830016_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qua
II

M Division -of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
830016 Facility Status: Active
Permit AWS830016
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit
Routine County:
Scotland Region:
Fayetteville
Date of Visit:
02/17/2017 Entry Time: 10:00 am Exit Time: 11:00 am Incident d
Farm Name:
7169
owner Email:
Owner
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
20987 McGirts Bridge Rd
Laurinburg NC 28352
Facility Status:
Compliant ❑ Not Compliant Integrator
Murphy -Brown LLC
Location of Farm:
Latitude:
34° 48' 27" Longitude:
79° 23' 12"
On the north side of SR 1433 approx. 1.7 miles southwest of its intersection with SR 1407, northwest of Laurinburg-Maxton
Airport.
Question Areas:
Dischrge 8 Stream impacts Waste Col, Stor, 8 Treat
Waste Application
Records and Documents Other Issues
Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008
Secondary OIC(s):
Onstte Representative(s): Name Ttge Phone
24 hour contact name Mike Cudd Phone :
On -site representative Mike Cudd Phone :
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspectorjs):
Inspection Summary:
No lagoons
page: 1

Permit: AWS830016 Owner - Facility: Murphy -Brown LLC Facility Number. 830016
Inspection Date: 02/17/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish 1,200
Total Design Capacity: 1,200
Total SSLW: 162,000
page. 2

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number. 830016
Inspection Date: 02/17/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
reu Ng, Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes No Na Ne
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
■ ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance altematives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number. 830016
Inspection Date: 02/17/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yea No No No
Crop Type 1
Coastal Bermuda Grass
- - —._ --
(Pasture) --
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil "type 1
Wagram loamy sand, 0 to
2% slopes
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
(]
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
E ❑
❑
18, Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yea
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?
❑
E ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
[]
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 [] ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
[]
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS830016 Owner - Facility: Murphy -Brown LLC Facility Number. 830016
Inspection Date: 02/17/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yee No Na No
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
E ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
N ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
M ❑
❑
Other Issues
Yes
No Na Me
28. Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑
E ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
E ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWO of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility?
❑
E ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ M ❑ ❑
CAMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with on -site representative? ❑ 0 ❑ ❑
34. Does the facility require a follow-up visit by same agency? ❑ E ❑ ❑
page: 5

0 Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number
830016 Facility Status:
Active permit: AWS830016
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Scotland Region:
Fayetteville
Date of Visit:
03111I2015 Entry Time: 04:30 pm
Exit Time: 5:00 pm Incident #
Form Name:
7169
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487
Physical Address; 20987 McGirts Bridge Rd
Warsaw NC 28398
Laurinburg NC 28352
Facility Status: ECompliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34° 48' 27" Longitude: 79° 23' 12"
On the north side of SR 1433 approx. 1.7 miles southwest of its intersection with SR 1407, northwest of Laurinburg-Maxton
Airport.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008
Secondary OIC(s):
On -Site Representative(s):
24 hour contact name
On -site representative
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
No lagoons - dry stacks.
Name
Mike Cudd
Mike Cudd
Robert Marble
Title
Phone
Phone
Phone
Phone:
Date:
page: 1

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 03/11/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Swine
Design Capacity
Current promotions
Swine - Feeder to Finish 1.200 == I
Total Design Capacity: 1,200
Total SSLW: 162.000
page: 2

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No No No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ E
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ ■
❑
c. What is the estimated volume that reached waters of the Stale (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ N
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
N ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le.l large
❑
■ ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
N ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Me
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below,
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 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: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No No No
Crop Type 1 Coastal Bermuda Grass
(Pasture)
Crop Type 2 Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1 Wagram loamy sand, 0 to
2% slopes
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
E ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
■ ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes NoN& No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ N ❑
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?
❑
Rainfall?
❑
page: 4

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
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?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
E ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a PDA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No No No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
E ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
E ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon I Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 830016 Facility Status: Active Permit: AWS830016 Denied Access
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Scotland Region: Fayetteville
Date of Visit: 03111/2015 Entry Time: 04:30 pm Exit Time: 5:00 pm Incident#
Farm Name: 7169 Owner Emall:
Owner Murphy -Brown LLC Phone: [phone]
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 20987 McGirts Bridge Rd Laurinburg NC 28352
Facility Status: E Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34' 48' 27" Longitude: 79' 23' 12"
On the north side of SR 1433 approx. 1.7 miles southwest of its intersection with SR 1407, northwest of Laurinburg-Maxton
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Ronald Lee Matthews Operator Certification Number: 990008
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone:
On -site representative Mike Cudd Phone:
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
No lagoons - dry stacks.
Robert Marble
Phone:
Date:
page: 1

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Swine
Design Capacity Current promotions
❑ Swine - Feeder to Finish 1,200
Total Design Capacity_ 1,200
Total SSLW: 162,000
page: 2

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 03/11/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ m
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.eJ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yes No Na We
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS830016 Owner - Facility: Murphy -Brown LLC Facility Number: 830016
Inspection Date: 03/11/15 lnpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No No Ne
Crop Type 1
Coastal Bermuda Grass
(Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Wagrem loamy sand, o to
2% slopes
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving'crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
E ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
E ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
■ ❑
❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
El w ❑ ❑
20, Does the facility fail to have all components of the CAWMP readily available?
❑ E ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 03/11/15 Inpsection Type: Compliance Inspection . Reason for Visit: Routine
Records and Documents
Yes No Na Ne
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
01113
(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?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
830016 Facility Status: Active
Permit: AWS830016
Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine County:
Scotland Region:
Fayetteville
Date of Visit:
03/20/2014 Entry Time: 02:00 pm Exit Time: 3:00 pm Incident #
Farm Name:
7169
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-29&1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
20987 McGins Bridge Rd
Laurinburg NC 28352
Facility Status:
Compliant ❑ Not Compliant Integrator:
Murphy -Brown LLC
Location of Farm:
Latitude:
34° 48' 27" Longitude:
79' 23' 12"
On the north side of SR 1433 approx. 1.7 miles southwest of its intersection with SR 1407, northwest of Laurinburg-Maxton
Airport.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator: Michael L Cudd Operator Certification Number: 25233
Secondary OIC(s):
On -Site Representative(s):
24 hour contact name
On -site representative
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
No lagoons - dry stacks.
Records reviewed 3110114.
Site visit 3120114.
Name
Mike Cudd
Mike Cudd
Title
Phone:
Phone:
Phone
Robert Marble Phone:
Date:
page: 1

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 03/20/14 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Swine
Design Capacity Current promotions
Swine - Feeder to Finish
Total Design Capacity:
Total SSLW:
page: 2

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 03/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
110
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
11011
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
e ❑
❑
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
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yes No Na Me
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS830G16 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 03/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
wagram
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
[]
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
■ ❑
❑
determination?
17_ Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
N ❑
❑
Records and Documents
Yes No Na No
19. Did the facility fall to have Certificate of Coverage and Permit readily available?
❑
N ❑
El
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
If Other, please specify
21, Does record keeping need improvement?
❑
0 ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
El
page: 4

r
Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830015
Inspection Date: 03/20/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22, Did the facility fail to install and maintain a rain gauge?
❑
■ ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑
E ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fait to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No Na Ne
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
E ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? if yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
E ❑
❑
(i.e.. discharge, freeboard problems, over -application)
31, Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
E ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewfinspection with on -site representative?
❑
E ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
■ ❑
❑
page: 5

Division of Water Resources
Division of Soil and Water Conservation
0
Other Agency
Facility Number.
830016
Facility
Status: Active
Permit: AWS830016
Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County:
Scotland Region:
Fayetteville
Date of Visit:
02/25/2013 Entry Time:
04:00 pm Exit Time: 5:00 pm Incident #
Farm Name:
7169
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
20987 McGirts Bridge Rd
Laurinburg NC 28352
Facility Status:
Compliant ❑
Not
Compliant Integrator.
Murphy -Brown LLC
Location of Farm:
Latitude:
34' 48' 27" Longitude:
79° 23' 12"
On the north side of SR 1433 approx. 1.7 miles southwest of its intersection with SR 1407, northwest of Laurinburg-Manton
Airport.
Question Areas:
■ Dischrge & Stream Impacts waste Col, Stor, & Treat . waste Application
Records and Documents Other Issues
Certified Operator: James Brian McGugan Operator Cerlification Number: 986752
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Cudd Phone :
On -site representative Mike Cudd Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s)-
i
nspection Summary:
No lagoons. Three dry stacks.
Records reviewed 2/15113
Site visit 2)25113
page: 1

