830028_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 830028
Facility Status: Active Permit; AWS830028
❑ Denied Access
Inpsection Type: Compliance Inspection
Inactive Or Closed Date:
Reason for Visit Routine
County: Scotland Region:
Fayetteville
Date of Visit: 02/14/2017 Entry Time: 08:00 am Exit Time: 9:00 am Incident 2
Farm Name: 7097 - Gibson Farm
Owner Email:
Owner Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address: 8465 Gibson Rd
Gibson NC 28343
Facility Status: Compliant ❑
Not Compliant Integrator. Murphy -Brown LLC
Location of Farm:
Latitude: 34" 46' 10" Longitude:
79° 33' 43"
From Laurinburg take 74 West to Hwy. 79 and turn Lt. 79 and proceed througth Springfield about 1.5 miles beyon Springfield
and
the farm entrance is on the right (past turkey farm which is on the left.).
Question Areas:
Dischrge & Stream Impacts
Waste Col, Stor, 8, Treat Waste Application
Records and Documents
Other Issues
Certified Operator: James Brian McGugan Operator Certification Number: 986752
Secondary OIC(s):
On-Stta Representative($):
Name
24 hour contact name
Mike Cudd
On -site representative
Mike Cudd
Title
Phone:
Phone :
Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector)s):
Inspection Summary:
page: 1

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 02/14/17 Inpsecction Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
Swine -Gilts 425
Total Design Capacity: 425
Total SSLW: 63,750
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00 38.00
page: 2

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 02/14/17 Inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yee
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)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
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. Stprage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)? I
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
❑
❑
❑
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
x86 No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 02/14/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yea No Na Me
Crop Type 1
coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
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
❑
M ❑
❑
Management Pian(CAWMP)?
15. Does the receiving crop andlor land application site need improvement?
❑
■ ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
M ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M Cl
❑
Retorts and Documents
Yes
No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
M ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
N ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
M ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number. 830028
Inspection Date: 02/14/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(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?
❑M
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
❑
Other Issues
Yes
NO Nd Ne
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
M ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
M ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewrinspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
M ❑
❑
page: 5

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 830028 Facility Status: Active
Permit: AWS830028
Denied Access
Inpsection Type: Compliance Inspection
Inactive Or Closed Date:
Reason for Visit: Routine County:
Scotland Region:
Fayetteville
Date of Visit: 03123l2015 Entry Time: 08:00 am Exit Time: 9:00 am Incident #
Farm Name: 7097 - Gibson Farm
Owner Email:
Owner: Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address: a465 Gibson Rd
Gibson NC 28343
Facility Status: Compliant ❑ Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm: Latitude:
34° 46' 10" Longitude:
79' 33' 43"
From Lau rinburg take 74 West to Hwy. 79 and turn Lt. 79 and proceed througth Springfield
about 1.5 miles beyon Springfield
and
the farm entrance is on the right (past turkey farm which is on the left.).
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat
Waste Application
Records and Documents Other issues
Certified Operator: James Brian McGugan Operator Certification 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):
Inspection Summary:
page: 1

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 03/23/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Swine
Design Capacity Current promotions
Swine - Gilts 425
Total Design Capacity: 425
Total SSLW: 63,750
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon t 19,00 1 35.00
page: 2

Permit: AWS830028 Owner - Facility: Murphy -Brown LLC Facility Number: 830028
Inspection Date: 03/23/15 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?
❑
E ❑
❑
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)
❑
❑ 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)
❑
❑ 0
❑
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
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No No Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
E ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
E ❑
❑
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
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ E ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ Cl
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN a 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: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 03/23/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No Na No
Crop Type 1 coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2 Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
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?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
N ❑
❑
Records and Documents
Yes
No Na r-9
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 03/23/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No No No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(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 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?
❑
M ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Outer Issues
Yes No No He
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,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
M ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon I 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 reviewlinspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 830028 Facility Status: Active Permit: AWS830028
❑ Denied Access
Inppection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Scotland Region:
Fayetteville
Date of Visit: 03/31/2014 Entry Time: 09:15 am Exit Time: 10:00 am Incident #
Farm Name: 7097 - Gibson Farm Owner Email:
Owner: Murphy -Brown LLC Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 8465 Gibson Rd Gibson NC 28343
Facility Status: 0Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34` 46' 10" Longitude:
79° 33' 43"
From Laurinburg take 74 West to Hwy. 79 and turn Lt. 79 and proceed Ihrougth Springfield about 1.5 miles beyon Springfield
and
the farm entrance is on the right (past turkey farm which is on the left.).
Question Areas:
Dischrge 8 Stream Impacts Waste Col, Stor, 8 Treat Waste Application
Records and Documents Other Issues
Certified Operator: Eric L Ferrell Operator Certification Number:
17634
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour Contact name Mike Cudd Phone :
On -site representative Mike Cudd Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 03/31/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine -Gilts
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19M
page: 2

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 03/31/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discha es & Stream Impacts
Yes No Na We
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ ■
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection Storage & Treatment
Yes
No Na He
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.l 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?
❑
■ ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? {Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
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?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%v/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: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number:
830028
Inspection Date: 03/31/14 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste ARglication
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
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
❑ M ❑
❑
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?
❑ M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑
❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
[] M ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ M ❑ ❑
If yes, check the appropriate box below.
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?
0
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 03/31/14 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
❑
■ ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■ ❑
❑
25, Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
■ ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
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
❑
❑
❑
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 1 Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
❑
❑
page: 5

ODivision of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 830028 Facility Status: Alive Permit: AWS830028 ❑ Denied Access
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Scotland Region: Fayetteville
Date of Visit: 03/04/2013 Entry Time: 09:00 am Exit Time: 10:00 am Incident #
Faun Name: 7097 - Gibson Farm Owner Email:
Owner: Murphy -Brown LLC Phone: [phone]
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 8465 Gibson Rd Gibson NC 28343
Facility Status: ECompliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34' 46' 10" Longitude: 79' 33' 43"
From Laurinburg take 74 West to Hwy. 79 and turn Lt. 79 and proceed througth Springfield about 1.5 miles beyon Springfield and
the farm entrance is on the right (past turkey farm which is on the left.). _
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Eric L Ferrell Operator Certification Number: 17634
Secondary OIC(s):
On -Site Reprosentative(s): Name Title Phone
24 hour contact name Mike Cudd Phone
On -site representative Mike Cudd Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Records reviewed 2115113
Site visit 314113
page: 1

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 03/04/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
=-reilts 425
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00
page: 2

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 03/04/13 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?
❑
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)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
S. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
& 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
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste ARRlication
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11, Is there evidence of incorrect application?
❑ N ❑ ❑
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: AW5830028 Owner - Facility: Murphy -Brown LLC Facility Number: 830028
Inspection Date: 03/04/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na He
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
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
❑
M ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
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?
❑
MCI
❑
If yes, check the appropriate box below.
WU P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS830028 Owner - Facility : Murphy -Brown LLC Facility Number: 830028
Inspection Date: 03/04/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and T' Rainfall Inspections
[]
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
N ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
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 Ne
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?
❑
❑
❑
(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 / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
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?
❑
E ❑
❑
page: 5

rm 3tz-g/(3
Division of Water Quality
Facilify Number ®- L� O Division of Soil and Water Conservation
© Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Dq ` Departure Time: County:3:412
Farm Name: _ 1L_'1 Owner Email:
Owner Name: (OLIJ Phone:
Mailing Address:
Physical Address:
Region I1` 0
Facility Contact: j"y\ t �� �. Title: Phone:
t Onsite Representative: 1 1 Integrator: l I ��/} l IBC QQ u &Own
Certified Operator: — �� C_ Certification Number: 1 � I cc 3 y
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
Dest n
Current
Dest Current Des'
"g R "'
Current
Swine
Ca act
Po p
h- ry� p,
Wet�Poult Ca act Po
ty p
p'tgn
Cattle Ca achy
Pop.
Wean to Finish
La er
Dair
y Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D , foul
@a aci P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
I
10ther
Discharges and Stream Impacts
l . Is any discharge observed from any part of the operation? []Yes [2pNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? []Yes [:]No CYNA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) [:]Yes ❑ No [�FNA ❑ 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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
[:]No
❑ Yes
No
❑ Yes
[ No
NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page I of 3 21412011 Continued

