830015_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
830015 Facility Status:
Active Permit: AWS830015
❑ Denied Access
Inssection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Scotland Region:
Fayetteville
Date of Visit:
02/14/2017 EntryTime: 04:00 pm
Exit Time: 5:00 pm Incident d
Farm Name:
7177
Owner Email:
Owner.
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 467
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 Cal, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone
On -site representative Mike Cudd Phone :
Primary inspector. Robert Marble
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Phone:
Date:
page: 1

Permit: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number. 830015
Inspection Date: 02/14/17 Inpsection 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
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19,00 51.00
page: 2

Permit: AWS830015 Owner - Facility : Murphy -Brown LLC Facility Number: 830015
Inspection Date: 02/14/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na--Ne
1. Is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b_ Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
01111
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
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.)?
5. 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?
❑
01111
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 NQ Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 100/6/10 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 -Brawn LLC Facility Number" 830015
Inspection Date: 02/14/17 Inppection 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 loam
Soil Type 2
Norfolk loamy sand, 0 to 2%
slopes
Soil Type 3
Wagram loamy sand, 2 to
6% slopes
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 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
❑ ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑ ❑ ❑
Records and Documents
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?
❑ E ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS830015 Owner - Facility: Murphy -Brown LLC Facility Number. 830015
Inspection Date: 02/14/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yea
No Na Ng
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■ ❑
❑
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?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes
No Na He
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?
❑0
❑
❑
(i.e., discharge, freeboard problems, aver -application)
31. Do subsurface tile drains exist at the facility?
❑
❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection-with on -site representative?
❑
N ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Type of Visit 40Compliance Inspection Q Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 'LZ Li�^1 Arrival Time: DDeparture Time: 6�. County: Region:
Farm Name: �! I —r ��7 ? Owner Email:
Owner Name: U( Phone:
Mailing Address:
Physical Address:
Facility Contact: I�NIK-� Cudl Title:
Onsite Representative: u
Certified Operator:
Back-up Operator:
Phone No:
integrator: aC
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o= I 0 u Longitude: =° 0 I 0 u
Design Current
Design @nr 40Mgn Current
Swipe Capacity Population
Wet PoultryCapFacity Population Cattle Capacity Popniation
❑ La er ❑ Dairy Cow
❑Non -La er JE1 Dairy Calf
_.
u Dairy Heifer
'' ❑ Dry Cow
Dry PoultryF
"'�''
❑ Wean to Finish
❑ Wean to Feeder
❑Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
❑ Non -Dairy
❑ La ers
Farrow to Finish
El Beef Stocker
❑ Non-ts ers
❑ Gilts
El Beef Feeder
El Pullets
❑ Beef Brood Co
❑ Turkeys
❑ Boars
x _..
Other
❑ Turkey Poults
❑ Other Number of Structures:
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
El Yes PNo El NA El NE
❑ Yes
❑ No
® NA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
PNA
❑ NE
❑ Yes
❑ No
❑ Yes
IP No
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
12128104 Continued

Facility Number:gam Date of Inspection S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes
❑ No P NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): f p
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
�No El NA El NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
VNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
P No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
F-'
9. Does any part of the waste management system other than the waste structures require
El Yes
No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
�INo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
No El NA El NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
`
❑ PAN ❑ PAN > 10% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside ofAcceptable Crop Window Evidence of�JWind Drift ❑CApplliicati�on Outside of Area
12. Crop type(s) �-i.[�7ttL[ �YY�'�" ss . 7Q 4, J , JAt r C54�i�it i/USG/�d►
13. Soil type(s) MG Co
' V
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] yes
O No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ 9 No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
�contm entsreEaplairt any IV, S answerssandlor�anyrecammendations arhany other comn ats
seawmgs of faceiity totbetter�explatic situations (use addc#ional pagan necessary) ,y.. - ,,
&4S rev t'X'4k ^ '41It((
-
'
Reviewer/Inspector Name Phone:
Reviiewer/Inspector Signature: Date: 11
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection FTAFs;]
Reouired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes PNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes PTNo J!;�❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes [PNo ❑ 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
bPNo
❑ NA
❑ NE
23_
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
RNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
10 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
RNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
RdNo
❑ 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
[INA
[INE
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
[ANo
El NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
l
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[�No
1B
El NA
El NE
33.
Does facility require a follow-up visit by same agency?
[I Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

type of visit; w t-ompuance inspecnon v vperatiou neview v structure r vatuatnon v i ecnnicai Assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: I Cq-30Departure Time: S I County:
Farm Name: J `� —t ri ri I Owner Email:
Owner Name: f'V\vl"[i( 6,A (--,D cc". CN LCC_ Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Region:_
Integrator: 1.7�D4%tl
T— -
Certification Number:
Certification Number:
Longitude:
'Dg�C urrent
" `
Design urrent
Swrline Ca aci o
le Capacity Pop.
La er
Non -La er
Design Current
Wean to Finish
Dairy Cow
Dairy Calf
Wean to Feeder
Feeder to Finish
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D , foul Ca aci Po
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
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)?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ® NA ❑ NE
❑ Yes ❑ No aNA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 'D No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

[Facility Number: j - Date of Ins ection: a /3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: i
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): :3 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Q 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
Z? 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
& 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
R No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0] No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application OutsideofApprofv�ed Area
12. Crop Type(s) �G�1 �i �`c�.t�GL�ctJQSs j Q S �E � l�l I 0 [ ()ue. d Se
13. Soil Type(s): V No i t ni iQ - a i lflr`�
14. Do the receiving crops differ from those designated in the CAWM ?
❑ Yes
F] 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
E] 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
b 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
e No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
[] Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[:]Yes
[!!?No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No
25. is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes allo
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 [P No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes [:]No
Other Issues
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
NA ❑ NE
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
�No ❑ NA
If —
❑ NE
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
Fj 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
10 No ❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
T
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
P No ❑ NA
❑ NE
❑ Application Field ❑ Lagoon/storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No ❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
10 No ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No ❑ NA
❑ NE
Comments (refer to question . E plain any YES answers andlor any addditioaal recommendations or any atber comments.
Use drawings of facility to better explain situations (use additional pages as necessary,).
Reviewer/Inspector Name: �e� �4 ��—
Phone: cit0-433 ' 33a)
Reviewer/Inspector Signature:
Date: _�a�
Page 3 of 3
21412011

Itype or v esn: w lLompuance rnspecnon V tiperanon rceview V arrucrure waivanon V r ecnnrcar Assisrance I
Reason for Visit: 4) Routine Q Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: Arrival Time: Departure Time: County: SCOT'�
L D Region: ►
Farm Name _ 5-j t l j Cq ] q tl )_ Owner Email:
Owner Name: .V,j�,,y� - Phone:
Mailing Address:
Phvsical Address:
Facility Contact: % Title: Phone:
if
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Certification Number:
Certification
Number:
Longitude:
Current 3F
Design tL
Design Current
O_MUesign
Swine
Capacity
. Pop^ t Poultry
,Curie
Capacity Po pF_
Cattle Ca aci Po
P ty w
Wean to Finish
Layer
'
;;
Dai Cow
Non -La er
Dairy Calf
DairyHeifer
���;F� Wit;
DesignCurrent4
D Cow
Farrow to Feeder
s" ^
D : Poult ,
Ca acl PO
Non -Dairy
Layers
Beef Stocker
Non -Layers
Beef Feeder
Soars
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field ❑Other:
❑ Yes Wo ❑ NA ❑ NB
a. Was the conveyance man-made?
❑Yes
❑ No
NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑Yes
❑ No
P NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑Yes
� 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 2/4/2011 Continued

Facili Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3
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 [PNA ❑ NE
Structure 6
❑ NE
❑ NA
❑ Yes
No
❑Yes
[ No
❑NA
❑NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
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): Q2S�6 opPl GI-4A:Jjad��)j &S zeal
.�
..,
13. Soil Type(s):�
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0 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
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste TrIfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �fl No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P9 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

Facili Number: Date of Inspection: 3 1117117--
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No [3NA ❑ 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 ❑ 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 �5No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes M No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: 7 �J
21412011