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 02/25/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
Swine - Feeder to Finish 1,200
Total Design Capacity:
Total SSLW:
page: 2

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 02/25/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
0 M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
110
❑
C. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
■ ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (l.e./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? {Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
C7
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
[]
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
[]
page: 3

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number:
830016
Inspection Date: 02/25/13 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste Agplication
Yes
No Na No
Crop Type 1
Coastal Bermuda Grass
(Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Wagram
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
E ❑
❑
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18, Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ ❑ ❑
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?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS830016 Owner - Facility : Murphy -Brown LLC Facility Number: 830016
Inspection Date: 02/25/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
M ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
■ ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
M ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
[]
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
❑
❑
27, Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
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, over -application)
31. Do subsurface tile drains exist at the facility?
❑
M ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon 1 Storage Pond
❑
Other
❑
If Other, please specify
32, Were any additional problems noted which cause non-compliance of the Permit or
❑
M ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
■ ❑
❑
34, Does the facility require a follow-up visit by same agency?
❑
■ ❑
❑
page: 5

type or visit: 04ompuance inspection V tperation Keview u structure Evacuation %J Iecnntcal ASSIStance
Reason for Visit: *Routine O Complaint O Follow-up O Referral O Emergency_ O Other O Denied Access
Date of Visit:2 �5` Arrival Time: Departure Time: County Region: ->aO
►
Farm Name: [ 1bq Owner Email:�
Owner Name: U_C Phone:
Mailing Address:
Physical Address:
Facility Contact: 5 y
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
0
Title: Phone:
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
EDesin 'Current
Swine "` Eo P•
..
WetFoul ti Y
Design
Ca aci
P t3
Current
PoCa
P•
Design Current
aci Poh
P h' P-
Wean to Finish
Layer
Nan -La er
1] . Poul
Design
Ca aci
Current
P,o
Dai Cow
Wean to Feeder
Dai Calf
Feeder to Finish
Farrow to Wean
(2 oC>
Dai Heifer
Cow
Farrow to Feeder
Non -Dairy
Beef Stocker
Farrow to Finish
Layers
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes CQ No ❑ NA ❑ NE
[—]Yes ❑ No
[—]Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes � No
® NA ❑ NE
NA ❑ NE
[2PNA ❑ NE
[:] NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: Date of Inspection: 2-ILVI,3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure i Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 2— 3
Spillway?:
Designed Freeboard (in): MOAJE — N Q LAG-cotf�C_
Observed Freeboard (in): ��
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
9 No ❑ NA ❑ NE
❑ No J5 NA ❑ NE
Structure 6
❑ Yes CR No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
P No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7_ Do any of the structures need maintenance or improvement?
❑ Yes
® 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?
f
T
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 W 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 ❑ Evidenceof Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): c;'Zs. !N`� "/ t � �/
SS c &5� , s� - cs` aft/ 0 �J
13. Soil Type(s): Ocary M
!
14. Do the receiving crop iffer from those designated in the CAWMP?
❑ Yes
[7�No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
P No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
RNo
❑ 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
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
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

acili Number: - Date of Ins ection: 9 9
NE S
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes IM No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes P No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ®No [] NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes ® No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [M No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit`? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAW-W?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes 0 No ❑ NA ❑ NE
[:]Yes ® No ❑ NA [D NE
❑ Yes E] No ❑ NA ❑ NE
❑ Yes ® No
❑ Yes T No
[:]Yes ® No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
� 2- f 3
Reviewer/Inspector Signature: Date: /
Page 3 of 3 21412011

Type of Visit & Compliance Inspection ()Operation Review Q 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: q 4
�11 Aa�
Arrival Time: Zi t� �+-- Departure Time: � �:�3 County: �TL./ rJv LJ Region:
Farm Name: / 1 4r Owner Email:
Owner Name' Phone:
Mailing Address:
Physical Address:
Facility Contact: ,/vim Title: Phone No:
11��
Onsite Representative: u Integrator: Att444�0 L —
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: FT 0 ' 0 " Longitude: = ° 0 { = "
Swine
Design
Capacity
Current
Population Wet Poultry
Design Current
Capae�i�"Population
=Cattle
Design Current
Capty Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
❑Non -La er
❑ Dairy Calf
Feeder to Finish
Qt7
Dry Poultry
Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Layers
❑Non -La ers
❑ Beef Stocker
❑ Gilts
❑Beef Feeder
❑ Boars
❑ Pullets
❑Beef Brood Co
Other
❑ Turkeys
❑Turke Pouets
Number of Structures:
❑ Other
❑Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
�'No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
1P NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
PQNA
❑ 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
El NE
2. Is there evidence of a past discharge from any part of the operation?
[I Yes
Iq No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Rlo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: Date of Inspection
Waste Collection &Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? El Yes
�lo El NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [�NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
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
91 No
ElNA ElNE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes
Wo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
E�4o
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
[P No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside ofAcceptable Window Evidence of W� ind Drift ❑ Application Outside of Area
/❑
12. Crop type(s) L� 9z T4l J �✓t t-�elC� 6 '� �T'� 1 �� , 6-Tk("" J R4-$�
13. Soil type(s)
14. Do the receiving croWdiffer from those designated in the CAWMP?
❑ Yes
Fio
❑ 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
No
ElNA
[INE
17. Does the facility lack adequate acreage for land application?
ElYes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
W No
❑ NA
❑ NE
5 l ✓r S r�` Cc v�G�
Reviewer/Inspector Name d Phone: TIU 3 - 300
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection ` u
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 6�0 ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists El Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes $jNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Fain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
PNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
J§No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes,Q
No
ElNA
ElNE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
91 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
JpNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
*Ej No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Wo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
(a 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
PNo
❑ 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
F?No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
O)No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
A No
❑ NA
❑ NE
Additional Comments and/or Drawin95
.'"na Rt
i
Page 3 of 3 12128104

Facility Division Number .© ion of Water Quality
- ion of Soil and Water Conservation
®g Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review Q Structure Evaluation p Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral Q Emergency O Other O Denied Access
Date of Visit: Arrival Time: '7f Departure Time: ounty. egion:
IV
Farm Name: ti*
Owner Email:
Owner Name: �(u,Q., -emu,,« U.[� Phone:
Mailing Address:
Physical Address:
r
Facility Contact: j C _ Title: Phone:
Onsite Representative: 4
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator:MtL44p —kfjA4 s U—C—
Certification Number:
Certification Number:
Longitude:
Design Current
Design:.
Current _
: Design Current
Swine Capacity Pop.
Wet PoultryCapacrty
Pop.
Cattle
Capacity Pop.
y
w.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -Layer
DaiEy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
``'` `Des o
_.g
CurrentDry
Cow
Farrow to Feeder
D , P,ault'- Ca aci
Po
Mon-Dai
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
,.f
Turkeys
-
Other
Turke Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does 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'o No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
� No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili Number: - Date of Inspection: 2
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
Identifier: 1 21_
Spillway?:
Designed Freeboard (in): �N _ ���
Observed Freeboard (in): � —2
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
Structure 5
No ❑ NA ❑ NE
❑ No NA ❑ NE
Struc e 6
❑ Yes
o
r
[] 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 ONo ❑ 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):
13. Soil Type(s):
14. Do the receiving crops`$iffer from those designated in the CAWMP?
). 5k,,,. QA4, otw_q�
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP [:]Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes No ❑ NA ❑ NE
❑ Yes t No ❑ NA ❑ NE
❑ Yes
V No
❑ NA
❑ NE
❑ Yes
[�)No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ 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 TIs!fers
❑ Rainfall [:)Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspecti ns
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes . No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

