current
Design Current
Swine
Capacity Pop.
Wet Ponttry
Capacity
Pop.
Cattle Capacity Pap.
Wean to Finish
I
fLayer
Dairy Cow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
f""'
DairyHeifer
Farrow to Wean
Design
Current
Cow
Farrow to Feeder
D , P,oul
Ca aci
Po ,
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkex Poults
Other
Other
Discharges and Stream Imoacts
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 DWR)
❑ Yes P No ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes ❑ No
[ NA ❑ NE
NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No 77❑''NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

F ciliNumber: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes t® No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [:] No JUNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
fir
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes] No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes LM4j No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes OD 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 o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ® No ❑ NA ❑ NE
maintenance or improvement? C�
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes kNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Frvidence of Wio Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): �h54"i
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
IF 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
o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
Yes
No
[3 NA
[] NE
Reouired 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
No
❑ NA
❑ NE
the appropriate box.
❑WUP El Checklists ❑ Design []Maps [:]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E�j No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes] No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes] No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

1"cility Number: jDate of Inspection:
24, Did the facility fail to calibrate waste application equipment as required by the permit,
❑ Yes
J)o No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
a No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
® No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
� No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately,
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes N No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ILU No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes M No ❑ NA ❑ NE
Comments {refer to question #)•Explain any YES answers and/or any additional recommendations or any other comet' 'I" t
• T
e drawings of facility to -better exptain situations fuse additional pa�es'as::necessary). Usram_
4a Xa,4,4'J'�_
9/0--lezy—yoyr (6 ty)
Reviewer/inspector Name:
ReviewerAnspector Signature:
Page 3 of 3
❑ Yes [P No ❑ NA ❑ NE
❑ Yes EFzNo ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
j No
❑ NA
❑ NE
Phone:
Date: l�
21412011

0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
830015 Facility Status: Active
Permit: AWS830015
❑ Denied Access
Inpsection Type:
Compliance Inspection
inactive Or Closed Date:
Reason for visit:
Routine County:
Scotland Region:
Fayetteville
Date of visit:
03/11/2015 Entry Time: 07:30 am Exit Time: 8:00 am Incident #
Farm Name:
7177
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
16789 Old Lumberton Rd
Laurinburg NC 28352
Facility Status.
Compliant ❑ Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm:
Latitude:
34° 46' 14" Longitude:
79° 23' 23"
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, Star, & Treat
Waste Application
Records and Documents Other Issues
Wells
Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008
Secondary O1C(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone :
On -site representative Mike Cudd Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number: 830015
Inspection Date: 03/11/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated operations Design Capacity Current promotions
Swine
Swine - Farrow to Feeder 1.350
Total Design Capacity: 1,350
Total SSLW: 704,700
Waste Structures Observed
Disignated
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19,00 32.00
page: 2

Permit: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number: 830015
Inspection Date: 03/11/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges &_Stream Impacts
Yes
No No 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 DWO)
❑
❑ ■
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWO)
❑
❑ 0
❑
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 No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
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
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No No Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS830015 Owner -Facility: Murphy -Brown LLC Facility Number: 830015
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, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
McColl
Soil Type 2
Norfolk
Soil Type 3
Wayram
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
E ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
N ❑
❑
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?
❑
N ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes
No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
D 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

� - 4
Permit: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number: 830015
Inspection Date: 03/11/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 'I" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
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 Ne
28. Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
■ ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility?
❑
E ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWM P?
33. Did the Reviewertinspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

■ Division of Water Resources
❑
Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 830015 Facility Status: Active Permit: AWS830015
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Scotland Region:
Date of Visit: 03/19/2014 Entry Time: 08:00 am Exit Time: 8:30 am Incident#
Farm Name: 7177 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
❑ Denied Access
Fayetteville
910-296-1800
Physical Address: 18789 Old Lumberton Rd Laurinburg NC 28352
Facility Status: Compliant Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34° 46' 14" Longitude: 79° 23' 23"
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: 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:
Records reviewed 2128114
Site visit 3119114.
page: 1

Permit: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number: 830015
Inspection Date: 03/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
Swine - Farrow to Feeder
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type IdentiFer Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00
page: 2

Permit: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number: 830015
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?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
1:10
❑
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?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑0
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
M ❑
[]
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le.! large
❑
■ ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
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?
❑ ■ ❑ ❑
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: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number: 830015
Inspection Date: 03/19114 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
McColl
Soil Type 2
Norfolk
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
❑
❑
❑
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
❑
M ❑
❑
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 Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
■ ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
■ ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
ri
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number: 830015
Inspection Date: 03/19/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Crop yields?
❑
120 Minute inspections?
[]
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
MOD
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑0
❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
M ❑
❑
Other Issues
Yes No Na Ne
28. Did the facility fail to properly dispose of dead animats within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At.the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface Tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Fond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 830015 Facility Status: Active
Inpsection Type: Compliance Inspection
Permit: AWS830015
Inactive Or Closed Date:
Reason for Visit: Routine County: Scotland Region:
Date of Visit: 02/26/2013 Entry Time: 04:30 pm Exit Time: 5:00 pm Incident #
❑ Denied Access
Fayetteville
Farm Name: 7177 Owner Email:
Owner: Murphy -Brown LLC Phone: [phone]
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 18789 Old Lumberton Rd Laurinburg NC 28352
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34° 46' 14" Longitude: 79' 23' 23"
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:
Records reviewed 218113
Site visit 2126113
page: 1

Permit: AVVS830015 owner - Facility : Murphy -Brown LLC Facility Number: 830015
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
Swine - Farrow to Feeder 1,350
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00
page: 2

Permit: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number: 830015
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
M ❑'
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
Cr What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■ ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na He
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
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
C]
B. Do.any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Me
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
[]
Is PAN > 10%/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: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number:
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit:
830015
Routine
Waste Application
Yes
No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain
Dversead
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
McColl
Soil Type 2
Norfolk
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
❑
M ❑
❑
Management Plan(CAWMP)?
15, Does the receiving crop andlor 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?
❑
M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
O ❑
❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
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: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number: 830015
Inspection Date: 02/26/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
O ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
M ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26, Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27, Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No Na Ne
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
M ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWM P?
33. Did the ReviewerAnspector fail to discuss reviewlinspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

iype or visit: w L ompuance inspection v Lrperauon tceview v btructure r,vatuanon V iecnmcai Assistance
Reason for Visit: 4D Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Q Arrival Time: Q Departure Time: << County: SCeTL�WO Region: %CAV
Farm Name: t� /�SD✓1 Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: / ' 6 Title: Phone:
/► 4or'-p /"I - �
Onsite Representative: Integrator:
" S' Certified Operator: Certification Number: / 76s
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle C►specify Pop.
Dairy Cow
Wean to Feeder
I jNon-Layer
D . P,oul
Layers
I
Design
Ca aci
Current
P,o
Dairy Calf
Dairy Heifer
DIX Cow
Non -Dairy
Beef Stocker
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
O#her
- Other
Non -Layers
Pullets
Turkeys
Turke Poults
Other
Beef Feeder
L I Beef Brood Cow
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
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 DWR)
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
0�1 NA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
❑ Yes
[:]No
V?NA
❑ NE
❑ Yes
J�j No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
Page I of 3
21417014 Continued

Facili Number: jDate of Inspection: 3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Stru�_
Identifier:
Structure 2 Structure 3 Structure 4 Structure 5
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): h
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
No ❑ NA ❑ NE
❑ No �I NA ❑ NE
Structure 6
❑ Yes P No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Aaolication
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes No ❑ NA 0 NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[�[ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
[] NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
n No
❑ NA
❑ NE
Reauired 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
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
r No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[�j No
[] NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
EpNo
❑ NA ❑ NE
Page 2 of 3
21412014 Continued

Facili Number: -74 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes N No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[—]Yes
No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
[:]Yes
No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
[:]Yes
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
[e 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 [51 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
any ad' 'ons or. any other conxments:� + ,��•
Comments refer to question # Ex lain an AYES answers ditional,recommendatr �:.
Use drawings o�fac�bty to better explaan„situateons (use ad.andlor
ditional pages as necessary)
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ,;%323�
Date: 9 33 1 Jr
21412014

i ype or visit: W t ompuance inspection v vperauon Keview V nrructure r,vamarion V i ecnmcai Assistance
Reason for Visit: 41 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: 0 '3 uw, Departure Time: 0� County: 5�'07Z+^% Region: /ems
Farm Name: ��h Owner Email:
Owner Name: %�f �� r3Oh Phone:
Mailing Address:
Physical Address:
Facility Contact: �y �hsOh Title:
Onsite Representative: Q
N
Certified Operator:
Back-up Operator:
Phone:
Integrator: ,•(u,�,pls tr-�hOw�
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Current
Des -
Cnrrent�
-
Design Garrent
IIgcIVPow
Ct
Wet Poltry
Capacity
Ppgn
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Feeder to Finish
Farrow to Wean
432o 2aco
Non -La er
Dairy Calf
Dairy Heifer
Dry Cow
Farrow to Feeder
D . 1?oultr
Ca aci
Po
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
-
Turke s
Other
Turkey Poults
Other
Discharges and 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 �o NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No [ NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 l/4/2011 Continued

ti
Facility Number: - Date of Inspection: 5 6
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes � No NA NE [p
T" ❑
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): .26 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
[:]Yes " No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes F No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.r
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window �+❑ Evidence
of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): `- A� vhuL[A i} SSC�C�h J 1 ��•. �. �y}Q,(�¢�
❑ NE
r
13. Soil Type(s): C llwd,, Ket�.5y,Ae
T
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
`� No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
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
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
LP
❑ NA
❑ NE
❑ Waste Application [] Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