Type of Visit EMompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit eikoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 'ZS %i� Arrival Time: 7=dof1 ^ Departure Time- County: S40-111, °l
Farm Name: -5-/ 77 - / Colder 717 7 J Owner Email:
Owner Name- A('43rbN1A/ . LLC- Phone:
Mailing Address:
Regionlx"E�
Physical Address: /J�j
Facility Contact: �'f� Title: LysQ- W Phone No:
Onsite Representative: Integrator: XW - 161-0-1,JA-1 qq
Certified Operator: Tam e,5 $ • / R G G' u g a N Operator Certification Number: / & 75 Z
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = o = i Longitude: ❑ ° =
Design Current
Design Current
Design Current
SvrZne Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ DairyCow
❑ Wean to Feeder
❑ Non -Layer
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
Farrow to Feeder
135 O
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl
El Turkeys
Other
❑ Other
❑ Turkey Poults
❑ Other
Number of Stnaetures:
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes (A No ❑ NA ❑ NE
❑ Yes
❑ No
0 NA
❑ NE
❑ Yes
❑ No
® NA
❑ NE
[#NA
❑ NE
❑ Yes
❑ No
❑ Yes
O'No
❑ NA
❑ NE
❑ Yes
E4 No
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

14h.
Facility Number: 6�3 Date of Inspection zl �fl
Waste Collection & Treatment
4. Is storage capacity (structural plus stone storage plus heavy rainfall) less than adequate?
❑ Yes
0 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
I? No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: 5"/77 `/
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Vj 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
tO 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
0 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[29 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
UNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
JRNo
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. , ❑ Yes O No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs [:]Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) l�r i-�.•ud �, (F 1teas �u v� 57. Al t/ e, vs- -ee4 J
13. Soil type(s) Nc Coll *Ono/k bia 4 ra"
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 18 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes gNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes [�r No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ElYes JNo ❑ NA ❑ NE
18. is there a lack of properly operating waste application equipment? ❑ Yes V No ❑ NA ❑ NE
Comments {refer to question M Explain any YES answers and/or any recommendations or any other comme4ts.
Use drawings of facility to better explain situations. (use additional pages as necessary}:
a
Reviewer/Inspector Name �R�`eky /� � Phone: 910,V33.334)0
Reviewer/inspector Signature: Date: '51-0 % —ZO/O
Page 2 of 3 12128104 Continued

Facility Number: 63 --D/5 Date of Inspection
Recuuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes M No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0 No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No [:1 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
D!] No
❑ NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P6 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
(Z7 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
IM No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[HNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 L
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® 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
[FNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
C&No
❑ NA
❑ NE
Page 3 of 3 12128104

Type of Visit 40 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit *Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1-30Arrival Time: Departure Time: Q %� County: SS'01L-n 4
Region:
r
Farm Name r rl Owner Email:
Owner Name: _M _&JA4n.T Phone:
Mailing Address:
Physical Address:
Facility Contact: l _ /^S' Title: Phone No:
Onsite Representative: k Integrator: tOLw`'
Certified Operator: T'r"Q S r "t- V qu _ Operator Certification Number: /��?*�O�
Back-up Operator: _ t '"�' �ii�Q0� Back-up Certification Number: 9119 7Y0
Location of Farm: Latitude: = o = I E__1 « Longitude: = o ❑ 1 ❑ u
ligg
NO IDesign Current
Capacity Population Wet Poultry
Design Current Design Current
Capacity Population Cattle Capacity Population
rWine
to Finish
❑ Layer
❑ DairyCow
to Feeder
❑Non -Layer
El Dairy Calf
r to Finish
❑ Dai Heifer
to Wean
La ers
❑ D Cow
Non -Dairy
❑Beef Stocker
❑ Beef Feeder
❑Beef Brood CowlTurke
I I Number of Structures:
to Feeder
to Finish
❑Non -La ers❑
Pullets
s
❑ Turke Poults
1 10Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
�No
❑ NA
ElNE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
O NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
qNA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
PNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[P No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
[P No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. if yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: r
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): i
5. Are there any immediate threats to the integrity of any of the structures observed?
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes trNo ❑ NA ❑ NE
❑ Yes ❑ No.,&NA ❑ NE
Structure 5 Structure 6
❑ Yes ItNo❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes L7 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes `lam No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes RI�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/improvement?
IL Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes )h No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of
Wind Drift ElApplication Outside of Area
12. Crop type(s) ayyvk,L GZy ��Q �, —C. , �✓Qc Lt f� Q� T
13. Soil type(s) A e-61
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
H. Does the receiving crop and/or land application site need improvement? ❑ Yes
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ Yes
No ❑ NA ❑ NE
�No ❑NA ❑NE
�] No ❑ NA ❑ NE
�pNo El NA El NE
PNo ❑NA El NE
.® , � 3300
Reviewer/Inspector Name $ , r" Phone:
Reviewer/Inspector Signature: Date: b�
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ W'Up ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ErNA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
tp No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
V1 No
❑ NA
ElNE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
I? NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[q
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes]
No
El NA
❑ NE
If yes, contact a regional Air Quality representative immediately
l
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
0 No
❑ NA
❑ NE
32.
General Permit? (ie/ discharge, freeboard problems, over application)
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[QNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
e No
❑ NA
❑ NE
Additional Comments and/or Drawings::..
Page 3 of 3 12128104

(Type of Visit i, Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit ORoutine 0 Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: L 14 /6 0 ArrivalnTime: /'� Departure Time: L' �4 County:
-F
Farm Name: M I Owner Email:
Owner Name: W h Phone:
Mailing Address:
Physical Address:
Facility Contact: �t`L' VKO-S Title:
tf
Onsite Representative:
Certified Operator:
Back-up Operator:
Region: P)2V_
Phone No:
Integrator: �4 &V U)N Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o = ` =" Longitude: = o = t = U
Swine
Design Current -' Design Current'
Capa�ciAy Population Wet Poultry Capty Population
,. Design Current
Gattle. Capacity Population
❑ Wean to Finish
❑ Layer
❑Dai Cow
❑ Wean to Feeder
❑ Non -Layer
iry Calf
El Feeder to Finish
1)ry poultr
❑ Layers
Dairy Heifer
❑ Farrow to Wean
❑ Dry Cow
Farrow to Feeder
_0
/50-4
❑ Non -Dairy
El Farrow to Finish
❑ Beef Stocker
❑ Non -Layers
Gilts
❑Beef Feeder
❑ Pullets
❑ Turke s
P1_1 Boars
Beef roo d Cow
-
Other
Nvmber�of Structures:
❑ Turkey Poults
❑ Other
10 Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes F No ❑ NA ❑ NE
❑ Yes
❑ No
0 NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
10 No
❑ NA
❑ NE
Page l of 3
12128104 Continued

Facility Number: 83— Date of Inspecdon
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
JP No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
W NA
❑ NE
Structure ] Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
N
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
r-] 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
�9 No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
J] No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 4P 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 El Yes �] No ❑ NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes R3No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [:IPAN > 10% or ] O lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
IJ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Comments (refe>rto q won #)�E ji anyYES nswers auiorany recomr�[endations or anygother comme nts.
ruse draw[ngs offac[lrty to*,betterexpla[nssttuat[ons.(usefaddihonal1pages as necess561
ary,):
AL
Reviewer/lnspector Name Phone: I A V 33 3.�CO
Reviewer/Inspector Signature: Date: � I6
Page 2 of 3 12128104 Continued

r ON
Facility Number: Date of Inspection
Re uired 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 appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑Maps ❑Other
❑ Yes
ip No
❑ NA
❑ NE
❑Yes
9No
❑NA
ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Wcather 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
jg No
❑ NA
❑ NE
❑ Yes
IM No
❑ NA
❑ NE
❑ Yes
�] No
❑ NA
❑ NE
❑ Yes
A No
❑ NA
❑ NE
❑ Yes
09 No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes RS No ❑ NA ❑ NE
❑ Yes JS No ❑ NA ❑ NE
❑ Yes ®No ❑ NA ❑ NE
❑ Yes 5j No ❑ NA ❑ NE
❑ Yes
�3 No
❑ NA
❑ NE
❑ Yes
18No
❑ NA
❑ NE
Additioaal,Commezts and/orDrawings =Oft"
Hy
Page 3 of 3 12128104