[Facility Number: -1A Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
01 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
[P NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ 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
[a No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
7l�
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
'�'No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[�LNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
TT��I No
❑ NA
❑ NE
T"'d' """4 ZlZ 31t z'
Sit Vl��- %7f71/2r
Reviewer/Inspector Name:
Revi ewer/] nspector Signature:
Page 3 of 3
Phone: 3�
Date: 3 J"7) 2
21412011

q -tZ- 201b
O/
Type of Visit 16-om�pliance Inspection Q Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 3 2S—/D Arrival Time:%� Mom. Departure Time: %:OA /y County: S�dflG�✓�
Farm Name: 7169 Owner Email:
Owner Name �!L— /jt,.1/ Phone: '
Mailing Address:
Region: �i�
Physical Address:
Facility Contact:' Ckcl _ Title: L�'u 1` Phone No:
Onsite Representative: Integrator: Af
Certified Operator: �e-- SaA/ Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 0 0 = ` =" - Longitude: = o = , 0
n C►urrentSwine
fc.,apacity PopuLttion
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
Wean to Feeder
n-La er
❑ Dairy Calf
FFeeder to Finish
;Z 00
Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
ElNon-Dairy
El Farrow to Finish
❑ Layers
El Beef Stocker
ElGiltsGilts
❑ N ers
El Beef Feeder
❑ Boars
❑
❑ Beef Brood Co
--
El Turkeys
Other
❑ Other
❑ Turkey Poults
❑ Other
Numtter of Structures:
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 03No []NA ❑ NE
[]Yes
❑ No
[)I NA
❑ NE
❑ Yes
❑ No
ETNA
❑ NE
ONA
❑ NE
❑ Yes
❑ No
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
ONo
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

-Facility'Number: 1?3 —D/&
Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes M No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes EdNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: -714 �
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): MAP IA012 &JdtjVAJ LtS-0-4
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes [2(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 VrNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes R�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 El NA El NE
maintenance or improvement? `
Waste Application
10.
Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
& o ❑ NA
❑ NE
maintenance/improvement'?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
0 No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
Croptype(s) 13GVL--.K4�P0.S ►-L J S",��rt' Gr�i �811wS����
13.
Soil type(s) JAJX
a
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
-VINo ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement'?
❑ Yes
PyNo ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
W No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
PjPNo ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
Wo ❑ NA
❑ NE
'aE F2rw. t.�a 5
holdiM�
p[�`
uiva �� bu; ld s
4­�,t4- �. I- i s
Wes 1 c � s
R. P � � i �. �
o �► i-�
�' � � l d s �,., �
h a ,.► � weL � o At S .
Reviewer/inspector Name
Reviewer/Inspector Signature:
Phone: 330 V
Date: ZZO / V
Page 2 of 3 12128104 Continued

Facility Number: g,3 —Ej/(o Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes S 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 ❑ Other
21. Does record keeping need improvement? if yes, check the appropriate box below_ ❑ Yes 0291 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 ElNE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes M 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
ONo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
J9 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
R No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[A No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P9 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
�9 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 I.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
EfNo
❑ 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
[VNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
HNo
❑ NA
❑ NE
Page 3 of 3 12128104

IType of Visit • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit ORoutine O Complaint O Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: r Arrival Time: Departure Time: County: Sr�i�_ Region'
Farm Name: L� S s �b"� Owner Email:
Owner Name: N �' Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: E= o ❑ ' = Longitude: =° [�' ❑
Design Current
;, . Design
Current Design Current
Swine Capacity Population
WetPo�ultry, Capacity
P�op� ulaho :T Cattle Capacity Popnlation
❑ Wean to Finish
❑ La er
= ❑ DairyCow
❑ Wean to Feeder
❑Non -La er
❑ DairyCalf
Feeder to FinishI-
zaDairyHeifer
❑ Farrow to Wean
D Poul-
❑ D Cow
❑ Farrow to Feeder
" "
El Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
El Beef Brood Co
-:
❑ Turkeys
Other n
❑ Other
❑Turke Poults
❑Other
;;`.,
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
P, No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
(� NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c- What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
[PNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
WNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Q9 No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No "f!)NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? Cl Yes
P 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
J�PNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
�No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
N 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 D Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) jjWqraW
14. Do the receiving croY differ from those designated in the CAWMP?
❑ Yes
N No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
KI No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
6 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
In No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
C&No
❑ NA
❑ NE
.. .�,_'�:, `,-' - �. z
Comments (refer to question #) Egplam aiiy YES' answers and/or any recomiueodati&is:or sny otherjicomments T,
Use drawmgs`.of facility to better eaplam sitvahons. (use additional pages as necessary);,,,
ReviewerllnspectorName j/ f Phone: f�f`IfS`f'S�
Reviewer/Inspector Signature: Date:(O&CIEZ
rage 1 0j 3 111.1&U4 conrtnuea

Facility Number: Date of inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Q!FNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design [I Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
IFNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
1p No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
[]Yes
IE�No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
F No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
F
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
PNo
❑ 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
ElNA
El NE
and report the mortality rates that were higher than normal?
[�
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31 _
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
P No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
4 No
❑ NA
❑ NE
Page 3 of 3 12128104

re92e
L
f Visit WCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
n for Visit l9 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: Z . S— County: Region:
Farm Name: _ 7�1`_/ _p Owner Email:
Owner Name: /JfL � r'4!pfi fj1'dl�/✓ Phone:
Mailing Address:
Physical Address:
Facility Contact: /�Gt !( �I-"A14_'1'itie: w Phone No:
Onsite Representative: �i'%G �P✓�Integrator: ��'�<isy �r�/1
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = I = 11
Longitude: = ° = 4
Designs 3C,urrent
Design Current
Swine
C►a acPo ul'aY otn
t
p } _p
W etPaultry
C•dpacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑Dairy Cow
❑ Wean to Feeder
-Layer
❑Dairy Calf
Fee der to Finish
Z
-: MP} F1 f Ski='-
❑Dairy Heifer
❑ Farrow to Wean
Dry Poultry
z
- _
El Dry Cow
El Farrow to Feeder
sus -
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑Gilts
❑Non -La ers
❑ Beef Feeder
❑ Boars
❑Pullets
❑ Beef Brood Cowl
-
-
❑ Turkeys
Other
❑ Other
* _ __
❑ Turkey Pouets
❑ Other
Numb_erOf Structures:
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
PtNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Ycs
DdNo
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[gNo
❑ 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 tram any part of the operation?
❑ Yes
y--j No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
[2rNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: S3 — 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
[5?No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): A10 La SOdx/
5. Are there any immediate threats to the integrity of any of the structures observed?
El Yes
q
L� ] 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
WNo
❑ 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
Z No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
® No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
O No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
EffNo
❑ NA ❑ NE
maintenance/improvement?
IL _ Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
RNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 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) J:!j k..0 _ d 0,�` �G /� � 61 N_i v,h,, J . Sha4K 6im
,l ( V, S ; J
13. Soil type(s) lja&
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[M No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement`?
❑ Yes
[21No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
2 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[2f No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
la�z' A/o La
-Sol
! r �T SL��w� �i.. Z%NG 1.✓c�� ���S.S�
t25se 5/9 v"7 6%�s e / Zoo7 L(' //
No It : ham � Ar is 41S{ol / 41uYri IS o //S.
Reviewer/Inspector Name ,� � 2 V Phone: ���. 7'3�• �3��
Reviewer/Inspector Signature: Date: �-� O
ruge,g of j 1-11ZO v4 t-onunuea

Facility Number: 193 —�lp Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes EgNo ❑ 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 ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below_ ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yesrid
LD No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
PrNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
RTNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
R No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
rMNo
❑ 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
Vj No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
RNo
❑ 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
01 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 1 .
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
ElNE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
P No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
RNo
❑ NA
❑ NE
Page 3 of 3 12128104