7
Facili Number: Z4 -14 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
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 [W No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31 _ Do subsurface file drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ Yes No
[-]Yes No
❑ Yes] No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question € ): Explain any YES answers and/or any additional recommendations orany,other commt!iiW 4
Use drawims of facility to better explain situations (use` additional pages as necessary). _ - �-
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 9�0-y3�37
Date: 6
21412011

iype of visir: wuompuance inspecuon v uperarmon rceview lV bn-ucrure Evamanon lJ iecnnucai Assrsrance I
Reason for Visit: 0 Routine Q Complaint O Follow-up O Referral O Emergency 0 Other O Denied Access
Date of Visit: 16��Z I Arrival Time: I p $:3 Departure Time: l0: County:TLlb.l�
Farm Name: 6; 65 pr — Owner Email:
Owner Name: -T'Cr . G i kt _ Phone:
Mailing Address:
Physical Address:
Region: P90
Facility Contact: i G— L S a n _ Title: Phone:
Onsite Representative: It Integrator: M "`fit.C7�✓.-S.L t
Certified Operator: r' Certification Number: r7,6
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design :' Current Design Current
Swine Capacity Pop: Wet Poultry C►apacity Pop. Cattle
Design Current
Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
-Layer
Dairy Calf
Dairy Heifer
u
Crreut Dry Cow
P,o P. Non -Dairy
Beef Stocker
Feeder to Finish
Farrow to Wean
Farrow to Feeder
20
-
Design
D , P,oultr. Ca aci
Layers
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
113eef Brood Cow
Boars
Other
Pullets
Turke s
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
[—]Yes [P No ❑ NA ❑ NE
a. Was the conveyance man-made?
❑ Yes
❑ No
1P NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
[
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
M NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
'JE] No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
M No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: - Date of Inspection: (o IZ
I IT
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
jR7M2 NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: �^
Spillway?:
Designed Freeboard (in):
�
T
Observed Freeboard (in): 3q
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
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
M 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)
rZ]
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
;] No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 tbs. ❑ Total Phosphorus [3 Failure to Incorporate Manure/Sludge into
Bare Soil
M Outside of Acceptable Crop Window F] Evidence of Wind Drift M Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
;g No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
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
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 V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [1 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EP No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Condmued

F'9cili umber: jDate of Inspection: Za i 2-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ;K No ❑ NA [] NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes is No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes IM No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[] Yes
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
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
VNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
CKNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
EjjNo
❑ NA
❑ NE
5 h aj' o /h tcL.1,a �io� 62? �s`o$ ►Mt �r vc^ �.�� �p pe'-50 -•
Was ho � (� /2 �- ^' r %� �a ►^- , ch e
l'm v-4tk
_ki
1101-k /4 r /�ie5S�9e wq 5 %� o•.
vr- u mu: ' r��r� p�-�sov�►�Q1 - 1as�— PS cam•-. tccf- r. s
�4wPkl i
C-?o
'rl2#1 7
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
WIN 05APP
I
Phone: '?b-i­J3�-33VD
Date: 25_IZ
2/4/2011

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: r County: 8C6T_1-AfJb Region: F74W
Farm Name_TG, G+ D SOn FBI m - _ Owner Email:
Owner Name: T Gj 6:; Sor) Phone:
Mailing Address:
Physical Address:
Facility Contact: j t �� 5-Del Title: Phone:
Onsite Representative: 11 Integrator: 1~,utrpT�t y—BrVtJh, L.
�
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Swine Cap ity Pog.
can to Finish
Design Current Design Current
Wet Poultry Cap Pop. Cattle C►apacity Pop.
Layer Dairy Cow
Wean to Feeder
I
IN22:La er
DairyCalf
Feeder to Finish
-" =' Dairy Heifer
De-`.
_*� gn=Cnrrent D Cow
D . $ouItEyVIRI acr P,.o Non -Dairy
Layers Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Pullets
113cef Feeder
Boars
113eef Brood Co —
Uther
Turkeys
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
[]Yes
[:]No
(� NA
❑ NE
❑ Yes [:]No NA [] NE
❑ Yes No [] NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412011 Continued

FAeili 'Number: - Date of Inspection: S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No WNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Q9 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes EP 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 ��t❑ Application Outside of Approved Area
12. Crop Type(s): COQga l "uda (��**aS Gg,,,) , �5m . wri;, DW/'%J
13. Soil Type(s): (S Aft r ae%30,
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
P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
g No
❑ NA
❑ NE
acres determination?
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
1P No
❑ NA
❑ NE
Reauired 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
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
Lo No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑Monthly and I" Rainfall Inspections
❑Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P) No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Eallo ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Fffeill "NUmber: 23- Date of Inspection: 23 1
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Ej No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes IR No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes � No ❑ NA 0 NE
❑ Yes Epo ❑ NA ❑ NE
❑ Yes Z No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
.Use drawings of facility to better explain. situations (use additional p gese as necessary) mendahons or any othercomments Reviewer/Inspector Name: �il�-� ar6 lc- Phone: l 1 o -q 33.3 3 CO
Reviewer/Inspector Signature: 'W L�+�l "� Date: Sj 23 t j
Page 3 of 3 21412011

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: 2 (10 1 Arrival Time: �t-1=-t-Y--tgt 11 Departure Time: Wl County: C �rl Region: t"i4O
Farm Name: T.G. r s0 Owner Email:
Owner Name: l . G • G SDn Phone:
Mailing Address:
Physical Address:
Facility Contact: 4 G- r _ G 5 oil, Title: Phone No:
Onsite Representative: I Integrator:
v' 1 /7&3�
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = e [7] ' = « Longitude: 0 ° = I 0 "
Design Current
Design
Current
Design Current
Swine
Capacity Population
Wet Poultry Capacity
Population
C►attle Cwapacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
❑Non -La er
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
ceder to Finish
6v
Farrow to Wean Dry Poultry
❑ Farrow to Feeder
❑ La ers
❑ Non -Dairy
❑ Farrow to Finish
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl
❑ Turke s
Other
❑ Turkey Poults
❑ Other
❑ Other
Number of Structures:
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
� No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
P NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No ;OYA
❑ 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
MNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
VhNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
t§No
❑ NA
❑ NE
other than from a discharge?
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
®No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No NA [INE
ructure
Struc ure 1 Structure 2 Structure 3 Structure 4
Structure
5 6 .
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
?No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No ❑ NA ❑ NE
P
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
PNo ElNA ElNE
(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
allo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
QEPNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn,
etc.)
❑ PAN ❑ PAN 7 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Windo ❑ Evidence of Wind Drift El Application Outside of
Area
12_ Crop type(s) B 0AUC r_4 . 1 , 5A4 i �(A nikrSald
13. Soil type(s) (N
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
N No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
PNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
M No
❑ NA
❑ 'NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
q4No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
PNo
❑ NA
❑ NE
n y
emdm$'nts (refer to question`#) Esplam iiny YES answers an any recomrpendattons"or an other comments
drawings: of facility #o Netter espla�n situatYons. (use a..ddittanal. pages as necessary)"
2.
G6J `Q,A Gied reds'
AL
.
Reviewer/Inspector Name Phone:
Renewer/Inspector Signature: Date:
v
12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 03No ❑ 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 ❑ Desig
n ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes M)No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No PYA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
ElNA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
)DNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
XNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�zNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
YrNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
II
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
To
❑ 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
ElNA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
r
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
PNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
Oo
❑ NA
❑ NE
{
Additional Comme6ts`aid/oDrsw�ngs , �r"•
a
12128104

