820139_INSPECTIONS_20171231

NORTH CAROLINA
r._�
Department of Environmental Qua

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
820139
Facility Status:
Active Permit AWS820139
[] Denied Access
Inssection Type:
Compliance Inspection
inactive Or Closed Date:
Reason for Visit
Routine
County: Sampson Region:
Fayetteville
Date of Visit:
03/2312017 Entry Time: 12:30 pm
Exit Time: 1:00 pm Incident S
Farm Name:
Simmons Farm
Owner Emali:
Owner.
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
6640 Old Mintz Hwy
Garland NC 28441
Facility Status:
Compliant ❑
Not Compliant
Integrator. Murphy -Brown LLC
Location of Farm:
Latitude: 34° 52' 11" Longitude:
78° 27' 08"
On the east side of HWY 411 approx. 1 mile south of its intersection with SR 1214 at McDaniel
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Danny Lee Tyner Operator Certification Number: 28715
Secondary OIC(s):
OnSfte Representativels): Name Title Phone
24 hour contact name Michael Ammons Phone
On -site representative Michael Ammons Phone
Primary Inspector. Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820139 Owner - Facility : Murphy -Brown LLC Facility Number. 820139
Inspection Date: 03/23/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
rffSwine - Farrow to Wean 3,839
Total Design Capacity: 3,839
Total SSLW: 1,662,287
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 25.00
page: 2

Permit: AWS820139 Owner - Facility : Murphy -Brown LLC Facility Number. 820139
Inspection Date: 03/23/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e.l large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed andlor managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
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%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820139 Owner - Facility : Murphy -Brawn LLC Facility Number. 820139
Inspection pate: 03/23/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Wasto Application
Yes No Na No
Crop Type 1
Com, wheat, Soybeans
Crop Type 2
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 3
Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Blanton sand, 0 to 6%
slopes
Soil Type 2
Norfolk loamy sand, 0 to 2°1
slopes
Soil Type 3
Wagram loamy sand, 0 to
6% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14, Do the receiving crops differ from those designated in the Certified Animal Waste
❑
■ ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop andlor land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M ❑
❑
Records and Documents
Yes
No Na Na
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
■ ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other'?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
Mo
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS820139 Owner - Facility: Murphy -Brown LLC Facility Number. 820139
Inspection Date: 03/23/17 Inpsection Type: Compliance Inspection Reason for Visit Routine
Records and Documents
Yes No Nit No
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
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?
❑
E ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yea No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
■ ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(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
❑
❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

F Wd
Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number-
820139
Facility Status: Active
Permit: AWS820139
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date.
Reason for Visit:
Routine
County:
Sampson Region:
Fayetteville
Date of visit:
09/22/2015 Entry Time: 09:00 am Exit Time: 10:00 am Incident #
Fans Name:
Simmons Farm
Owner Email:
Owner.
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
6640 Old Mintz Hwy
Garland NC 28441
Facility Status:
Compliant ❑
Not Compliant Integrator:
Murphy -Brown LLC
Location of Farm:
Latitude:
34° 52' 11" Longitude:
78' 2r 08" -
On the east side of HWY 411 approx. 1 mile south of its intersection with SR 1214 at McDaniel.
Question Areas:
Dischrge & Stream
impacts
Waste Col, Stor, & Treat
Waste Application
Records and Documents
Other Issues
Certified Operator:
Robert T Young
Operator Certification Number:
18461
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Michael Ammons Phone:
On -site representative Michael Ammons Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s)
Inspection Summary:
page: 1

Permit: AWS820139 Owner - Facility : Murphy -Brown LLC Facility Number: 820139
Inspection Date: 09/22/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Swine
Design Capacity Current promotions
❑ Swine - Farrow to Wean
3,500
[] Swine - Feeder to Finish
1,000
Swine - Wean to Feeder
400
Total Design Capacity: 4,900
Total SSLW: 1,662,500
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 34.00
page: 2