-B IMS 311al n V�5
Division of Water Quality
iFacilify Number $ 3 �9 Q Division of Soil and Water Conservation
- -- �- Other Ageney
Type of Visit ®-Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: %'pp Departure Time: 7; 00 County: SCA441214 Region:
Farm Name: -+-+ .1 % 9 S-�e.y S-6,\j Owner Email:
OwnerName: 3+� n! Phone:
Mailing Address:
Physical Address:
Facility Contact: V-x­J g Tl Title: iMa r _ �� Phone No:
Onsite Representative: Integrator: /yl t[" ,, &k-6x.fW
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑ Q = I = 11
Longitude: = o =,
11
Design Current
Design t urren�t,,,
Design Current
Swine
Capacity Popula4tion
Wet Pouf
Capacity Population
Cattle Capacity Population
❑ La er ❑ DairyCow
❑ Non -La er ❑ DairyCalf
° ❑ DairyHeifer
❑ Farrow to Wean
Dry Piiulfry'
' a ❑ D Cow
❑ Farrow to Feeder
❑ La ers
"
` , El Non -Dairy
OF arrow to Finish
❑ Beef Stocker
❑ Gilts
❑ Boars
❑ Non -Layers
❑ Pullets
❑ Beef Feeder
❑ Beef Brood Cowl
❑ Turke s
Other
❑ Other
_ - rfr�
El Turkey Poults
❑Other
...
Number of Structures:
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish Z �
Discharges &Stream Impacts
I. is any discharge observed from any part of the operation?
El Yes
� No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field El Other
a. Was the conveyance man-made?
El Yes
� No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El 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?
El Yes
[$ No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
10 No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: g —
Date of Inspection Z �ISf—O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): VA
Observed Freeboard (in): /1(/f1
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 59 No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes [9No ❑ NA ❑ NE
❑ Yes [9 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 W No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [A 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 [dNo ElNA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes q No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [y] No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift El Application Outside of Area
GS
12. Crop type(s) e v6,.,," .� &t:' l G'r4;3 SA't4 L/O - S .
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17_
Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to`question #): Explain any YES-atisvrers and/or.any recommendations -or -'an othe`rscomments.
Use drawings of facility to better explain situations. (tise:additional pages as necessary):2.
,r
Reviewer/Inspector Name I —
;iGe,� q,, —^� Phone: 'NO,
If 33 ,3b
Reviewer/Inspector Signature:
Date: Z—1�t--Z007-
Page 2 of 3 12128104 Continued

Facility Number: .3 -- f Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ['A No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 59 No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design
g El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes T 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?
El 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
j No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[PNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
1XNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[9 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
%No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[� No
❑ NA
❑ NE
Page 3 of 3 12128104

Type of Visit I* Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit B Routine O Complaint 0 Follow up 0 Referral 0 Emergency O Other ❑Denied Access
Date of Visit: -/,j - O Arrival Time: % : Departure Time: —;;Pol. `"
A0 : � County: 5eald Region: r)eo
Farm Name: `k, / Owner Email:
Owner Name: k /L✓� Phone:
Mailing Address:
Physical Address:
Facility Contact: )J Title:
Onsite Representative: RaN4guyn sY
Certified Operator:
Back-up Operator:
Phone No:
Integrator: "L
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: Q a =' = « Longitude: = ° 0 I = W
Design Current Design Current Design Current
Swine Capacih Pop�ul�tin Wet Poultry C� pacify Population Cattle Capacity Population
❑ an to Finish
❑ Layer
❑ Dairy Cow
❑ an to Feeder
❑ Non -Layer
❑ Dairy Calf
Feeder to Finish 11200
W :r ❑ Dairy Heifer
❑ Farrow to Wean
` ❑ D Cow
:�-<Dry�P.atry�;-t,
ul
ElNon-Dairy
❑ Layers El Beef Stocker
❑ Non -Layers ers ❑Beef Feeder
El Pullets El Beef Brood Co
❑ Turke s -
;y1 s
Other
❑ Other
�-
❑ TurkeyPoults
❑Other Number of Structures: Q
❑ Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
Discharges & Stream Impacts
. Is any discharge observed From any part of the operation?
❑Yes
IN No
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
[--]Yes
J9 No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
Q0 No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑Yes
F] No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑Yes
A] No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
,k] No
❑ NA
❑ NE
other than from a discharge?
Purge 1 of 3
12/28/04
Continued

Facility Number: '93 —/(y
Date of Inspection T _d
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
N4
❑ Yes tNoo
*A ❑ NE
ElYes XNA
❑ NE
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) d
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No NA ❑ NE
through a waste management or closure plan? /
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes P No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 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 El NA El NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes CP 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) AC F e� �A l� �s�tri✓
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15, Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18, Is there a lack of properly operating waste application equipment? ❑ Yes
No
❑ NA
❑ NE
�No
El NA
❑NE
No
19
[I NA
El NE
No
❑ NA
❑ NE
V1 No
❑ NA
❑ NE
Comments (refer to question'#): .Explain any YES answers and/or any recommendations or any othertconiments�'
Use drawings'of facility to better explain situations. (use additional pages as necessary):
ReviewerA nspector Name Phone:0
Reviewer/InspectorSignature: Date: O-7—I3 `ZOD(p
rage z vJ j 11Ziz0iv1l Uunttnuea

Facility Number: $ — (0 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. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[ 'No
❑ NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
11 No
El
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
o
❑ 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
91
El
El 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
ElNA
ElNE
If yes, contact a regional Air Quality representative immediately
�&o
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
VNo
❑ NA
❑ NE
Page 3 of 3 12128104

Type of Visit ® Compliance Inspection 0 Operation'Review 0 Lagoon Evaluation
Reason for Visit ®Routine C) Complaint O Follow up O Emergency Notification O Other. ❑ Denied Access
Facility.Number Date of Visit: Time:
not O eratiarsal Belt►vc Threshold
O Permitted IS Certified 13Conditionally Certified 0 Registered pate Last Operated or Above Threshold
Farm Name: _ 0 .� , U. S z R C County: 'C.�[Q
Owner Name: C nra WS GI.�n G ' Phone No: jib 22 S 6 3
Mailing Address: X 9s _ G Lj
Facility Contact: VA }J r%Ackicm 6 _, i cnr Title:
OnsiteRepresentative:r 4y1eh12nln4[{car __
Certified Operator: U
Location of Farm:�' `f�a �Jt13
Phone No:
integrator
Operator Certification Number:
I@Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �' �• ��
Design Current
Swine ranarifS• Pl nnisatinn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
® Farrow to Feeder
' pp
O
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons 106Se ev OL-t I
Holding Ponds 1 Solid Traps
Design Current Design Current
Poultry Ca acitv Population Cattle Ca acitt Population
❑ Laver Ron-Dain,
airvNon-Laver
❑ Other
Total Design Capacity
Total SSLw
Discharges & Stream Impacts
1. Is ar v discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Sprav Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is obsmed, 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 pan 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
Identifier.
Freeboard (inches): Urzsz ca mt:L
05103161
No
El Yes
❑ Yes
❑ No
El Yes
El No
❑ Yes
❑ No
❑ Yes
[P No
❑ Yes
M-No
❑ Yes
PNo
Structure 5
Continued

Facility Number: —
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes P No
❑ Yes R No
❑ Yes MNo
❑ Yes �Q No
❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes W No
11. Is there evidence of over application? ❑rl � Excessiv1e Ponding ❑ PAN [I Hydraulic Overload El Yes allo
12. Crop type �ZP phi , r� � >G- a '% A A - .,..
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [P 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
P No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
[9No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
N No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.)
❑ Yes
P No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
P No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
P No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
PNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
[,UNo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
U.No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
P No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
KI-No
[] No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
Cammn_ts on refer to IIesti# Ez Iatnran YES a� sw�ers aIIdlor at10R9 Q! ant11
en-
,
eiCOI_mentS.
y U�SCd1ti0II81ay
Use dra s of faces to better eirplarn srtuattoIIs opv ❑Final Notes
� grecommenda�}•
A 4R5�
S ^ 4 �-�,` 5 F`s'ri' t S�-� �� �� GI.t e G r. 4m`•v�G
W �-� - C- "e't �A a � %G.,4 Ge., 6r- kv-4-J-3 4-C, Lj� f � La_ •
is S4a( { n'-16 ya'-c ryecPrc�`Q��,ate-{'cv-.-. T�c� r.p
6-nc' m Ct S a- J' 64
Reviewer/inspector Name
Reviewer/inspector Signature: Date: 2
05103101 [ Continued

Facility Number: q,3 — Date of Inspection
Odor Lsues
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 bladc(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a p'ermanent/temporary cover?
❑ Yes ❑ No
❑ Yes Q No
❑ Yes O No
❑ Yes ® No
❑ Yes 6No
❑ Yes No
❑ Yes No
05103101

i
Type of Visit ® Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Date of Visit! � l � Time: :3
! Facility
`Number L8
!got O erational 0 Mow Threshold
® Permitted ® Certified [3 ConditionalIy Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: — CG.rr"I.U3 17,-, County-: _iCol [!mod _•
Owner Name: CcxrGiG3 it, leg Phone No: v -
Mailing Address: iZ ax _s 1\
Facility Contact: 2 t ✓1 Title: L At M Phone No: _ Sly &. r _
Onsite Representative: Integrator:
Certif ed Operator: 121J-n t Cj f l; no _ Operator Certification Number: _ a U 31
Location of Farm:
© Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ° Longitude • �•
Design Current
SW2t1e C4n4Mfr Pnnnl9finn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
® Farroxv to Feeder
q c>p
p
❑ Farrov,- to Finish
❑ Gilts
❑ Boars
Number of Lagoons
Holding Ponds / Solid Traps
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Laver ❑ Dairy
❑Non -Laver ❑ Non-Dairy
❑ Other
Total Design Capacity
Total SSLW
auosurtace mratr
No Liquid Waste
Discharses & Stream Impacts
1 _ Is am, discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is obsen•ed, was the convevance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes. notifi, DWQ)
c. if discharge is observed, what is the estimated flow in sal/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 anv adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes [91No
❑ Yes E�No
Structure 6
Identifier:
Freeboard (inches): fJ e, serf lMik-
65103/0I Continued