f
-- (♦ Division of Water Quality '�
4Faaility Number Q Division of Soil and Water Conservation
- -- Q Other Agency
Type of Visit 4P Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine Q Complaint Q Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: �►[�9%Q9-1 Arrival Time: .® Departure Time: County: D Region:
WO
Farm Name: - .��C�'. SQ►'f Owner Email:
Owner Name: � • �� � ,SOh �sg3) z�s y911 Phone: _
Mailing Address:
Physical Address:
Facility Contact: T. 6. 6�oTitle:
Onsite Representative:
Certified Operator: A
Back-up Operator:
Location of Farm:
Phone No: Integrator: We / — 946&)n
Operator Certification Number: 17635
Back-up Certification Number:
Latitude: = o E__1 1 =" Longitude: F-1 ° = I =
Desigu Current .
Destgn*� Current
Design Current
Swine
Capacity Pop ation
Wet Poultry f
Capac1- Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑Dairy Cow
❑ Wean to Feeder
❑Non -La er
❑Dai Calf
Feeder to Finish
ZO
j �11
�*4
❑Dai Heifer
❑ Farrow to Weans
Dry Poultry
M
ElD Cow
❑ Farrow to Feeder
❑ Non -Daily
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Non-ers
❑ Beef Feeder
❑ Boars
❑Pullets
❑Beef Brood Co
l„
❑ Turkeys
Other
`
d
❑ Turkey Poults
❑ Other
❑ Other
r of Structures:
NumbeMINOR
11 _..._ .
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
M' No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
r7'3 NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
1B No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
n No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: —14 Date of Inspection `r
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
P No
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
[--]Yes
[]No
PNA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): C(
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
JC3 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
PNo
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate publie health or
environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
nNo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
E4No
❑ 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
5No
❑ NA
❑ NE
maintenance or improvement?
Waste Apolication
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 F No [I NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground El Heavy Metals (Cu, Zn, etc.) I
❑ PAN [:IPAN > l0% or ] 0 ]bs ❑ 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) 5rA
13. Soil type(s) QA e -
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 4No ❑ 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
�9 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
%No
❑ NA
❑ NE
+a�?''.e,*rii'
Contin r,�r-�to que�,on##,) E�tlarn�any� �nswers and!_orkany;ree�omroeodatrons or any other comme
;Use drawxngs,af facthty toybetter explain sttuat�ons {use.addtttonal pages as necessary)
Yy`
Reviewerllnspector Name T
Phone:
Reviewer/Inspector Signature:
Date: /
Page 2 of 3 12129104 Continued

w
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [ANo ❑ 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
i' 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?
[:1 Yes
r] No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
10 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 property dispose of dead animals within 24 hours and/or document
❑ Yes
E..No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
O-No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 I.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
V,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
[ANo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
19 No
❑ NA
ElNE
Additients andlor Drawings
Page 3 of 3 12128104

Division of Water Quality
Facility Number--�L� O Division of Soil and Water Conservation .
0 Other Agency- _ T
L
Visit 0Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of visit: 13 Arriva?l Time: Qn, Departure Time: County:` "ogan Region: p
Farm Name: t Iz—r SD t? �n _ Owner Email:
Owner Nvimre I i t Y 6SOY? Phnnr­
Mailing Address:
Physical Address:
Facility Contact: /if G. S� _Title:
t4
Onsite Representative:
tt
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
'.' ❑ Wean to Finish
❑ Wean to Feeder
FderFinish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Phone No:
Integrator: ^ tWR
Operator Certification Number: U �s
Back-up Certification Number:
Latitude: = o =1 = « Longitude: E� o = 4
Design Current
Wet Poultry Capa�Population
LJ Non -Layer J
Dry
.',,Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turke 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
apac>ry ropuiaatton
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non-Dai
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: . L
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes. notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑Yes WNo ❑NA ❑NE
❑ Yes
❑ No
WNA
❑ NE
❑ Yes
❑ No
V1NA
❑ NE
NA
❑ NE
❑ Yes
❑ No
❑ Yes
F No
❑ NA
❑ NE
❑Yes
ZYNo
El NA
❑NE
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
Q9 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No TNA ❑ NE
5t cture i Structure 2 Structure 3 Structure 4
Structure
5 acture 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 413 y
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ElNA ElNE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
® No El NA ❑ NE
through a waste management or closure plan?
I
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
Wo ❑ NA ❑ NE
8_ Do any of the stuctures lack adequate markers as required by the permit?
El Yes
� No El NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
;0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Apolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Q No ❑ NA ❑ NE
maintenance/improvement'?
1 l . Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
1)_� 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 Aeptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
G,-e6S — �M , &,I, awj�
12. Crop type(s) , r 1
13.
Soil type(s) r I CL;kd F1!*%a*,,eyA1 e
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
21 No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
n 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
nNo
❑ NA
❑ NE
Comments (refer to question #) Explain anv YEStanswers and/or any recom:mendatronsorany other' comments. `
Use drawings of facility to better explain situattons.: (use additional pages as necessary)
T
Reviewer/Inspector Name r
7771 Phone: v0) Y, UCJ
Reviewer/Inspector Signature:
Date: 0 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 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWM P readily available? If yes, check ❑ Yes 19 No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No []NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22, Did the facility fail to install and maintain a rain gauge? ❑ Yes [P No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P No ❑ NA ❑ NE
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
1�4No
❑ 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
2T Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
M No
❑ NA
❑ NE
Other issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
J�j No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[B 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
fallo
❑ NA
❑ NE
6encral Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
r No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
01 No
❑ NA
❑ NE
Page 3 of 3 12128104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time&M Departure Time: 0 - . 0 County: 50011Qhd Region:
3 iS r
Farm Name: �'G. G ain cm _ Owner Email:
Owner Name: -A onn S 64b5or+ Phone:
Mailing Address:
Physical Address:
Facility Contact: 1 hpr-,as 6' Title: pPhone No:
Onsite Representative: u Integrator: Prcm, tom S-bl'
Certified Operator: N Operator Certification Number: 1 7C35-
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 n 0 I= u Longitude: 0 0 0 l 0"
jr0es.iln
Current
Design Current
Design Current
Swine
city Population
Wet Poultry C►apacity, ..opuiation
Cattle Capacity Population
❑ an to Finish
10 Layer
❑ Dairy Cow
❑ an to Feeder
110 Non -La er I
Dairy Calf
Feeder to Finishr
❑ Dairy Heifer
Farrow to Wean
T
Dty Poultry,
❑ D Cow
❑ Farrow to Feeder
ElNon-Dairy
El Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
— —
Other
❑ Turkey Poul[s
❑ Other
❑ Other
Number of Structures:
,tire •=
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
U.No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[9NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
CANA
❑ 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
tANA
❑ 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
ONo
❑ NA
❑ NE
other than from a discharge'?
Page I of 3
12128104
Continued

Facility Number: — Date of Inspection 3 O
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 'Er"' No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [--]Yes ❑ No !Q NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): i t
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes W 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 F�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 environment I t reat, notify DWQ
7. Do any of the structures need maintenance or improvement? 10 Yes o ❑ 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 K No ❑ NA ❑ NE
maintenance or improvement?
Waste Apolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes P4 No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes )N 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 ❑ Application Outside of Area
12. Crop type(s)
q
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �INo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement'? ❑ Yes IT.No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ yes K 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 E,No ❑ NA ❑ NE
❑ Yes §�No ❑ NA ❑ NE
.Comments (refer to question #): Explain any YES answers and/or any recommendations or any Other commentsbu;
Use drawings`'af facility to better explain situations.,,(use additional pages as necessary}c ' xl;t
:sue
ri, w &fi�_ OK Nrt Pn-w S 0 n 40f 0 La bI1
Reviewer/inspector Name �— v Phone: /6 3
Reviewer/Inspector Signature: Date:
Page 2 of 3 112128104 Continued

Facility Number: — Date of Inspection 3
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Q9 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes I;sNo ❑ NA ❑ NE
the appropriate box. ❑ WTJp ❑ Checklists ❑ Desig
n El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes )gNo ❑ 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
P No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
E�No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
EP No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ERNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
[a No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[�-No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to property 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
M No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
M No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[11No
❑ NA
❑ NE
Additional Comments�andlor Drawings: t
w
Page 3 of 3 12128104

Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine Q Complaint O Follow up O Referral Q Emergency O Other ❑ Denied Access
Date of Visit: 7 ZO -O �P Arrival Time: Departure Time: County: Co a.v Region:
Farm Name: / • G, G i IU70 J Owner Email:
Owner Name: G is "b r'5 1 Phone:
Mailing Address:
Physical Address:
Facility Contact: I Title: Phone No:
Onsite Representative: 7 _ �_.___ �1'A;9,2iv Integrator:
Certified Operator -
Back -up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o [=
= 4f Longitude: = o = I = u
Design Current Design Current Design Current
Swine :apacity Population Wet Poultry Capacity Population Cattle Oapacity Population
❑ an to Finish airy Cow
❑ an to Feeder ❑Non -La er ❑ Dairy Calf
Feeder to Finish 2 fl �� ❑ Dairy Heifer
❑ Farrow to Wean x: El Dry Cow
aDry Poultry �' . -�
El Farrow to Feeder ❑ Non -Dairy
❑ Farrow to Finish ❑ Layers
�� � ❑ Beef Stocker
❑ Gilts ❑ Non -Layers ❑ Beef Feeder
❑ Boars �] Puilets
❑Beef Brood Cowl
a, - ❑ Turkeys
Other y ❑Turkey Poults
❑ Other ❑Other Number of Structures:
Discharges & Stream Imoacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[A.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
E4 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
F No
❑ NA
❑ NE
2_ Is there evidence of a past discharge from any part of the operation?
❑ Yes
[?lNo
❑ 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— /* Date of Inspection 7-z --O(o
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
M No
❑ NA
❑ NE
a, if yes, is waste level into the structural freeboard?
❑ Yes
No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Y
Designed Freeboard (in):
Observed Freeboard (in):
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
{1 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 0 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [U No ❑ NA ❑ NE
maintenancelimprovement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes SM 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 ❑ Appplication Outside of Area
12. Crop type(s) &.1AVu dlc. 1! /i,, SKf411 C iwiy 1 D VurSee-
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
M No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
[A No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
(9 No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
QfNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
(A No
❑ NA
❑ NE
'Comments.(refer to question ft' Explain any YES answers and/or any;recommendations or any other comments
:,Use drawings of facility t6better explain situations. (use additional pages as necessary): r r
Ak
T
Reviewer/Inspector Name i s phone:
q/ 3.300
Reviewer/Inspector Signature: Date:
7 - 2.O - Z OD6_
Page 2 of 3 12128104 Continued