Permit: AWS820139 Owner - Facility : Murphy -Brown LLC Facility Number: 820139
Inspection Date: 09/22/15 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?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
moo
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
0 ❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
M ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
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 Na Ng
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 (Le1 large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
N ❑
❑
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
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820139 Owner - Facility : Murphy -Brown LLC Facility Number:
820139
Inspection Date: 09/22/15 Inssection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yes No Na Ne
Crop Type 1
Com, Wheat, Soybeans
Crop Type 2
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 3
Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Blanton sand, 0 to 6%
slopes
Soil Type 2
Norfolk loamy sand, o to 2%
Slopes
Soil Type 3
Wagram loamy sand, 0 to
6% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑N ❑ ❑
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ 0 ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ ❑ ❑
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?
❑ ■ ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS820139 Owner - Facility : Murphy -Brown LLC Facility Number:
820139
Inspection Date: 09/22/15 tnpsection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yea No Na No
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
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?
❑
❑
❑
25_ Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
M ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e.. discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
E ❑
❑
CAWM P?
33. Did the reviewer/inspector fail to discuss reviewliinspection with on -site representative?
❑
N ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

t
Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number. 820139
Facility Status: Active
Permit; AWS820139
❑ Denied Access
Inpsection Type: Compliance Inspection
Inactive Or Closed Date:
Reason for Visit: Routine
County:
Sampson Region:
Fayetteville
Date of Visit: 09/22/2015 Entry Time: 09:00 am Exit Time: 10:00 am Incident #
Farm Name: Simmons Farm
Owner Email:
Owner: Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address: 6640 Old Mintz Hwy
Garland NC 28441
Facility Status: Compliant ❑
Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm;
Latitude:
34° 52' 11" Longitude:
78° 27' 08"
On the east side of HWY 411 approx. 1 mile south of its intersection with SR 1214 at McDaniel.
Question Areas:
Dischrge & Stream Impacts
Waste Col, Stor, 8 Treat
Waste Application
Records and Documents
Other Issues
Certified Operator: Robert T Young Operator Certification Number: 1B461
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Michael Ammons Phone
On -site representative Michael Ammons Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

r IV
Permit: AWS820139 Owner- Facility : Murphy -Brown LLC Facility Number: 820139
Inspection date: 09/22/15 Inpsection Type: Compliance inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean
3,500
[] Swine -Feeder to Finish
1,000
Swine - Wean to Feeder
400
Total Design Capacity: 4,900
Total SSLW: 1,662,500
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 34 40
page: 2

Permit: AWS820139 Owner- Facility : Murphy -Brown LLC Facility Number: 820139
Inspection Date: 09/22/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges 8i Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
[]
Other
❑
a. Was conveyance man-made?
❑
0 ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
M ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■ ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
N ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No No Ne
k. 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 (LeJ 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
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the -waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No No No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 01113
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 Ibs.?
❑
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

1
Permit: AWSB20139 Owner - Facility : Murphy -Brown LLC Facility Number: 820139
Inspection Date: 09/22/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Com, Wheat, Soybeans
Crop Type 2
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 3
Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Blanton sand, 0 to 6%
slopes
Soil Type 2
Nortolk loamy sand, 0 to 2%
slopes
Soil Type 3
Wagram loamy sand, 0 to
6% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14, Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
E ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
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?
❑
E ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

f
Permit: AWS820139 Owner - Facility: Murphy -Brown LLC Facility Number: 820139
Inspection Date: 09/22/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na Ne
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
23, If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑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?
❑
❑
❑
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,
❑
a ❑
❑
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?
❑
❑
❑
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 review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number:
820139 Facility Status:
Active permit: AWS820139
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Sampson Region:
Fayetteville
Date of Visit:
10/1712013 Entry Time: 08:30 am
Exit Time: 9:15 am Incident #
Farm Name:
Simmons Farm
owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
6640 Old Mintz Hwy
Garland NC 28441
Facility Status:
Compliant ❑ Not Compliant
Integrator: Murphy -Brown LLC
Location of Farm:
Latitude: 34' 52' 11" Longitude:
78' 27' 08"
On the east side of HWY 411 approx. 1 mile south of its intersection with SR 1214 at McDaniel
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Danny Lee Tyner Operator Certification Number: 28715
Secondary OIC(s):
An -Site Representativo(s): Name Title Phone
24 hour contact name Michael Ammons Phone :
On -site representative Michael Ammons Phone:
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Robert Marble
Phone:
Date:
page: 1

j
Permit: AWS820139 Owner - Facility : Murphy -Brown LLC Facility Number: 820139
Inspection Date: 10/17/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean
Swine - Feeder to Finish
Swine - Wean to Feeder
Total Design Capacity:
Total 5SI_W:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1
page: 2

