820203_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental W6

type of visit: (/-Compliance inspection V uperation Review U Structure Evaluation V Iectinical Assistance
Reason for Visit: (DIo—utine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: VS "1 Arrival Time: Departure Time: 4!. County: S4)lf Region:
Farm Name: �i� t'� & �J !` a r Owner Email:
Owner Name: 107 7 v,Y-M ! 'LL'c ( Phone: Z f t(•J 3
V
Mailing Address:
Physical Address:
S'✓t
Facility Contact: -0 `I ` { ntL'V-✓`lc Title: Phone:
Onsite Representative: t Integrator: W-e F�"! 11-7--,C-`
Certified Operator: L'I Certification Number: - / ? 6� C
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity Pop.
Design Gnrrent Design Current
W,et Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Daia Calf
Feeder to Finish
D
&
— Dairy Heifer
Design Current Dry Cow
D ,p1'oultr" @a aci Po P. Non -Dairy
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes 'CJ-Nu—❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[:]Yes
❑ No
E NA NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
[:]No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gatlons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
[:]No
NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[3-,No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[:]Yes
No
ET
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Faeili •Number: - 31 Date of Inspection:
yG
Waste Collection & Treatment
4. C storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
-NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
�
❑ 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
E3 o
❑ 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
to
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
0 Yes
[j-?To
❑ NA
❑ NE
S. Do any of the structures lack adequate markers as required by the permit'?
[:]Yes
❑ 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
[DNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
0 Yes
[EI—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): ' l) e",V S, ro o
13. Soil Type(s): _ u Z�. i 4 Ct 3a5 hats
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes E]�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 [n No ❑ NA ❑ NE
acres determination'?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
0 o
❑ NA
❑ NE
❑ Yes
E3`�o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [TNo ❑ 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'ves, check the appropriate box below. ❑ Yesf No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and i" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA [] NE
Page 2 of 3 21412015 Continued

Facility Number: ,`( t" - 77 Date of Inspection:
24, Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [g-No ❑ NA ❑ NE
r
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0 o ❑ 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 [3<lo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [Dr o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
Q�
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[ErNo
❑ 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
1Vo
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
To
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Commei is {refer to gU`eshon #) Eapla_ �n any �` y recom_mendattonslorlariy oth Mixed menu.
YES _answers and/or an addit'onal
Use drawin swot fa ilito tietter eklain situations nseaddtbo all�esas necessa
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 3 of 3
6 k( '0 V1
4( - IlLr'-.3L8 ifS 1
PhonALl- V 3 -3.33 1
Date: t'5 G wA L
21412015

Type of Visit: &C—ompliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit: C Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency Q Other 0 Denied Access
Date of Visit: V� Arrival Time: rto Departure Time: County: :? i� Region: t"--"
Farm Name: �p�c�` +2dy� fl ��_� "t'i Owner Email:
Owner Name: n� 1t n4 r� Phone:
Mailing Address:
ri-7 Af rvv(
3
Physical Address: _ ��AA
Facility Contact: Mcf c; Kjn�vl _ Title: Phone:
Onsite Representative: �` Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Certification Number:
Longitude:
ijmjDesign Current
Swine Capacity Pop.
W,.et Poultry
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity P.
Wean to Finish
La er
Dairy Cow
Wean to Feeder O
(
Non -La er
-
D . P,ouI J -
La ers
Design
Ca"'aci'
Current
P,o
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
D Cow
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other Turkey Pouets
Other Other
Discharges and Stream Impacts
I _ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [�Jo ❑ NA ❑ NE
❑ Yes ❑ No
E ] Yes ❑ No
❑ Yes
❑ No
❑ Yes
[ o
❑ Yes
LE"No
M—NA ❑ NE
M'NA ❑ NE
®'NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page 1 of 3 21412015 Continued

Facie Number: - Z Ct3 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [B--Nv ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Q-NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z—af
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[D'go
❑ 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
[]'1fo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[I —No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[]"No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[] No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [] No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] Yes [ "No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [] Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):"_,
1
13. Soil Type(s): �--{ c-C--Ur U�( wt c%- L
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [Ef No ❑ NA ❑ NE
15_ Does the receiving crop and/or land application site need improvement? ❑ Yes ❑" No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑'No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes �o ❑ NA ❑ NE
❑ Yes ['3­No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[�J-No
❑ NA
❑ NE
20. Does the facility fail to have al components of the CAWMP readily available? If yes, check
❑ Yes
[ o
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and i" Rainfall Inspections
[:]Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ff No
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

Facih Number: - ©ate of Ins ection:- , /
:. Did the facility fail to calibrate waste application equipment as required by the permit? Fryes RgZko ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Q"Vo ❑ 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 E No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ['Flo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[] Yes [�T_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 [3—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 [TNo
❑ 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 [2rNo ❑ 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 EyNo ❑ NA ❑ NE
Ca nments (refe to tlaesiion #): Explain any, YES s � ers;and/dr any, iidditi6nal-i recommendotions or any other conil
s. = s
Usefdraw `in 'tiff._ gs _acdEty to utter c�cpiam°sitoationsr{use;add�tronl11
pages as necessary) -rill.CH
J( --- wo-
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
-6K51
Phonel(() "� �7 3
Date: J
21412015

for Visit: URoutine O
O Follow-up O Referral O Emergencv O Other O Denied Access
Date of Visit: Arrival Time: fQ Departure Time:County:
Farm Name: evit:V Fc-stA Owner Email:
Owner Name: %r..<- r fJ ti Phone:
Mailing Address:
Physical Address:
Facility Contact:
~K_
Onsite Representative: C
t�
Certified Operator:
Back-up Operator:
Location of Farm:
I(,iflr4 // Title:
Latitude:
Region:
Phone:
Integrator: f c
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity op.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Wet Poultry
La erI
Non -La er
Layers.
Non -Layers
Pullets
Design
Capacity
Design
aci
Gnrrent
Pop.
I
t
Current
P,o .
Design
Cattle Capacity
I Dairy Cow
I Dairy Calf
IDairy Heifer
Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Current
Pop.
Other
Outer
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes Io ❑ NA ❑ NE
❑ Yes ❑ No ❑;WA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
[:]Yes
[:]No
C;;�A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
❑ Yes
[:]No
[DNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
[:]Yes
❑r ^No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[�No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

[Facility umber: - jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[3:4 ❑ NA
[ ] NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
FINA
D NE
Structure 1 Structure 2 Structure 3 Structure 4-
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[3-1Qo
❑ 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
[31110
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[JJ o
❑ NA
❑ NE
8. Do any of the structures 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
[a -No
❑ NA
ONE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�
V go-
❑ NA
❑ NE
maintenance or Improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Igo.- ❑ 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): N Ed 96-0
13. Soil Types): _ 1�rrCG it ' V Li 4L, L a Pik �3 .i k"s
—
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
DIo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
HTNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ff'-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑/ �No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes g�YQio ❑ 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. D Yes dNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [�fNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes [21'No ❑ NA ❑ NE
Page 2 of 21412015 Continued