Facility Number: _j —/� Date of Inspection 7-Z -
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ y­UP ❑ Checklists ❑ Design ❑ Maps ❑ Other
❑ Yes
71 No
❑ NA
❑ NE
❑ Yes
Q9 No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
11 No
❑ NA
❑ NE
❑ Yes
7 No
❑ NA
❑ NE
❑ Yes
V] No
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
El Yes
®No
El NA
El NE
❑ Yes
[$ No
❑ NA
❑ NE
❑ Yes V No ❑ NA ❑ NE
❑ Yes ;9 No ❑ NA ❑ NE
❑ Yes [% No ❑ NA ❑ NE
❑ Yes A No ❑ NA ❑ NE
❑ Yes
10 No
❑ NA
❑ NE
❑ Yes
10 No
❑ NA
❑ NE
Additional Comments and/or Drawings:,
T
Page 3 of 3 12128104

Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facilirc Number
Date of Visit: .3 ( Time:
�- - - - Nat O erational Belnw• Threshold
® Permitted ® Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm !dame: f (;r, gory, County: -_ rf l a.'d _ Fk�___
Ow•nerName: l G, Phone No; _CL:�L3) ato.s •-4i -7'/
Mailing Address: to d •
J
Facility Contact: t • �S r Pri 4n S Uri _Title: Phone No:
Onsite Representative. , G ,,, �� C oo, Integrator:
Certified Operator: _ T. c, x, k S o-n - Operator Certification Number: l y G 3 5-
Location of Farm:
® Swine ❑Poultry ❑Cattle ❑Horse Latitude Longitude �' �•
Design Current
Swine Canarity Pnnnlafinn
❑ Wean to Feeder
® Feeder to Finish
43 • p
3
❑ Farrow to Wean
❑ Farrou to Feeder
❑ Farrow- to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Laver FER
Da'
❑ Non -Laver Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 0 ❑ No Liquid Waste Management System _
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge orieinated at: ❑ Lagoon ❑ Sprav Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is obsen-ed, did it reach Water of the State? (If yes, notify D WQ)
c. If discharge is observed, what is the estimated flow in eaUmin?
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 anv adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Qo1lection S Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inchesl: 1 4
❑ Yes UNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
(4 No
❑ Yes
® No
❑ Yes
Q No
Structure 6
05/03101 Continued

Facility Number: ff3 — 14 Date of inspection L O
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes EINo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes W 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 QitNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
qNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
CO No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
[P No
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12. Crop type _ Q e rm u d c... -iz C-cc& c A S ,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
[A No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
J�j No
16. is there a lack of adequate waste application equipment?
❑ Yes
EDNo
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
UQ No
19.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ VAT, checklists, design, maps, etc.)
❑ Yes
P No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
W 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
[$3 No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
® No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
J] No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
�5 No
25.
Were any additional problems noted which cause noncompliance of the Certified A WMP?
❑ Yes
P No
[� No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments'{refer h3geestioe3� Explam�any YES answers.-and%or any recommeudahonsorYany-other comments.
Use dwings of�fac�ity to better explatn stfuahons (use addtaanal pages as o e`�ss� ry}�` ❑Field Copy ❑Final Notes
1 &-"\ f L Ca. (P , d 0 C-> A 1.-4 (VO 0 c ,
Reviewer/Inspector Name
Reviewer/Inspector Signature: i` Date:
O510310.1 l Continued

Facility Number: g.3 - Date of Inspection 3�
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid 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?
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes Q No
❑ Yes No
❑ Yes ® No
❑ Yes ❑ No
05103101

3
Type of Visit O'Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit &Routine O Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number 3 f Date of Visit: Q. Time: Qa
-- • ...� Tot O erational �elou• Threshold
O Permifted ©Certified © Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: _ G C`Y- k' ne," County: _ S C.=-�C "e� _tea
Owner Name: _ =-Cyr . &'*h Phone No: _��7 � � — ��t �—
Mailing Address: „p 6,�3 ox I C �S Z.d3
Facility Contact: 1 G • Crt bin Title:
Onsite Representative: - G a ]h S J r,
Certified Operator: !Co.,
Location of Farm:
Phone No:
Integrator: Pre A �..,.�
Operator Certification Number: ^1 *&3 ,S
IC7 Swine [IPoultry 7-1Cattle❑Horse Latitude �' �' �� Longitude ��� �• ��
Design Current Design Current Design Current
Swine Ca acity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder I I I ❑ Laver ❑ Dairy
© Feeder to Finish ❑ Non -Laver ❑Non-Dain°
❑ Farrow to Wean
❑ Farro-w to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
10 goan Total SSLW
Number of Lagoons I J LU Subsurface Drains Present jLj lagoon area 1LJ_Sprnv Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System I
Discharges 8 Stream Impacts
1. Is anv discharge observed from any part of the operation?
Discharge ori_inated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man -mane?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d- Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there an}' adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure
Identifier:
Freeboard (inches)_ 3 a
❑ Yes 82 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
®,No
❑ Yes
5jNo
❑ Yes
Z) No
Structure 6
05103101
Continued

Facility Number: $3 — t Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed?�(ie/ trees, severe erosion, ❑ Yes q No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes [ INo
(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 [ANo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes PrNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste AiDBlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes WNo
12. Crop hype 11 es--"' -I- V%
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes EP 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?
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? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes Q No
❑ Yes [ 3 No
❑ Yes 5No
❑ Yes [�i No
❑ Yes [:J!No
❑ Yes W No
❑ Yes [PNo
❑ Yes [KNo
❑ Yes ® No
24. Does facility require a follow-up visit by same agency? ❑ Yes (2 No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes [!!No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
v3iv3ivl c ontmuea

Facility Number:qa - 1+ Date of Inspection (d 3
Odor ]s" sues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor below
liquid level of lagoon or storage pond with no agitation?
2T Are there any dead animals not disposed of properly within 24 hours?
28. Is there an.- 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?
10. XN ere any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts. missing or
or broken fan blade(s). inoperable shutters. etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover?
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes CYNo
05103101

Facility Number Date of Visit: O ime:
rO Not Operational 0 Below Threshold
Permitted 0 C`er�ti'feed1 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
I
Farm Name: 4 , _ O� b SI�Y� County: SC
Owner Name: 7= V, Phone No:
Mailing Address:
Facility Contact: Title: hone No:
r
Onsite Representative:r Integrator:
Certified Operator: Zhawl 0 S_ [� Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a ° 0" Longitude Oa 6
Design��`tCu' Tent
Design Ctirent �� _ I Design Curreut
r
Swine Ca act1Pa Mahon
TE
Cattle Ca acity P,o ulaeo0n
Poultry Ca Be]tV Po ' uhttion
Wean to Feeder
❑ Layer
❑ Dai
eeder to Finish
❑ Non -Laver- ❑ Non -Dairy I
F
Farrow to Wean
- ="
❑ Other s=
❑ Farrow to Feeder
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
T. ,
_
❑ Boars
Total SSL,V1'
Number 01IL"gonsj
urface Drains Present 10 Lagoon Area 10 Spray Field Area
Holdittg Ponds / Solid Traps
❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
C. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Freeboard (inches):
Structure 5
❑ Yes kINO
❑ Yes o
ElYes tNo
❑ Yes o
ElYes o
El Yes o
❑ Yes ® No
Structure 6 .1
05103101 1Continued

Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
4
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
,,.�
closure plan?
❑ Yes
1� 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
o
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
AKfNo
1 l . Is there evidence of o r application? Excessive onding ❑ PAN ❑ Hydraulic Overload
5
❑ Yes
WNo
12. Crop type S B �e'-
13. Do the receiving crops differ with those designated i Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
KNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
[9!N0
b) Does the facility need a wettable acre determination?
❑ Yes
*0
c) This facility is pended for a wettable acre determination?
❑ Yes
KNo
15. Does the receiving crop need improvement?
❑ Yes
16. Is there a lack of adequate waste application equipment?
❑ Yes
'gNo
KNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
4 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
o
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
Cl Yes
o
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ YesfNo
o
21. Did the facility fail to have a actively certified operator in charge?
El Yes
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
(ie/ discharge, freeboard problems, over application)
o
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
ElYeso
T
24. Does facility require a follow-up visit by same agency?
❑ Yes
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to quesdan #): ExplaincroC`m
nyaYtoEnSs,�a(unsswe eards�da.in#tido/noarlapnayg
ecommendations or ativotField
nuFinal
o' pmyeN'.
A.
ersuau
otesUse,rwgs oacll 'tobetter ex situ1.
_
�►� rltllD ooG Well
M
Reviewer/Inspector Name "'
444
Reviewer/Inspector Signature: Date:
05103101 1 Continued

Facility Number: f 3— Date of Inspection 1 6
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?
❑ Yes ❑ No
❑ Yes
No
ElYes
No
&
❑ Yes
�No
Yes
VNoYes
❑ Yes
❑ No
05103101