Permit: AWS820139 Owner- Facility., Murphy -Brown LLC Facility Number: 820139
Inspection Date: 10/17/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na Na
1. Is any discharge observed from any part of the operation?
❑M
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No Na Na
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le.l large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
■ ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
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?
❑ 0 ❑ ❑
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: AWS820139 Owner- Facility : Murphy -Brown LLC Facility Number: 820139
Inspection Date: 10/17/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Com, Wheat, Soybeans
Crop Type 2
Coastal Bermuda Grass
(Nay, Pasture)
Crop Type 3
Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Blanton sand, 0 to 6%
slopes
Soil Type 2
Norfolk loamy sand, 0 to 2%
slopes
Soil Type 3
Wagram loamy sand, 0 to
6% slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ M ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop andlor land application site need improvement?
❑ E ❑ ❑
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?
❑ ❑ ❑
1B. Is there a lack of property operating waste application equipment?
❑ M ❑ ❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 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?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS820139 Owner - Facility : Murphy -Brown LLC Facility Number: 820139
Inspection Date: 10/17/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na Ne
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fait to install and maintain a rain gauge?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
[]
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27, Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na Ne
28. Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑
■ ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
■ ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ E ❑ ❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ E ❑ ❑
34. Does the facility require a follow-up visit by same agency? ❑ 0 ❑ ❑
page: 5

- l<
- Division of Water'Quality
Facility Number - �] 0 Division of Soil and Water Conservation
t� Other Agency
Type of Visit: OCompliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: (DRoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: p! Departure Time: . QQ County: %./ Region: /j1 !7 -
J Farm Name: i�r. n +Q r� ' �Z't�rK Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
lI
Facility Contact: Title: Phone:
" A
Onsite Representative: r Integrator: __ '7✓rlh
Certified Operator: `( Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swills
Design Current Destgn+Current "Design Current
.va`-8dyi "W4� —`avif 3 iK
Cl
CaBacEty Pop Wet Roultry Capac�ty�Pop - Cattle Capacity Pop.
La er Dai Cow
Wean to Finish
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
)O
�T Dai Heifer
Design�Cu err nt. D Cow
D . Poultry Ca aci P Non -Dairy
Layers Beef Stocker
Non -Layers Beef Feeder
Pullets Beef Brood Cow
Farrow to Wean
Farrow to Feeder
t7
Farrow to Finish
Gilts
Soars
I
Other
Turkeys
Turks Pouets
Other
Other
Discharges_and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes W No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes [—]No
❑ Yes � No
[] Yes []p No
P9NA
❑NE
❑NA
❑NE
❑NA
❑NE
Page I of 3 21412011 Continued

Facili Number: Fj 9, - Date of Inspection: 5 -1S 2--
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Ug NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �91r
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 it 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 altematives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
1 I . Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
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.
U Yes
i � No
U NA
U 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 M 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 M No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes fo No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: ,;L— Date of Inspection: S- t5 Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes M No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes ® No
the appropriate box(es) below. T
❑ 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
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ( No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[—]Yes
M No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
f�j No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question ff): Explain any YES answers and/or any additional recommendations or any other comznents�
= :
Use drawings of facility to better explain situations (use additional pages as necessary).
,. �....:
Rec" q—ev , ewyj '511-:017—,
Reviewer/Inspector Name:
Phone: `)10-�M %7300
Reviewer/Inspector Signature:
Page 3 of 3
Date:
21412011

i ype of visit: W c:ompiiance inspection V uperation rceview V structure Evatuanon V 1ecnmcai assistance
Reason for Visit: & Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:4� f
Arrival Time: r jK Departure Time: County: '!►ti
Farm Name: S) M 1'�I D nS 7 w" -► l Owner Email:
Owner Name: /+�Ir.�'y�-j rf/ kyw�+� Phone:
Mailing Address:
Physical Address:
Facility Contact: 1 Y t Y�A=.-"CV1S Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Region: AyO
Integrator: M� -Q�-r ot,2o 0 L`C_
Certification Number:
Certification Number:
Latitude: Longitude:
Swine
Design Current 't"� "Design
a
Capacity Pop. W,etPoultry '„Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dai Cow
Layer
airy Calf
Non -Layer
DairyHeifer
Cow
t _.
Design
f D yPou1 Ca aci
Current
l;o
Non -Dairy
Layers
Beef Stocker
Beef Feeder
Beef Brood Cow
= Non -Layers
Pullets
Turke s
Other
Turke Poults
Other
Other
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
NA ❑ NE
NA ❑ NE
�NA ❑ NE
] NA ❑ NE
❑ NA ❑ NE
Page l of 3 21412011 Continued