Type of Visit 0 Compliance Inspection U Operation Review Q Structure Evaluation U Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: i} 6 Arrival Time: Departure Time: /.'30 County: Region:
Farm Name:M 5-S-1731 Owner Email:
Owner Name: AMAIA Phone:
Mailing Address:
Physical Address:
Facility Contact: t=`��.�.0� S Title:
N
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator: AwQ Rm-mi +
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = 0 = 4 = Longitude: = ° E__1 ' = u
Design Current
Swine Capacity Population
Design Current
Wet Poultry Capacity Population
Design Current
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -Layer I
❑ Dairy Calf
❑ Feeder to Finish
Dry Poultry
❑ Dairy Heifer
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish �
❑ Dry Cow
❑ Non -Dairy
❑ La e rs
El Beef Stocker
❑Non -Layers
El Gilts
❑ Beef Feeder
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Boars
❑ Beef Brood Co
_...
Other
Numh�r of Structures:
❑ Other
10Other
Discharges & Stream Imoacts
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
[� 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
P No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
[P No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

rY Facility Number: IBT57 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 E3 NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 5573I
Spillway?:
Designed Freeboard (in):
r7N
Observed Freeboard (in): 1
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
0 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
E?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
PO No
❑ NA ❑ NE
maintenance or improvement`?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Ocrr,,J q C PaS4-(4.e , qa SM . 6-f 4 u.r,rsead -
13. Soil type(s) f Qrj " t U 4 p1;
Coxville, Waaeni,
MCCPa
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
(A No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
MNo
El NA
El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
determination?❑ Yes
$ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
V] No
❑ NA
❑ NE
;C�tne�nts (Teter°to question #)Explarn�any Y,E5 answersYanorany omnendations or any other comiuents.
Use dra!wuigs of tacifity to�be� r�expla n sib tions. {use a�fional p�ag as necessary):
Reviewer/Inspector Name W � Phone: 4 33 :37
Reviewer/Inspector Signature: Date: 47161ab
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 JP No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes W No ❑ NA ❑ NE
the appropirate box. ❑ WDP ❑ Checklists ❑ ❑ Maps
Design
g p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes IN No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
ElNA
ElNE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
J§ No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
P No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�9 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P 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
1� No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[N No
❑ NA
❑ NE
-.y.- -
AddikiodalrComnients aiid/or. Drawings.
„ d
Page 3 of 3 12178104

® Division of Water Quality
Facility Number g 3 /$— O Division of Soil and Water Conservation
Other Agency
Eof Visit 46 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
n for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other,, _ El Denied Access
Date of Visit: Q Arrival Time: Departure Time: County: Region: _
Farm Name: �} SI r171 Owner Email:
Owner Name: f ' `i� _ Phone:
Mailing Address:
Physical Address:
Facility Contact: _ Ah A-04.1 S _ Title: �}`u^- Phone No:
Onsite Representative: Integrator: 1- L
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = 0 = I = 11 Longitude: [= o [� f =
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Populations,`',
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder /3SID 1
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ ur-key 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?
❑
Dairy Cow----F-
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c_ What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes W No ❑ NA ❑ NE
❑ Yes
❑ No
[�NA
I9
❑ NE
El Yes
El No
NA
❑ NE
16NA
❑ NE
❑ Yes
❑ No
❑ Yes
[ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

k .f
Facility Number: — / Date of Inspection I.:$laq/07
Required Records & Documents ��
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes PgNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No LPNA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No 1P 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 V No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes PNo ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
®. No
❑ NA
❑ NE
2&
Did the facility fail to have an actively certified operator in charge?
❑ Yes
PNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
P No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
fpNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
1p No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
EP No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
fp 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
rp No
❑ NA
❑ NE
Page 3 of 3 12128104

Facility Number: 3 — l Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
PNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
�NA
El NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: nil)
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 33 h
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
1�?No
❑ NA
❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
�No
❑ NA
Cl NE
through a waste management or closure plan'?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [9No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 'o 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 19 No ❑ NA ❑ NE
maintenance or improvement?
Waste Anoueation
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes 1PNo ❑ NA ❑ NE
11 _ Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [QNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 1 O lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
&�yU mu& CC --a Zed .1)1
/it A4 At Cott
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18_ Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA ❑ NE
�No ❑NA El NE
Ef No ❑ NA ❑ NE
Q No ❑ NA ❑ NE
t{No ❑ NA ❑ NE
IComments (refer to question f: Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Pave 2 of
Phone:
Date:
t2/28/Od Continued

�i
Type of Visit O Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: '/1 Arrival Time: �OnIO/} Departure Time: ' j County: SCt]�7c*syrY Region:
Farm Name: 1Z S� 771 e OlAd Gk" Cr 4"1 L _ Owner Email:
Owner Name: _&&" ; ���� Phone:
Mailing Address:
Physical Address:
Facility Contact: M; Kc- mP4oAJS Title: Phone No:
Onsite Representative: integrator: 8nr-1.1nl
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = I = 11 Longitude: 0 ° = I [__1 "
Design Current
Design Current
Design Current
Swine C►apacity Population
Wet Poultry
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
❑Non -La er
❑ Daig Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry SEMI
, , ❑ D Cow
Farrow to Feeder O'"�"'"'�"''�`
`
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
"� El Beef Stocker
❑ Gilts
❑Non -La ers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
�
❑ Turkeys
Other �_ -
❑Turke Poulis
❑ Other
❑ Other
Number of Structures:
Y*¢rt Yam::-.CrY•-
- :''-".
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[P No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
[4 No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
0 No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (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 adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
[gNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: g33 — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes JA 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: Y
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 47
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
jNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
MNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
IM No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
V1 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
[I Yes
jr No
ElNA [INE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
[--]PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift El Application Outside of Area
12_ Crop type(s) &Prig L G=e_`�..,) .S/ d.l1 0"24 n/
O
1
L b+ CV9f-cc1 J
13. Soil type(s) Na,4 j!�Cc6It
l4. 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
0 No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
91 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[11 No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
O No
❑ NA ❑ NE
aY sit; 3 .
Comments (referttoaqueshon°, Explain:any YES:answers andlor any.recommendations ortany�otlier comments °
.Use drawings of�factlity�to better explain situations. (use additional pages as necessary):i
7
ReviewerlInspector Name 't T � S > Phone:
Reviewer/Inspector Signature: -;•[ram Date: 2- Z� (p
Page 2 of 3 12128104 Continued

i
Facility Number: 3 - s Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes I] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes JM No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists [3 Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 00 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ AnnuaI Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? [:]Yes ,[No ❑ NA ❑ NE
23_ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
M No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
PQ No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
•K No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
MNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
M No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
9jNo
❑ 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
,KNo
❑ 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
Cl Yes
1jNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[NNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
PILNo
❑ 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: 112 - `0 ' Arrival Time: %0'/Z Departure Time: Count- ��aNd Region: 640
Farm Name: 4r.S� 7, 7! 601A (tam S # 7/ 7 -1 ) Owner Email:
Owner Name: 114u rD 4. a �l'� Phone:
Mailing Address:
Phvsical Address:
Facility Contact: :p tt-- j Title:
Onsite Representative: : 1ic
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Phone No:
Integrator: /iil'it,01" 8'o`60,1AI _
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ o ❑ Longitude: = ° = i
Design ' Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
II ❑ Non -Layer
Other
❑ Other -- -
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Design Current'
Cattle Capacity Population
❑ Daia Cow
❑ Daig Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes. notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No [M NA ❑ NE
❑ Yes
❑ No
[3NA
❑ NE
❑ Yes
❑ No
® NA
❑ NE
IN NA
❑ NE
❑ Yes
❑ No
❑ Yes '
El No
0NA
El NE
❑ Yes
[--]No
[gNA
❑ NE
12128104 Continued