Facility Number Date of Visit: Z't'D`� Tune: .'�
Q Not Operational Q Below Threshold
#Permitted 0 Certified 0 Conditionally Certified 13 Registered Date Last Operated or A ve Threshold:
Farm Name: :. .�..�. Qh .....�..117............................... County: ...�G °�L
OwnerName:........I :.......................... ....... L:r. c., .F. ..................... Phone No: ......W. .......... ...._ .
Facility Contact: .. Title: Phone No:
Mailing Address:
Onsite Representative:.............. .......... Integrator: &fWW+cCl�+Y-,��r.��_
Certified Operator:,,,,,,! Xd7_Ls.Qj . .......... ..... . Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ° « Longitude 0 6
=-Design Current''' Design..Current Dena
- Ca ci Po elation- .-poultry.-.-,-.,Ca i; : Po elation Cattle Capa
Wean to Feeder
INFeederto Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
El Gilts
❑ Boars
[] Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
Other
Total, Design Capacity
Total SSLW
Nuiinber=of i.agiioas Subsurface Drains Present Lagoon Area . ❑ Spray Fidd Area
`h
Holdetg Ponds /Soled Trapsx: : , No Liquid Waste Management System r x = f
;. w_ .
Dischar es & 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 VNo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes KN0
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 o
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes XNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ........................................................................... ...................................................................................................................................._......
Freeboard (inches):
5100 Continued on brisk

_-
Facility Number: 93 — J � I Date of Inspection UZ-6 -e-,>
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
KNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
tdNo
(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
gNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
O
/
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
O'No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
910
11. Is there evidence of ver application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
gNID
12. Crop d7/G'/fC�d
type r4 c it
13. Do the receiving crops differ with those designated/in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
9No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
KNo
b) Does the facility need a wettable acre determination?
❑ Yes
#No
c) This facility is pended for a wettable acre determination?
❑ Yes
KNo
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 readily available?
❑ Yes
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Iallo
(ie/ WUP, checklists, design, maps, etc.)
Yes
[0'No
%`
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
KNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
ONo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
JXNo
22. Nail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
o
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
to
0140
Yi iV :e�' d fci .. H ri re pQfe�i d#rrt0g this:Visit: Yop wi1.1 xee iye 06 futt6gr : .
coriesi) rideike' abacit this visit - .. - .. - : -. -. -.: • ..:.:::.: . :.:.. • . • ... • ..::.::. • : - . • . • .
/ `' I
��ef_ Q-n f���K� ao��este�!•
r4.,,ft /qvls
Reviewer/Inspector Name A- - -�• .
Reviewer/Inspector signature: Date:

t
Facility Number: — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes ❑ No
liquid level of lagoon or storage pond with no agitation? f
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 A No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the Iiquid surface of the lagoon? ❑ Yes KNO
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes �No .
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes IGo
32. Do the flush tanks lack a submerged fill pipe or a permanenthemporary cover? ❑ Yes ❑ No
5100

Facility Number Hate of Visit: Time: `3fi Printed on: 7/21/2000
Q Not Operational 0 Below Threshold
Opermitted © Certified © Conditionally Certified Q Registered Date Last Operated or Ab9 ve Threshold•
Farm Name: r..%.. :....................
fir.. ,G3 re.. County. ��4 �..
OwnerName.....1....'........................... ...... ....!.Sd}.......................................... Phone No:O-�..2.....1..........
Facility Contact: ........4'9..1. ../��e.!~......./........................ritle:............................................I................... Phone No: �J
l4lathn Address I 1.� l..�t........ ...- ..... .......FJS4t-f ...................................................:..��a-7.3.......
g
tv�
Onsite Representative:...........C�Lc1.,('t../.............................. Integrator: --.----..... Q (,V4.--,'I ..-. ..... ...............................................
� Certified Operator ...... 721.p,M.0 5.... Ca,//77
-.... ..(,1.S.pr............................... Operator Certification Number.......................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �° C�:: Longitude �• �° �«
Design Current
Swine Canacity Ponulation
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer 117 Non -Dairy
❑ Other
Total Design Capacity Z�7
Total SSLW
Number of Lagoons I j ❑ Subsurface Drains Present JJEI Lag-nn Area JE1 Spray Field Area
Holding Ponds / Solid Traps I I ❑ No Liquid Waste Management System
Discharges 8: Stream Impacts
I. 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 o
h. If discharge is observed. did it reach Water of the State? (Il'yes, notify DWQ) ❑Yes �INo
c. II dischai-Le is observed. what is the estimated Ilow in gal/mint?
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 stontt storage) less than adequate'? ❑ Spillway ❑ Yes X2(N0
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......... ................................ .................................... .......... .......................... ....................................
Freeboard (inches):
5100 # Continued on back

Facility Number: rz—'Z47Date
of inspection Printed on: 10/26/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
�KNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑Yes
9No
(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
[XNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
KNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings'?
❑ Yes
, v[�No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
9No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
E�No
12. Crop type 4jo 5X1,
13. Do the receiving crops differ with those designate n the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
ANo
14. a) Does the facility lack adequate acreage for land -application?
❑ Yes
o
b) Does the facility need a wettable acre determination?
❑ Yes
JNo
c) This facility is pended for a wettable acre determination?
❑ Yes
RINo
, `Wlo
15. Does the receiving crop need improvement?
El Yes
16. Is there a Iack of adequate waste application equipment?
❑ Yes
o
�t
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?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
RCNo
19. Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
KNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
O(No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
�dNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes XNo
23, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes XNo
24. Does facility require a follow-up visit by same agency? ❑ Yes UM
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 11No
Rio viola idiis:ordifeidj2sv►&b%noted.dtWingthis:visit:-Yoi)will-.eceiyeiiofucthge
.•:•corresuottid(e�rce:a�otit:this visit:�:-:-:�:-:-:-:�:.:.:.:.:.:.:.:.:•:•:•:-:-:-:•:•:•:�:�:�:-:-:-:�:•:-:•:-;

i�
Facility Number: S5 — Date of inspection Z-zge-VPrinted on: 10/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atfor 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
29. 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 o
30. Were an major maintenance problems with the ventilation fans noted? (i.e. broken fan belts, missing or 7
Y ] P () g
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes �No
`-`
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes \�__
32. Do the flush tanks lack a submerged fill pipe or a permanenUtemporary cover? ❑ Yes ❑ No
lAddifiona]'Commentsan or: rawin k s
5100

O Division of Soot and Water Conservation . Operation Rgview
s Q Division of Sal and Water^Conservation' 'Compliance-inspechon •� G
Division of Water Quality `Compliance -Inspection y �` a
,y 0 Other Agency , _Operation -,Review _
JQ Routine 0 Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm)
Permitted 9 Certified 0 Conditionally Certified ©Regis#eyed 0 Not Operational I Date Last Operated:
Farm Name: ......................
.y..-'�.......`..._....1.. ...... ( � 1:�-k�?�j....................................................... County:...................
.U.
Owner Name.
1�. �.�?.rr........... + �.. s�X� ............................. .. Phone No:..... l�� ?...-.....................
Facility Contact: ................�_.'.-.L'? �Q....Lz.r�..Y.... .......... Title:..........................
Mailing Address: .......... e..O..!.....D..y,........... A.5.................................................
Onsite Representative: ..........r.,,�,• .} 6�- .,
Certified Operator: �J
Location of Farm:
--....I ............................. Phone No:.....----..._.................... . ................
. }....,NC ..................... ae 3
Operator Certification Number: `
.........................................
r
...........................................................................................................................................•----..............................._..............__......................................................._..............._.. T
Latitude �•�`�•: Longitude �•�4 �
,Y _ Design Current _ Design Current, Design Current
Swine Ga acity Po elation '_Poultry Capactty:_Population . °Cattle Ca achy Population
==
-
❑Wean to Feeder
; ❑ Layer ❑ Dairy _
❑ Nan -Layer ❑Non -Dairy
-- ❑ Other -
S Total De_stgn Capacrity �3a
-n TotaI:SSLW
IN Feeder to Finish
Q
❑Farrow to Wean
❑Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑Boars
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 4NO
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the convevance man-made'?
h. If discharge is observed, did it reach Water of the State? (If yes, notify DNVQ)
c. If discharge is observed. what is the -estimated now in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure ? Structure 3 Structure 4 Structure 5
Identifier: �f
Freeboard (inches):p I ............
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3123/99
❑ Yes ONO
❑ Yes gNo
A/ A_
❑ Yes gNO
❑ Yes krNo
❑ Yes ^KNo
❑ Yes ro
Structure 6
❑ Yes X
No
Continued on back