acili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Pg NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 t f
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Z] No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a [:]Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [� No ❑ NA ❑ NE
maintenance or improvement? T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes f No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
I
T
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
T
❑ 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 Ep No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis [j 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 J�Q 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

Facili Number: -77 Date of Inspection:
r,
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [] Yes ® No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus Ioss 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 N 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
0 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
1P 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
01 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
Lice drawings of facility to better explain situations (use additional pagesas necessary)mendahons�orany:other camm
{ 9 ) PY Y ational
v lSj-i- Co"NLC-4 SI 1411
-e�r-ds eol wed 41,0111,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: elto-W[�33-3�Oa
Date: Y'O a
21412011

46._
Type of Visit i Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up Q Referral Q Emergency O Other ❑ Denied Access
Date of Visit: ! Arrival Time: Departure Time: County: ;;A "'t 54J Region:
Farm Name: l M hs m 1 Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: 44 On Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator IIA1 ��W �1
Operator Certification Number: (/"9
Back-up Certification Number: ��;"
Location of Farm: Latitude: E__1 o E--] ' E__1 u Longitude: = ° = I = u
o,1�yI
�.
Design
" ,Current
Designs Current
.-
Design Current
Swine
F� �% i
AAAA Gapactty
Population
I
tiRe
Wet Poultry CapacttyPop�uiation
❑ La er
Cattle Capacity Population
❑Dai Cow
Calf
❑ Wean to Finish
Wean to Feeder
LW
Feeder to Finish
16M
Dairy Heifer
Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
:._ .....:. , .....:- _� :.
❑Non-Dai ry
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
—
---..... -
❑ Turkeys
Other
I-FE-10ther
-
❑ Turkey Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
❑ Yes
�No
[INA
ElNE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
T
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
q)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
V?NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
1�4 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Wj No
❑ NA
❑ NE
other than from a discharge'?
Page I of 3
12128104
Continued

4" Facility Number: Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Stru I
ture 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): SY if
❑ Yes ElNA ElNE
ElYesrNo
No 9§ NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 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 No ❑ NA ❑ NE
maintenance or improvement?
Waste ApDlication
10.
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
ANo
[INA ❑ NE
maintenance/improvement?
L
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
1PNo
❑ 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 Wind Drift ❑ Application Outside of Area
12.
Crop type(s) s►►1 , lW�
13_
Soil type(s)t f��t
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
�DNo
ElNA ElNE
15.
Does the receiving crop and/or land application site need improvement? ElYes
`PNo
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
Wo
❑ NA ❑ NE
r A A w
`Comments (refer to question #): Explain any YES^"answers andlor any recommendations or any other comments
Use drawingstof facility to better explain situations. (use aiiditional pages as necessary):
Reviewer/lnspector Name 1 I I Phone: `'S t 1
Reviewer/Inspector Signature: TjmxijA&L ILE Date: 2
rage 2 off 12/1X/04 Continued

{ Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [�'No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes F No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes] No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes No ❑ NA ❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
`�
El NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El 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
[P No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
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 ReviewerAnspector fail to discuss review/inspection with an on -site representative?
❑ Yes
J§ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
&No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Paige 3 of 3 I Z/28/04