Facili Number: - Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes C6 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ® NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): CJ�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[A No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
allo
❑ 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
IM 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
[�q No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes
[k No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [R 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): �Gc.�S�� l be (mu c a__ (fl � , ji"Q. 4u re. , -� 1(0- e r g
13. Soil Type(s): L_A)CL�r, %Ci fV"----
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
PNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
[3Yes
[�?No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
[] Yes
r7h No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Fit 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 0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No
23. If selected, did the facility fail to instal] and maintain rainbreakers on irrigation equipment? ❑ Yes )B No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

F ciliNumber: $ - � Date of Inspection: 3- —/
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 (a No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ❑ No 0 NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [ No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [ No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes [8 No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
M No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�B No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use addition al` pages as necessary).
%A-� v 31q 1 l3
.- __� e
Reviewer/Inspector Name:('
Reviewer/Inspector Signature:
Page 3 of 3
Phone: q 1 O 4 3.3 -" R16
Date:
21412011

t ype of visit: W compliance Inspection U Operation Review U Structure Evaluation U 7Vechnical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:/�� IZ_� Arrival Time: l Departure Time: %d!� h County: SC�i�'JV Region: �D
Farm Name: ! IO �j Owner Email:
Owner Name: M ro Phone:
Mailing Address:
Physical Address:
Facility Contact: le+i Cott Title: Phone:
Onsite Representative: N
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator: M U4 f2!'4,.`Y/ZQuJLA
Certification Number: 2
Certification Number:
Longitude:
Dest n' 'g Current Des � ign CCurrent
Swine Capacity P,op. Wet Poultry Capacity ' Pop.
Cattle I
Design Current
acity Pop.
Wean to Finish
La er
Non -La er
Design Current
DiI . ul Ca achy F
Layers
Non -Layers
Pullets
Turkeys
I Turkey Poults
Other
Dairy Cow
Wean to Feeder
airy Calf
Feeder to Finish
Farrow to Wean
Dairy Heifer
Dry Cow
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Soars
Beef Feeder
Beef Brood Cow
Othe
Other
Discharges and Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes [;E� No ❑ NA ❑ NE
a. Was the conveyance than -made? ❑ Yes ❑ No Qy NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No [8 NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No M NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 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
41..

Facility Nudtber: Date Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes EP
No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No NA ❑ NE
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure I Structure 2 Structure 3
3S
Structure 4
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 Structure 6
❑ Yes IP No ❑ NA ❑ NE
❑ Yes T 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 [P 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) IT
9. Does any part of the waste management system other than the waste structures require ❑ Yes (� No ❑ NA ❑ NE
maintenance or improvement? T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from
designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
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.
❑ NE
❑ Yes No ❑ NA ❑ NE
r
❑ Yes [P No ❑ NA ❑ NE
❑ Yes [P No ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
❑ Yes
�No
❑NA
❑NE
No
❑ NA
❑ NE
j� No
T�
❑ NA
❑ NE
No
❑ NA
❑ NE
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes fo No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes E0 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
DNA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Nuthber: 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 EP
No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
24. 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)
3 L Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No ❑ NA ❑ NE
❑ Yes 1P No ❑ NA ❑ NE
[:]Yes CP No [DNA ❑ NE
❑ Yes [P No ❑ NA ❑ NE
32. Were any additional prob]ems noted which cause non-compliance of the permit or CAWMP? ❑ Yes y No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes QJ No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes _M No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name-
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �" 3
Date: 3 iZ
21417011

i ype or visit: w Lompuance inspection v e.uperatnon Review V structure r:vatuation V reenntcat Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: rV Arrival Time: Departure Time: f?� n County: ,�L.�p Region: AW
r-
Farm Name: 0 f Owner Email:
Owner Name: j,1niQu,�,.l �C Phone:
Mailing Address:
Physical Address:
Facility Contact: M eItt. l_LCW Title: Phone:
Onsite Representative: Integrator: mjmeL-0>Lown
Certified Operator: ��� Certification Number: /Z63y
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
x
EMEF best
tit° Cp rent
CPo k
Swine
. Capacgrty
Wet PoultryCa4 paetty�P p Cattle Capacity op.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Layer
Dairy Calf
Feeder to Finish
`=:F -
Dairy Heifer
Design Current
Farrow to Wean
Dry Cow
Farrow to Feeder
DPoul z Ca a _Po
Non -Dairy
Farrow to Finish
-
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Putlets
Beef Brood Cow
."'.Y
Turkeys
Other
Turkey Poults
Other
Other
Dischmes 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 Wo ❑ NA ❑ NE
[:]Yes [—]No
[:]Yes [-]No
❑ Yes [] No
[:]Yes [} No
[:]Yes No
NA ❑ NE
NA ❑ NE
® NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

FaciNty Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): k
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
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?
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 Eft" 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 CWindow ❑/�Evidence of
Wind Drift 1 ❑ Application Outside of Approved Area
12. Crop Type(s): LO�t�4j&-4'-rbul 6K-&&5 C�F' ") . —<;;4,. e
13. Soil Type(s):
14. Do the receiving cropsYiffer from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination'?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
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.
❑ Yes
E� No
[] NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
[] NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 4 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 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

lFacility Number: Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes a No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [�j No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
❑ No
® NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
® No
❑ NA
0 NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[:]Yes
0 No
[DNA
❑ 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
(:!f No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[� No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[M No
[DNA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[M No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[� No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
� No
❑ NA
❑ NE
Comments (refer to question # ): Explain any YES answers and/or any additional recommendations or any other comments.
--]
Use drawings of facility to better explain situations (use additional passes as necessary).
9-2 t S V-W; 2121 I t 2
s,It i tit - 31 l 2A t z,
ReviewerlInspector Name:
ReviewerlInspector Signature:
Page 3 of 3
Phone: 7
Date: l 2
Z/4 011

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit • Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1 Arrival Time: Departure Time: County: SZ-VTZ-14—ALD Region:
Farm Name: A7 0'3 7 Owner Email:
Owner Name: -hWC'%' L Phone:
Mailing Address:
Physical Address:
Facility Contact: I ►tt ITitle:
Onsite Representative:
Certified Operator: L
Back-up Operator:
Phone -No•
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = c = I = u Longitude: = ° 0 I 0 u
Design
Capacity
Current P Design Current
Papulhon Wet Poultry Cap ty�Population
Design Current
Cattle Capty Popniation
❑ Wean to Finish
❑ La er
❑Dai Cow
❑ Wean to Feeder
❑Non -La er
Dry Poultry '..
❑ La ers
2 ❑Non -La ers
❑Pullets
El Turkeys
EjTurkey Poults
❑Other
❑Dai Calf
El Feeder to Finish
❑ DairyHeifer
❑ Farrow to Wean
❑ D Cow
❑ Farrow to Feeder
El Non -Dairy
❑ Farrow to Finish
Gilts
❑ Boars
-
Other
❑ Beef Stocker
❑ Beef Feeder
❑Beef Brood Co
Number of Structures:
Other
Discharges & Stream Im acts
1. Is any discharge observed from any part of the operation?
❑ Yes
�No
11
❑ NA
❑ NE
Discharge originated at: ❑ Structure El Application Field El Other
a. Was the conveyance man-made?
❑ Yes
❑ No
�3 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
[�NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
P NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
❑ Yes
` ` No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
EpNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: f1i— Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [M No [INA ❑ NE
a. If yes, is waste level into the structural freeboard? []Yes ❑ No [5aNA ❑ 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
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
T No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
(P 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
[8 No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
'
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift El Application Outside of Area
12. Crop type(s)
l a" E 5m,
13. Soil type(s)
V
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
\ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
I8_ Is there a lack of properly operating waste application equipment?
❑ Yes
Ep No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as aecmar.vi;
• f to 6�6_lrl I;. V'" i'ewtj v'1 31 Yl
•Sr Core I d '�lYl ►1
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date: VAL
Page 2 of 3 12128104 Continued

Facility Number:03— Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes '® No ❑ NA ❑ NE
f
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Lr
No ElNA ElNE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
EP No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[P No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
4 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification'?
❑ Yes
[A 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
[P No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit'? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
10 No
❑ NA
❑ NE
Page 3 of 3 12128104