Facility Number: Date of Ins ection:!jffi-'f3 TM
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes L`_�l o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ER-9 ❑ 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 [)d!'o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes M 3Wo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application- Field ❑ Lagoon/storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes Ld-,"7o❑ NA ❑ NE
❑ Yes 1;3 l�o ❑ NA ❑ NE
❑ Yes 0�o ❑ NA ❑ NE
❑ Yes io ❑ NA ❑ NE
❑ Yes [3No
❑ Yes Ca'No
❑ Yes Ea'*No
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
lUie-drawmes
Comments refeir to question Explain an x YES.answers and/or an additional recommendations an other commep�`
E� y y y
of:facilttv.to better expfarnisit o"ns (use' additional'.pa as necessary)."
0
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
V�
Phone: '16 .)
Date: NkA

Division of Water Resources
❑Division of Soil and Water Conservation
Older Agency
Facility Number.
090203 Facility Status: Active
Permit: AWS090203
❑ Denied Access
lnpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine County: Bladen Region:
Fayetteville
Date of Visit:
09/23/2015 Entry Time: 01:00 pm Exit Time: 2:30 pm
Incident #
Farm Name:
Mr. Holmes Sites #1 - #14, #1 7, #18, Blueberry Sow, Bladen ,Ar
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 2313 Mr Holmes Farm Rd Garland NC 28441
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34' 49' 09" Longitude: 78" 32' 41"
From the intersections of NC 242 and SR 1002 in Ammon, go 2.0 miles north on NC 242 to farm entrance on right
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 : 910-28MO87
On -site representative Michael Ammons Phone: [phone]
Primary Inspector: Robert Marble
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Lagoon Levels
3081 = 48"
3082 = 72"
3084 = 38"
3086 = 72"
3088 = 67"
3090 = 65"
3092 = 63"
3093 = 74"
3096 = 60"
4205 = 66"
2004 = 64"
2042 = 53"
Phone:
Date:
page: 1

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number: 090203
Inspection Date: 09/23/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Swine
Design Capacity Current promotions
❑ Swine - Farrow to Wean
3,700
❑ Swine - Feeder to Finish
63,446
El Swine - Wean to Feeder
11,103
Total Design Capacity: 78,249
Total SSLW: 10.500,400
page: 2

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number: 090203
Inspection Date: 09/23/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard freeboard
Lagoon
1
20.00
Lagoon
10&11
32.00
Lagoon
12&13
32.00
Lagoon
14
30.00
Lagoon
17&18
32.00
Lagoon
19 & 20
Lagoon
19&20
33.00
Lagoon
2&3
31.00
Lagoon
4&5
20.00
Lagoon
6&7
32.00
Lagoon
8&9
32.00
Lagoon
AMON
29.00
Lagoon
BLUEBERRY
Lagoon
HOLMES 1
Lagoon
HOLMES 10&11
Lagoon
HOLMES 12&13
Lagoon
HOLMES 14
Lagoon
HOLMES 17&18
Lagoon
HOLMES 2&3
Lagoon
HOLMES 4&5
Lagoon
HOLMES W
Lagoon
HOLMES 8&9
Lagoon
NURSERY
08/23/05
page: 3

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number: 090203
Inspection Date: 09/23/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na Ne
1. is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
M 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
0 ❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
0 ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
E ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
■ ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 4

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number:
Inspection Date: 09/23/15 Inpsection Type: Compliance Inspection Reason for Visit:
090203
Routine
Waste Application
Yes No Na Ne
Crop Type 1
Com, wheat, Soybeans
Crop Type 2
Coastal Bermuda Grass
(Hey, Pasture)
Crop Type 3
Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
SOIL Type 1
Butters fine sand, 0 to 2%
slopes
Soil Type 2
Centenary sand
Soil Type 3
Foreston loamy sand
Soil Type 4
Ocilla loamy sand
Soil Type 5
Norfolk loamy fine sand, 0
to 2% slopes
Soil Type 6
Leon sand, 0 to 3% slopes
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ 0 ❑ ❑
determination?
17, Does the facility lack adequate acreage for land application?
❑ ❑ ❑
1 B. Is there a lack of properly operating waste application equipment?
❑ N ❑ ❑
Records and Documents
Yes No Na He
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑N ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 5

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number: 090203
Inspection Date: 09/23/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes 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?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26, Did the facility fail to provide documentation of an actively certified operator in charge?
❑0
❑
❑
27, Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No Na Ne
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
E ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑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 I Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
N ❑
❑
CAWMP?
33. Did the Reviewerlinspector fail to discuss review/inspection with on -site representative?
❑
N ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 6

Type of Visit: %:YU fiance Inspection V Uperation Review V Structure Evaluation U I-echnical Assistance
Reason for Visit: (Routine 0 Complaint 0 Follow-up O Referral Q Emergency 0 Other 0 Denied Access
Date of Visit: i4tipArrival Time: Departure Time: I /LI .lrT I County: 'p t►I/ ` Region:
Farm Name: c� c-v✓ VAS Owner Email:
Owner Name: lk tdy Phone:
Mailing Address:
Physical Address:
Facility Contact: C4 BT W 11 eft_ Title: Phone:
Onsite Representative: [ _ _ ]integrator:
Certified Operator: -D�"4jt4 Certification Number: S
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine . ,.
.. .....
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Design Cnrrent
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
"
Design C+urrent
D . Ponl Ca aci Fo ,
Dairy Calf
Feeder to Finish
M40
U00"
Dairy Heifer
Farrow to Wean
Dry Cow
Non -Dairy
Farrow to Feeder
Farrow to Finish
ILayers
Non -La ers
I
Beef Stocker
Gilts
I
Beef Feeder
Boars
jPullets
I
Beef Brood Cow
e- Turkeys
Other Turkey Puults
�i
Other , Other
Discbar es and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ET5o ❑ NA ❑ NE
[:]Yes
[:]No
2lA
❑ NE
❑ Yes
[:]No
[4-NA
❑ NE
❑ Yes ❑ No
[:]J�A
❑ NE
❑ Yes
❑ NA
❑ NE
[:]Yes g o
❑ NA
❑ NE
Page I of 3
21412014 Continued

r
Facility Number: - Date of Ins ection:
Aste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [:]No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure i Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[]�F ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑-No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[�--�o ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[] To ❑ 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
[3-N-o— ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes
L_l o ❑ NA
❑ NE
maintenance or improvement?
1 l . Is there evidence of incorrect land application? if yes, check the appropriate box below.
❑ Yes
❑400 ❑ 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 0 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
[] o ❑ 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
, To ❑ NA
❑ NE
acres determination?
/No
17. Does the facility lack adequate acreage for land application?
❑ Yes
u ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[glo ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Ej,<!o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes EKo ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers 0 Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22- Did the facility fail to install and maintain a rain gauge?
❑ Yes
o
❑ NA
❑ NE
23. 1f selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
wo
❑ NA
❑ NE
Page 2 of 3 21412014 Continued