type of Visit 4P Compliance Inspection U Operation Review 0 Structure Evaluation U Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: J rJ Arrival Time: Departure Time: ;'3 County: S S0*'-1 Region:
Farm Name: s,,II+�'''tM06%5 _ Owner Email:
Owner Name: %h��t.�!1-1�--� Phone:
Mailing Address:
Physical Address:
41
Facility Contact: t 11k,.rit S_ Title: Phone No:
���
Onsite Representative: ( Integrator: — r Uc w"+ Certified Operator: t.J� -G�'`i nee- Operator Certification Number: ` $<92q
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =e =' =] Longitude: [—]° E:]' =
Design
Current
Design Current
Design Current
Swine
Capty
Population
Wet Poultry
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
Wean to Feeder
q00
O
❑ Non -Layer
❑ Dairy Calf
Feeder to Finish
1 D
O
-
❑ Dairy Heifer
Farrow to Wean
3��
b
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑Beef Stocker
❑ Gilts
❑ No ers
❑ Beef Feeder
❑ Boars
Pullets
❑Pullts
❑Beef Brood Co
❑ Turkeys
Other
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts
I . is any discharge observed from any part of the operation?
❑ Yes
�LNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[ ] NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
1P NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
Wo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
`DNo
❑ NA
❑ NE
other than from a discharge'?
12128104
Continued

Facility Number: Date of Inspection ( '
TT��
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[)4No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
PC NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
;9 No
❑ NA ❑ NE
(ic/ 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
E? No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
0 No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
5 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 l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑Evidenc f Wind Drift Application of
Area
12. Crop type(s) do 4/&n2jJq 044S
/Outside
13. Soil type(s) 95v L444 W0
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
IN 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
C54 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
y No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
(�j No
❑ NA ❑ NE
Comments (refer to question #) -Explain any YES answers and/or anv���mendations or any other i! ents..
Use drawings of facihty to beiter.e_ lain situations. (use additional pag s ss n sary):
i
Reviewer/inspector Name Phone
Reviewer/Inspector Signature: Date:
/2/2&4 Continued

Facility Number: �— I Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes W No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [PNo ❑ NA ❑ NE
the appropriate box. ❑ V�Up ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes QFNo ❑ 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
[WNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
09 No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
E�No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
M No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
(21 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
n 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
1� 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
[5 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 1, Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
N No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[ i No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
M No
❑ NA
❑ NE
12128104

Division of Water Quality
Facility Number �. � O Division of Soil and Water Conservation
Q Other Agency
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine O Complaint Q Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: S SoQ
Z d Arrival Time: t7$: fj tM Departure Time: %.7' County:
Farm Name: _ rr.nrr�orl5 FGt1rr� Owner Email:
Owner Name: _MUMAb,4` Phone:
Mailing Address:
Physical Address:
Facility Contact: IVtC1-%r-Lrd si'I A Title:
Onsite Representative:
Certified Operator: Qgge a.V1nfy--
`jtro(
Back-up Operator:E2
. �
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Integrator:
Phone No:
-.6
Region: 00
r
Operator Certification Number: 70157,62
/
Back-up Certification Number: IQb11;_lo
Latitude: 0 0 = I = N Longitude: [= ° = A =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
�i oo I ❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
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)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non-DaiEy
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: a]
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 A
❑ NE
❑ Yes
❑ No
A
❑ NE
❑ Yes
❑ No
Q�NA
//❑`�''NA
❑ NE
El Yesto
o
❑ NE
❑ Yes
❑ NA
❑ NE
12128104 Continued

Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No A NA [INE
Srcture 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 [-INA❑ 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 17No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �1 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑f h,Evidence of�Wind
D��riift ❑ Application Outside of Area
12. Crop type(s) .. Q�rW� gCC_7� 111i1`�� SI'YIAM l�l'CLln OY am„� - -
13.
Soil type(s) 9 t T
[l17 O&_
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
(3 No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
I &
Is there a lack of properly operating waste application equipment?
❑ Yes
�No
El 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):
AL
I
Reviewer/Inspector Name Phone: 9/0 q 33'3�
Reviewer/Inspector Signature: ate: Z3 7
12128104 Continued