/ Z-ZD -OS
Facility Number: g — S Date of Inspection /2 O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [K 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?:
Designed Freeboard (in):O
�j
Observed Freeboard (in): 3 S
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
� No
El NA [I NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
ULNo
❑ 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
�4No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the pen -nit?
❑ 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
[ZNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
EANo
❑ NA ❑ NE
maintenance/improvement?
1 l . Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
M No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Applicatioon Outside of
Area
12. Crop type(s) SCYiUt k a, (lira _ SA- mll am,�hl C d Vi�.seed
13. Soil type(s) Wo Q Lt 1 a B /yre�
14. Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
1�9 No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
N No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination%❑
Yes
�ANo
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
(5&No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
allo
❑ NA ❑ NE
Reviewer/inspector Name �' .! s Phone:l!,�/OJ Zfff& _15'Al IW730
Reviewer/Inspector Signature:M44fi.�Date: /Z —7A—ZOOS
12128104 Continued

Facility Number: S,] — /S Date of Inspection Z =20-6
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. ❑ WU, ❑ Checklists ❑ Design
g ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 9No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22_ Did the facility fail to install and maintain a rain gauge? ❑ Yes B No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 19 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
Da No
❑ NA
❑ NE
26. Did the facility fai I to have an actively certified operator in charge?
❑ Yes
14 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
M No
YN
❑ NA
❑ NE
Other Issues
29.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P9 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
DS 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
X 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
[XNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
;9 No
❑ NA
❑ NE
12128104

Type of Visit 0 Compliance Inspection O Operation Review 0 Lagoon Evaluation
Reason for Visit *Routine O Complaint O Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number 3 I S Date of visit: - 7- Time:
Not Operational Q Below Threshold
® Permitted ® Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: a. r r a \I, i Fay r,,. -T I Z 7 County: S Ga +l a.A F �v
Owner Name: ( a r... NS s Faogqs Z. - c- , Phone No: S I `p .2 44
Mailing Address: P 0 in x -i S9 a-, r. W , �i N or+L C aya1', %,& .2 R 't rip
Facility Contact: Title:
Onsite Representative:
Phone No:
Integrator: CAr r o 1� '
Certified Operator: Operator Certification Number:
Location of Farm:
W Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 ' Du Longitude 0 9
Design Current ;Design Current ., D�'esign Current
` " Ca achy P,a nlatian
Swine _ Ca aciri P,o ulation Poultry Ga acrty P,o alation'= Ga_ttle
❑ Wean to Feeder ❑ Layer ❑ Da'
❑ Feeder to Finish ❑ Non -Layer ❑ Non-Dai
❑ Farrow to Wean
® Farrow to Feeder F 3 ,5 o ❑ Other
❑ Farrow to Finish
Total Desi` n Ca
P
❑ Gilts
I
Total'S
El Boars -<
Number of Lagoons 0 ❑ Subsurface Drains Present ❑ La oon Area 10 Spray Field Area
Holding Ponds /Solid Traps F — — — ----- ❑ 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 I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
"
Freeboard (inches): 3y_ _
❑ Yes © No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
05103101
Continued

Facility Number: 83 — /,j Date of Inspection ®
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9_ Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Apiplication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
❑ No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments(refer to question � ;E:plaut nny YES answers,and/aranyrecommendattons'or anyouter commen
�5 "- B Je, _. �' -- .. � ."b+aGYJ'Jl"a�F.l. !na
40
Use, ra s of fac tt� Yo'better� explain sttuadons Oise addttiorial;pages as aece�ssary) es
'.. Not
�79t .$:.. . .. 5:•' '.., ;_I! ... .,. "-- .. 'i?N'�s .
- Scycro� SI,.o11 OA<cdZ �+q5 i -1 #.� L�c�oDr�, P SC0..3c re—V, C.vc awA
o, 4F--n e> 4 +\, 4Z4 c a " dZ ,..�.�.�,.. } A;_b.MQ a s
\o � e6M w�. -"�. I+t SPe- L'tOr C0.\�cOZ-
Reviewer/Inspector Name }"
E
Reviewer/Inspector Signature: Date: 9 — `T _ .4
05103101 ✓ T / Continued

v
Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint Q Follow up O Emergency Notification 0 Other ❑ Denied Access
Datc of Visit_ �. Time: 1��J
Facility Number
Nnt O eratinnal Below Threshold
MPermitted ® Certified E3 Conditionally- Certified © Registered Date Last Operated or _above Threshold:
Farm Name: r' OL Counn: FW0
Owner Name: rk Phone No: —S LQ 2 } e,
Mailing address: a ox _ gJ t� I Aa.Psz e S 1j I G• ae3q l
Facility Contact: ivTitle: Phone No:
Onsite Representative: Me_ -,z^ (n<a!LLcf- Integrator: C5
Certified Operator: J . %fV%!4 �KOkl� GxLf�_2w Operator Certification number. 17-6 Sa
Location of Farm:
IN Swine ❑Poultry ❑Cattle El Horse Latitude ' �' K Longitude
Design Current
Swine Canarity Pnnnlatinn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to «V can
® Farrow- to Feeder
' Q
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Ca acity Population Cattle Ca acits Population
❑ Laver ❑ Dairy
❑Non -Laver ❑ Non-Dairy
Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 S ray Field Area
Holding Ponds / Solid Traps [] No Liquid Waste Management System
Discharaes S- Stream Impacts
1. Is any discharge observed from any part of the operation?
Dischar_e originated at: ❑ 1_aaoon ❑ Spray Field ❑ Other
a. If discnam.- is obsen ed, was the conveyance than -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 eNidence 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. L storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
OSIV3101 3 8
❑Yes EPNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [XNo
❑ Yes Eallo
❑ Yes Q No
Structure 6
Continued

Facility Number: — I S Date of Inspection —�--'
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? (D Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes O No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ©No
11. 1s there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ hydraulic Overload ❑ Yes 2� No
12_ Crop type dP �-
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes Q No
K a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
(P No
Required
R _ ords & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
Q 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
91 No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
EZNo
20_
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[51 No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
0 No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
$] No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit-
Gomments (n l lwgtto,�question '�Expiain airy E5 answees and/or any recommgdations or any other commeets.
. ap}
Use:drawings of41011 to be#ter eyplain situations. (use addmoeal_pages asjnecsary):
z ❑Field Copy ❑Final Notes
lctA�- -So( i 56�r�r0 to 11 I-1( ,03 A -t
t.wnc4r BYAN +-6,b h,eer-A -f-O t`nCf t,,CL, nf:a for t "G
l., i C34\ l cqe.r�i e ve rri LJ c o re�J a r�e c{ i n M Gr,ck 03 � UIL si n Ce E �,•� -
t-e � Cd 4-- L i i'6 ^ tQ oil -c.c.s aci -
Reviewer/Inspector Name zh -
Reviewer/Inspector Signature: 1 Date:
05103101 Continued

Facility lumber: g — Date of Inspection
dor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there anv 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 J�j No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc_) ❑ Yes [RNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes [k] No
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover? ❑ Yes ❑ No
05103101

Type of Visit © Compliance inspection p Operation Review 0 Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification 0 Other ❑ Denied Access
Date of Visit: S � D Time: ) QS
Facilih• lumber t�
Not Operational Q Below Threshoid
Permitted ® Certified ❑ Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: carno{t S -17-b-+,4 �c,,- County: c 'F-W,0
Owner Dame: Go r'C.ts it C it jtj `7 L Phone No: -
MailingAddress: P._is. a o x Q"'—te -- _ OCssiS_C'LL_� /)C._ 2g348
Facility Contact: Title: _ LAti2't Phone No:
Onsite Representative: c Integrator: _C 6
Certified Operator: f[i � Operator Certification Dumber: 1J. 03
Location of Farm:
&!� wine ❑ Pouttry ❑ Cattle ❑ Horse Latitude ' 01 - Longitude ' �• i
Design Current Design Current Design Current
Swine Capacity Population Poultry Ca acity Population Cattle Ca ackv Population
❑ Wean to Feeder FE11E Lava E
Dairy
❑ Feeder to Finish ❑ Nan -Laver Non-Dain
❑ Farrow to Wean.
® Farrow- to Feeder Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ILI La oon Area 5 rav Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges 8- Stream Impacts
1. Is anv 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 obsenred, did it reach Water of the State? (If yes, notif}. DWQ)
c. If discharge is observed- what is the estimated flow in eat/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 ? Structure 3 Structure 4 Structure S
❑ Yes 9J No
❑Yes El No
❑Yes El No
❑ Yes
❑ No
❑ Yes
[%No
❑ Yes
[�allo
❑ Yes [3No
Structure 6
Identifier:
Freeboard (inches): 2 I
05103101 Continued