Facility Number: — 1 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes R No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes ® 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 M No
S. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes 5 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes [4No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes P No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Rp r' , f ..(1 t _ . / Q — n
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes �3 No
14_
a) Does the facility lack adequate acreage for land application?
❑ Yes
M No
b) Does the facility need a wettable acre determination?
❑ Yes
[)3 No
c) This facility is pended for a wettable acre determination?
❑ Yes
[RNo
15.
Does the receiving crop need improvement?
❑ Yes
� No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
M No
Reuuired
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
P 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
[�ILNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
E� 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
�3 No
(ie/ discharge, freeboard problems, over application)
23,
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
5D 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.
Comen ts(reter to'quesfia"#) Eirplatn4ia y YE aers dloran} recommen'datioi s or anOW }''otlieracotum nts.
c'❑
1 p ( P� ry�-
Use dra ofo-facilr to�betteraexNtnatiotts. use additions ase `- ❑Field Copy Final Notes
t`0,Cor,4 o 'fCJ'M co tw
0
Reviewer/Inspector Name £, AA ' J / /;` r ` o fa-t 4 57� rwL! - ... , .
fib-
Reviewer/Inspector Signature: Date. :�
05103101 Condnued

Facility Number: 9_g — Date of Inspection
Odor Issues _
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor bclo'A-
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_c, 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 submerLed fill pipe or a permancntitemporary cover?
❑ Yes [:]No
❑ Yes 5Q No
❑ Yes E ] No
❑ Yes [] No
❑ Yes No
❑ Yes O No
❑ Yes ❑ No
Additional Comments and/or Drawings:
w
05103101

Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: % J2 Time: a !-T
fS �
iD Not Onerational O Re
0 Permitted ® Certified Q Conditionally Certified © Registered Date Last Operated or Above Threshold:
_ `/ .
Farm Name: f'�Fie 7/69 Count,: —S�a r r�.tJ
Owner Name: rir�iTy-/�� �' d�s Phone No: /.��/ .Z 9—T �7
Mailing Address: 1.✓ .� a 31�
Facility Contact: .. as4 �i��..Jl _ Title: Phone No: /
Onsite Representative: ,�5_ `� Integrator: 5.....�� /161%d Odd
Certified Operator: /�.� ���� Operator Certification Number: -
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ' " Longitude ' '
Design Current
LI Feeder to Finish
❑ Farrow to Wean
Farrow to Finish
Gilts
Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population -'
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non-Dai
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons 10 Subsurface Drains Present ❑ La aon Area 10 S rav Field Area
Holding Ponds 1 Solid Traps 10 No Liquid Waste Management System
Discharees & Strearn Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4_ Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Freeboard (inches): C/o rx
05103101
Structure 5
❑ Yes kNo
❑ Yes XNo
ElYes JKNo
❑ Yes ;No
❑ Yes KNo
❑ Yes ONO
❑ Yes ;No
Structure 6
Continued

Facility Number: 83 — /gr
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 Anolication
10. Are there any buffers that need maintenance/improvement?
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ hydraulic Overload
12. Crop type «�
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps etc.)
19. Does record keeping need improvement? (ie/ irrigat , freeboard, waste analysis & soil sample eports)
20. is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23_ Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes Mo
❑ Yes )ZNo
❑ Yes &No
❑ Yes Jf No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes J;No
❑ Yes KNo
❑ Yes 9No
❑ Yes (�Go
❑ Yes ONo
❑ Yes 6f No
❑ Yes eo`No
❑ Yes A No
❑ Yes �No
❑ Yes ® No
❑ Yes X No
❑ Yes KNo
❑ Yes rJXNo
—
❑ Yes allo
❑ Yes RNo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
�.�• c �. .a.GI � i G . } a�R_7men
iGt ,00
ts (refer to question;#)Explatnlany YES}answers,aud/or any recommendarions or snyotbercommenam v : a Y 'mat(use additional; pages asecessary):
se draRzngs;of factlttyto bettereaplaituattons•,❑
Reviewer/Ins ector Namej
P .w s
Reviewer/Inspector Signature: Date: ZS dz
05103101 Continued

Facility Number: Date of Inspection � �L-
E 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?
2T 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 ,KNo
❑ Yes �No
❑ Yes KNo
❑ Yes *0
❑ Yes 9No
❑ Yes ONo
R Yes ❑ No
05103101

F_ Facility Number Date of Visit: - 2— _3 Time: I==
Q Not Operational Q Below Threshold
.#Permitted [3 Certified © Conditionally Certified © Registered Date Last Operated or Abboo a Thr old: .........................
Farm Name: ................. 2...................................71 �oJ.. �'^ �..... .............
{ �� 9 ...... County:........
//
OwnerName: ...... (1aY..ng.l r..s� ......... .l 7 ... .....:4FS.! ........................... Phone No:.......................................................... ......... ............. .......
Facility Contact: ....... ..: ......... Cc< .�1., M..1�................... Title:...... �' .0 ........ ! ... Phone No: ...............
Mailing Address: .......................................................
Onsite Representative: Integrator:............................................................................. .
Certified O erator: 4
p ...�...r..................... P?5061-_h1t1w5................................. Operator Certification Number:
..........................................
Locationof Farm:
❑ Swine '❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• ����
H . Design Curreiit Design" Curr_enit Design Current
capacitypopulation Cattle --Swine Pouf3Caact Po ulad-on Ca C7 Popnlatwn
❑ Wean to Feeder ❑ Layer ❑Dairy
❑ Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
Farrow to Wean ;
Farrow to Feeder ❑ Other
Farrow to Finish Total Do Ca act
❑cites p ty 1�lJd
El Boars Total SSLW
_._ a,
Number of Lagoons ❑ Subsurface Drains Present 110 Lagoon Area ❑ Spray Field Area
Holding Poi ds / Sohd'Tiraps ❑ No Liquid Waste Management System -=M.
tnischaraes & stream lm teacLS
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. ll'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 Structurc 2 Structure 3 Structure 4 Structure 5
❑ Yes K140
❑ Yes )00.
❑ Yes KNo
❑ Yes 1'No
❑ Yes ElNo
❑ Yes P�No
❑ Yes d3zlo
Structure 6
Identifier: ....................
Freeboard (inches): SQ
S/00
Continued on back

Facility Number: ? — Date of inspection �O� Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes �J 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 eNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate pubtic health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste A lication
10. Are there any buffers that need maintenancetimprovement?
11. Is there evidence of over application? ❑ Excessive P9nding ❑ PAN ❑ Hydraulic Overload
12. Crop type fie►- " a iJ r-az&�
13. Do the receiving crops differ with those designated
14. a) Does the facility lack adequate acreage for land
S/N, eve,,-fGeel
ie Certified Animal Waste Management Plan (CAWMP)?
cation?
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. Fait 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?
NQ.00 a(ionis er• ftficienc{ps were pgted- d(rt hig this'visit; - Yowill-Seceiye ;iti fuirther
corres�deitee. about; this :visit.
':
ecoendatonsor anoier commentCommenogeestton#}ExhuQa_YES answers and/or any, } any -_
Use drawinp,�s o€facility t i-better explain situations _(use additional .pages as n�ecc ary) _
/`"rm eP44 /IB[l5-&5 4 41 &�� al — nos, e-5 -far
A
ElYesNo
[]Yes A No
❑ Yes ANo
❑ Yes XNo
❑ Yes F110
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes 4,N0
❑ Yes M No
❑ Yes FkNo
❑ Yes �No
❑ Yes %60
❑ Yes j No
❑ Yes No
❑ Yes KNO
❑ Yes No
❑ Yes *0
❑ Yes ,, ``ONO
L
Reviewer/Inspector Name Jp ,
Reviewer/Inspector Signature: Date:
5100