z3 o�i
Facility Number: Date of Inspec on
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes M No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes JP 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 P9 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 (S No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �9 No ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
nNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P9 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
T No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
7LNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
5d 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
[ANo
❑ 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
18 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
US No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
QKNo
❑ NA
❑ NE
Comments and/or
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: A b Arrival Time: Departure Time: '3 County: _9"f266rJ Region: 1"f'0
Farm Name: Sim I on_� F44_rh, _ Owner Email:
Owner Name: Awrah q —y %1 r. , tif— Phone:
Mailing Address:
Physical Address:
Facility Contact: _ -j Tr ` S Title: Phone No:
Onsite Representative: Integrator: LU —�r'ol.lc� t .
Certified Operator: G-60 e— r1P� Operator Certification Number: 9P,5 18 I
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =1 0 = I = 11 Longitude: 0 ° = I = u
Deli n Currents
g
Desi n Co rent
g .D`e
4 •
n Current
Swine"�Capacity-Population
Wet P IhyCapac�ty 4Popula6on
Cattle ��Capacity Population
[] Wean to Finish
❑ La er
❑Dai Cow
Wean to Feeder 6
❑Nan -Layer
❑Dai Calf
Feeder to Finish pQp
=
❑ DairyHeifer
Farrow to Wean
Dr}� oultry P
❑ D Cow
❑ Farrow to Feeder
"Y
El Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
Gilts
Non -La ers
❑ Beef Feeder
PE113oars
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
Other ` .
.. ;
❑ Other
❑ TurkeyPollets
100ther
..
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes `M No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes ❑ No
rnNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes ❑ No
IFNA
❑ 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
f?NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes—kNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes )$44o
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: a �'�
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
0 No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
EPNA ❑ 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
t 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
❑ NA ❑ NE
through a waste management or closure plan?
�No
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
IgNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
P No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below_
❑ Yes
,1 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
14 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[� No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
Reviewer/I4spector Name I JI Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

a Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 1�1 No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps p ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 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 10 No ❑ NA ❑ NE
23. If 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
$1 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
09 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
2T Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
bNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
® No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 I. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
n No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[& No
❑ NA
❑ NE
Additional`Comments and/or Drawn{ �r
: _�.,�
AL
Page 3 of 3 12128104

Type of Visit 0 Compliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up 0 Referral 0 Emergency ()Other ❑ Denied Access
Date of Visit: Q 11
Arrival Time: pqr G Departure Time: County: P'1 Region;
Farm Name: Owner Email:
Owner Name: QQa,,,-k IV 1 X n'1S Phone:
Mailing Address:
Physical Address:
Facility Contact: �j _�—,, - _+ Title:
Onsite Representative: �hlCi� 1+ r4 .5m1A
Certified Operator:
Back-up Operator:
Phone No:
Integrator: M VOU4
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = e [� f 0 Ai Longitude: = ° = I =
Swine 4
Current
Capacity Population
Destga C**urrent
WetPoultry Capacity Population
Design1111111111111111�0urlientilill
Cagle' Capacity Population
❑ Wean to Finish
❑Laver
❑Dai Cow
Wean to Feeder -La er
❑Dai Calf
Feeder to Finish
❑ DairyHeifer
(� Farrow to Wean 5DO
" ';'
❑ D Cow
❑ Farrow to Feeder
� Dry Poultry
❑ Non -Dairy
❑ Farrow to Finish
' ❑ Layers
❑Non
❑ Beef Stocker
❑ Gilts
> -Layers
Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ Turke
-
Other
s
❑ TurkeyPoults
rx �` 4�i
❑ Other
❑Other
x
NiJmberofStru'ciures:
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
❑ Yes
V3 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[�&NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NNA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[ff No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
PNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facili Number: ,
h' Bo� �3 Date of Inspecrion
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
I;a No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No E9 NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): -;,7- tt
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
Qg 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
tR No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[)-!JNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
[�fl 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 El Outside of Area
12. Crop type(s) rVX_Uj a G- ig m SiM � 2,0
13. Soil type(s) �jO f1 l I—i A WO-9 .
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
} d No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
W No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
1� No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
$3 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
F,.3iS WE
Comments (refer toqueshon#) Explain any YES answers and/or any recommendations or any other comments.
Use drawings offacthiy to better explain situations. {use additional pages as necessary):
A6
Phone: t*Q 33`3
Reviewer/Inspector Name_ �.r.,..a .
Reviewer/Inspector Signature: WIRA Date: 4
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [`] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes 4 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? ElYes [N No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes []1 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
4 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
El 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
0 No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Q§No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
Q3 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
1p 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
'F' No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
Additiotil Comments and/or Drawings
Page 3 of 3 12128104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 'j�lf �+ Departure Time: County: stw.p va Region: foe d
Farm Name: _ % Jh— w-A Ac .r / of 44 _ Owner Email:
Owner Name: __ u v V t lea w. •!� rR +'A^ s Phone:
Mailing Address: Pc) Ro s e , l �_ 5
Physical Address: /f
Facility Contact: Title:
Onsite Representative:c I�ai_ S tk
Certified Operator: C�� 'e I A K s+ aY
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number: f 'Ps�g 7
Back-up Certification Number:
Location of Farm: Latitude: = e = I ="
Longitude: 0 ° = I = u
Swine
Design Current Design Current
Capacity Population . Wet Poultry Capacity Population
❑ Layer
e n 6 I ❑ Non -Laver
i
❑ Wean to Finish
[ T Wean to Feeder
[TFeeder to Finish
10o 0
/ v♦
[;; arrow to Wean
ct
- U
9Se v
El Farrow to Feeder
El Farrow to Finish
[I Gilts
El Boars
Other
❑ Other
Dry Poultry
ElLayers
❑ Non -Layers
❑ Pullets
❑ Turkeys
El Turkey Pouets
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
airy Cow
El
Dairy Calf
El
Dairy Heifer
El
Dry Cow
[I
Non-Dairy
❑
Beef Stocker
El
Beef Feeder
❑
Beef Brood Co
Number of Structures: l
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
I
❑ Yes [gNo ❑ NA ❑ NE
❑Yes
❑No
❑NA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
El No
❑ Yes
Lj No
❑ NA
❑ NE
❑ Yes
[dNo
❑ NA
❑ NE
12128104 Continued