Facili Number: jDate of Inspection:
24. 1j1id the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [:]Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
Ea>e-] ❑ 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
Dq1
❑ 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
®.lei
❑ 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
❑ N
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
O No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
(ErNo
❑ NA
❑ NE
Comments (refer to questionft Explain any YES answers and/or any additional recommendations�or"any other comments:
Use drawings o[ facility to better explain situations (use additional pat:es'as necessarVi. yt ...
(24
1-6.7-
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �� r
Date: in
21412011

Division of Water Resources
Division of Soil and Water Conservation
El Other Agency
Facility Number:
090203 Facility Status:
Active Permit: AWS090203
El Denied Access
Inppection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Bladen Region:
Fayetteville
Date of Visit: 08/20/2014 EntryTime: 01:30 pm Exit Time: 2:30 pm
Farm Name: Mr. Holmes Sites #1 - #14, #1 7, #18, Blueberry Sow, Bladen ,Ar
Owner: Murphy -Brown LLC
Incident #
Owner Email:
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 2313 Mr Holmes Farm Rd Garland NC 28441
Facility Status: Compliant Not Compliant Integrator. Murphy -Brown LLC
Location of Faun: Latitude: 34" 49' 09" Longitude: 78° 32- 41"
From the intersections of NC 242 and SR 1002 in Ammon, go 2,0 miles north on NC 242 to farm entrance on right
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Teddy E Wade Operator Certification Number: 22588
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Michael Ammons Phone : [phone]
On -site representative Michael Ammons Phone: [phone]
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Lagoon Levels:
2004 = 44"
2042 = 48"
3081 = 57"
3082 = 60"
3084 = 72"
3086 = 42"
3088 = 72"
3090 = 68"
3092 = 44"
3093 = 68"
3096 = 63"
4205 = 59"
page: 1

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number: 090203
Inspection Date: 08/20/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Swine
Design Capacity Current promotions
[] Swine- Farrow to Wean
Swine - Feeder to Finish
El Swine - Wean to Feeder
Total Design Capacity:
Total SSLW:
page: 2

Permit: AWS090203 Owner - Facility : Murphy -Brown LLG Facility Number: 090203
Inspection Date: 08/20/14 lnppection Type: Compliance Inspection Reason for Visit: Routine
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
1
20.00
Lagoon
10&11
32.00
Lagoon
12&13
32.00
Lagoon
F
14
30.00
Lagoon
17&18
32.00
Lagoon
19 & 20
Lagoon
19&20
33.00
Lagoon
2&3
31.00
Lagoon
4&5
20.00
Lagoon
6&7
32.00
Lagoon
8&9
32.00
Lagoon
AMON
29.00
Lagoon
BLUEBERRY
Lagoon
HOLMES 1
Lagoon
HOLMES 10&1 i
Lagoon
HOLMES 12&13
Lagoon
HOLMES 14
Lagoon
HOLMES 17&18
Lagoon
HOLMES 2&3
Lagoon
HOLMES 4&5
Lagoon
HOLMES 6&7
Lagoon
HOLMES 80
Lagoon
NURSERY
08/23/05
page: 3

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number: 090203
Inspection Date: 08/20/14 Inssection 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?
❑
E ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
N ❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
0 ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
■ ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Nam
4. Is storage capacity less than adequate?
❑
N ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le.l large
❑
= ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
N ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
� ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ E ❑ ❑
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: 4

I
Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number:
Inspection Date: 08/20/14 Inppection Type: Compliance Inspection Reason for Visit:
090203
Routine
Waste 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
Butters fine sand, 0 to 2%
slopes
Soil Type 2
Centenary sand
Soil Type 3
Foreston loamy sand
Soil Type 4
Ocilla loamy sand
Soil Type 5
Norfolk loamy fine sand, 0
to 2% slopes
Soil Type 6
Leon sand, 0 to 3% slopes
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ E ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ N ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑ ■ ❑ ❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
WU P?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 5

f _%
Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number: 090203
Inspection Date: 08/20/14 tnpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No No 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
❑
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
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26, Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No No Ne
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
E ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
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 I Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
N ❑
❑
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: 6

Type of Visit: 'Compliance Inspection O Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Q4outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: Arrival Time: Departure Time: County: Regio—
7"
Farm Name: Owner Email:
Owner Name: Z Phone:
Mailing Address:
Physical Address:
Facility Contact: r�,N —Ij Q41 ✓IX Title:
Onsite Representative: i
Certified Operator: Le
Phone:
Integrator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish ,.
-
Dairy Heifer
Farrow to Wean
Design
Current
Cow
Farrow to Feeder
Dr. i;oult .
Ca aci
P,o
_Dry
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
_
Other
Turkey Poults
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
2-555
❑ 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
F-NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
®'NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[B No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
�No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued A

Facili Number: A I Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes L_l 'No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No g3-11"A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ga-llo_ ❑ 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 [Zj>e' ❑ 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 ❑ Xo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Q[,X° ❑ 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 LI q0_ ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [7]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): _/mac_ G 5 V
13. Soil Type(s): deg N ll\ 5 to, CY 0 Ile _ �1 �„a � t J q
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.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
[:]Yes
io
❑ NA
❑ NE
❑ Yes
G'Ko-
[DNA
❑ NE
❑ Yes
Io
❑ NA
❑ NE
[:]Yes
too
❑ NA
❑ NE
❑ Yes
[]'No
[] NA
❑ NE
[:]Yes
[�J-3db
❑ NA
❑ NE
❑ Yes
[Zlo
❑ NA
❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Eql�o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard [:]Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Nco ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes �j4 ❑ NA ❑ NE
Page 2 of 3
21412011 Continued �,

Facility Number: pate of Inspection: UILF
24. Did the facility fai to calibrate waste application equipment as required by the permit? ❑ Yes No
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �o
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
EINo
❑ NA
❑ NE
❑ Yes
Q'�4o
❑ NA
❑ NE
[—]Yes
0,No
❑ NA
❑ NE
❑ Yes E2'go ❑ NA ❑ NE
❑ Yes Wo ❑ NA ❑ NE
❑ Yes Cj ko ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes �' o
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes E2 o
34. Does the facility require a follow-up visit by the same agency?
Reviewer/tnspeetor Name:
❑ Yes
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
Reviewer/Inspector Signature:
Page 3 of 3

r
M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
090203 Facility Status: Active
Permit: AWS090203
❑ Denied Access
inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine County:
Bladen Region:
Fayetteville
Date of Visit:
1011712013 EntryTime: 1130 am Exit Time: 12:15
pm Incident #
Farm Name:
Mr. Holmes Sites #1 - #14, #1 7, #18, Blueberry Sow, Bladen ,Ar
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
91D-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
2313 Mr Holmes Farm Rd
Garland NC 28441
Facility Status:
Compliant ❑ Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm:
Latitude:
34" 49 09" Longitude:
78" 32' 41"
From the intersections of NC 242 and SR 1002 in Ammon, go 2.0 miles north on NC 242
to farm entrance on right
Question Areas:
Dischrge & Stream Impacts Waste Cal, Stor, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator: William Victor Sutton Operator Certification Number: 26076
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Michael Ammons Phone ; 910-289-6087
On -site representative Michael Ammons Phone : 910-28MO87
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Lagoon Levels
2004 = 45"
2042 = 41"
3092 = 66"
3088 = 60"
3090 = 66"
4205 = 66"
3086 = 37"
3084 = 40"
3082 = 48"
3080 = 59"
Page: i