Facility Number: — Date of Inspection _ U/
printed on: 1/4/2001
30.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, and/or public property)
31.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
No
32.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan bIade(s), inoperable shutters, etc.)
❑ Yes
No
33.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
No
34.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
o
0
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Reviewer/InspeCtor Name s� m rr
Reviewer/Inspector Signature: Date:
01/01/01

QR Routine O Complaint O Follow-ue of DWQ ins ection O Follow-up of DSWC review O Other
Facility Number Date of Inspection �=J
Time of Inspection 1124 hr. (hh:mm)
P
ermitted © Certified 0 Conditionally Certified © Registered 0 Not Operational Date Last Ope ted:
�r .7
FarmName: .. �...I.. .....-- ...... ••-••-••--••••...... County:...... ............. ....•-••-•-•.................... .
Owner Name: C-Cf I! Cd.��..+s.........A ... ....... ' ................. Phone No:..........., .`. 6 .
;...................................................................
Facility Contact: .. }5........ T4�.L�................................. Title:
.. L ..... Phone No: .....---•--•--•--...............
Mailing Address: ...... .!,..b... .f'QGl? .,r....... * -*....��......................................... ........ .a tl` W�.._. .............g�l...
Onsite Representative; ...........:.�. ............
................................................._........................ Integrator:......................��...._._._......................
Certified Operator: ..... Le...................................... �. ...................................... Operator Certification Number: ........................... ...............
Location of Farm:
Latitude. • ' 44 Longitude 0 ` 66
- Design . Current
$wine Cspacrt 'Po ulatzon Poultry
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
Q j1
Farrow to Finish
❑ Gilts
❑ Boars
Design Current'= = Destgn
Caoacitv.,_Ponulatinn -Cattle _..;
❑ Layer
❑ Dairy
❑ Non -Layer
= ❑ Non -Dairy
;.'� ❑.Other
: Tofa1�D
., as
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes �No
Discharge originated at: El Lagoon El Spray Field ❑ Other
a_ If discharge is observed, 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 ycs, 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
Identifier: , it
Freeboard (inches): ....................................
Structure 2 Structure 3 Structure 4
Structure 5
❑ Yes ANo
[I Yes XNo
❑ Yes 4No
❑ Yes No
❑ Yes No
❑ Yes ANO
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, []Yes gNo
seepage, etc.)
3/23/99 Continued on buck

Facility Number: j — Date of inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes ErNo
(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 0No
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes 5�No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes tdNo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes A No
11. Is there evidence of over application/I? ❑ Excessive Ponding ❑ PAN
❑ Yes ,EWo
12. Crop type er udn tf
13. Do the receiving crops differ with those designa ed n the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes WNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes ®No
b) Does the facility need a wettable acre determination?
❑ Yes ONo
c) This facility is pended for a wettable acre determination?
❑ Yes ONo
15. Does the receiving crop need improvement?
❑ Yes A No
16. Is therc'a lack of adequate waste application equipment?
❑ Yes AlNo
Reauired Records & Documents
17.- Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes 414o
20- Is facility not in compliance with any applicable setback criteria in effect at the time.of design? ❑ Yes ONo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ,®-No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ict discharge, freeboard problems, over application) ❑ Yes qNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes WNo
24. Does facility require a follow-up visit by same agency? ❑ Yes ,fNo
25, Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes
1o8i0ir de.... . es .were npte during Ois;visAt; • Yoi} wiil.teoeive 0 lfuttitgr -
cories deuce Aauti this visit: .. .. .. .. .
Comntents,(�efer to question #)Explain any l'F.S answers andlor any>recommendattons o� any other comments.
;,cr�''ax"rr. _ _ sr- _
Use drawnngs of facrbty to better explatn sttuahons. (use addrt,onalipages as[necessary
Reviewer/Inspector Name
15
MA
Reviewer/Inspector Signature: Date: - 9— d-D

Facility Number: 3 Date of inspection .L GQJ
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 [(lo
28. Is there'any evidence of wind drift during land application? (i.e..residue on neighboring vegetation, asphalt, ❑ Yes�l 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 RNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes VNO
31. Do the animals feed storage bins fail to have appropriate cover? ❑Yes PINo----
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No

Q Division of Soil andWater Conservation
Division o- Sail a`nd-Water Conservation = Compliance`liisspec n rT;- = �# �=
Y
M - f- vesibn of Water Quality . =Coritpiianryce is~spectron - 15-
+ s
,+ - Other Agency Operation -Review = c } * t #
— _
10 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review OWther
Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm}
© Permitted [3 Certified Q Conditionally-C�eertified 13 Registered j] Not O erational Date Last Operated: ..........................
Farm Name:l� 1 i I s / �o County:....`Ci./C''!.....................................
cz r r�o
....................I..•---.---- ....
Owner Name:.....(,�/`�'O... `...... Phone No
1 w s................. s.... ...............................
Facility Contact:
Title:
Phone No:
MailingAddress:.............................................................................
Onsite Representative: ..,ffi,f........�e: leSe Integrator: ..... ...............................................................................................................................................
Certified Operator: ................................................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------=---------------------------------------------------------------
Latitude ' ' 44 -Longitude • & 4.
_ Design' Current'.
Swine CabaClty I Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current - . Design -, Current
Poultry Capacity- Population Cattle-. Capacity '--Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design..Capacity._:
TotaUSSM
Number of Lagoons ❑Subsurface Drains Present ❑ Lagoon Area ❑spray Field Area
..
Holding Ponds/ Solid Traps ❑ No Liquid Waste Management System
Discharttes & 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. lI' dischargc 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 gaUrnin?
d. Discs discharge bypass a lagoon system'? (If vcs, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway des ❑ No
Structurff 1 /} Structure 2 Structure 3 Structure 4 Structure 5 / Struc re 6
Identifier: �al `- -4- � Nah o re k �rm pis '6e' �' ? 6/CA►�M fr
Freeboard (inches): .....-..... �arG° ...Y..�!a �...^ L° ( �`.....4h.�`�..... 'j�—�... � .. �4` `.a�rr........1 ........�.
p ..... ...
5- Are there any i e ' to threats o the tegrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes ❑ No
2 — ! — 00 seepage, etc.)
3/23/99 {4 Continued on back

Facility Number 3 [)ate of Inspection
Time.of Inspection p 24 hr. (hh:mm)
0 Permitted XCertified © Conditionally Certified © Registered 0 Not O erational Date Last Operated:
Farm Name: rRrn'7 jj4./ County:..... Cif`............................
.................................?.L...................................................................... q
U.�uer Name: C /r + ,c.................. Phone No: /0 " a1r�3�.3�.... .. ........
4r.,rJ......................... �.......�-�7 -..-.-................................ ...
Facility Contact: ........... �.1./..C..... fir' ................Title:................................................................ Phone No: .......... .........................................
Mailing Address: .............. P.P. ........ OrQ O 5�..... ��Gar�i�t�'��........1!..4:........................ a..3�...
Onsite Representative: .......... :7; '. !:1rY1.... ..1�1�. 1Y�/h a ............................... Integrator:....... rr+?1�5...... n�•r}C...'. ...
Certified Operator: ............................................
Location of Farm:
I........ Operator Certification Number: ..........................................
Latitude Oro` Longitude • �°
Design
swine
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I
F
Dairy
❑ Non -Layer Non -Dairy II
❑ Other
Total Design Capacity pQ
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 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)? ❑ Yes] No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance roan -made?
h. II' discharge is observed. died it reach: ❑ Surface Waters ❑ Waters of the State
c. If dischai-Le is observed. what is the estimated llow in gal/min?
d. Does discharge bypass a lagoon syslern?
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?
.i s•,
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes No
❑ Yes No
❑ Yes Y No
❑ Yes KNo
❑ Yes VNo
❑ Yes 'VNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
I=rceboard (inches): .......... ................... ............... ................... ................................... .... ........ ............................ ............................... ..... ....................................
00
1 /6/99 I ! Cvntinu on back
/45��°es Ad cv 47 a., -- T a� pc c ac vss .L�ri re S 4r