Facility Number: $3 — Date of Inspection
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?
4. 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,? r ❑ Excessive Ponding ❑ PAN
12. Crop type
�71
❑ Yes ANO
KYes ❑ No
❑ Yes X No
XYes ❑ No
❑ Yes 0 No
❑ Yes YNo
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes
14. a) Does the facility lack adequate acreage for land application? ❑ Yes
b) Does the facility need a wettable acre determination? _� �°�'J" '+r"�. �U O(Yes
c) This facility is pended for a wettable acre determination? �`l • QI'r ❑ Yes
15. Does the receiving crop need improvement? -� �/' rev 1n ❑Yes
16. Is there a lack of adequate waste application equipment? _-;,xm-e W4 Q/'"«S ElYes
f
Required Records & Documents J AL%'
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
IT Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & le re o
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?
�o yiblaEigiis or• deficiencies •Were noted• during 4his:visit. Yoii, Wit-•i-e�eiye lid futt��r'
corre�orideike: about: this visit_ - : - : -
9.
CDC qj
�. Ides + ► eT off; j' L ,moo I ! + c� �s� , 09W
rws," 15 T4 4
1" -4
Jn1a . w 1�tit
Qjf No
No
❑ No
❑ No
❑ No
XNo
Yes (]No
[Yes ❑ No
Yes ❑ No
EJ Yes Po
❑ Yes ;91 No
❑ Yes KNo
❑ Yes KNo
❑ Yes [XNo
❑ Yes VNo
Reviewer/luspector Name " �:�` ,- r _, L i
Reviewer/Inspector Signature: %��,/1,,r, Date: 07$0
3/23/44

,1 s
b Division of Soil and Water Conservation ❑ Other Agency �d
5
Division of Water Quality
Routine O Complaint V Follow-up of DIVQ inspection O Follow-up of DSWC review O Other
Date of Inspection -Z7-
Facility Number
Time of Inspection ® 24 hr. (hh:mm)
[3 Registered Certified 13 Applied for Permit Permitted Q Not Q crational Date Last Operated
-1.-Q J.
Farm Name:......1...�_..L�...........��.c..��.��'�-...��lr........................... County: ...........
� G
Owner Name:......,........................T 4:......................Phone No:.........7�......................
r.
Facility Contact: ' ..t........................................................ Title: T .fir ........................ Phone No: ........ - 5�.V ......... ..........
P6Mailing Address: . D .........
Onsite Representatiye:- ��S4. �'�-- Integrator:....., L�. ..----
r.------...... `� .........I ............. 'v✓�
+�
Certified Operator_77, ev.'.94 .... ....,��-,ck-451--1- ....................... Operator Certification Number,.........................................
Location of Farm:
Latitude 0• 0' " Longitude • ' "
e".
.Current ;
rrme, r. Capacity Population' hPoultry *e
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
0
'o
...Current �,����� �` Des�gu- �� Current ,•
��Popttlateott-�Cattle�^�� Capactty�Poptela'tton���
M ❑ Dairy
,I0 Non -Layer 1
❑ Non-Dairy
�z-
.
❑Other
TOta DPSIgII Clty
32o
'Total
k
SSLW
General
1. 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 ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25197
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
No
❑ Yes
No
❑ Yes
�NO
❑ Yes
kNo
❑ Yes
KNo
Continued
on back

Facility Number: —�
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures OLagoons.11oldinp Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure ? Structure 3 Structure 4
Cl Yes XJN
o
❑ Yes ® No
Structure 5 Structure 6
Identifier:
------
`......................... ....................... ....................................... ....................................................... ............... ........
.....-..........-....
Freeboard(ft):.......................................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes KNI
l L Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes K No
12. Do any of the structures need maintenance/improvement? ❑ Yes Q 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 No
Waste Application
14. Is there physical evidence of over application? ❑ Yes pq i 0
(If in excess of WMP, or runoff enteri g waters of the State. notify D Q)
15. Crop type .....J (.!lriA�Ql0. .. ... r.�/`�
16. Do the receiving crops differ with hose designated in the Animal Waste Management Plan (AWMP)? ❑ Yes No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes No
18. Does the receiving crop need improvement? ❑ Yes No
19. Is there a lack of available waste application equipment? ❑ Yes A No
20. Does facility require a follow-up visit by same agency? ❑ Yes *No
21- Did Reviewer/inspector fail to discuss review/inspection with on -site representative'? ❑ Yes k\To
22. Does record keeping need improvement? ❑ Yes No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste :Management Plan readily available? ❑ Yes P(Na
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 0 lo
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes PNo
No. violations.or deficiencies.were. noted -during this visit..You.will receive no further
correspondence about this. visit.'
Comments,(refer�ta question #).- Explain any,VES answers andlor a'nv recom-mendattons gr any other commeiits.��" � y
N
Use;drawrngs of fac�hEy to.better explati sttuahons {use.additional pages as necessan)
/Ueeal d,o JOA rqe JPverseeJ aJA4 4 �b-� , C�-.S:iji- c•, ni�-� Sri e�
+� j hQ Ct 1 - CO, OW— ins
Doh K� �S � �. ns [.�C h � � ]� � D v � r B.._. � -L. �`
P �
rarm IDoks jood *- t)eI1 ma;KA;,LJ,
7125/97
Reviewer/inspector Name `.
Reviewer/Inspector Signature:
Date:

12 Routine O Complaint O Follow-up of DW Ins ectiou O Follow-up of DSWC review Q Other
Facility Number f FDate of Inspection -3 -97
Time of inspection, e ! ! UO Use 24 hr. time
Farm Status: Total Time (in hours) Spent onReview
or Inspection (includes travel and processing)
Farm Name: 1- C--7 " 0�,6s o r1 L ; Ue5 +oc-k County: SC af(4 VX4
Owner Name:....._,.:.nC-� . � � �O 5 ° ''- f Pbone No; 71
Mailing Address- Y' 66?� ,�,�o ; p Sa C- _ Z. 13 `-} ...,.,............
Oasite Representative: G - a • 6 San! / o r; a �. S7e i fi r; D 4W da d Ft r-Ats4 I w—.
C-�73
Certified Operator..... - a_: 105 ° " Operator Certification Number. 5--
Location of Farm:
Latitude �•�'r-��" Longitude Q• �' Q�'
[3 Not Operational Date Last Operated:
Type of Operation and Design Capacity
`�Q at e 7s a Ru r saY' iftie
Swtaexs�Nnmber�� Ponitry Number Cate�Tuniber
h
Wean to Feeder: ❑
Feeder to Finish , ❑ Non- L Beef
�Y
Farrow to Wean �" `"+� p F '
'` ,w� '.� 'v' G ' 4 „P�'�icei MI."yy Rc*#.6'#�Y[ S&" 9✓>' '" 4il,o:`°tt
1'aTroW to Feeder - f �• � .� � - r _ � � "fir �
Farrow to Finish z� g❑ Other Type of livestock gf
^� "� 3�sp"�sa..yAr..
..r .,,sv ��..~�. ..x�.z' --�. l-- '•� yam'.-r ..1...s *S`r.w: - ,- ,k�` 5.
"" _Number of Lagaoas'! Holding Ponds Subsurface Drains Present rr
❑Lagoon AreaI Spray Field Area
�.
General
1. Are them any buffers that need maintenanmlimpTovement?
2. is any discharge observed from any part of the operation?
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it Teach Su f= Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gaUmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Was there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/bolding ponds) require
mainteaaacefm4nvvement?
❑ Yes
PtNo
❑ Yes
; No
❑ Yes
❑ No
❑ Yes
[I No
❑ Yes ❑ No
❑ Yes RNo
❑ Yes ' No
r
I] Yes No
Confinued on back

6. Is facility not in compliance with any applicable setback criteria? r] Yes
'o - •
7. Did the facility fad to have a certified operator in responsible charge Cif inspection after I/l/97)? ❑ Yes ]$,No
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes 10 No
Structures (Lagans and/or Holding Ponds
9. Is structural freeboard less than add?
❑ Yes
Iallo
- - Freeboard (ft):— -_ Lague 1 Lagoon 2 Lagoon 3
' _Lagoon 4
� �7,.�—
10. Is seepage observed from any of the structura?
❑ Yes
No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
PdNo
12. Do any of the structures need maintenancefunprovement?
❑ Yes
Q 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 adquate markers to identify start and stop pumping levels?
❑ Yes
RNo
Waste Application
14. Is there physical evidence of over application?
❑ Yes
�Na
(If in excess of WMP, or runoff entering waters of the Stale, notify DWQ)
15. Crop type U c'M U a_
16. Do the active crops differ with those designated in the Animal Waste Managemeat Plan?
❑ Yes
x(No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
PNo
18. Does the cover crop need improvement?
❑ Yes
O No
19. Is there a lack of available irrigation equipment?
❑ Yes
No
For Certified Faciiities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
No
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
❑ Yes
ONo
22. Does record keeping need improvement?
❑ Yes
q No
23. Does facility require a follow-up visit by same agency?
❑ Yes
CINo
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes
IoNo
Comrirdnts (refer to gtiestron ##� Explain arty YFS aasweis aniline any rccommmdatzons or any ot>rer oomments�
'' a,.g n� apt a -
Use dr �vrngs of facrlitty W better weplarn sttua�ons'{use.add tio�ual�pag #&ne �'� '' "
} ld o f� 5 r
i QrM , J
Ho
Reviewer/fnspector Nance `�
Reviwer/Inspector Signature: Date: -3 i
cc: Division of K'ater Quali Wager Quality Section, Facility Assessment Unit 11/14/96