Facility Number: — Date of Inspection 1
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [� No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes IP No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes " No
$. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes 14 No
12. Crop type I? es y„tiAe-
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
ER No
16. Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[51 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
W No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
V No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24_
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes M No
10 — were noted during this visit. You will receive no further correspondence about this visit. No violations or deficiencies T
Gomments (refer,to gneshon # Explain ativ YES answers�andlor any recommeniiatmns eir an} other melts .
Use`!rM s of=f c tn,betterrte. lam situattons use addihonai pages;as rse`cessary) ,
.. g . �.. . _-_ ❑Field Copy El Final Notes
Reviewer/Inspector Name k:,i _ < <�, ::. rn.,e.`
Reviewer/Inspector Signature:
Date:
05103101
Continued

8,3
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
liquid level of lanoon or storage pond with no agitation?
27, Are there any dead animals not disposed of properly within 2Y hours"
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, buildin_ structure. and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. \Verc 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 Mj No
❑ Yes /�g No
0 Yes 14 No
❑yes [nNo
❑ Yes [A No
❑ Yes Q'`io
❑ Yes ®No
05103,101

Type of Visit A Compliance Inspection Q Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time:
rO Not Operational 0 Below Threshold
SPermitted W Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: 25o� 7172 _ County:
Owner Name: _ .sue./d ,,.. Phone No:
Mailing Address: � � - & C - 247p4p
Facility Contact: .rr / 1 Title: Phone No:
Onsite Representative: 4.f Integrator:
Certified Operator: /70-otr� "'e'c�•- Operator Certification Number: 2 COY
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a 9 " Longitude 0 °
Design Current.
swine CalincitY Po ulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder /
Farrow to Finish
Design Current Design Current
Poultry Ca acitY Population Cattle CaDacitv Po ulation
❑ Layer ❑ Dairy
❑ Non -Layer 10 Non -Dairy
❑ Other
Total Design Capacity
I ❑ Boars Total SSLW I
Number of Lagoons l ❑ Subsurface Drains Present JI❑ Lagoon Area I❑ Spray Field Area ]
a d Traps ❑ No Li uid Waste Mana ement System
Holding Ponds /Soli -
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 Colleytion & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Freeboard (inches): h
05103101
Structure 5
❑ Yes XNo
❑ Yes No
❑ Yes KNo
❑ Yes gNo
❑ Yes *0
❑ Yes �'o
❑ Yes KNO
Structure 6
Continued

Facility Number: jr3 — / Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes XNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes )<No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes U-No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes XNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes 1KNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes >rNo
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes Wo
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes gNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes X(No
b) Does the facility need a wettable acre determination? ❑ Yes �<No
c) This facility is pended for a wettable acre determination? ❑ Yes XNo
15. Does the receiving crop need improvement? PTYes 0 No
16. Is there a lack of adequate waste application equipment? ❑ Yes Wo
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
ANo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
WUP desi
❑ Yes
No
(ie/ checkli ts, maps c.)
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
JNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
CgNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
CK No
(ie/ discharge, freeboard problems, over application)
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
KNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
9LNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes [R No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
.` V et<er ezpiatn siruauons. tuse�aapiaonai pages�as necessary)
�. , _ E� I �' s Field Copy Final Notes
.. W t t
ReviewerlIns ector Name _
p
Reviewer/Inspector Signature:
f�
Date: T 1 Q2
05/03/01
Continued

Facility Number: — : Date of Inspection i Dz
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 K No
❑ Yes ANo
❑ Yes XNo
❑ Yes PirNo
❑ Yes �'No
�j Yes 1❑�No
Additional Comments andlorjDrawings: ^. ' . M1w
i
05103101

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0outine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility_ Number Date of V isit: Z �Time: /
F Not Operational O Below Threshold
13 Permitted U Certified 13 Conditionally Certified 0 Registered Date Last Operated or
- ................... ...... Above Thr old: ----------------- _..
�...........................Farm Name: ........... 7 County:........
...
Owner Name: Phone No:
�'1.,............................... ........
Facility44
Contact: �t� 5 .CC�l.,t..�3.... ..Title: ..... ! Phone No:
fff...................... x.._........... t............... _........
Mailing Address:
Onsite Representative: .......................... Integrator:........................................................
Certified Operator: ..... _j ,,►►q,{,� .J-A.f ...................... Operator Certification Number:_ .....
Location of Farm: I
[]Swine []Poultry ❑ Cattle []Horse Latitude �� �� Longitude �• �� �•�
Design Current
Design Current
Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Other
Design Current
Cattle Capacity Population
PDairy
Non -Dairy
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
or
ng p ❑ No Liquid Waste Management System
Holdt Ponds / Sohd Tra s : _
Discharges & Stream Imp_ac_ts
. 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'? El Yes �No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes r0
c. If discharge is observed, what is the estimated flow in galhnin'? 1
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 drNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 010
01/01 /01 7 Continued

Facility Number: — Date of Inspection Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes eNO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes JKNo
(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 VNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes Wo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes )J No
Waste Application
/ \
10. Are there any buffers that need maintenance/improvement? ❑jYes ANo
11. Is there evidence o over application? ❑ Excessive o�n-ding /IPAN ❑ Hydraulic Overloa es [INo Y
12. Crop type tQ ✓ C� lJ�
13. Do the receiving crops differ with those designated the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19- Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit'?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
yiolatiotis er dof cleni-ies -tivere h6fed during 4hls:visit: - Yoh wfll-febOW iio fui•thi
.... abauti this visit ....... - .......... .
❑ Yes *0
❑ Yes 9No
❑ Yes A,
0
❑ Yes 8q "o
❑ Yes Kqo
❑ Yes RTO
❑ Yes JgNo
❑ Yes P&0
❑ Yes +������ o
❑ Yes rNo
❑ Yes VNo
❑ Yes D�No
❑ Yes ;No
El Yes 'EV40
❑ Yes J.No

Facility Number: — I Date of Inspection S Printed on: 10/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes �No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes )T�No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
roads, building structure, and/or public property) kr
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ELNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? P_Ies ❑ No
or - -
rawutgs,
A.
J
5/00

10 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review MLOther
Facility Number Date of Inspection !
Time of Inspection 1 24 hr. (hh:mm)
Permitted © Certified 13 Conditionally Certified © Registered 0 Not O erational Date Last Operated:
Farm Name: Lc.d- s........�..... 1.7.L...................................... County:......... a' 1... ........ ........... _........
Owner Name:........Cilrftjl-�.... Phone No: ..........
Facility Contact: ...... Title Phone No:
MailingAddress: ........................................................................SP..... .......................................................................................... ..........................
Onsite Representative: %jdo 0-x r'e Integrator:................
.....�..............................................
Certified Operator: ................................................. ; . ............................. I ............................... Operator Certification Number:..........................................
Location of Farm:
Latitude ' i •6 Longitude ' 4 6=
Design',, Current Design Current = >==-Desig" ' 1 .Current
Swine Ca aci Po ulation Poultry Capacity Population Cattle °--':Capacity "Po' ulation
❑ Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish 10 Non -Layer I Non -Dairy
:. ❑ Farrow to Wean
❑ Farrow to Feeder • ❑ Other
❑ Farrow to Finish Total Design 'Capacity
❑ Gilts
❑ Boars Total'SSLW:':
Numher of Lagoons - ❑Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds I Solid Traps', ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No.
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If' yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in ga]/rnin'r
d. Does discharge bypass a lagoon system'? (If ves, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches}: .... l...Z.._~'3
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
)&s ❑ No
Structure 6
5. Are there any ia teats to th integ ty of any of the structures observed? (ie/ trees, severe erosion,
mme
3/23/99 2— 5-- OD seepage, etc.)
❑ Yes ❑ No
Continued on back