Facility Number: �?,2 — j3 �#' Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[�' NNo
❑ 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): j q 11
Observed Freeboard (in): '/24
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
G�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
ErNo
❑ 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
ElNA ElNE
8_ Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
,9No
Id 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
U No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[ "No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
�
CJ No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 ibs ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑,pEvidence of Wind Drift ❑j Application Outside of Area
12. Crop Pe(s) v w.u� l�ta �X
h
13. Soil type(s)B At o
14. Do the receiving, crops differ from those designated in the CAWMP?
❑ Yes
[VNo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[INo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`
❑ Yes
ER"No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
ElYes
[3,"Noo
❑ NA ElNE
18. Is there a lack of properly operating waste application equipment?
ElYes
t_g<
❑ NA ❑ NE
:xphtin aay YES, an"
"x'plain situatioris..(ust
Reviewer/Inspector Name I- Zil� S� •w' _ '° ° ` _"` Phone: qIJ !S
Reviewer/Inspector Signature: Date: GZ5 03 O S
12128104 Continued

Facility Number: — 3g Date of Inspection Ct�OrOS
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [5 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 9< ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ pp ica ' ❑ �p frecbeard ❑ ❑ &&4An*1ys-is ❑ Waste Transfers ❑ A ion
❑ Rainfall ❑ Sig ❑ Gre�, ❑ 121041iffut-einsryeetiens ❑ M, Ins ections ❑ Weather eute
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes []"N' o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [alo ❑ 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
LTNo
El NA
[I NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
[4 o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
B-510
❑ NA
❑NE
Other Issues
28_
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
2 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Ka 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
91 o
❑ 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
❑Ilo
❑ 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
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
E: (o
❑ NA
❑ NE
Add�lionwfCoEnments and/or Drawings: >- �' -
12128104

(Type of Visit • Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit • Routine Q Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: t f7 Mme: : I s
Facility Number .'� i 3
O Not O erational Q Below Threshold
M Permitted M Certified [3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: ..... ._S_; v►t ^Mp h5 .— AKMA............_...•-•--•-•-•-•-- ........................._ County:...........
Owner Name:.. t�' ! V �J. rg 4h�!�4 . _ --- - - - - Phone No:
Mailing Address:.._. . .._ ..Se....R!
Facility Contact: ..!+!�_.. Title: Phone No:=z-
Onsite Representative:..—v-,', Integrator:
Certified Operator:___..G&�_e..... Operator Certification Number:-._- �S
Location of Farm:
M Swine ❑ Poultry ❑ Cattle ❑ horse Latitude • 4 « Longitude • ` �f.<
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation? ❑ Yes [&No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes g$No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes PKNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes $�No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier...... ...... ...................................... ..........
Freeboard (inches):
12112103 Continued