$-wts
3 R. 02
'///z/zo/o
Type of Visit
C�ommppliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
[routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: 00 County: Region:
Farm Name: 2" -70 Owner Email:
Owner Name: A4- 8ynww i-- L C Phone:
Mailing Address:
Physical Address:
Facility Contact: A4' kr- C"dd Title: L n!M A""'aje4— — Phone No:
Onsite Representative: Integrator: M-8"&JAI
Certified Operator: e5; C' Operator Certification Number: /7/ 3 e/
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = = 6 = Longitude: [� n =
Design Current
Swine Capacity Population
Design
Wet Poultry Capacity
Current
Population
Design Current
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
E]Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
I
I
❑ Dairy Calf
Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean Dry Poultry
❑ Farrow to Feeder
Farrow to Finish ❑ Layers
Gilts ❑ Non -La ers
Boars ❑ Puilets
❑ Turkeys
Other ❑ Turkey Poults
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
number of Structures:
❑ Other ❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
B NA
❑ NE
❑ Yes
❑ No
EJ<A
❑ NE
[9-KA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ NA
[I NE
El Yes
��To
2 o
❑ NA
❑ NE
12128104 Continued

Facility Number, —dz8
Date of Inspection 3-2-7-/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 1 Structure 2 Structure 3 Structure 4
Identifier: 70 Q 7
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 g
5. Are there any immediate threats to the integrity of any of the structures observed?
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes ErNo
❑ Yes E3 No
Structure 5
❑NA ❑NE
❑ NA ❑ NE
Structure 6
❑ Yes ETNo ❑ 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 thre , notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes Lit No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [& o ❑ 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 Ela Yes o ❑ NA ❑ NE
maintenance or improvement?
Waste Application ,_�
10. Are there any required buffers, setbacks, or compliance alternatives that need ElM Yes o ❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application'? If yes, check the appropriate box below. ❑ Yes L_7<o ❑ NA ❑ NE
❑ Excessive Pond ing ❑ Hydraulic Overload ❑ Frozen Ground [:]Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] 0 ]bs [:]Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)�Kae!.� tfPaS::.. t� SLt+� ll✓{,`,✓ r�+7. 5 • J
13. Soil type(s) na
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ErNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement`? ❑ Yes L+'J 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 ,�, N"o ❑ NA El NE
18. Is there a lack of properly operating waste application equipment? [I Yes L''fNo ❑ NA ❑ NE
Comments refer to question n a tx"
( q #}. Explain any YES answers and/or any recommendations or any o[tier comments
Use drawings: of facility to better explain situations. (use additional pages as necessary) -a
s
Reviewer/Inspector Name I K 1--V 7 wive, [S F.= Phone: g!Q-5`-33-3300
Reviewer/lnspector Signature: Re,-� Date: %+,V) GL OyD
12128104 Continued

Facility Number: 83 — 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 El Checklists El Design El maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ONo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain
Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
M No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
2<o
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
BIN'.
❑ 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
2 o ❑ 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
ONo ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No ❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32_ Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No ❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
Gj o ❑ NA
❑ NE
12128104

n�S _C'j 4."CL 4//03/09
Facility Number
C utvision of Water Quality
0 Division of Soil and Water Conservation
0 OtherAgency
Type of Visit ecompliance Inspection O Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit Routine Q Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: -/D — O Arrival Time: Departure Time: County: Region: "220
Farm Name: -709 7 Owner Email:
Owner Name: /L�uYPhone:
Mailing Address:
Physical Address:
Facility Contact: P12kj 34M ft 44'N u' Title: `- v ✓ `Phone No:
Onsite Representative: Integrator: /Llwya�, Bmuvnl
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other .
❑ Other
Back-up Certification Number:
Latitude: = c ` Longitude: = ° 0 ` = "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
Layer
1 I ❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current:
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ®i f
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
ETNA
❑ NE
❑ Yes
❑ No
❑'NA
❑ NE
C NA
El NE
❑ Yes
❑ No
El Yes
D o
[INA
❑ NE
El[ Yes
o
❑ NA
❑ NE
12128104 Continued

Facility Number: 83 — 2.$ Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ONo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): / 9
Observed Freeboard (in): 3Jr
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
B No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[ oo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
Q<
❑ 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
,
LJ`No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�,,//
2<0
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes E o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 13U'AA_,._d Cs. ���x �� ill ��:�✓ �Oyrrs �J
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
O'No
❑ NA
[INE
LJ No
❑ NA
❑ NE
[2lo
❑ NA
❑ NE
El -No
El NA
El NE
3<o ❑NA El NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name R j Plewe_CS Phone: yIC• fr33 , 33a o
Reviewer/Inspector Signature: Date: 3 /D r Z-00
I2128104 Continued

Facility Number: JT3 — Z $ Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ElOther
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes L"No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes R No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes B No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes L'`SNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes [2 o ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Comments and/or Drawings:
❑ Yes No ❑ NA ❑ NE
❑ Yes B o ❑ NA ❑ NE
❑ Yes L<oo ElNA ElNE
ElD Yes o ❑ NA ❑ NE
❑ Yes LSNo ❑ NA ❑ NE
❑ Yes B o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes 2No ❑ NA ❑ NE
12128104

BTN-.( cno
ntston ofiNvater Quality'
Factltty Number S 3 2 O: Di '� iii of Soil and Water Conservation
v -- -- — — Q:Oe cj'
E
f Visit ompiiance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
n for Visit autine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 3-2$ O Arrival Time: I /T 1/0 Departure Time: County: Ste' ` �I"' Region:
Farm Name: ,7,9 9 7 Cp9 /10,5O Al / M "-Al Owner Email:
Owner Name: /11 � 0dp _ L�hrzJA/ Phone:
Mailing Address:
Physical Address:
Facility Contact: ^f 3 234ktC a vNfrr Title-. Phone No:
Onsite Representative: Integrator: 6.V W/✓
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: o [� , =,c Longitude: 0 °
:Swine � f-
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Gilts
❑ Boars
Other
❑ Other
Design Current- Uesign Current Design C
Capacity Population ,et :P.oultry . Capacity Population Cattle Capacity' P.or
LJ Non -Layer
r Dry Poultry
❑ Layers
s
❑ Non -Layers
s
❑ Pullets
❑ Turkevs
❑ Turkey Pouets
❑ Other
❑ Dairy Co",
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures C
Discharges & Stream impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (ifyes, notify DWQ)
?. Is there evidence of a 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?
Page 1 of 3
❑ Yes M No ❑ NA ❑ NE
❑ Yes
[A No
❑ NA
❑ NE
❑ Yes
2 No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[P No
❑ Yes
P No
[:INA
❑ NE
[:]Yes
6?] No
❑ NA
❑ NE
12128104 Continued

Facility Number: 93 — 27 Date of Inspection ZS-4
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
EY No
❑ NA
❑ NE
a. I f yes, is waste level into the structural freeboard?
❑ Yes
[)fl No
❑ NA
❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identi fier:
Spillway? --
Designed Freeboard (in): / 9
Observed Freeboard (in): Z �
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ 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
ff) No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
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 F No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Eo No ❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application'? If yes, check the appropriate box below. El Yes ®No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) &—+� u O�.�e't"
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[2] No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
[� No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination '?
❑ Yes
[A No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application'?
❑ Yes
[M No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment'?
❑ Yes
V1 No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recomiiitendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name rG ✓ j Phone: ��t7� �33 3300
Reviewer/inspector Signature: Date: .3'ZS- Z40B
Page 2 of 3 12/28/04 Continued