HIGH FREEBOARD NOTIFICATION
DATErnME
DWQ Contact s
Name of Person �[[��
contacting DWQlS173' _Telephone Na.(9�) 276- ®G
FARM Name 717
County
Facility No. d - 1
rr
Freeboard level of the Lagoon A7 a �mn 4/ -these f4r I-S
Conditions of the spray fields:
NARRATIVE: (Include any instructions given to the fanner at the time of the call)
(A copy of each notification should be forwarded to the "CAFO BOX' in John Hasty' office
as soon as possible)

Y r,` �,Drvtscon of Soil and_Water am. Conservaton Operatwn Revrew
� � r.. .�
" Drvrs�on of Soil and Water Conservahgq- 6iipLance;Inspechon
t
ision of Water Quatrty Compliance Inspection DivF
Other A enc" era hon'Revrew.
14DRoutine 0 Complaint 0 Follo►i•-up of DWQ inspection 0 Follow-up of DSW C review 0 Other
Facility Number Date of Inspection
Time of Inspection p 24 hr. (hh:mm)
j (Permittcd Certified 13 Conditionally lC�ertified 0 Registered 0 Not Operational Date
Last Operated:
Farm Name: L.A�LY7.. .......f. [. .1 Countv:............ 2i Jq,-of ...............................
....................... ..... ......................
Owner Name, ......... .tY17�L...........�.................... ................. Phone No: .............f°..`.a.�.-3�[
Facility Contact: - $..-�,�.:.....:. -f�xf�...........Title Phone No:
............................
]♦Tailing Address: ........... to.s.........[J !L>..........g�C................................... ..............VlF4 Fair ........... ................... .``� -�
Onsite Representative: — itl']l^'�. &.k! C ............. Integrator: .......... ..........................................1..............................
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
.......................................................................................................................................................... ...................... l
Latitude �� �' ��� Longitude
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
r
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer 1 ❑ Dairy
❑ Non -Layer I0 Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons 10 Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation (If yes, notify DWQ)`?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If'discharge is observed, was the conveyance nian-made?
b. If discharge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State
c. If discharge is observed. what is the estimated flow in ,a]/ntin?
d. Does discharge bypass a lagoon system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any 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?
Structure I Structure 2 Structur: 3
Identifier:
Freeboard (inches):
Structure 4 Structure 5
❑ Yes No
❑ Yes 0 No
❑ Yes fo No
MIA -
El Yes [�"No
❑ Yes UfNo
❑ Yes 5dNo
❑ Yes 9No
Structure 6
116/99 Continued on back

Faciilify Nbmber: g — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
Y seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes 9No
❑ Yes j? No
9 Yes ❑ No
Yes ❑ No
❑ Yes 9 No
❑ Yes 06 No
11. Is there evidence of over application? ❑ Pondina ❑ Nitrogen ❑Yes MNo
f /
12. Crop type ........... u�� r.....i.
r
ds........................................ .......... .............
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [(No
No
Does the facility lack wettable acreage for land application? (footprint)
❑ Yes
VNo
IN
15.
Does the receiving crop need improvement?
1 r C 4 �+ 1�B
❑ Yes
X No
16.
Is there a lack of adequate waste application equipment?
T"' i�"^ �"�
❑Yes
d�No
Required
Records & Documents
17.
Fail to have Certificate of Coverage 8c General Permit readily available?
le Vag�j n //t /� _ aCrrs` 0 Yes No
�x •fo
=4 Nrti$ a
18.
readily av it
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? { i�
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste
analysis & soil sample reports)
❑ Yes
WNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a certified operator in responsible charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewerfinspector fail to discuss review/inspection with on -site representative?
24. Does facility require afollow-up visit by same agency? /4 : arr,�
�. 1VA.V10l�ti0iI3:OT tdeficiericies.were noted. during #his:visit:. Yoti �vili.reeeive nar further. .:
. ... . potndeiz .... ut... v............. _ .. . .
mitients (refer tei quest,on #): Explain any YES answers aiid/or ady:recornm
e:drawings: of facility.to ;hitter explain situations. (use additional pages as nec
Tkw Aed -& pe
tA4J6, Ids
fits � 4�_�� 41� 1ptww
Reviewer/Inspector Name
Reviewer/Inspector Signature:,��,�
is or any:otlier comnni
n
❑ Yes Xj No
❑ Yes j No
❑ Yes to No
❑ Yes XNo
All El es�KNo
d S�i
s
t4.y kdal-,e Aad4- - 1
- f�"
Pal. C.�IwmP its IV
cAW,*,P ji�� &1/, 6 & ill . e
Date:
1 /6199

.,v�- - � .. �.s..� �.v�or^ .dam: - W.. - �... r. _.:.�:• �p,:.a--, ,-• ... ads% � .;-a�,c.. �k'�ua� Y`�; .�a^w z�br w'>iti,.�rt,",00� -.
'" 13 Division of Soil and Water Conservation Other AgencyK��
� � � Division of Water Quality � ���� � F
Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up or DSWC review 0 Other
Date of Inspection
Facility Number
Time of Inspection bEz ?A hr. (hh:mm)
D Registered Wertified© Applied for Permit Permitted 113 Not O eratinna! Date
%Last Operated:
..........
Farm Name; .21.. ..-7 County:...._ Q l..�' QL.........................................
Owner Name:-f—a.(..:r a..l �... ........!.. !� �.. C.j ............................... Phone No:............Zr��..h�.�,�..................................
.....
Facility Contact L.. .... Title:M . Phone No: Z 76
Mailing Address: r ....
g .... .....8 ..}............................................................-!a:... s. .. 'N Z2r-?v
Onsite Representative:..... e � ) } .......... Integrator• .............
Certified Operator......................:......................................................................................... Operator Certification Number:
Location of Farm:
Latitude ' 4 « Longitude =• ' 0"
� ' fi Dhstgn ' 4Current
`:�.
y Deli A'Current :'< `:"` D6' r Current
.>F ,' ... �Y' ..f t4
i F'
'�k �„ Ca aca, rt= s
i =Swine ' Population Poaltry Ca . acit Pd elation Catt[e Ca act, Po itlahon.
g p t3
�.
„ . } ;y _ P EY u P
. ... �_.... P'� P _
'
❑ Layer d ❑ Dairy
FE
❑Non -Layer ❑ Non -Dairy
JM
❑ Other:..:F
-Total Design Capacity 3 S�a
. , _. F� rta u
f� , ��,.,
zi
Total:ssL„f;
%Nuiaber _f Lagoons°/ Holding Fgnds�� ❑Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
tic. �'i. o ",y ❑ No Liquid Waste Management System m:t t
X„§ 1' w jai X.. �� Mh%t 4
�,� ..` ,niS�Y•, � `.-
Wean to FeederFeeder
to FinishFarrow
to Wean
, Farrow to Feeder
3 5`�
❑Farrow to Finish
❑ Gilts
❑ Roars
General
1. Are there any buffers that need maintenance improvement?
❑Yes
No
2. Is any discharge observed from any part of the operation?
❑Yes
No
Discharge originated at: ❑Lagoon ❑ Spray Field ❑Other
a. If discharge is observed, was the conveyance man-made?
El Yes
❑ No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
El Yes
❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑Yes
❑ No
3. Is there evidence of past discharge from any part of the operation?
❑Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
[I Yes
No
5. Does any part of the waste management system (other than lagoons/hoIding ponds) require
❑Yes
1A No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑Yes
�] No
7. Did the facility fail to have a certified operator in responsible charge?
El Yes
� No
7/25197