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number: 090203
Inspection Date: 10/17/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Swine
Design Capacity Current promotions
Swine - Farrow to Wean
Swine - Feeder to Finish
[] Swine - Wean to Feeder
Total Design Capacity:
Total SSLW:
page: 2

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number: 090203
Inspection Date: 10/17/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
1
20.00
Lagoon
10&11
32.00
Lagoon
12&13
32.00
Lagoon
14
30.00
Lagoon
17&18
32.00
Lagoon
19 & 20
Lagoon
19&20
33.00
Lagoon
2&3
31.00
Lagoon
4&5
20.00
Lagoon
fi&7
32.00
Lagoon
8&9
32.00
Lagoon
AMON
29.00
Lagoon
BLUEBERRY
Lagoon
HOLMES 1
Lagoon
HOLMES 10&11
Lagoon
HOLMES 12&13
Lagoon
HOLMES 14
Lagoon
HOLMES 17&18
Lagoon
HOLMES 2&3
Lagoon
HOLMES 4&5
Lagoon
HOLMES W
Lagoon
HOLMES 8&9
Lagoon
NURSERY
08/23/05
page: 3

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number: 090203
Inspection Date: 10/17/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
discharges_& Stream Impacts
Yes
No Na No
1. is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ E
❑
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)
❑
❑ N
❑
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
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na Na
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
0 ❑
❑
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 slacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 4

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number:
090203
Inspection Date: 10/17/13 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste 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
Butters fine sand, 0 to 2%
slopes
Soil Type 2
Centenary sand
Soil Type 3
Foreston loamy sand
Soil Type 4
Ocilla loamy sand
Soil Type 5
Norfolk loamy fine sand, 0
to 2% slopes
Soil Type 6
Woodington loamy sand
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?
❑ ■ ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ M ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ M ❑ ❑
1 B. Is there a lack of properly 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: 5

Permit: AWS090203 Owner - Facility : Murphy -Brown LLC Facility Number: 090203
Inspection Date: 10/17/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
%es 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?
❑
M ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
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?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
M ❑
❑
Other Issues
Yes
No Na Ne
28. Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
E ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(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 1 Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
M ❑
❑
CAWMP?
33. Did the Reviewerlinspector fail to discuss review/inspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 6

i
Type of Visit: Compliance Inspection 0 Operation Review p Structure Evaluation Q Technical Assistance
Reason for Visit: 0,1Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: /d'� Arrival Time: Departure Time: ; j County: S
Farm Name: - ' Owner Email:
Owner Name: ,Dailr L IX.,r r , 7"r- Phone:
Mailing Address:
Physical Address:
Facility Contact: �ur,��rlp7� Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Region:
Integrator: ���r�7-
Certification Number:
Certification Number:
Longitude:
Design Current Design Current Design Current
Swine
Capacity Pop. MEMMWet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
Layer Da' Cow
Wean to Feeder
I jNon-L2yer I Calf
�TH
O —D -" D ' Heifer
Feeder to Finish
Farrow to Wean
Design Current Dry Cow
Farrow to Feeder
D . P,oul Ca aci Pao Non -Dairy
Farrow to Finish
I Layers Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other Turkey Poults
Other Other
1
I-=
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 �No ❑ NA ❑ NE
[:]Yes ❑ No ❑ NA 0 NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
[] NE
❑ Yes
S No
❑ NA
❑ NE
❑ Yes
jC No
❑ NA
0 NE
Page I of 3 21412011 Continued

Facili Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any in:tmediate threats to the integrity of any of the structures observed?
❑ Yes
rV 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
g 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
[g No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[7No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
2 No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 tbs. ❑ 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): Zrry�iL �py 3z'd� �/�I✓r� �ly�taa��,�tt-
—
13. Soil Type(s): hS
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?
Vj Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Cig-No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
51 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
®.No
❑ NA
❑ NE
Required Records &_ Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[gNo
❑ 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. [Z Yes P34ro ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis OSoilAnalysis [:]Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [—]Yes C3 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - g? Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
` 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes f No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Q 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
allo (DNA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
R) 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
Qs1 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
La No ❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
R1 No ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�No ❑ NA
❑ NE
Comments (refer to question #.;-Explain any YES answers and/or any additional recommendations or any other comments:-.-+- '
Use draw►nEs oflacitity to better explain situations (use additional owes as necessarv).
M� SCu `G / S !.v r N r s / rs � e / ev
un� n� c7r�r- i pP� e rn—,L---
'J,
F-Du lot
ReviewerAnspector Name:
Phone: ?/O-�/j.�--33-00
Reviewer/Inspector Signature:
Page 3 of 3
Date: ^/02+,�p2o .
21412011