Facility Number: Z g Date of Inspection 3 —2S D
Re aired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 16 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes P No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps 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 [)d No ❑ NA ❑ NE
23. 1f selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [R 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 pen -nit?
❑ Yes
[� No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
[0 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
Q9 No
❑ NA
❑ NE
Outer Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
M No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
V1 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
P4 No
❑ NA
[I 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
E] 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
�Z No
❑ NA
❑ NE
Page 3 of 3 12128104

a
i ype of visit (9 Compliance Inspection U Operation Review U Structure Evaluation O Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: '1� Q Arrival Time: %�d�'/Eta.� Departure Time: County: 5CO'Ha6 Region: ��
Farm Name: &Jisui r 0171 Owner Email:
Owner Name: //Virg} J aaulw/ Phone:
Mailing Address:
Physical Address: �7
Facility Contact: -4,44d j4 S UuA 04 ciyKre-Y Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
�J Phone No: &
Integrator: //r U� ��M aW
Operator Certification Number:
Back-up Certification Number:
Latitude: =] c E::] ' [—] Longitude: [-1 ° =' =
fu
Design
Current
Design Current
Design Current
Swine
Capacity Population
Wet Pou..ltry
Capiy Population
Cattle Capacity Population
El Wean to Finish
UPLayer
❑Dai
Cow
ElWean to Feeder
ILI Non -Layer
1-1
DairyCalf
❑ Feeder to Finish
$ - -,:.
El Dairy Heifer
El Farrow to Wean
'Dry Podltry -
•.
El Dry Cow
❑ Farrow to Feeder'
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
El Pullets
❑
❑ Beef Brood Cowl
Other
- Turkeys
g El Turkey Poults
❑ Other
T ❑ Other
H"~ Number 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?
Page 1 of 3
❑ Yes V No ❑ NA ❑ NE
❑Yes
TNo
❑NA
❑NE
❑ Yes
[P No
❑ NA
❑ NE
El NA
[I NE
El Yes
No
❑ Yes]
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

r Facility Number: S3— Z$ 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 [ONo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): Lq
Observed Freeboard (in): 39
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [N 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 0 No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
79 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
`P" No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any pan 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? Ifyes , check the appropriate box below.
❑ Yes
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) �, ear►.1 o..� [- s:
13. Soil type(s) a-Lj
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ONo
❑ NA ❑ NE
15_ Does the receiving crop and/or land application site need improvement?
❑ Yes
M 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 property operating waste application equipment?
❑ Yes
§0 No
❑ NA ❑ NE
Comineots (refer to question #i7: Explain any YES answers and/or any recommendations or any otheF conimentsL1 ^4
Use drawtags of fac ty�to better explain situations. (use additWnM pages as;necessary): y 9;
/o. Y33.3330 •
Reviewer/Inspector Name _ �! Phone
Reviewer/Inspector Signature: Date: Z—/J�" ZOO
Page 2 of 5 1212 04 Continued

Facility Number: 3 — Z Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 10 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 El 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 V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[P No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment`?
❑ Yes
0 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
O No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
(� No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
M No
ElNA
ElNE
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
WNo
❑ 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
Of No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
XNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Type of Visit ®Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit ®Routine Q Complaint 0 Follow up Q Referral Q Emergency 0 Other El Denied Access
Date of Visit- Ds Arrival Time: 2: Departure Time: /Z; .30 County: SC,0Region: r'�Q
Farm Name: 70 7 (�Sdi✓ �---� Owner Email:
Owner Name: &94444 W �YaL,J fy Phone:
Mailing Address:
Physical Address:
Facility Contact L'I-�`L Gr'✓Gll Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator: WO oOZ R_ kf& J A J
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o = I = {I Longitude: = ° =1 ' El u
Design Current Des*!�R_Mm�r`,Nnt
Caacity Po ulation Wet PoCa atton P try pa
DesignSwine
P ty P
❑ Wean to Finish
❑ Layer
❑Dai Cow
❑ Wean to Feeder
I ❑ Non -Layer
❑Dai Calf
ElFeeder to Finish
El Farrow to Wean
Dry Poultry
w.;, .:
;.
,
❑ Dai Heifer
❑ Dry Cow
El
Farrow to Feeder
Discharges &Stream Impacts
1. Is any discharge observed from any part of the operation?
❑Yes
[9 No
❑ NA
❑ NE
Discharge originated at: El Structure El 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)
El Yes
f � 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
9 No
❑ NA
❑ NE
2. Is there evidence of a past discharge From any part of the operation?
El Yes
19 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
[kNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: 83 - ,Z $
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
3U
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 ['No ❑ NA ❑ NE
El Yes LvNo ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes [19No ❑ NA ❑ NE
ElYes n 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 X No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes L No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) ��qq
9. Does any part of the waste management system other than the waste structures require El Yes 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste AVI Wfication ,,te�rr
10. Are there any required buffers, setbacks.. or compliance alternatives that need El1Y
Yes No ❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below_ ❑ Yes
[XNo ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
Crop type(s) �u-,.c,c C/A_
-
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
P4 No ❑ NA
❑ NE
15_
Does the receiving crop and/or land application site need improvement? ❑ Yes
PJ No ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? ❑ Yes
K No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
P9 No ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
[]a No ❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name I r A[" a S f Phone: g/
Reviewer/Inspector Signature: Date: 4 -Df
-Page 2 of .t 12128104 Continued

Facility Number: V 3 -Z Date of Inspection riO-Of O
Required Records &_Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [�No ElNA ElNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [gNo ❑ NA ❑ NE
the appropriate box. ❑ Wl_JP ❑ Checklists ❑ Desig
n ❑ Maps El Other
21 _ Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [XNo ❑ 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 [yNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[)I No
❑ NA
❑ NE
26, Did the facility fail to have an actively certified operator in charge?
❑ Yes
QlNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? [--]Yes MNo ❑ NA ❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[4 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
QVNo
❑ 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
El NE
If yes, contact a regional Air Quality representative immediately
31,
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
Pa 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
QTNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
ZNo
❑ NA
❑ NE
Additional Comments and/or
Page 3 of 3 12128104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: II ~D 8'o Arrival Time: �� Departure Time: —� County: �4{ �a�d Region: G'eO
Farm Name: Gikk 5"j rcivhn 7097 Owner Email:
Owner Name: M tf l _ -&-a L J pf Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: RaNJ !, Bu ►w. 1fi -fv C'j-
Certified Operator:
Back-up Operator:
Location of Farm:
Swine _
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boar.
Other
❑ Other —
Phone No:
Integrator: Af,V . &-0 JAI --
Operator Certification Number:
Back-up Certification Number:
Latitude: [ e 0 , = Longitude: 0 0 = ,
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
1. ❑ Layer
1! 10 Non -La ei
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ElStructure ElApplication Field ElOther
a. Was the conveyance man-made?
Cattle
Design Current
Capacity Population
I
El Dairy Cow
El Dairy Calf
El Daia Heifer
❑ Da Cow
ElNon-Dairy
❑ Beef Stocker
ElBeef Feeder
❑ Beef dC
-- -
Number of Structures:.
Owl
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 [N No ❑ NA ❑ NE
❑ Yes
VNo
❑ NA
❑ NE
❑ Yes
N]No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
12128104 Continued

f'
Facility Number: — Z
Date of Inspection /-29—_
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): (g..
Observed Freeboard (in):
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 N No ❑ NA ❑ NE
El Yes 59No El NA ❑NE
Structure 5 Structure 6
❑ Yes NNo ❑ 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 0 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) YM
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 10 No El NA El NE
maintenance/improvement`?
IL Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes PNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 'gep-mv(�_ A-,
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
DE No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
XNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',
El Yes
9TNo
❑ 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
WNo
❑ NA
❑ NE
ReviewerAnspector Name �/�ii`Cf j� y�� `` ` "Y tAi
1 "- Phone: (9/0)#S6 -15'V
Reviewer/Inspector Signature: Date:
r unpins �.....:.......�

10
Facility Number: Date of Inspection / Z$—d.$
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 o No ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists ❑Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [)fNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22_
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[�l No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
XNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
W No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
91No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[IffNo
❑ 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
[ZNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
01 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
TNo
❑ 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
[;rNo
❑ 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
[UNo
El NA
El NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[)''No
❑ NA
❑ NE
A�dditioiialrcComments niid/or Drawings: '.r
12128104

w
Facility Number Date of Visit: 'QY Time:
rO Not O erational 0 Below Threshold
0 Permitted O Certified [3Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name:
.S co+ ) aycR �R"
�o �+ -'a.r Coun: ty.`
Owner Name: C 0, " 011-` — a-r V..-b _ _.t� Phone No: S 10 - -793 -
Mailing Address: _ -e b_ ac,.x z�a /y,'/ / Al,_. 44 C0 r a /i.rq 17J qS.9
Facility Contact:
Onsite Representative:
Certified Operator:
Location of Farm:
Title: Phone No:
Integrator: _C..,r - o X% l
Operator Certification Number:
G2 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �' �� �u Longitude
Design Current
Swine Capacity Po ulatioi
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
© Gilts $
❑ Boars
Number of Lagoons
Holding Ponds / Solid Traps C
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I L E-1
Dairy I
❑ Non -Layer Non -Dairy
❑ other
Total Design Capacity
Total SSLW ._
Subsurface Drains Present 10 Lagoon Area ❑ S ray Field Are$
No Liquid Waste Management System
Discharges & Stream Impacts
I . 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 Structure 5
Identifier:
Freeboard (inches): st
OS/03/01 i
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure b
Continued