Facility Number:g —
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (LagoonsZoldinu Ponds, Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1
Identifier:
Freeboard (ft): ..........3....................
Structure 2 Structure 3 Structure 4 Structure 5
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenancelimprovement?
(If any of questions 9-12 was answered yes, and the situation poses
an inunediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application 1
14. Is there physical evidence of over application?
(If in excess of WNW, or runoff ent rin waters of the State, notify DWQ)
15. Crop type ...................................................... ......... I ...... I ............... ... ..........................
16. Do the receiving crops differ th those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
No.vialation`6edefidencies.weri-' 'ted;duringthis:visit. ,-Yoa:willi66 e:iTo.furtliei•,::
correspondehee about this: visit:. • . . . : ... : .:. . ... . . . . . . . .:. .:.:. . . . .
%QrT B raj U (WJ �ifCt�� �S lOt"r /Lc, %�GG�!aYk�� d— _1111# d C
re-5pf; ey
❑ Yes �No
❑ Yes Z_No
Structure 6
❑ Yes No
❑ Yes No
❑ Yes XNo
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes ;No
❑ Yes o
❑ Yes j( No
❑ Yes kNO
❑ Yes �No
❑ Yes No
❑ Yes No
❑ Yes No
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: �, r z Date: 1/0 _ 2 L

E3 DSWC,'Atiiniil,,-Feedli)tOPeriiti6W,,ReVi&*"-",
Routine
Follow-up of
I Facility Number I
Follow-up of DSWC review 0 Other
Date of Inspection -9
Time of Inspection 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm S
1tatus• 0 Registered 0 Applied for Permit (ex:1.25 for I hr 15 min)) Spent on Review
: Certified [3 Permitted or Inspection (includes travel and processing)
I
D Not Operational Date Last Operated -
Farm Name- . ...... County:
Land Owner Name: Phone No:
FacfliyConetact: Title: Phone No: . .....
Mailing Address: Af C
Onsite Representative: Integrator:- painda tif
I
Certified Operator: .... . ..... . ...... . . ..... Operator Certification Number:
Location of Form:
qF . 1 —10
.... 435F T;75i;
Latitude Longitude
Type of Operation and Design Capacity
to .
. . . . . . . . . . . .
....���.,... Ca acr Po "elation Poultry . Ca achy Po elation CattleCa aci 0 elation
Farrow to Wean
'Dinign"',Cav a V a. q, _UTa;7w to Feeder 1 K'5__Q 1 PAP,
..... . . . . .
FarrowQ Finish
. ....... . ..
,Total gLw
❑ other
N
g"
A
EM8.of Lagoons.`! Holding Ponds10 Subsurface Drains Present
10 Lagoon Area jarO—Spray Field Area
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Lagoon [3 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/inin?
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?
4/30/97
El Yes No
El Yes 0
0 Yes [I No
[:]Yes [I No
[]Yes [I No
❑ Yes No
❑ Yes No
El Yes 0
Continued on back

vacility Number: --OP --. 15
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes No
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes o
,Structures (Lagoons and/or Holding, Pond
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes XNO
Freeboard (11): Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Strutture6
c
10. Is seepage observed from any of the structures?
❑ Yes kNo
11. is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes ANo
12. Do any of the structures need maintenance/improvement?
❑ Yes XNo
(1f 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 ANo
Waste AARnlication
14. Is there physical evidence of over application?
❑ Yes ANo
(If in excess of WMP, or nmoffen, erin waters of the State, notify DWQ)
15. Crop type �...1' 1.t,...... .... _ .... _.... r....
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes XNo
17. Does -the facility have a lack of adequate acreage for land application?
❑ Yes KNo
18. Does the receiving crop need improvement?
❑ Yes ANo
19. Is there a lack of available waste application equipment?
❑ Yes 9,Vo
20. Does facility require a follow-up visit by same agency?
❑ Yes AVo
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes KNo
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management PIan readily available?
❑ Yes , No
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ANo
24. Does record keeping need improvement?
[:]Yes ANO
Comments (refer. to question ; Eicplam any YES'answeis and/or any recommendations _or any=other comments -u fr,
Use drawings,of facility to better explain situattons;(use aildthonalpages as necessary) art;
PL
F4-tr 1 1.5 i A. Fond S4cp_- a..►j I rt
Reviewer/Inspector Name
Reviewer/InspectorSignature: Date: g—Z7-9G
cc: Division of Water Ouality. ter Oualitv Section. Facility Assessment Unit 4/30/97

State of Norf h Carolina
Department of Environment,
Health and Natural Resources •
Fayetteville Regional Office
James B. Hunt, Governor p E l-H N F-R
Jonathan B. Howes, Secretary
DIVISION OF WATER QUALITY
July 25, 1996
Carroll's Foods, Inc.
1 ] 6 James Street
Laurinburg, NC 28352
SUBJECT: Compliance Inspection
Swine Farms
Hoke, Scotland and Richmond Counties
Dear Sir:
On July 2, 1996, an inspection of several animal operations was performed by the
Fayetteville Regional Office (FRO). Please find enclosed a copy of our Compliance Inspection
Report for your information. It is the opinion of this office that these facilities are in compliance
with 15A NCAC 2H, Part.0217, and that Animal Waste Management is being properly performed.
Should you have any questions regarding this matter, feel free to contact me at (910) 486-
1541 ext. 325.
Sincerely,
Ricky Revels
Environmental Technician IV
Enclosure
cc: Facility Compliance Group
Wachovia Building, Suite 714, Fayetteville N&EW
FAX [phone]
North Carolina 28301-5043 An Equal Opportunity Affirmative Action Employer
Voice 910=486-1541 50% recycled/ I M. post -consumer paper

Facility Number., 3 - l.S
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
Date: 7 - Z - 9(.
Time: / 3 Y- o
general Information:
Farm Name: 717 7 County: SC-4&+I4L*.. <L
Owner Name: Ca YYo I I' r Fo, a r N c . Phone No: 010.) zg3 -34 3 �
On Site Representative: _ Al Lauer Integrator: arro '_S s
Mailing Address: Po A *-,,-+, , S S (C
Physical Address/Location: Fin • L a.. iw6n=� 7SO- as" 0' Q74 .o; -s
�,.. r wf// � a �� _t ro s 1 7�e�e,��1'�G �'rs{� __ fYr'�� . ProGe t `� o •t�% _o � 7�v •..�� ��r�,
Iroc-.J so t..C� a� �'srJL �rA,i� �c-op.�cs�. ,'Yt� �•r�c fa �� ••.•.. .
Latitude: 1 I Lonpi
Operation Description: (based on design characteristics)
T of Swine No. of Animals Type of Poultry No. of Animals 7jpe of Cattle No. of Animals
tz Sow -&jcaPJ © Layer O Dairy
0 Nursery a Non -Layer ❑ Beef
❑ Feeder
OtherTy pe of livestock Number of Animals:
Number of Lagoons: (include in the Drawings and Observations the foeboard of each lagoon)
Facilily Inspection:
Lagoon
,
Is Iagoon(s) freeboard less than I foot + 25 year 24 hour storm storage?:
Yes 0
No QY'
Is seepage observed from the lagoon?:
Yes 0
No Er
h erosion observed?:
Yes ❑
No
Is any discharge observed?
Yes ❑
No Q"
O Man-made Q Not Mart -made
Cover Crop
Does the facility need more acreage for spraying?:
Yes 0
No
Does the cover crop need improvement?:
Yes 0
No C'
( list the crops which need improvement)
Crop type: C'oas4,�k EI-, Ldj Acreage:
Setback Criteria
Is a dwelling located within 200 feet of waste application?
Yes ❑
No L'
Is a well located within 100 feet of waste application?
Yes 0
No ar'
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream?
Yes ❑
No i_
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream? yes 0 No
AOI — January 17,1996

Maintenance
Does the facility maintenance need improvement? Yes ❑ Noe
Is there evidence of past discharge from any part of the operation? Yes ❑ No V'
Does record keeping need improvement? Yes ❑ No &""
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes lr No ar
Explain any Yes answers:
Signature: _ &I, � -�•� Date: 7 o z /9 6,
1-0
cc.. Facility Assessment Unir Use Attachments if Needed
Drawings or Observations:
0
.. +.n rrr— i __� _r. mom- '�J 1E' +.�. - _T• s.. .Zw - •�•--• _ �.
AOI -- January'17,19%