1%, i " /
M
' ""_v_ �J t'c��_
f ivision of Water Quality
Facility Number ®- _D ® Di UslowjogotlraWUMater Eonservatioa
® Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: c ,Region: �/ D
Farm Name: rl/GLV d In ..r r r `-r Owner Email:
Owner Name: � ,cis /71 ,nlr , -t-`- Phone:
Mailing Address:
Physical Address:
Facility Contact: j2C4.0,d /i r-4/^0' 't- Title: Phone:
Onsite Representative: -!5' A__e_ Integrator: �l�,t.
10,
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
}Design
Design Curreut
Current .
Design Current
Swine
Capacity Pop
We# Poultry
Capacity Pop.
Eattle Capaci#y Pop.
-,:
Wean to Finish
Wean to Feeder
Feeder to Finish
La er
Non -La er
`r
Dairy Cow
Dairy Calf
Dairy Heifer
Farrow to Wean
Farrow to Feeder
D , P.oultr, .a.
Design Current
Ca aci Po
Dry Cow
Non -Dairy
Farrow to Finish
Gilts
Boars
La ers
Non -Layers
Pullets
Beef Stocker
Beef Feeder
Beef Brood Cow
Turkeys
Othe
Turkey Poults
Other
Other
Discharees and Stream Impacts
I . Is any discharge observed from any part of the operation? [—]Yes [RNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? []Yes [:]No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) [] Yes [:]No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
[:]Yes �o
❑ Yes Z} No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: j:�- Date of Inspection. /,';z—
Waste Collection & Treatment /�,
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? co Yes ,�i�fo` ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ® No ❑ NA ❑ NE
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): j
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 [a 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 5g No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Q 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 ofWind Drift ❑ Application Outside of Approved Area
I 1❑
12. Crop Type(s): >'�S��c r �L V rrn Wk r�-i /SD/>i'ss _ f /6r/7�td
/
l �``
13. Soil Type(s): L t'Jle__ ILL S / rme r L; I/r /A4:,rL' --�
jV
14. Do the receiving crops differ from those designated in the CAV MW? ❑ Yes ® No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes [a No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
Reauired Records & Documents
19. Did the facility fail to have the 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 O-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. Q Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard SWaste Analysis ❑ Soil Analysis [] Waste Transfers
❑ Rainfall [] Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes ® No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - p Date of inspection: - p--
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [3 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes RNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ® No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below,
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes g No ❑ NA ❑ NE
❑ Yes [Z No
❑ Yes JZ No
EK Yes ❑ No
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other conimen#s
use drawings of facility to better explain situations (use additional pages as necessary).',
►%�rri� stir r�-,�
Or 1 � -r- Y� �e
Iif-
d
L- c� �- �d� lS �' r r � � �� 5� 7'`=',d� r7v:�� ill c`r b ear►-� b{Lt�� a�S' "
r /
Sr�a'S WY�z< 7Jp�f urr�� Dy— dvr��r���r'
!
� ,Y � Oi 3 OY�++'C_ tJrr�' Tr.� p 1' !v/�✓v��
Reviewer/Inspector Name:
Reviewed]nspector Signature:
Phone: 2__/ 11 _:5_r 10
Date:
21412011
Page 3 of 3

Type of Visit: Co,.mmpliance Inspection Operation Review O Structure Evaluation O Technical Assistance
0 �
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region: r
Farm Name: Mme"/% r/1 % Owner Email:
Owner Name: ,10Z4,;d G /7%r/�'�� �_ Phone:
T
Mailing Address:
Physical Address:
Facility Contact: Title: _A&Zs•/ Phone:
Onsite Representative: Integrator:
r�a
Certified Operator: 15 . Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Design
Current
Design Current
Swine
Capacity Pop. WetbP©tiltry
Capacity
Pop.
Cattle Capacity Pop.
an toFinish
La er
Dai Cow
an to Feeder
V
Non -La er
Dai Calf
der to Finish
_ ` Y ; _
V '
Dairy Heifer
arrow to Wean
,.r� �.,
Design
Current
Dry Cow
Farrow to Feeder
Dr $oul
Ca aN.,
P,o
Non -Dairy
Farrow to Finish
ILayers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Othe
urkey Poults
Other
Other
Discharees and Stream Imaacts
I. Is any discharge observed from any part of the operation?
❑ Yes
Z No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2_ Is there evidence of a past discharge from any part of the operation?
❑ Yes
gg_No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
&No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
t 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes allo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ®.No ❑ NA ❑ NE
(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
f g 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
iC� No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[::]Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes SNo ❑ 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 L❑ Evidence of Wind Drift Application Outside of Approved Area
12. Crop Type(s): AiSQrr . P-1.CY�S''�'� ���/I>�lGlh�'rr---►� — .
13. Soil Type(s):
14. Do the receiving crops differ from those designated in tKe 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?
❑ Yes o No ❑ NA
❑ Yes CE�No ❑ NA
❑ Yes ® No ❑ NA
❑ Yes ® No ❑ NA
❑ Yes 3 No ❑ NA
[::]Yes ® No
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [?No
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. � Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ® Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 10 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ®-No
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

jFacWty Number: -,203 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Dd.No ❑ NA ❑ NE
r
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes Lg-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 M No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 0 No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
® No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
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
[RNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
allo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or..=anydotherrcomme - S.
Use drawinss'df facility to better explain situations (use additional vases as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: �pZ— t*0-4pv //
21412011

Type of Visit (tl Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: � Arrival Time: ® Departure Time: ti County: Region:`
Farm Name: 'Day cl tt- Owner Email:
Owner Name: tF_2cwiU L.— ���� Phone:
Mailing Address:
Physical Address: �/
Facility Contact: e 1'+ P✓17 Title: �� ► l Y' Phone No: 5��.� f, 3 qZ
Onsite Representative: a-u — Integrator:
Certified Operator: `=_^_ — Operator Certification Number: ?��2
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 e = = Longitude: = ° 01 = u
Swine
Design Current
Capacity Population Wet Poultry
Design
Capacity
Current Design Current
Popu[ation Cattle Capacity Population
❑ canto Finish
❑ Layer
❑ DairyCow
El Dairy Calf
❑ canto Feeder
❑ Non -Layer
Feeder to Finish
El Farrow to Wean
El Farrow to Feeder
D C7
Dry Poultry
❑ Dairy Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
El Beef Feeder
❑ Beef Brood Co
Number of Structures:
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
Other
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
9No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
RNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
0 No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

s
Facility Number: 6— tT Date of Inspection
t
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): 19
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes EK 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
N(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
gNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10, Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
MNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
0 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outsideof Area
12. Crop type(s) �ryt llliir+� .S �.+► r/ '2_21/
GK
13. Soil type(s)
1617
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
N No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
M.No
❑ NA ❑ NE
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
R No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
14 No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
JO-No
❑ NA ❑ NE
ry
Comments refer to pes� q—tioo ` �( � Explain any" -YES answers and/or any, recommends#eons or any other. comments = r -
Fexplain
x s as necessary). w�
Use diaw�n' s of facili to better ex lain situations. use addrtronal a e,
g h P ( P g
Reviewer/Inspector Name I Phone:
ReviewertInspector Signature: Date: (7

r
ti
,.S Facility Number: — 3 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes O,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 ❑ Desig
n ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [9No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes EgNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [3 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
51 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[,R No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
W No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
EKNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
JHNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
19 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
5Z[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
K,No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
XNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
L-No
❑ NA
❑ NE
l2/28/04

P
Type of Visit 0-cmQpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: !rArrival Time: ��(7t� Departure Time: �p�r t7 County Region:
Farm Name: f1 Me r /—� Owner Email:
Owner Name: Lr/'� T/ Phone:
Mailing Address:
Physical Address:
Facility Contact: ;J /&-no10 "ti t Title: 4�Pf cf _ Phone
—No:
Onsite Representative: Svw-,P __ __ Integrator: /:�'/` 75/
Certified Operator: -��Operator Certification Number: �7�w
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o = ' [:D u Longitude: = o = ,
Design C►urrent
Design Current Design Current
Swine
Capacity Population
Wet Poultey Capacity Populatiot Cattle C•apaeity Population
❑ Wean to Finish
10 Layer
❑ Dairy Cow
❑ Wean to Feeder
10 Non -Layer
I
❑ Dairy Calf
eeder to Finish
C7
❑ Dairy Heifer
Dry Poultry ❑ Dry Cow
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Non -Dairy
❑ La ers ❑ Beef Stocker
❑Non -Layers ❑ Beef Feeder
❑ pullets ❑ Beef Brood Cowl
❑ Turkeys
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Turkey Poults
❑ Other Number of Structures:
❑ Other
Discharges & Stream I moaets
1. Is any discharge observed from any part of the operation?
❑ Yes
P! -No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation'?
❑ Yes
E� No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
allo
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