FacilityNumber: 8 Z — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [lo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes 14 No
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? ❑ Yes PNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes W No
9. Do any stuctures lack adequate, gauged markets with required maximum and minimum liquid level ❑ Yes IR No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes (,No
I I. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes CKNo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type & V � _ 5�►U et ra. K
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 KNo
b) Does the facility need a wettable acre determination? ❑ Yes 09No
c) This facility is pended for a wettable acre determination? ❑ Yes X[No
15. Does the receiving crop need improvement? ❑ Yes JXNo
16. Is there a lack of adequate waste application equipment? ❑ Yes OLNo
Odor Issues
17. 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?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
I9. 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)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ia No
Air Quality representative immediately.
❑ Field Copy ❑ Final Notes
)s- weed. 1611eF-oN-,eJ- [&�& , 4alv.,­�) e4ec_4 -
a . We4A5 a;o v,,a "`fie- of t k-�Svo.,,- +G �O e' C.* th ?'rA- wee),- .
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
!'nnd"uvd

FaciliO Number: 2 —1.311 Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes in No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUlYhecklisri5,,�'desig"napo,,eetc.) ❑ Yes I&No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes MO
❑ Waste Applicaticko-O FreeboaW- ❑ Waste Analysbo"�❑ Soil Sampling/
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 7.No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes KNo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes RNo
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes 0 No
28. Does facility require a follow-up visit by same agency? ❑ Yes 23 No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes P No
\'PDES Permitted Facilities
30. Is the facility covered under a NPDFS Permit? (If no, skip questions 31-35) JK Yes ❑ No
3I. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes KNo
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes J9 No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes KNo
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ONo
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes XNo
❑ Stocking Fort❑ Crop Yield ForJV'�O RahiW ❑ Inspection After 1 " RIB
❑ 120 Minute Inspectiois❑ Annual Certification Forhy""_
12112103

FRO
State of North Carolina
FA
Department of Environment,
Health and Natural Resources A
•
Fayetteville Regional Office
James B. Hunt, Jr., Governor � C
Jonathan B. Howes, Secretary C
Andrew McCall, Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
December 13, 1995
Quarter M. Farms, Inc.
RE: Simmons Farms
PO Box 759
Rosehill, NC 20458
SUBJECT: Compliance Inspection
Sampson County
Dear Sir:
On November 13, 1995, an inspection of your animal operation was performed by the
Fayetteville Regional Office (FRO). Please find enclosed a copy of our Compliance
Inspection Report for your information. It is the opinion of this office that this facility is
in compliance with 15A NCAC 21-1, Part.0217, and that Animal Waste Management is being
properly performed.
Should you have any questions regarding this matter, feel free to contact me at (910)
486-1541.
Sincerely,
Ricky Revels
Environmental Technician IV
Enclosure
cc: Facility Compliance Group
Wachovia Building, Suite 714, Fayetteville, North Carolina 28301-5043 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Site Requires Immediate Attention: /V/O
Facility No. $ Z - / 3
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: II - /3 , 1"5
71me: /S 30
Farm Name/Owntr: S i Kvw, o N s Far,.-. Uv,ajc.- • W. 1- a v ­ -s It rc-
]Mailing Address: PD s9 C z % if-s 19
County:
Integrator: * ��.,� �. �a ,� } Phone:
On Site Representative: _ , _.M,L ZG1 w y ' 1 G.,, I Phone: ► o E6 z S
Physical Address Imation:411 &­44f.-e-, Rvs�
CL IQNCL _ FaVk. V-"4-"moo" � t_4-
Type of Operation: :Swint PoultryCattle
Design Capacity: -314os2 Aw-wu-..Number of Animals on Site: 4�so
*DEEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: f Longitude-,_ � •
�r
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) (
Was any seepage observed from the
Is adequate land available for spray?
Crop(s) being utilized: COQxA
Does the facility meet SCS minimum setback criteria? 20D Feet from Dwellings? (fis)or No
100 Feet from Wells? ors? or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o44;)
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes o6j)
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or(* If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? 4� No
Additional Comments:
�6r No Actual Freeboard: ,3 Ft. 3 Inches
oon(s)? Yes otNiWas any erosion observed? Yes odp7
ii>or No, Is. the cover crop adequate? (!t5P or No
RG k ells /? Z"�
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.