Facility Number: 83 — .78
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?
$. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12, Crop type
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17_
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18,
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
❑ No
(ic/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (�ef9ito,-question #). Explam`any YES-ansRers and/o' ns-or anyxother omments.
F
Use dra s of faciL to better ex lam situati' ons. (use s�
ty p dtlthonalkpages'as neces'`sary)
w�ng
®Field Copv ❑ Final Notes
f y
.... _....
Ito v w- 1 a'T ea h c
L,,j t� n ''r �? � w O � � D w U T a '� • 1 Q h Ot � , r. PL
O !p CY' 4 \� /-S ,
Reviewer/Inspector Name
Reviewer/inspector Signature:
Date:
05103101 61
Continued

r
r- - - -
® Dhision.ofWater Quality
O Division of Sail and Water Consen ation� r
t O Other Agency
4
Type of Visit ® Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number
Date of Visit: Time:r Sr
g
Not O erational 0 Below Threshold
® Permitted [P Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: f county:- Q r n;-k_.,d
Owner Name: r•r) i,(rs ao 13 Phone No:
Mailing Address: 0 1 Q Ok �' — �a1'SG L] rJ _ G. 4 3 91 _
Facility Contact:—L4A.06 C 1�r✓�- --_ _Title: kAi( Phone No:
Onsite Representative: 2t Integrator: C16rTp �[ S
Certified Operator: to p r., f fl6i'� C2 Operator Certification Number:
Location of Farm:
W Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a 6 " Longitude 0 4 C] K
Design Current
Design Current Design Current
Swine Capacity Population
Poultry Ca selty Population Cattle Cauncitv Population
❑ Wean to Feeder
10 Layer I I 1 10 Dairy
❑ Feeder to Finish
❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Gilts ! fi
Total Design Capacity
❑ Boars
Total SSLW
Number of Lagoons
�j
❑ S rav Field Area
❑ Subsurface Drains Present ❑ La oon Area
10 No Liquid Waste Mana ement S 'stem
Holding Ponds 1 Solid Traps
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ La;yoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge'?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes r7f No
LPI
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes allo
❑ Yes ® No
❑ Yes [ANo
Structure 6
Identifier:
Freeboard (inches):
05103101 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, ❑ Yes (51 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 O No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes q No
Waste Application
10. -Are there any buffers that need maintenance/improvement? ❑ Yes P No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes [� No
12. Crop type (R.a CM t -.Lr' A, .Sk" • 6-Vy'j ' - — - -
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes { No key
0This facility is pendcd for a wettable acre determination? ElYes No em
15. Does the receiving crop need improvement? ❑ Yes No
16. Is there a lack of adequate waste application equipment? ❑ Yes ® No
Reuuired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
O 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? (ic/ irrigation, frecboard, waste analysis & soil sample reports)
❑ Yes
[LNO
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
[6 No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
fgNo
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. —71
_
.� cL cedr�a#t �a k .yard-+ r
` s ,tea �,. 5 c, a �) i6 x G s t rn r�;sl dl +` jss'r� �tlEer4 COmment8.
Commepds refer to uestion # >J ~ lain an YES ansRersLandlor an recommendattonsi Field Copy Final Notes
or�apy o
Use drawings of la:cilrtyito better eiplam situatronw(use additional pages as necessary)
..�
Reviewer/Inspector Name , , • c_.....i . ..
Reviewer/Inspector Signature: Date: 3
05103101 r� Continued

Facility Number: Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of 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 ncighboring 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 submerged fill pipe or a permanent/temporary rover?
Comments
PYes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes l� No
❑ )'es ® No
❑ Yes ® No
09 Yes ❑ No
05103101

iV
Type of Visit ® Compliance Inspection Q Operation Review Q Lagoon Evaluation
Reason for Visit ®Routine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
L Facility lumber Date of Visit: 3 Time:116,66
• -•• k Not Operational 0 Below Threshold
® Permitted ® Certified O Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: � r C , County:
r
Owner Name- t e—r'�r-b (k .5 ek �` Phone No: O - a,1-G - Jb G 3 -
Mailing Address: P- ,_t�,, RaX .� (- t,3 6- S 6,LJ _%c . €i
FacilitV Contact: ""�� c. Title:
OnsiteRepresentative: _M�rdel 64c,�2C-8U�
Certified Operator:
Location of Farm:
Phone No:
Integrator: L' 6 r-'M I, {, f C
Operator Certification Number:
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 6 0 4 Longitude 0 •
Design Current
Swine r'anneifv Pnnnlafinn
❑ wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
® Gilts h
® Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Laver I I 1 10 Dairy
❑ Non -Lave; I I IM Non -Dairy°
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons L f J ILl Subsurface Drains Present JIU Lagoon area }LJ Sprav Field Area
Holding Ponds / Solid Traps u ❑ No Liquid Waste Management System
Discharges & Stream Impacts
I. 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. notiffi• DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon systetn? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Vl%ere there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
1(
MM
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 4 No
❑ Yes [3No
❑ Yes Q No
Structure 6
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, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes Q2 No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Auptication
10. Are there any buffers that need maintenance/improvement? ❑ Yes 5§No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes [P No
I2. Crop type 4-
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [Sj 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 Sri No
16. Is there a lack of adequate waste application equipment? ❑ Yes ® No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Pcrmit readily available?
❑ Yes
[S No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(icl WUP, checklists, design, maps, etc_)
❑ Yes
[55 No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
CgNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
IM No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
[XbNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
91 No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
O No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
VANo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
C1No
0
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
�Commeu#si.(refer Wo uuestion`ft"E=plain�any YrES anstyers andlor;anyrecommendatrons orjany other comm6&9s i
,
❑ Field Copy ❑ Final Notes
i &-4.� SSi ( a G�w� d o -told- 7�(, J,
Reviewer/lnspector Name
Reviewer/Inspector Signature: Date: 3
05103101 Continued

I�
Facility Number: 3 — Cyr Date of Inspection
Odor Issues
26, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
2T Are there any dead animals not disposed of properly within 24 hours? El Yes M No
28. Is there any evidence of wind drill: during land application? (i_e. residue on neighboring vegetation. asphalt. ❑ Yes No
roads, building structure. and/or public property)
29, Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i_e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters. etc.) ❑ Yes �5 No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes R No
32_ Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover? ❑ Yes ❑ No
'AdditionafComments and/or,Drawings:_
05103101

Type of Visit 0 Compliance inspection 0 Operation Review Q Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up Q Emergency Notification 0 Other ❑ Denied Access
Facilih- Number bate of "' isit: t7 Time: d dd
10 Not Operational Q Below- Threshold
Permitted 0 Certified 0 Conditionally Certified M Registered Date Last Operated or Above Threshold:
Farm Name: COUnty: Scram �i✓a
Owner Name:. Sis����Lyhx S Phone No:
Mailing Address:
Facility Contact: k s' Cti � Tide: Phone No::!
OnsiteRepresentative: Integrator: si�r�1Lh,E/co
Certified Operator: S".J Operator Certification Number:
Location of Farm-,
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' u Longitude 0 0
DesignCurrent a =Des' Current D Current
_ ! �n
Swrne=- Ca acin Pa ulatioxi°. , �LLQJJ
ai - == Ca��acity .Pa elation`"r : Cattle a- Ca acltti Po ietgtaon <.
❑ Wean to Feeder ; 'Laver Da'
y, ❑Feeder to Finish Non -Laver Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder. Other
❑ Farrow to Finish Total Design ;MP40t} ;
w Gilts ! 6
❑soars Total SSLW
lumber,of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ S ray Field Area
„Noldtag Ponds'f Solid ;Traps : ❑ No Liquid Waste Management System _
Discharges S Stream Impacts
1. is any 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 observed, did it reach Water of the State? (If ves. notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If ves, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
IN. aste Collection & Treatment
❑ Yes eRNo
❑ Yes KNo
❑ Yes .791No
❑ Yes i No
❑ Yes ONTO
❑ Yes XNo
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes gNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inchcs):
05103101 Continued