'
Facility Number: ff7—,,,V3j
Date of Inspection 9-
Waste Collection & Treatment
' 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
M No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): %
Observed Freeboard (in): (P
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[@ No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
® No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental three no DWQ
7. Do any of the structures need maintenance or improvement?
{[Yes
R
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
MNo
❑ 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
Flo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
El Yes
AA
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s)
13, Soil type(s)
14, Do the receiving crops differ from those designated in the CAWMP?
_WYes
Wo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ RNo
❑ NA
❑ NE
lb. 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
PK�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
gNO
❑ NA
❑ NE
Comments {refer to question;#j Explain any YES answers or any recornmen dattons,or env other comments
. - •- = a';`.-z — .,,rt ma's.
.Use drawings of facility to'better explain situations (use additional pages as necessary,)
�9W.W.•Gc Aufrq'-C1 hti
3 �.'.
/'( � r'cLp�f ��%�Yj ��` �z�I�•—t_
��w�•- �`" � CTL�ns-�C.i .���--
/�
_
Reviewer/Inspector Name
Phone: _�}'�jh`�3_
Reviewer/Inspector Signature:
Date:0%G
' 'V 12128104 Continued

4
Facility Number: r,, 75;� Date of Inspection bt2,5�—'ep�
c Required Records & Documents
e
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes UNo ❑ 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 ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EjNo ❑ 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
5ZLNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
UNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
®,No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
;RNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
JZINo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
'INo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Uq No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
JKNo
❑ 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
ZNo
❑ 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
10 No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
M No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
allo
❑ NA
❑ NE
12128104

Division of Water Quality IV-79�
Facility Number 0 Division of Soil and Water Conservation _
0 Other Agency
Type of Visit
Com ce Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
Eoutine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: I -2%% i7 Arrival Time: } CJ Departure Time: ; 3 (� County: Region- &d
Farm Name: `}•:� at.U: A� trt�" r fi �' - Owner Email:
Owner Name: 0.�`t%t )'J'l,or'� _ Phone:
Mailing Address:
Physical Address:
Facility Contact: t Title:
Onsite Representative: S a�-�-e--
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator:��`���
Operator Certification Number: . � 7Sf70
Back-up Certification Number:
Latitude: [=o = Longitude: =o=; =
it
Design Current Design Current.
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes UNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: — `rj Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes ERNO ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1-2 L4
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 [INo ❑ 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
C& 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
[2.No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ yes
ZNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
RjNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Q- c'i'` C
13. Soil tyPe(s) L .w,_.
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
N No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ayes
❑ No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
n No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
EffNo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
gNo
❑ NA ❑ NE
Comments (refer ta,q on #) Egpl any YES: ans es ndlor any Memo mendations or any other comments.
- A 1
Use drawings Aaaciii to better ex
. ty , plaan s[tuatious. {use additional pages as;�necessary}:
AL
tnerrl rt h.a,5 rio 1m bte-,- Cain 1 m L& -e
�'•[3�'mu.�Q To atrJ
r� daps .
w
ewer/Inspector Name �� Phone:ewer/inspector
Signature: Date:
E
Page 2 of 3 ` 12178104 Continued

1
Facility Number. Date of Inspection
f
R uired 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 CA WMP readily available? If yes, check ❑ Yes 5(No ❑ NA ❑ NE
the appropirate box. ❑ WDp ❑ Checklists ❑ Design ❑ Maps
p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes � No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 14 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes (ANo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
k9,No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
C.No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[XVo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
KNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
KNo
❑ 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
59 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
KNo
❑ 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
(L No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
9No
❑ NA
❑ NE
Additional Cominen`ts andlor Drawings
NeP. pu r �,at y. % ; 7� -� Shad b fbr-4' -5 ` ;4wr
y � �
LUc'r Ta Grp '`-°�e`�`� p�Dw n b�-i>a
Page 3 of 3 12128104

Type of Visit Qrtompliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit tU.t5utine O Complaint O Foilow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: I b --a tArrival Time: �. Departure Time: County Region:
Farm Name: t-�tz id J t� 1'I- t - �y Owner Email:
Owner Name: 0( // [ f_'1` Y'i �7' Phone:
Mailing Address: I WaLaa
Physical Address: ,,y}
Facility Contact: t r)&U J Mac.,_- Title:
Onsite Representative: �!L S
Certified Operator: 5�z�
Back-up Operator:
Phone No:
Integrator: �Y�1��s �fTs- r_
lov
Operator Certification Number: / 2z'4'7_0
Back-up Certification Number:
Location of Farm: Latitude: ❑ o E__1' = Longitude: =1 ° =1 I = `+
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other .
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
Non-Layet
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & 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'? (byes, notify DWQ)
Cattle
Design...Current
Capacity . Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Coy
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [KNo ❑ NA ❑ NE
❑ Yes
MNo
❑ NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
❑ Yes
rNo
❑ NA
El NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[9No
❑ NA
❑ NE
12128104 Continued

{ Facility Number: — 8 Date of Inspection —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes X No ❑ NA ❑ NE
.Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
19 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
4 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
R1 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
Z No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes 54 No ❑ NA ❑ NE
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes Dd No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) 2ey1-
IV
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes XLNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ayes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes [K No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application'?
18. Is there a lack of properly operating waste application equipment?
❑ Yes M No ❑ NA ❑ NE
❑ Yes JZNo ❑ NA ❑ NE
Comments: (refer to question #): Explain any YES answers and/or any recommendations or any other c�om�yments.
�1R
Use drawings of facility, to better explain situations. (use additional pages as necessary).
C fl!- ti W r4,k �r�af ''� ar�i'!1 ajaz
; t 491.
Reviewer/Inspector Name rs— Lv`� �lc. !
Phone: /4—y3L3;_
Reviewer/Inspector Signature:
Date: /o tp r D
Page 2 of 3 12128104 Continued

t
Facility Number:{ Date of Inspection b 10
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes (K No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes JRNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes [3 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
D�No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ONo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
RNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
L3No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
E No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
C,No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
T&No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
DI 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
04 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
NLNo
❑ 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
W No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
� No
El NA
El NE
Additional Comments and/or Drawings:
i
R
Page 3 of 3 12128104