Site Requires Immediate Attention: A10
Facility No. $3 -1S
DMSION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 7-ts I `F , 1995
Time: 13 : 5 1
Farm NantelOwner: C aY-vo 11 ' s a^ r71 `t -1 CQ v -oi f's "o v d �.vc
`/Mgling Address:_P9192 Old towheri6ni_flwy L.aw,_;N6(A_ NC zS 35 Z.- --__
County: 5'c- 4-1r. N d
-Integrator: Phone:
On Site Representative: Phone:_ K910,) 2-7-7- / 300
Physical AddresslLocation:_
Type of Operation: Swine Poultry Cattle
Design Capacity: .350 Number of Animals on Site: /, 350_
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: c *(0' is " Longitude: 79 ° Z3 ' 21
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) �SPor No Actual Freeboard: 3 Ft. 0 Inches
Was any seepage observed from the la oon(s)? Yes ojtS�Was any erosion observed? Yes ok!V
Is adequate land available for spray? ems- r No Is the cover crop adequate? d�Dor No
Crop(s) being utilized: Cvms /
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? or No
100 Feet from Wells? t�or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes oK�)
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes oxg�
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 of manure, land applied,
spray irrigated on specific acreage with cover crop)? �or No
Additional Comments:
R•- Rwe_ls
Inspector 16ame
Kt�k�
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

lel 00 '06 m eo
/3 : s-/
- DIVISION OF ENVIRONMENTAL MANAGEMENT
November 4, 1994
SUBJECT: Compliance Inspection
5CP.t L county
Hear 111�
JM J f
on , an inspection of your animal operation was performed
by
the
Fayetteville Regional Office (PRO). Please find enclosed
a copy
of
our
Compliance Inspection Report for your information. It is the
opinion
of
this
office that this facility is in compliance with 15A NCAC 2x,
Part .0217,
and
that Animal Waste Management is being properly performed.
should you have any questions regarding this matter, feel
free to
contact
aye at [phone].
Sincerely,
Enclosure
cc: Facility Compliance Group

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Scotland Count L.
This southern border county was
estabished in 1899. Laurinburg is the
county seat of Scotland County, named
so for Scotland in the British Isles from
which many of the early settlers of the
region came. 4X

• r
r
ICI I % % % %1I
I WI
WORTH CAROLIHA DEPAR1NZW Or ZW11=0WN3CRT, HEALTH b NATURAL P.IWURCIE;S
DIVISION Or AL KRNAG PEM
Fayetteville Regional Office
Animal Operation Compliance Inspection rorm
.'+%:aoa:..nr't:. :p�N _ _. :.'. '.7F'•°Q =RPM
�...MVV-��-w.s:>.�i+si`a:rtR� �, ,..,�' �i.�..�tl�K..e?0K
M� .�. ��... �.�!!.'T•• �..:.'f��� y""'
11'
a N
�.....-n.. .........:.....�... r.�'iW'i.. •On:9NbM..b:aWKW.%.n. i.:[i�
>� �e N'���NwO�J
J:1Ni..�w�..l.rK �+k.a�ir�2+�K�v�%nvoa...,w.r.rM.e.e•wre«sre�.rlo: c�tx � ��:°r��°o-:wr�a.iO
4�%x�•,�..-
.. ..... ...... .n.::...w�. n:..v.v w.....
«Kye. %M9i01 I.iM1pK,k•?�w«�F} ���p�r.�a.nM'wrwu..w�`?vw i�i �<k<anNYi
kv. 'FY>�-RiiMh% >+�F ��. .iV,>... -«w
�..��`d'
%r.!'rh.rNdeO�Ne+KtKq.%l0�`
.�. .�A4M• f..�
�Ynr.,,rMOA
�...v:v.�� vrw�>xY0
Iforg Old 4/4 a1J
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 Operation Type:
Horses, cattle, OR
, poultry, or sheep
146".y
1. Does the number and type of animal meet or exceed
the (.0217) criteria? ICattie (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 WMISTRATIW.
3. Are animals confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a CERTIFIED ANIMAL
WASTE XRNAGE30M PLAN? - —
5. Does this facility maintain waste management
records (volumes of manure, land applied,
spray irrigated on specific acreage with
specific coven crop)?
6. Does this facility meet the SCS minimum
setback criteria for neighboring houses,
wells, etc?
Em© . is
IL/
I/

�1s4 101 eo 100 00:00
fi
tMULT-1 ilk III
0NER
Pie10 -site Hantagement
1. Is animal waste stockpiled or lagoon
construction within 100 ft. of a USGS
map Blue Fine 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
CIRTIFIGTION pI.RW
5. is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar man-made devices?
&. Does the animal waste management at this
farts adhere to Best Management practices
(MP) of the approved TION?
7. Does animal waste lagoon have sufficient Kopf
freeboard? How much? {Approximately S )
S. is the general condition of this CAFo facility,
including management and operation,
satisfactory?
CxION IV
Comments

Information contained in this database is from non agency sources and is considered unconfirmed
Farm Emergency ll Form
Farm Number 1 -
Farm Name 17111
Owner First Name
Owner Last Name arro S Foods Inc
p Reporting Q Compialn
Source eS Stutts
Inches
Date11-31-2000
rime
Call Number
Plan Due Date Date Plan Date Freeboar
(? equals blank) Received Level OK
Breached
Q es O No
Freeboard Lagoonl
- -
IF-18-2000
Q es Q O
Freeboard Lagoonl
Overflowed
Q es Q O
Freeboard Lagoon3
LOIssue
Q Yes Q O
PermissionioPump
Q Yes
Freeboard Lagoon4
Inundated
Q Yes Q O
Freeboard Lagoons
Flooded
Q Yes Q O
Freeboard Lagoon6
Pumping Equipment
Q Yes Q O
Comments

Information contained in this database is from non agency sources and is considered unconfirmed
Farm Emergency Call Form
Farm Number P3
Farm Name
Owner First Name
Owner Last Name Farroll's Foods Inc
1(g Reporting 0 Complaint
Source IlLes Stutts Inches
Date 11 -24-2000
Time I
Call Number 1645
Plan Due Date Date Plan Date Freeboar
(? equals blank) Received Level OK
Breached
10 Yes * O
Freeboard Lagoonl
11/26/2TD
I
Depopulated
10 Yes 0 O
Freeboard Lago0n2
7
F
Overflowed
10 Yes 0
Freeboard Lagoon3
7
F
LO Issue
10 Yes * No
PermissionTopump
10 Yes 0 No
Freeboard Lagoon4
F
Inundated
�s 0 No
Freeboard Lagoon5
Flooded
10 Yes O
Freeboard Lagoon6
Pumping Equipment
10 Yes @) �o
Comments
Ady! s ed. lo. IdUow.. P1 a rL .......................................... ........ . ........................................ ................. I .........................
................................. I .............................................. ........................................................................................................................................
.TA. T ......................................................................................................................................................................................................................
............................................................ ................................................................................................................... . ..........................................
.o hn.Hasly ......................................................................................................................................................................................................
................................................................................................................ I ........................................ I ......... I .... I .................. I ........................................
..................................................... . ............................................................................................................................................................................
........................... 11, .................................................................................................................................................................................................
............ ........................................................................................................... . .......................................................................................................
......................................................................................................... I ................................................. ................ I ....................................
............. I .. . ................ .......................................................................................................................................................................................... I
................................................................................................................................................................... I ....................... I ........................................
............................................................................................................................................. ... ...................................................................................
................ I ................... I., ...................................................... I .................................... I ................................................................... .....................
..................................................... I .......... ........................ ................ I ............................ I ..................................................................
..................................... I ........................... .................. I .....................................................................................................................................
................................................. ........ I .............................. 1.1111". .............. .... ..............................................................................................
............................................................................................................................................. .... .................... ..............................................................
..................... I ............ ... ................................................................................................. I .................................................. ...................................
.......................................................................................................................................................................................................... ........................
.......................................... " ................................................................................................... .................................................. I .................................
.......................................................................... ........................................ I .......................... .......... 1. ... . ... I .................................... I ..........................
............................................ I .......................................................................................................................................................................................
.............................................. I .................................................................................... I ................................................................................................
.............................. I ................... I ...................... I'll ........................................... I ...................... I .... I .................................................... ..." ......................
.............. I ............................................ I ............... I ................................................................................................................................ I ......................