Facility Number: 8.3 — ,6r
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?
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 Application
10. Are there any buffers that need maintenance/improvement?
I I - Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type fijr?iss.�� S�abl�>.fs/�
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?
(ie/ WUP. checklists, design, mmapetc.) c/
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems. over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes KNo
❑ Yes KNo
❑ Yes P�No
❑ Yes )SNo
❑ Yes gNo
❑ Yes )9Xo
❑ Yes �No
❑ Yes ❑ No
❑ Yes P9 No
❑ Yes ®No
❑ Yes No
VYes ❑ No
❑ Yes 1, No
❑ Yes KNo
❑ Yes VNo
❑ Yes KNo
❑ Yes ® No
❑ Yes ® No
❑ Yes No
❑ Yes No
❑ Yes ;E9 No
❑ Yes X No
E3 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this -0sit.
Cammeats�(irefer to question #): ;Explain any YES:ansrs'ers and/or=any ritonitntadatiaiss ar any:other;comments. _ _ _
Use:drawings of tacdity:to better eitplam sitnatioi (use additmnal pages as ueeessarti) . { ❑ Field Copv _ ❑ Final Notes
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 15 0Z
05103101 Continued

A 0
Facility Number: 7,?v Date of Inspection
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
Kyes
D No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
0 Yes
[KNo
2&
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation. asphalt,
❑ Yes
[N 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?
El Yes
EF No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters.. etc.)
El Yes
(RNo
31.
Do the animals feed storage bins fail to have appropriate cover?
0 Yes
Apr
w1i No
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover? XYes E:1 No
-additional C-t)mments,2ndlor:Drariiiigs--',
AL
05103101

r
of Visit O,Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit KRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: 9-Oi Time:
T::E&_J_ 1j[ 0 Not O erational Q Below Threshold
® Permitted [3 Certified [3 Conditionally Certified © Registered Date Last Operated or Above Threshold: .........................
Farm NameP..... 70.� T Co .� 4... se -c County :......_.....
........ .....
OwnerName: C( o 15................. ..... ._.4.... .................. Phone No: .................................................... .............................
Facility Contact: R5.. .GQ.U.-'ns...... .....Title:...!? � , ...................... Phone No:....................................................
Mailing Address:.,...,,,,,.
....................................................
Onsite Representative: ...................................................
Certified Operator:................
.........................................
Location of Farm:
..... Integrator:
.... Operator Certification Number:.......
A.
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �I « Longitude • ° .6
Design Current
ow1111C Uapacity Population
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other I
Total Design Capacity
Total SSLW
Number of Lagoons _ ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Fonds /Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes No
Discharge originated at: ❑ Lagoon [I Spray Field [I Other
a. If discharge is observed, was the conveyance man-made? ❑ YesN0
b. If discharge is observed, did it reach Water of the State? (If yes, notify DW Q) ❑ Yes A1�4
0
c_ If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes NNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes I No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes Po
01/01/01 3(J�<!
Continued

Z
Facility Number: V ;j Date of Inspection $ o?g-Ol Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes )No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ YesNo
(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 Wo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ElYes KNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes AN 0
Waste Aoolication
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN n❑ Hydraulic Overload ❑ Yes ONO
12. Crop type I� Umu_
pa ur►ia rl [� sw n d �csSCt�l --
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes kNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes r0
b) Does the facility need a wettable acre determination? ❑ Yes �� 11No
c) This facility is pended for a wettable acre determination? ❑ Yes o
15. Does the receiving crop need improvement? ❑ Yes ATNo
16. Is there a lack of adequate waste application equipment? ❑ Yes AWO
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
[KNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.)
❑ Yes
[ 'No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
j-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?
(iel discharge, freeboard problems, over application)
❑ Yes
�j No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency'?
❑ Yes
�No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[J�No
10 yi a igris:off- defe..... were poised d4trt . �h..v...... vr.. r t'eeiye do furt�gr
cori•esporide>r�ce shout this visits ::::::::.::.:::::: .

Facility Number:
Date of Inspection Printed on: 7/21/2000
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
Ayes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
o
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
o
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
P�o
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
Mo
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
�No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
6zies
❑ No
lAdditional Comments and/or ra
wutgs-: _ -
J
5100

Revised April 20, 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number g3 - a' — Operation is flagged for a wettable
Farm Name: Fa.- o - r acre determination due to failure of
On -Site Representative: Part/1 eligibility item(s) F1 F2 F3 F4
Inspector/Reviewer's Name:
Date of site visit: i�— f 7
Date of most recent WUP: 1-- 5 f7
Annual farm PAN deficit: A ff pounds
Operation not required to secure WA
determination at this time based on
exem ' n E9 E2 E3 E4
Operation pended for wettable acre
determination based on P7 P2
Irrigation System(s) - circle #ae�ard-hose traveler; 2. center -pivot system; 3. linear -move system;
4. stationary sprinkler system wlpermanent pipe; 5. stationary sprinkler system wlportable pipe;
6. stationary gun system wlpermanent pipe; 7. stationary gun system wlportable pipe
PART I. WA Determination Exemptions (Eligibility failure, Part 11, overrides Part I exemption
E1 Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D2/D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an I or PE.
E3 Adequate D, irrigation operating parameter sheet, including map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part III. (NOTE: 75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part II. Complete eligibility
checklist, Part II - F1 F2 F3, before completing computational table in Part III).
PART H. 75% Rule Eligibility Checklist and Documentation of WA Determination
Requirements. WA Determination required because operation fails one of the eligibility
requirements listed below:
F1 Lack of acreage which -resulted in over application of wastewater (PAN) on -spray
field(s) according to farm's last two years -of irrigation -records:
F2 Unclear, illegible, or lack of information/map.
F3 Obvious field limitations .(numerous ditches; failure to deduct required _-.
bufferlsetback acreage;-or.25% of total acreage identified in CAWMP includes:, -.:-
small,- irregularly shaped fields - fields less than 5 acres for -travelers -.or less than
2 acres for stationary. sprinklers).
F4 WA determination required because CAWMP credits field(s)'s acreage in excess
of 75% of the respective field's total acreage as noted in table in Part III.

r
Iq �*4. ewe, i P
Revised April 20, 1999
Facility Number V - 1'
Part Ill. Field by Field Determination of
75% Exemption Rule for WA Determination
TRACT
NUMBER
FIELD
NUMBER',2
TYPE OF
IRRIGATION
SYSTEM
TOTAL
ACRES
CAWMP
ACRES
FIELD
%
COMMENTS3
FIELD NUMBER' - hydrant, pull, zone, or point numbers may be used in place of field numbers depending on CAWMP
and type of irrigation system. If pulls, etc. cross more than one field, inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption; otherwise operation will be subject to WA determination.
FIELD NUMBER2 - must be clearly delineated on -map.
COMMENTS' - back-up fields with CAWMP acreage exceeding 75% of its total acres and having received less --than 50%
of its annual PAN as documented in the farm's previous -two years' (1997 & 1998) of irrigation records,- cannot serve as the
sole basis for requiring a WA Determination. -Back-up fields-must.be noted in -the comment section and must be accessible
by irrigation -system. -
Part IV. Pending WA Determinations -
Pi Plan lacks following information:
P2
-.1/P3
Plan revision -may satisfy75% rule based -on adequate -overall PAN deficit and by
adiustingg-all field acreage to -below 75% usexate-.

Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number 3 g Date of Inspection - %W
Time of inspection � 24 hr. (hh:mm)
0 Permitted © Certified 0 Conditionally Certified © Registered JE3 Not Operational Date Last Op ted•
Farm Name: :...........cQK7 ............. ...-......_...................-----.---...
:�.. �d g7......`.�'.... SOS....Lir�Y`'....................... County
Owner Name: ... carrg#s X .. � Phone No: r� r----------- ----
Facility Contact: ...Le�i ......�L ............................. Title: 1...`.!............. Phone No: .....................
/I _ :\ -
Mailing Address:..
Onsite Representative: ........................................................... . .
Certified Operator: ..... 57GiS..�? ! ................
�ilSs
............................................
Location of Farm:
Integrator: ~�
Operator Certification Number:
Latitude ' ° 44 Longitude ' 4 46
Discharges !k Stream Impacts
L 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 ]agoon 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 Structure 5
Identifier: .!�
Freeboard (inches): .....�...................
❑ Yes UYjNo
❑ Yes P�No
O
❑ Yes ''
❑ Yes N0
❑ Yes No
❑ Yes No
❑ Yes �No
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? (ieI trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes 4No
Continued on back

Facility Number: 3 — zr Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement?
11. Is there evidence of over application? ❑ Exceysive Ponding ❑ PAN
12. Crop type per. en,
13, Do the receivint crops differ with those desi
14. a) Does the facility lack adequate acreage fo'
in the Certified Animal Waste Management Plan (CAWMP)?
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
IT. 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/ WCTP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
yi AtiOjis -oir. deficiencies v re ppte#_ �1iti`i . 9 #his:vis}t; : You w l:seceipe rio fui-t tee
corresporicence a�oiti this is ................................... .
❑ Yes 1�_No
❑ Yes [�No
[:]Yes Y&o.
❑ Yes ffl�No
❑ Yes 0 No
❑ Yes A.No
❑ Yes P(No
❑ Yes J&No
❑ Yes 4 No
❑ Yes )KNo
❑ Yes ONo
❑ Yes Wo
❑ Yes )(No
❑ Yes KNo
[]Yes �No
❑ Yes ANO
❑ Yes No
❑ Yes allo
❑ Yes No
❑ Yes No
❑ Yes ONO
Z a0 ousel e r<e Nf a,IC-
Reviewer/Inspector Name =J .� =!'Yfij`� i.�
A C `/ �,,.r�3fi_-72
.
Reviewer/Inspector Signature: /.. kl,e�� Date: l - G f

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

® Routine O Com laint O Follow-u of DW ins ection O Follow-u of t)SWW'C review• O Other
Facility Number Date of Inspeclion
Tinle of Inspection Spy 24 hr. (hh:mm)
0 Permitted 9 Certified [3%ConditionallyCertified
�r© Registered 13 Not Oper:€lional Date Last Operated: ..........................
Farm Name: ...........
.......
....Q(!......'....
.....fN-'`'.......-rari'1rti.................... County: .........
al
..
Owner Name:.........."L3'p/V...........F ! YItG. Phone No: .......................................................................................
Facility Contact: ..-----.-le1.1..! L�...���................Title:..... ........... Phone No:............--.....
- ` /
Mailing address: �� ....... L .35fct ...: Al' wf ............................... ..................
..............I..................
Onsite Representative: ..... -� ± mn.......... C Ytr�... ..... Integrator• ..........�Y7�D,/!5,....
5.:.........................
Certified Operator:,,,,,,,,,,, ,•, Operator Certification Number:
Location of Farm:
A,
..........................................................................:................................................................................................................................................................................................ �
Latitude �' �° Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer I I Dairy
❑ Feeder to Finish JEI Non -Layer I❑Non Dairy
❑ Farrow to Wean
❑ Other
❑ Farrow to Finish Total Design Capacity
Gilts
❑ Soars Total SSLW
Number of Lagoons ❑ Suhsurface Drains Present 110Lagoon Area 10Spray Field Area
Holding Ponds 1 Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation (if yes, notify DWQ)'?
Discharoc originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. lf'discharge is observed, did it reach: ❑ Surface Waters ❑ Waters of the Slate
c. If discharse is observed. what is the estimated flo"v in Lml/tnin'!
d. Does discharge bypass a lagoon sysicriO
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?
Wa-ste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than 1dequa[CY
Structure I Structure 2 Structure I Structure 4 Structure 5
Identifier: 441
Freeboard(inches): ............................................................................................... ..........................................................................
❑ Yes 'A No
❑ Yes EXNo
❑ Yes (XNo
❑ Yes [7 No
❑ Yes lyNo
❑ Yes IgNo
❑ Yes [(No
SIRICtUre 6
1/6/99 Continued on back

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepacre, 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 pact of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation marking=s?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Ponding ❑ Nitrogen
12. Crop type ...............t�.�..... ....... .......... l ..... �.................. ...1�.......... ...
13_ Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. Does the facility lack wettable acreage for land application? (footprint)
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'? (ic/ irriQation. 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 certified operator in responsible charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24_ Does facility require a follow-up visit by same agency?
cr
�: NQ.vio;{ations.or- delicieYicies .were noted. trlu'rin'g Aiis'.-vi kit:. You wilLreeeiive no further. _.:
• : • o6r'respaidehi� e: at�out: this visit.;
[]Yes XNo
❑ Yes 9 No
['Yes ❑ No
❑ Yes 9'No
❑ Yes 4 No
❑ Yes 91 No
❑ Yes KNo
❑ Yes No
❑ Yes No
❑ Yes ONO
❑ Yes KNo
❑ Yes 0 No
❑ Yes IX No
Yes ❑ No
❑ Yes 9 No
❑ Yes jANo
❑ Yes 9 No
❑ Yes %No
❑ Yes [(No
"Comments'(refer to question.#): Explain any YES answers arid/oe any recommendations -or any. other comments : _ ma's a
Use:drawtngs;of facility.to better explain situations. (use additional pages as necessary)..1;n Pvq 4o Z!a"�
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: T — 25 11/6/99
T—

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
10 Routine O Complaint O Follow-up of DWO insvection. O Follow-up of DSWC review O Other
Facility Number
Date of Inspection
I I Time of Inspection j 24 hr. (hh:mm)
13 Registered 0 Certified 13 Applied for Permit 0 Permitted E3 Not O erational Date Last Operated:
Farm Name: _..l..� % 1e~rO L /'vim_ Countv:.......1.. 4...............................
-- ---------- ..............
f � r
Owner Name:.....ln..lr.! Q.l.�S....... .l..ft' .S1,:... Phone .............................
ll/ r........................./.
Facility Contact: ..f�.flC Title: �4... ....... Phone No:....azf�...^.,f2../�Q....
Mailing Address:... ......A ' 1� /Ijc�', r ��.....................
............................................•...----................................. ---. ..................
Onsite Representative:-G. ,f Integrator• .............. '��........... ................................
.......
Certified Operator,--- ...................................... Operator Certification Number
Location of Farm:
Latitude 0' =' = ff Longitude • 0' = L4
hDesign.f Ctirrent
Design Current t 4Design Curren nt
z � ,:.r. ��� �
Swine ;Capacity`'Poptilaltan
,�,.,, � .. „� a ��, ter.,
:°PoultryCapacity Population "Cattle CapacityxPopulatton
Dairy,
❑ Non-Dairy
o
Capacr<ty
n 7eV
Yl
otai SSLW,
Number of Lagoons / Holduig Ponds
❑ Subsurface Drains Present
❑ Lagoon Area
❑ Spray Field Area
xh
❑ No Liquid Waste Management System
y
❑ Wean to Feeder
`
❑Layer
❑ Feeder to Finish
❑Non -Layer
❑ Farrow Wean
to
Farrow to FeederOther
❑ Fan-aw
'�'otal
to Finish
DeS1�
❑
Gilts
❑ Boars
General
1. Are'there any buffers that need maintenancelimprovement?
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 Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gailmin?
d. Does discharge bypass a lagoon system? (Il' yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes � No
❑ Yes � No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes X No
ElYes #No
❑ Yes dNo
❑ Yes [�No
❑ Yes [�No