(Type of Visit • Compliance Inspection Q Operation Review Q Lagoon Evaluation
Reason for Visit 41 Routine 4 Complaint O Follow up Q Emergency Notification Q Other ❑ Denied Access
Facility Number a? a p3
Uate of visit:
a%/ Tune: a7 Za
Q Not Operational Q Below Threshold
01 Permitted W Certified © Conditionally Certified © Registered
Date Last Operated or Above Threshold: ... ..� _.__.
nFarm Name: ........... .f.LSD.xI�..._..���_rs.�C.'�..............._......................W..._.........
Cotu►ty:FRo..�._......+^�3.rx^.......�.wW.�W....W__....._._.
Owner Name:........ Q�I_a.S L..................... r *.! .... �. - -- ......
Phone No: _L�.!D�.......S...3'2.- 143I-A ..... .
Mailing Address:'
Facility Contact: ............. .................. .......................... ........... Title:.............._.........._....
Phone No:
Onsite Representative: ................................
Integrator:
Certified Operator:..__.Ua�.el ? .........Operator
Certification Number:. %,1,7 $ 70 M
Location of Farm:
❑ Swine ❑ Pouttry ❑ Cattle ❑ Horse Latitude • 4 Du Longitude • ' is
Design CurrentDesiga 31,Current=-
sPo ulaiion� Poultry . _- _ Ca ci Po'iiii;tion,--Cattle
Wean to Feeder
❑ Layer
Feeder to Finish
a cl y o
a gy
Non -Layer
Farrow to Wean
-
Farrow to Feeder
Other
Farrow to Finish
:mow Total Dtsi
_
_ x
El Gilts
Boars
1Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance roan -made?
I■ �•
`I❑ Non -Dairy
gp°Capacity x
Tn#al'SSLW::
❑ Yes M No
❑ Yes ❑ No
b. If discharve 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 ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [M No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes It No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .............. ... ..................... .......... .......................................................... .............................. .....
Freeboard (inches): Al it
12112103 Continued

acilitiWumber: g,� — o?D, Date of Inspection ail a7 03
5. Are there any immediate threats to the integrity of any of the structures observed? (ief trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Row Cr o P Ro+ak ► n rk % Q t f pwt%& JdL. f'E,S uwc 0 S
❑ Yes ® No
❑ Yes ® No
❑ Yes 5 No
❑ Yes jP No
❑ Yes M No
❑ Yes j No
❑ Yes ® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWNIP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes IN No
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? ❑ Yes ® No
16. Is there a lack of adequate waste application equipment? ❑ Yes W No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor 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
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes J 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 No
Air Quality representative immediately.

Facilitj Number: — ?( Date of Inspection •t7/O
Reauired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes j� No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
{ie/ WUP, checklists, design, maps, etc.} ❑
Yes No
23_ Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
26_ Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
❑ Yes
No
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
! No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
P No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
Yes
❑ No
31. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
® Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[aNo
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
50 No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
® No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form [R Crop Yield Farm ❑ Rainfall 1% inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
12112103

40
Site Requires Immediate Attention: —�
Facility No. P �o'a--
DIVISION OF ENVIRONMENTAL MANAGEMENT
f ANE"L FEEDLOT OPERATIONS SITE VISITATION RECORD
J DATE: Z116 , 1995
Time:
Farm Name/Owner: a ,d 940"-"3tL
Mailing Address: 2LSi A K fi �
county:_ a �5e ti• _ -
Integrator:1���_ .� Phone:
On Site Representative: ,y.v T Phone:
Physical Address/Location:
Type of Operation: Swine Poultry Cattle
Design Capacity: 2. a�c� Number of Animals on Site: "'sA ,
114
DEM Certification Number: ACE DEM Certification Num ACNEW
Latitude:,. ° Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) <Yejor No Actual Freeboard:_.3Ft. 4 Inches
Was any seepage observed from the =or
n(s)?
Is adequate land available for spray? No
Crop(s) being utilized:. Be
Yes or 4I Was any erosion observed? Yes or No
Is the cover crop adequate? Yes or No
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin ') W&sPor No
100 Feet from Wells? for No
Is the animal waste stockpiled within 100 Feet of USGS B1ue.Line Stream? Yes or G
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or(9
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes og No If Yes, Please Explain.
Does the facility maintain adequate waste management (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Ye or No
Additional Commen
7: f
cc: Facility Assessment Unit
Signature /
Use Attachments if Needed.

Site Requires Immediate Attention: Va
Facility No. `f 31 _
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 8 , 1995
Time: /d z�
Farm Name/Owner: _ _ .r e n47�,, e - _ - For Fu s l j0o v ;a
Mailing Address:
County:
Integrator: Phone:
On Site Representative:, _X'q ry�-Fir,_ Phone:
Physical Address/Location:_
f
Type of Operation: Swine ✓ Poultry Cattle 11
Design Capacity: 2.0 ass_ Number of Animals on Site: 4� 730 - 2gy0
DEM Certification Number: ^ACE DEM Certification Number: ACNEW
Latitude: ' " Longitude: ° "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) (9 or No Actual Freeboard: $,_Ft. Inches
Was any seepage observed from the la n{s)? Yes o No e Was any erosion observed? Yes or®
Is adequate land available for sp ? e or No Is the cover crop adequate? or No
Crop(s) being utilized:_ r'.7 -Pr ^, kd 61 J V k IOU
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? eo§ or No
100 Feet from Wells? Zor No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or tp
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes orb
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes orS 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)? 0 or No
Additional Comments:. _ well Ma , ,. L;-rj I—&)) I- a ­4c,-0i {: e he,aj
---
Inspector Name
cc: Facility Assessment Unit
14
Signature
Use Attachments if Needed.
k

r- .
NORTH CAROLMML DHPARTXICNT OF MWIROMKMT, BRALTh 6 HA-TMELAL PI SOMICES
OIVISICK OF ENVIRONKMTAL KAlAGElff V
Fayetteville Regional Office
Animal Operation Compliance Inspection Form
uY"� �:,��i�e�.�,,,...>.,:" :.M•K-•• �,,;,R�;e�;--P� •, .<;-.�.�::i.:«�.�.+�i.�.���;:�•-,i""'�:;�;L::::a ti,,..:
..` K,,K�..�,xw Qv:.,•: •,;J� KYr+•^`.y •V s�.
v':w?,•'gA�i.N�+��:;.-
r
awd Mere
i
_
iit.=I .k!'-.....-
(oA nv1{G (� L a _ a--
J
All questions answered negatively will be discussed in sufficient detail in
the -Comments Section to enable the deemed Fermittee to perform the appropriate
corrections:
SECTION I
Animal O *ration : Fi n i Sk' -
Horses, cattle swine poultry, or sheep
SECTION IY
7. Does the number and type of animal meet or exceed
the (.0217) criteria? [Cattle (100 head),
horses (75), swine (250), sheep (1,000), .and
poultry (30,000 birds with liquid waste
2. Does this facility meet criteria for
Animal Operation MZISTRATIOW.
3. Are animals confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a CERTTPIZD alH�'!AL
WASTE MAHAG-MQ P P�
5. Does this facility maintain waste management
records (Volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover crop)?
5. Does this facility tweet the SCS minimum
setback criteria for neighboring houses,
wells, etc?