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
CERTIFIED MAIL
RETURN RECEIPT REQI,.,JESTED
T. G. Gibson, III
T. G. Gibson
PO Box 165
Gibson NC 28343
Farm Number. 83-14
Dear T. G. Gibson, III:
A74 J ;oA
IDEHNR
April 9, 1997 N`E�E�VE0
APR 0 9 1997
F%cG. 0Fi-;G
You are hereby notified that T. G. Gibson, in accordance with G.S. 143-215.10C, must apply for
coverage under an Animal Waste Operation General Permit. Upon receipt of this letter, your farm has
thirty, (301, days to submit the attached application and all supporting documentation. In accordance
with Chapter 626 of 1995 Session Laws (Regular Session 1996), Section 19(c)(2), any
owner or operator who fails to submit an application by the date specified by the
Department SHALL NOT OPERATE the animal waste system after the specified date.
Your, application must be returned within thirty (30) days of receipt of this letter., Failure to submit the
application as required may also subject your facility to a civil penalty and other enforcement actions for
each day the facility is operated following the due date of the application.
The attached application has been partially completed using information listed in your Animal
Waste Management Plan Certification Form. If any of the general or operation information listed is
incorrect please make corrections as noted on the application before returning the application package. The
signed original application, one copy of the signed application, two copies of a general location map, and
two copies of the Certified Animal Waste Management Plan must be returned to complete the application
package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Permits and Engineering Unit
Post Office Box 29535
Raleigh, NC 27626-0535
If you have any question concerning this letter, please call Mike Lewandowski at [phone]
extension 362 or Ed Buchan with the Fayetteville Regional. Office at [phone]
Sin rely,
OF
�^ A. Preston Howard, Jr., P.E.
cc: Permit File (w/o encl.)
Fayetteville Regional Office (w/o encl,)
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

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. T. G. Gibson
P. O. Box 165
Gibson, NC 28343
Dear Mr. Gibson:
e��
- -ok
[DaHNFZ
DIVISION OF WATER QUALITY
April 4, 1997
SUBJECT: Annual Compliance Inspection
T. G. Gibson Livestock
Registration No. 83-14
Scotland County
On April 3, 1997, staff from the Fayetteville Regional Office of the Division of Water
Quality inspected the subject swine facility. Please find enclosed a copy of our Compliance
Inspection Report for your information. It is the opinion of this office based on the
information provided and observations made during the inspection that the facility was in
compliance with 15A NCAC 2H, Part.0217 at the time of the inspection. Please refer to the
comments section on the rear of the inspection form for information regarding your facility.
Please be aware that all swine facilities with a liquid waste collection system designed for
a minimum of 250 hogs must have a certified waste management plan on or before December
31, 1997. The district NRCS office, Agriculture Extension office, or the Division of Soil and
Water have specialist available to assist you with upgrading of existing facilities and
certification.
If You have any questions concerning this matter, please call John Hasty at (910) 486-
1541.
Sincerely,
/Iohn�C. Hasty, Jr.
Environmental Specialist
cc: Operations Branch
Central Files
Audry Oxendine - FRO DSW
Ed Holland - Scotland Co. NRCS
Wachovia Building, Suite 714, Fayetteville �A* FAX [phone]
North Carolina 28301-5043 Neff C An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/ 10% post -consumer paper

a. . --.- -, — ---- —
Rodtine
FACERYNamber
of DSWC
Date of k9ection I Y-3 -57 1
Time of Inspection *. I / I : OM use U hr. time
Fm=Sftm: TOW mme an Mun) Spent "Review
or Inspecdon (includes travel and processing}
Fuz Name: T- C—..7. &; Ins or. L ve-i +oc-k comtr. SC,5+ICx-4---
owner Name: phone NO: ZW-26-5'-- 9971
Mailing Address: J00 BoK &5— rJC-. Z13%43
Integrator WWC) -E—r-r-A—S.
Onske Representative:
CMtWoperatDr-
ope.stm catnemion Number. 17435
Location of Farm:
Latitude Longitude 49 4K
113 Not Oper—at—,O—M,Date Last Operated:
Type of Operation and Design Capacity
Qifi�
#
7w — M 5
4'swihit
JQ Dairy Wean to Feeder
Wean
to Finish Nora -Law
Mee
to Wean
Farrow to Eee
Faffo
Fanrcyw to Finish nish-
F
Panda' Subsurface Drains Present I.Boldm g
rM
Lagoon Area Spny Fxld Ara
fgr&v.l
1. An 6= my buffers 69 need MUFF
2. Is my charge observed from my part of the operation?
a. If &sdmffp is observed, west the amveyanoe maD-madc?
b. If discharge is observ4 did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in SdAnin?
d- Dow d=b&W bypass a lagoon system? (If yes. notify DWQ)
I h 6= evidence of past discharge from any part of the qpazd=7
4. Was them any adverse impacts to the waters of the State other than fmm a discharge? ! .
S. Does any part of the waste management system (other than hgoonAolding ponds) requim
5
Yes
ANo
D Yes
D Yes
E3 No
D Yes
13 Na
0 Yea
D NO
13 Yes -
JkNo
E3 Yes
)4No
13 Yes
"
Coadnued on back

b. Is halfty not in compliance with any applicable aedm* ab wb?
7. Did the SMIW BS to have a citified opantor in mponswe charge (ifinspection area inAm?
L Are that lagoons or rootage ponds an she which coed to be pwpcdy cloned?
Structures aAgoons safer Roldiat Foods
9. 1s structmal fireeboard less than adequate?
Frpebaand (8k on . - - Legoas 2 -Lgaom 3 _
10. Is seepage observed from any of the ?
11. L emxion, or any otha O=b to the integrity of may of the strvwtam observed?
12. Do any of the structures need
(If any of questions 9-12 was answered yes, tad the situation poses as
Immediate public health or environmental threat, notify DWQ)
.1.3. Do fay of the structures lack adquate markers to identify start and stop pumping levels?
Waste AaoTicatloa
A Is there physical evidence of over appHestiam?
.(If in excess of WMQQP, of runoff entering wafts of the State, notify DWiy
IC
15. Crup type U rat u d I
16. Do the active amps differ with those desigaa rd in the Animal Waste Management Plan?
17. Does the fscAity have a lack of adequate areoge for land application?
1& Does the cover crop need improvenkxV
19. Is there a lack of available irrigation equipment?
Eor CerHfled Facilities Oa1v
20. Does the facility fail to have a copy of the Animal Waste Mt asgcmtat Plan readily available?
21. Does the faxility fail to comply with the Animal Waste Management Plan in any way?
22. Don record keeping need ux proven?
23- Does facility mgWre a follow-up visit by same agency?
24. Did Reviewallnapector fail to discuss rewith owner or oymvtoz in charge?
i] It W'149
t] Yes IgNo
D Yes 0 No
t] Yes �INo
13 Yea ;6 No
El Yes JdNo
❑ Yea 0 No
D Yes RNo
E3 Yes V No
13 Yes P(No
p Yea F"
E3 Yes 10 No
© Yes 0No
E3 Yes
ANo
" 13 Yes
WNo
0 Yes
)q No
D Yet
FINo
© Yes
Ej No
Wnimc Oder. W i iTi{ .�:F��•4 $ay e% �a.� �{�i��y., Qr J{Q V�47 L{ at� W ILYi�.�. �•M t t•. d r
r >: r
Ust,�dra�ymgs'cf �ac�itY,-to better tx,Flaini,s�tuettout :�use_addiianalpaga ss�� w. � `� " �.
�-QTI►'1 %DONS J ODd .
Revkwer/inspector Name
Reviwer/lnspeetor Signature:
Daw 3-17
ea Dirtsion of Water Quallty(at'ater Quality Secdvm6 Faculty Assessment Unit 11/14/96

State of North Carolina
Department of Environment,
Health and Natural Resources
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
November 13, 1996
T. G. Gibson, III
T. G. Gibson
PO Box 165
Gibson NC 28343
SUBJECT: Operator In Charge Designation
Facility: T. G. Gibson
Facility ID#: 83-14
Scotland County
Dear W. Gibson, III:
t e e
1D[HHNF;Z
Nov 19 1996
FAVE T ILLE
RAG. OFFIG-
Senate Bill 1217, An Act to Implement Recommendations of the Blue Ribbon Study
Commission on Agricultural Waste, enacted by the 1996 North Carolina General Assembly,
requires a certified operator for each animal waste management system that serves 250 or more
swine by January 1, 1997. The owner of each animal waste management system must submit a
designation form to the Technical Assistance and Certification Group which designates an
Operator in Charge and is countersigned by the certified operator. The enclosed form must be
submitted by January 1, 1997 for all facilities in operation as of that date. Failure to designate a
certified operator for your animal waste management system is a violation of 15A NCAC 2H
.0224 and may result in the assessment of a civil penalty.
If you have questions concerning operator training or examinations for certification, please
contact your local North Carolina Cooperative Extension Service agent or our offiEe.
Examinations have been offered on an on=going basis in many counties throughout the state for
the past several months and will continue to be offered through December 31, 1996.
Thank you for your cooperation. If you have any questions concerning this requirement please
call Beth Buffington or Barry Huneycutt of our staff at 91gn33-0026.
Sincerely,
6
A. Preston Howard, Jr., P.E.,Z' r
Division of Water Quality
Enclosure
cc: Fayetteville Regional Office
Water Quality Files
P.O. Box 27687. :T�4 �
Raleigh, North Carolina 27611-7687 = An Equal Opportunity/Affiirmative Action Employer
Voice 919-715-4100 - 50°k recycled/ 10°/c post -consumer paper