•Facility Number. Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, [-]Yes NO
seepage, etc.) WO
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes KNo
(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? j�Yes ❑ No
r 8. Does any pat of the waste management system other than waste structures require main ten ance/improve men;? !❑ Yes R(No
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings? ❑ Yes DrNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes XTNo
11. Is there evidence of over application? ❑ Ponding ❑ Nitrogen ❑ Yes 7No
12. Crop type ......12�Tu.�!t'.... ... .................... L............ ....}...... ... ........................
pp*q
---...............................
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 9No
14. Does the facility lack wettable acreage for land application? (footprint) ❑ Yes XNo
15. Does the receiving crop need improvement? jYes ❑ No
�"e �1►' �
16. Is there a lack of adequate waste application equipment?� yl ! ❑ Yes KNo
Required Records & Documents I ® T�r�4�z
17. Fail to have Certificate of Coverage & General Permit readily available? �r _ le,91("Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc) ❑ Yes KNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes W No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes W No
21. Did the facility fail to have a certified operator in responsible charge? ❑ Yes WNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ONo
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 Wo
:: �fA.violatians.or. deficienci� .were'noted. du-nn..ttiis.visii.. You 01'retyeive nar ftiriher.:.:. ,, ``
corTespotidehee:abbut; this 'visit: .•.•.•.•. ..•.•.•.•.•.• •:•:-:-:-:
Coinmenff(refer to-destion #}; -Explain any YES answers and/or any: recommendations or aner comments -
Use & Wings`of facility to better explain situations. (use additional pages as necessary):.
we 5,.,o 4wZ 4C ..
-k rt ":q C.W W) a �-71X A rlt57,
n no roc C;tj
C�r�� 440 44CO4
mv"/
VT . ;-d -,�- r g q&,
5j-eO
'''7
.J�sI ,t,;.t/4-
Reviewer/Inspector Name S—e
Reviewer/Inspector Signature:
Date: 4 — 11/6199

K
Division of Soil and Water Conservation
0 Other Agency
Division of Water Quality
:
Routine 0 Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number Date of Inspection
Time of Inspection ,'dfJ 24 hr. (hh:mm)
0 Registered Certified © Applied for Permit 0 Permitted 0 Not Operational Date Last Operated:
Farm Name. �`'� County:CO%L/Gt.kd................................
2:4
Owner Name:...... r r`L2.f f .. .......... .......... f h........................ Phone No 3 ..
...............................................................................
t
Facility Contact: ... .�L........ ...................... Title: .... ... /►.! :.. ......... Phone No• Z%t —d 7r
Mailing Address:....... gale `.'...................................................................... W Q r� �-1 �3" � Y i.................... 2 � SQ.
............. .........
Onsite Representative: ... �L'S Slu.....................................................Integrator: ......................................................................................
Certified Operator:............................................................................................................... Operator Certification Number,...........................
Location of Farm:
Latitude =' ' " Longitude ' ' "
SnYi.S.£. �.
�VW)R� L-.'.);:L✓Yri w',a & AT A.iEIStn`JVG'� CNnt
- +%^ki.<, W %
`SuteK Capacity-'Populati&ti . : Poultry Capacity.'PopulationCatUe Capacity Popi�lafaon
❑ Wean to Feeder
❑ Layer ❑ Dairy
❑ Feeder to Finish
❑ Non -Layer a,; ❑ Non -Dairy w
f ❑ Farrow to Wean
' Farrow to Feeder
(j() ❑Other
�
❑ Farrow to Finish
. Wry xyy_, ,� x�y, r{ .3` t �: }.%3:, � �g �'^ •'-r> _'h'i: ?]x> � X�
54' Total Design Capacity pa r
❑ Gilts
4 a ry,
❑�
BOarS
Total
SSLWms»x�
�.:
�, �
Nnmber of, Lagtfans / Ioldtng Ponds ❑ Subsurface Drains Present ❑ Lagoon Area Spray Field Area s
.w
a -- F
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenancetimprovement?
❑ Yes
ONO
2. Is any discharge observed from any part of the operation?
❑ YeskNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a- If discharge is observed, was the conveyance man-made?
❑ Yes
❑ No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in gaUmin?
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
o
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑Yes
No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
o
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
o
7125197

Facility Number: —
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (LagoonsMolding Ponds, Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1
Identifier:
Freeboard (ft) 10.................
Structure 2 Structure 3 Structure 4
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 immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes qNo
❑ Yes JfNo
Structure 5 Structure 6
Waste Application
14. Is there physical evidence of over application?
(If in excess of , or runoff nterin ters of the State, notify DWQ)
15. Crop type .... ...............................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities _OoLy
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.vitilations•or de.rkiencies. were noted during this;visit. You.w'ill receive-iro ftirtiiec� : -
corresp6ndence a0o6t this;visit:
f0. f,,ek' areas CJ/r...eeWs a- w rr
Qlrev-rjt Cc�a'l /DD�S y'60d �Gc���I I �'.1' .r►��d.
0
❑ Yes ANo
❑ Yes fi�No
❑ Yes jl�No
❑ Yes �r0
❑ Yes KNo
❑ Yes )KNo
❑ Yes KNo
((Yes ❑ No
❑\\Yes IfNo
❑ Yes � .
❑ Yes JUNo
❑ Yes No
❑ Yes J� No
❑ Yes No
❑ Yes o
'4� y
7/25/97
Reviewer/Inspector Name
Reviewer/InspectorSignature: 14.6/� el`X Date: /e-2-1-

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
Ally 30, 1998
Donald Butler
Farm 7169
PO Drawer 856 T�); Lz U' I
Warsaw NC 28398
Dear Donald Butler:
A
••
-;,
NCDENR
NaarrH CARouNA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCE'S
r 1,98 Subject: Application No. 83-0016
Additional Information Request
T EVILE Farm 7169
REG. OFFICE Animal Waste Operation
Scotland County
The Non -Discharge Permitting Unit has completed a preliminary engineering review of the subject
application. Additional information is required before we can continue our review. Please address the following
components by August 31, 1998:
1) The Operation and Maintenance Plans (OMP) are missing from the permit application. Please
provide this information for review.
2) The site maps that were submitted with the permit application do not contain the locations and
acreage's of the Tract and Fields listed in the Waste Utilization Plan (WUP). Please provide a map
that includes this information.
All revisions / amendments are required to be signed and dated by both the landowner and the Technical
Specialist before they are submitted for review. Please reference the subject permit application number when
providing the requested information. All information should be signed, sealed, and submitted in duplicate to my
attention at the address below. The information requested by this letter, must be submitted on or before August
31, 1998, or the Division will return your application as incomplete in accordance with 15A N.C.A.C. 2H .0200
and your facility will be considered to be operating without a permit.
Please be advised that operation of the subject animal waste management system without a valid permit is
a violation of North Carolina General Statute 143-215.1 and will subject you to the enforcement authority of the
Environmental Management Commission.
If you have any questions regarding this request, please call me at [phone], extension 364.
Sincerely,
Brian E. Mondschein
Environmental Technician
Non -Discharge Permitting Unit
cc -FayettevillERegionii.Offrce, Water Quality!
Permit File
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
June 23, 1998
CERTIFIED MAIL
MURNIM—C-EIFT REQUESTED
arro s Foods Inc
7169
PO Drawer 856
Warsaw NC 28398
Farm Number: 83 -16
Dear Carroll's Foods Inc :
1;WAA
`�•
NCDENR
NORTH CAROuKA DEPARTMENT OF
ENVIRONMENT AND N.4URAL RESOURCES
You are hereby notified that 7169, in accordance with G.S. 143-215.10C, must apply for
coverage under an Animal Waste Operation General Permit. Upon receipt of this letter, your farm has
sig 60 da s to submit the attached application and all supporting documentation. In accordance
with Chapter 626 of 1995 Session Laws (Regular Session 1996), Section 19(c)(2), any owner or
operator who fails to submit an application by the date specified by the Department SHALL NOT
OPERATE the animal waste system after the specified date. Your application must be returned
within sixty (60) days of receipt of this letter. Failure to submit the application as required may also
subject your facility to a civil penalty and other enforcement actions for each day the facility is operated
following the due date of the application.
The attached application has been partially completed using information listed in your Animal
Waste Management Plan Certification Form. If any of the general or operation information listed is
incorrect please make corrections as noted on the application before returning the application package.
The signed original application, one copy of the signed application, two copies of a general location
map, and two copies of the Certified Animal Waste Management Plan must be returned to complete the
application package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Non -Discharge Permitting Unit
Post Office Box 29535
Raleigh, NC 27626-0535
If you have any questions concerning this letter, please call at [phone] extension or
Jeffery Brown with the Fayetteville Regional Office at [phone].
Sincerely,
.�r A. on oward, Jr., P.E.
cc: Permit File (w/o encl.)
Fayetteville Regional Office (w/o encl.)
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recyded/ 10% post-cgnsumer paper