� r �
Fadlity Number: 3— Z
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laeoous,Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
IdenEi fier:
Freeboard (ft):f
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 maintenance/improvement?
(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?
Waste Application
14. Is there physical evidence of over application?
(If in excess of W''` , or runoff ee teri ters of the State, notify DWQ)
15. Crop type ........
........_..... _..... I.............................._............................. ............ .....
.�......
16. Do the receiving crops differ wit ose d signated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
No:violations:or deficieincies.were.aoted.duritig this.visit.: You.will ieceive:no further
_�correspondenceab:outthis:visit::•::..-:•:.��:�.: _: .��.��•::.:.:,:. , ..:., �. ._
❑ Yes k(No
❑ Yes �No
Structure 5
❑ Yes kNo
❑ Yes XNo
❑ Yes O(No
❑ Yes �No
❑ Yes 1�Vo
❑ Yes RYNo
❑ Yes 0To
❑ Yes $No
❑ Yes R.'-No
❑ Yes ANo
❑ Yes YNo
❑ Yes PNo
❑ Yes kIN 0
❑ Yes ANo
❑ Yes ❑ No

sw.
M U Division of Soil and Water Conservation ❑ Other Agency
@ � Division of Water Quality {
�.b
10 Routine O Complaint Q Follow-up of MVQ inspection O Follow-up of DSWC review O Other
Facility Number
Date of Inspection 2I / z-97J
2
Time of Inspection 2 : 24 hr. (hh:nun)
© Registered A Certified © Applied for Permit [] Permitted 113 Not Operational I Date Last Operated:
Farm Name: 7 3 9 1 — C.!.. � 56,_ .. a r'' .................... County:.. . �' .......................
....... ........... ........ ......... .............--..
Ommer Name: .... 5,..,.�/11 .ct"F.�'pfl..s.............0 .. '.1...- -fi. ..---.................... Phone No:...... .7 ....~. 6. 11......................................
Facility Contact: , e s, S? .................................... Title: �� v4 � . ........................... Phone No: _5_01i-�
Mailing Address: iA t"fir-t.ZU.Inr.................................. ..Z �1
5.................................................. .
Onsite Representative:... ; e S ................................................................. Integrator:...... C r ?.L..-...........................................
Certified Operator; .................................................. ............................................................. Operator Certification Number:
Location of Farm:
..Q.A ....... 'h,e....n.b.F ........ S r e......e?....... N. ...Z..... J....1.,..1'.,,sr:(4 i.....so�, .....s�. ..ef....i.. t n ..t.�.E�.'.arti.................... I .......
PW
....... ..... ..
Latitude a 4 o Cf Longitude ' 4 I� GC
General
1. Are there any buffers that need maintenancelimprovement? ❑ Yes kNo
o
2. Is any discharge observed from any part of the operation? ❑ Yes
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a- If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes. notify DWQ)
c. If discharge is observed, what is the estimated flow in gaUmin?
d. Does discharge bypass a lagoon system'? (If yes. notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. 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 ]agoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes U(No
❑ Yes No
❑ Yes No
❑ Yes No
[]Yes D(No
Continued on back

Facility Number: -- 2
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes No
Structures (Lagoons,Holding Ponds, FIush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes )11_No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(ft): ........ 2....:3.(.........................................................................................._........................................................................................
10. Is seepage observed from any of the structures? ❑ Yes XNo
11. Is erosion, or any other threats to the integrity'of any of the structures observed? ❑ Yes No it
12. Do any of the structures need maintenance/improvement? ❑ Yes 1 Ne .'
(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?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ,L�S�."1.4�P4.......�...................................
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 Faciliti!Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
No.violations: or deficiencies. were: noted -during this:visit: Y&U'W'ill. receive' -fib further,
correspondence about this:visit:
❑ Yes XNO
❑ Yes ANo
❑ Yes gNo
❑ Yes P_No
❑ Yes VKNo
❑ Yes ONO
❑ Yes KNo
❑ Yes ONO
❑ Yes KNo
❑ Yes No
❑ Yes No
❑ Yes ❑ No
ITS 4r.,_ I.S cer4l 4r 7" 6l1+5l bk+ Lre-r1 5eiJo&— 6U5 More
-tl\.o- 2,00 fear L- es �� s.
60J /aekin Sf ro-,A
well ►tc cLr',�-�-4 c ool
7/25/97
Reviewer/Inspector Namewir!
)
Reviewer/Inspector Signature: Date: 1z Z - `��

Site Requires Immediate Attention: NO
Facility No. '93 _ZS
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 3Kl� 14 , 1995
Time: 09" Z 1
Gib 5on/ t=a r►vt
Farm Name/Owner: C l ls ' N o . -7 3 S 1 � Ca rro I/ s f=o ocl SAC arr�o _ _ ,
Mailing Address: :9*91 G%bsoM /Zd: 6;b56N RIC „�93,;4.3
County: Sca4iaNd.
Integrator: Phone:
On Site Representative: Phone: (910) Z 7(0 - 0 Co * S 0-t9c c e.
Physical Address/Location: 9*191 C,'bsot+ Rd 7 2 m4cs Near 6710-v / NC
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: 700 GfTts Number of Animals on Site: �`7oo Rcplate-ertnr,1 Gilts
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: ° Y6' 0 9 " Longitude: 77 " 33 '4& "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) (Es or No Actual Freeboard: 3 Ft. 2 Inches
Was any seepage observed from the lreDsor
n(s)? Yes o No Was any erosion observed? Yes Oro
Is adequate land available for spray? No Is the cover crop adequate? Qor No
Crop(s) being utilized: BzrrvoAAo,,
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings" a or No
100 Feet from Wells? es r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o N
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes 01&
Is animal waste discharged into water of Ole state by man-made ditch, flushing system, or other
similar man-made devices? Yes o N If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments: R eg, s 1 u c d
R 1 C K'A Re.'I c t s
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

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

KAW48UN
NCR= CAROL33fA DZP of INVntONMENT, SALTS b NATURAL PAMURCSS
DIVISION OF ENV1RCffiMZNTAL MANAGEMEZfT
Fayetteville Regional Office
Animal Operation Compliance Inspection Form
�Y� _ f ��ilk
�Ybp4: IoiV4iMKM�' %pipiLl4fp %� W1iJt0. :i..:NJroix�
( i9S
:'�'�+e-::.::ytin:��n�p.�,•�+��n+���rq�waPw-n�••.••.• •N.NI.x-H:x,w.x.n���i (� at11y�.%�np(�4� xaa
'i d •MMN•+M�' vav % :MfGX�c.-W„>���
MNR.�S 'Lp _ _ _
.0 :KM:k�AJIO.V�i>..s M�1L1Y�W.�wS��!�iui�•hY:R.Trviroi><••J:W w•.n�w•••••�w'M+..�..�.�YON4Y «w�:<�V�:
YwO� A. p.e44� .. �.4nF �q .• ytiy ,,,, .
�V`%iywN Mx ka •.o}.:1.
...-+'•^�u
-
5C
All questions answered negatively will be discussed in sufficient detail :n
the Comments Section to enable the deemed Permittee to perform the appropriate
corrections:
SZ=ON I
}animal 03eration Ts+ne:
Horses, cattle, swin poultry, or sheep
1.
Does the number and type of animal meet or exceed
the (.0217) criteria? [Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
poultry (30,000 birds with liquid waste
system)]
rr
2. Does this facility meet criteria for
Animal operation RBGISTRA?ION?
✓
3. Are animals confined fed or maintained
in this facility for a 12-month period?
✓
4. Does this facility have a CKRTrFum ANIMAL
ii M MANAGsKKRT PLAN?
S. Does this facility maintain waste management
records (volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover crop)?
6. Does this facility meet the SCS minimum
setback criteria for neighboring houses,
Wells, etc'?
Ltl_
A
9Do %64
, �;lif

f j
101 00 100 MOO
MMXOH XTX
Site Manaqwqnt
I. Is animal waste Stockpiled or lagoon
construction within 100 ft. of a USGS
Map Blue Line Stream?
2. Is animal waste land applied or spray
irrigated within 25 ft. of a USGS Hap
Blue Line Stream?
3. Does this facility have adequate acreage
on which to apply the Waste?
4. Does the land application site have a
Cover crop in accordance with the
�F Tlw
5. Is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar man-made devices?
S. Does the animal waste management at this
farm adhere to Best Management Practices
(BMF) of the approved MTMCATION?
7. Does animal waste lagoon have. sufficient
freeboard? Tow much? (Approximately )
S. Is the general condition of this CAFO facility,
including management and operation,
satisfactory?
SMGTION IV
Comments
l�spra4t�rj ��( +Ztcx.t �EvE� Ct = �1 qr.t o.� -7 11'i has
N/A