-.• If, f7-
Fao
State of North Carolina
Department of Environment,
Health and Natural Resources « • •
Fayetteville Regional Office
James B. Hunt, Jr., Governor ID � H ["*Af-Z Jonathan B. Howes, Secretary
Andrew McCall, Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
September 6, 1995
Mr. T.G. Gibson
PO Box 165
Gibson, NC 28343
SUBJECT: Inspection
Scotland County
Dear Mr. Gibson:
On July 14, 1995, an inspection of your animal operation 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 this facility is
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, please feel free to contact me
at [phone].
Sincerely,
Ricky Revels
Environmental Technician IV
RR/bs
Enclosure
cc: Facility Compliance Group
Wachovia Building, Suite 714, Fayetteville, North Carolina 28301-5043 Telephone [phone] FAX 91a486-0707
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Site Requires Immediate Attention: N O
Facility No. S 3 - / ti-
DIVISION OF ENVIRONMENTAL MANAGEMENT
AND AL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 5a 1 t , 1995
Time: Oct : 10
Farm Name/Owner: T.. G . 6, b so N Iff j %. 6, ��'bso •�
Mailing Address: PO 1.3v e 165 Gi bso ty NC_
—
County: Scuff 1 a d
Integrator: jaa:jwc od F"a v was Phone:
On Site Representative: i . C- G, bso r4 Phone: (Vo3�> Z G5 - 9- 9 7 /
Physical Address/Location: _
Type of Operation: Swine Poultry Cattle
Design Capacity: 432-0 Number of Animals on Site: 4-32_0
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 34 ° *-7, 57 ' Longitude: 71 0 38' Z5"
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) ®or No Actual Freeboard:-1—Ft. 0 Inches
Was any seepage observed from the la oon(s)? Yes Was any erosion observed? Yes on�
Is adequate land available for spray? Nor No Is the cover crop adequate? (&br No
Crop(s) being utilized: J3 z v m war,-, G014. Cv, r s C_ G ..,xs se s
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? a or No
100 Feet from Wells? Cfg>or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes orZ&
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or(&
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or(& If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes ofzWure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No N /l
Additional Comments: M-j r'a ci i•'
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.

• , State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Andrew McCall, Regional Manager
IN15TA
,&146ja
IL
C)EHNR
DIVISION OF ENVIRONMENTAL MANAGEMENT
Water Quality Section
August 14, 199.5
Mr. Carl Little
Dogwood Farms, Inc.
Post Office Box 49
Clinton, N.C. 28328
Subject: Concentrated Animal Feeding Operation
Inspections
Dogwood Farms, Inc. Facilities
Hoke and LScotland-�-Countkesl
Dear Mr. Little:
Thank you again for interrupting your schedule to assist in
the inspection of Dogwood Farms, Inc. swine facilities in Hoke and
Scotland Counties August 10, 1995.
Attached please find a copy of the inspection forms for the
facilities visited. We ask that you forward a copy of the forms to
the appropriate farmers with our thanks for allowing timely access
to their farms.
Again, thank you and Mr. Brian Spell for assisting in the
inspection process. If you have questions concerning the
inspections please do not hesitate to contact me at [phone].
er ,
V54�1-
ul E. Rawls
Environmental Specialist
cc: DEM Facility Assessment Unit
FRO Regional Files
Wachovia Building, Suite 714, Fayetteville, North Carolina 28301-5043 Telephone 910-48&1541 FAX 91a486-0707
An Equal opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Site Requires immediate Attention:
Facility No.
U� DIVISION OF ENVIRONM]W TAL MANAGEN ENT
AND 4AL FF'E DLOT OPERATIONS SITE VISITATION RECORD
DATE: r , 1995
Time: 6-5-
Farm Name/Owner: l: G .
Vailing Address: -0es. 2, c
B
.C"
County: c,4karlck _
IntegfRtor: ..mo d ` _ Phone:
On Site Representative: Phone:
Physical Address/Location: 3A _ idc4-4. ksP'4u-- _T
Type of Operation: Swine x Poultry Cattle
Design Capacity: 3Qera Number of Animals on Site: RAC
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude:. "A` �" Iror►gitude:.
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) �e or No Actual Freeboard:Ft. _Inches
Was any seepage observed from the lagoon(s)? Yes OA&Was any erosion observed? Yes of4i6:zseepage Was
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No Not Evaluated)
Crop(s) being utilized: (Spray Field or cover crop was not evaluated) _
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 or No
Is animal waste discharged into water of the state by man-made ditch, flushing system, or-0ther
similar man-made devices? Yes or(&,D 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(Waste management records were not
Additional Comments:
This was a very brief inspection. a more thorough inspection will be conducted in the future.
Please contact-..DEM should any condition arise that poses a danger to surface waters.
* This farm was not located on a USGS TOPO map to determine ?Blue Line" status.
If you have questions concerning this report please do not hesitate_ to.contact the inspector
at [phone]. Please contact the inspector if the above information is incorrect.
Inspector Name
cc: Faciliq Assessment Unit ),,,.If sq
It,
a�� CIS
Signature
Use Attachments if Needed.

101 00 '00 00c091 021 Pe3
CU c4� kra` uJ 7�
Jfr-
a �� Y-- �� DEPARTMW of v .
.ra �►sooacxs ;
�Vy DIMIUR OF IIwYIRKANAGiaUM 1''1 Gov
Fayetteville Regional Office
Animal Operation Compliance Inspection Form SQ //5-9
f�r�i'w:�. .Ry•;MR�' �a::y':c�a`atp`,Gtl:M uf. •••••
S k
w
�.vetw:«.�uK.wwa'
•,•�afi,wyan�i:W�s/�J�rxDx;:a�` �••+sw..r. #1y�+a"rvwerA'di'K n+i
p�
y��,�� ,>....I.�".*w�.w
Ma_w_,R�I�4 ~ �w
y�wFnY:.+i� .���rwM.y�ItJY�M�
.... r.vway:{.•�w.x�x A"M:
.t. .�.n.i'�•�..�.'_.:n
:.e:A.:.v
���n}�x..,.'°a°�FY.x r?R!,±'MraWi��':i','..
All questions answered negatively will be discussed in sufficient detail in
the Comments Section to enable the deemed Permittee to perform the appropriate
corrections;
SECTION I
Animal _Opera_tian Type:
Horses, cattle, swine, poultry, or sheep
Y I N
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 RBMISTRATiON?
3. Are animals confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a OaTrFro
MASTS MANAGZLBW PLAN?
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 5C5 minimum
setback criteria for neighboring houses,
wells, etc?

101 00 100 00:00
MIM III
FAM0
Field_Site- Kanaaetaent
9. Is animal waste stockpiled or lagoon
construction within 100 ft. of a USGS
Nap 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
ORTIFICATIM PLAT'!?
5. is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar man-made devices?
6. Does the animal waste management at this
farm adhere to Best 1anagement Practices
( 14P) of the approved OEMCATION?
7. Does animal waste lagoon have sufficient e;b-f
freeboard? How much? {Approximately 2
S. Is the general condition of this CAFO facility,
including management and operation,
satisfactory?
comments

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
T. G. Gibson III
T. G. Gibson
PO Box 165
Gibson NC 28343
Dear T. G. Gibson III:
�EHNF=1
June 9, 1997�
JUN 1 1 1997
Subject: Certificate of Cove agelo XWS830014
T. G. Gibson
Swine Waste Collection, Treatment, Storage
and Application System
Scotland County
In accordance with your application received on May 5, 1997, we are forwarding this Certificate of
Coverage (COC) to Farm No. 83-14, authorizing the operation of an animal waste collection, treatment,
storage and land application system in accordance with the State's General Permit (attached). This
approval shall consist of the operation of this system including, but not limited to, the management of
animal waste from the T. G. Gibson Farm, located in Scotland County, with an animal capacity of no
greater than 4320 Feeder to Finish and the application to a minimum of 38.0 acres of land as specified in
the Certified Animal Waste Management Plan (CAWMP).
The COC shall be effective from the date of issuance until December 31, 2001. 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.
In accordance with General Statue 143-215.10C, Animal Waste Management Plans shall include
the following components:
- A checklist of odor sources and best management practices to minimize these sources.
• A checklist of insect sources and best management practices to minimize these sources.
- Provisions set forth for acceptable methods of disposing of mortalities.
- Provisions regarding emergency action plans.
Your existing Certified Animal Waste Management Plan must include the above elements, by
December 31, 1998. Documentation of the certification must be available to inspectors onsite. Submittal
of the amended certification statement shall be required upon renewal of your permit coverage in 2001.
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

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.
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 J. K. Jallah at [phone] ext. 364.
Sincerely,
-f4'�-A. Preston Howard, Jr., P.E.
cc: (Certificate of Coverage only for all cc's)
Scotland County Health Department
F yayett vUle-Regional-Office, WaterQvality-Section
Scotland County Soil and Water Conservation District
Permit Files