NO
Routine O Comelaint O Follow-up of DWQ inspection O Follow-up of DSWC review 0 Other
Facility Number Date of Inspection
Time of Inspection I I-L;36, 24 hr. (hb:mm)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (ex:1.25 for 1 hr 15 min)) Spent on Review ,
ACertified ❑ Permitted or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated:
Farm Name: L1.�� __.. r...� ._ county: L�f� ._.._r ........ _ .._
Land Owner Name: _ _..._ _ .LDS .%�.�! b�dS Phone No: z 7�
Facility Conctact:... L. e5..�._ ... Title: _..�...
— .... Phone No:...__._ Imo.._ ...
Mailing Address: n?r. 7r�oQrZ�g
Onsite Representative: � ... .........�_.— Integrator: !+�.
Certified Operator:
Location of Farm:
Latitude 0 4 Longitude 0 4
Operator Certification Number:
Type of Operation and Design Capacity
.ow*�c+E-+' x^ta�pk4.ya, a.,sysec •a''.w,x *rs .'�'` € ,a -'.
� Design cara:it �� , � „Des�gn;� CdTrent , ,� � r Design Current
.� •� y t a aciPo uiahonx a7'�" C } �Ca acItv�Po ulation��� �,�.�.,, r_.�.•4rH;,Ga acr �Po ulabon�
❑ Wean to Feeder La [I Da'
Non -La er ��;
❑Feeder to Finish ❑ ❑ Non-DaiTy to Weans ts�53aasswaalaxk U wz r�
ar31G�s'sN aN.V Z
r s t ;
Farrow to Feeder a �Tiital-Design° Capacity Q�
Farrow to Finish
❑ Other s�
-
NUmber of i ago ins 141oldiag Ponds 6 ❑ Subsurface Drains Present Y,
�F, y
� � ��,� �, � ���� �� �;� � �•� � - -'� Lagaan Area ❑Spray Field Area �«:�
Genera
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Watery (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
❑ Yes No
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes ONo
❑ Yes 12fNo
Continued on back

1
Facbfity Number:...
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ YesXNo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes XNO
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes Ao
Structures (Lagoons and/or Holding Poo s)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes JNo
Freeboard (ft): Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
10. Is seepage observed from any of the structures?
❑ Yes ANo
11- Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes P(No
12. Do any of the structures need maintenance/improvement?
❑ Yes KNo
(If -any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes _O(No
Waste Application
14. Is there physical evidence of over application?
❑ Yes XNo
(If in excess of WMP, or runoff ent 'ng waters of the State, notify DWQ)
p
15. Crop type .Oe!`�v► _ ....! tg..... ......... ......... ........ ..... _....... __............. _-.... .._............ .......... _ ..._
16. Do the receiving crops differ with those designated in the Animal Waste Management flan (AWMP)?
❑ Yes PNo
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes Na
18. Does the receiving crop need improvement?
❑ Yes No
19. Is there a Iack of available waste application equipment?
❑ Yes A No
20. Does facility require a follow-up visit by same agency?
❑ Yes ,(No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
No
❑ Yes A(
Certft led Fac' 'ties Only
\
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes j(No
, \No
23- Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
24. Does record keeping need improvement?
❑ Yes No
Comments "(refer to question #€} Explain`any YES answers and/or;any recomancndattans or anyyother comments: E
Use drawings of facility to better ezplain.situations. use addthonal pages as necessary) b•. A' ,k r
rGi.r' a• i 5 i +n. sB� S�tn� e �r� i .1 Co � I� a..� c e � 4
Reviewer/Inspector Name x. , ' E -k-R r ..: .. s
Reviewer/tnspector Signature: Date: 9-2&-t%7
cc: Division of Water Quality, ater 4ualin, Section, Facility Assessment Unit 4/30/97

Site Requires Immediate Attention: No
Facility No. 83 - l!o
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 7' ) `i , 1995
Time: 1 `4' : `L7
Faun Name/Owner: Carro 1_�`s 71 9 _ C� ►-ro//'s �-vdcl xvc .
'Mailing Address: Rf. Z OcK 113/ 44 5 Gi,- -s 8)r;Ae _Rd. LQAWA160v5 WC _
County: se-41e-d. CL _ -
-Integrator: Phone:
'On Site Representative: Phone: iO z -7 1p - -7'955
`Physical Address/Location: SR J'f33 &q 54-S N"-t./ ('+ ,
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: 900 Far-FeNumber of Animals on Site: 900
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 3± ° #-g' ZZ" Longitude:-25 G z3' /& "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) �or No Actual Freeboard: z Ft. ( Inches
Was any seepage observed from the la oon(s)? Yes m®Was any erosion observed? Yes or�
Is adequate land available for spray? r No Is the cover crop adequate? �or No
Crop(s) being utilized: Coo s-� /
Does the facility meet SCS minimum setback criteria?' 200 Feet from Dwellings? or No
100 Feet from Wells? (Ya or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes 06�)
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or(O
Is animal waste discharged into water of the state by man-made ditch, flushing system, or _other
similar man-made devices? Yes ordg-o) If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? (e3,3r No
Additional Comments:
R,-e_k,j Rcy a-S
Inspector Name
? ;4 R"ds
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

101 00 100 00,00 021 P02
r
DIVISION OF ENVIRONMENTAL MANAGEMENT
November 4, 1994
SUBJECT:
Compliance Inspection
County
Dear } of '
On , an inspection
of your
animal operation Was performed by the
Fayetteville Regional Office (FRO).
Please find enclosed
a copy of our
Compliance Inspection Report
for your
information. It is the
opinion of this
office that this facility is
in compliance
With 15A NCAC 2H,
Part .0217, and
that Animal Waste Management
is being
properly performed.
Should you have any questions regarding this matter, feel
free to contact
me at [phone].
Sincerely,
Enclosure
cc: facility Compliance Group

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This southern border county was
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county seat of Scotland County, named
so for Scotland in the British Isles from
which many of the early settlers of the
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101 00 '00 00:00 021 P03
,r I.
WORTH CAROLINA DEPARMM OF ENVIRONMENT, WCRLTH & NATURAL MSODRC:KS
DIVISIOK OF ENVIRONMENTAL MANAGEMENT
Fayetteville Regional office
Animal Operation compliance Inspection Form
�bi "',:;yie+i pia' ;�;;:2 '^ '«�"' � s�n�rais"x+a�mi �aM,. �s�
a;�4iI�.:,rswMM.,r
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All questifts answerea negatively will be discussed in sufficient detail in
the Comments Section to enable the deemed Permittee to perform the appropriate
corrections:
SECTION I
imal f n T
Horses, cattle, swine poultry, or sheep
Y I N I COt4QWS
1. Does the number and type of animal meet or exceed
the (.0217) criteria? [Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
poultry (30,000 birds With liquid waste
system)]
2. Does this facility meet criteria for
Animal Operation RMISTRATIQN?
3_ Are animals confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a CmtTrFTM ANIMAL
WASTE RJULAGEPBW ELM?
S. Does this facility maintain waste management
records (volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover crop)?
6. Does this facility meet the 5CS minimau
setback criteria for neighboring houses,
wells, etc?

101
00 '00 00:00 021 PO4
c 1 IR IIl
Y H OOM UMS
_B-ite Management
1.
Is animal waste stockpiled or lagoon
_.
construction within 100 ft. of a USGS
Map Blue.Line Stream?
2.
Is animal waste land applied or spray
irrigated within 25 ft. of a USGS !lap
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
CHtTIFIGT10 MMi?
S.
Is animal waste discharged into waters of
the state by man -wade ditch, flushing system,
or other similar man-made devices?
6.
Does the animal waste management at this
farm adhere to Best Kanagement Practices
(B14P) of the approved TIFI TI .
7.
Does animal waste lagoon have sufficient
freeboard? How much? (Approximately 2, S )
S.
Is the general condition of this CAPO facility,
including management and operation,
satisfactory?
SI@=IOK IV
Commeat