A
'SEG'PION
PENM
Fieldite Mans ement
1. is animal waste stockpiled or lagoon
construction within 100 f t. of a USGS
Map Slue Line Stream?
2. Is animal waste land applied or spray
irrigated within 25 ft. of a USGS heap
Blue Lice Stream?
3. Does this facility have adequate acreage
on which to apply the waste?
4. Does the land application'site have a
cover crop in accordance'with the
CERT P'ICATION PLAN?
5. Is animal waste discharged into waters of
the state by marl -made ditch, flushing system,
or other similar man-made devices?
6. noes the animal waste management at this
farm adhere to Rest Management Practices
($MP) of the approved Cm
3T=CATIOM
7. Does animal waste lagoon have
ox sufficient )
freeboard: How much? (Approximately
a. is the general condition of this CAF'0 facility,
including management and operation,
satisfactory?
SXPMON Tv
comments

1 ✓
w+ ft vow"
fear= �Mi�L1Vr1yLM tw. MEW Wt i"Adsodw rawshme wo
)les�ae err � �
!be eMser' �� ���•. ��
Na< of tsar i�lese+ ��sit 7 *s. L
Address: Q T. 1 Am x' 3 fa A
to ilk& Vivisieei at a1 ]Qusstesnat at
eL ub" Leas. r`.
'r
A6g2041A, Q r- S9091<zz Phone No. :1, / o -, - ft-R _
County: ib /f7 PESO h
Farm location. Latitude And Long itude:3e5Z'="/MO tZ' W"(required) , .Uso,
Please attach a COPY of a county road map With location identified.
'^Y-,fie of operation (swine. layer. dairf. etc-): wrn,G
;.es i gn capacity (nunber of anlzals) : Z9 y-e F�sn - Fi r) _
Average size of operations' (12 month population avg. ) : Z9"
Average acreage needed for land appl-cation of waste (acres): . a
a=rr=r==r=ranowmaw=aaaaaarresmr
?echa3cal spocialist Gertltieasias
As a specialist designated by the North Carolina Soil and Water
Carew -ration Com=ssion puxsuar_f to 15A NGiC 6F .0005. I caz-zify zhat the "few or
sxrar:ded animal waste management system as installed for the `_a_= maned above
has an arsimal waste management plan that seats the designs. corstrscrion.
operation and aai.mtenanca stand&.-ds and specifications of the Division of
Envizonzaantal Management and the USCA-Soil Consecration Service anal/or the North
Carolina Soil and Water Conser-ration: Commission pursuant to 15:, NC:.0 2H.0217 and
:5A NCAC 67 .0001-.0005_ .he following elements and their ccr.esporsdyng asi:_�•;^
�itaria-ism been verified by me or other designated tec:-_Mical specialists and
are included :n the plar. as applicable: mi^.i== separations (bx:- a -ems) : liners or
equivalent for lagoons or waste storage ponds: waste storage capacity; adequate
quantity and amount of land for waste uti? ization (or use of third pa--ty) ; ac_sss
or ownership of proper waste application equipement; scheduler for tizinq of
applications; application rates; loaidinq rates; and the cont_ol of the discharge
e
of pollutzncs from stoz-=star rssnaf_ WVQnts less severe than the 25-year, 24-ksour
_ -
storm.
.3
tiaw. WE SecLbn aal (Please Print)
Affiliation. PAZ ESTSQF FARfN S Xe%
A&L-ass (Aqa =j) P. 0. Ar i. 41 Phone me. 1- 9-10 - 59z- S 7.71
Sirracu a:�- � C(����t►.. - - Dat.: r r� � �1s�
rrrwrwwrwwwwrr=rsrrrwrr=weLwrrswaarwrrrrrarwsaarrwrrr=errrrrrrrr==rereaw
�.� -
Crsser/=Q!�SeesO� -
I (we) understand the operation and —incana.nce procedures established in the
approved animal waste management plan for the farm named above and will implement
these procedures. 1 ,we) kunow that ashy additional exparsion to the existing
desir,n. capaCit-� ar the waste treatment arc-' storage system c_ _znztz,c rl of new
facilities will :equine a new certification ca be submitted to t.,te Civisioa of
Znvi_onmantal Management before the mew animals are stocked. 1 (we) also
�.
,-mderstand that t ere must be no discharge of animal waste :_ore Chris system to
Surface waters of the state either th_-mugi a :'ear: -made _:nveyance or t2 rough
_..no£_` f__:a a s"r ^ event less severe tLar, the 25-;fear, "-?dour storm. ':be
approved Plat. Will _ba riled az the fa_� and at the orf__e cf the kcal S0:1 And
water Corse^rat_or_ Disw=c-.
:tame o f Land er (P 1 ease Pri__^.t) : G
Sig^.atlre:
Iiam* of NA=Laaar, different f,= owner (Please print) :
31 gra, zuz a - Date:
It ots: A c_harige _n land ownership requires notification or a new certifir_atio:t.
(if the approved plan is changed) to be submitted to the Div #ion of
=nvircr--rental Management withirs 60 days of a title transfer.
Doi USE CNLY:ACOW#

OMOon of &wirorYnerttal MenaQement -
JCM06 3. Hurt Jr.. Governor
A. P=Mn Howard. Jr.. P.F_, D"&of
ei.+i;ti�%ili��'rrri�+f: is+ii��wa+i.i..��.3 �: ����+� �: ���r s�.�ra+R�►i�.j:
:2iS'I-.AUC7._-0NS FOR CER':'=ICATION OF APPROVED XVMIAL MASTS . PLANS FOR
YAW OR =2VC= AN-MMIA , +:AS":';' MAN.... I2=r' SYS:MSS SERVYtiG F`=LOTS
.n order to be dewmed permit -mad by the Division of
Ern►iz ormental Hanagement
( N) , the owner
of any new or expanded area �
wa:4 a management
system
caasc_sctad after
uartcurf 1, 1994 which is designed
to serve greater than
or
equal. to =116 animal
populations listed below is required to submit a
signed
certi_icati.on fast to OEM bagaza the new a:ximais are stocked an the
fa=.
2ast:tre operations
arm exempt from the requirement to
be certified.
100 head of cattle
73 hessee
230 wise
1,00a sbreep
30,000 hLzilw w1iX a 134mSd wasta :recast
'he certification must. be sighed by the oar of for feedlot (and sager if
different from the owner) and by any technical specialist designated by the Soil
and Watar Conservation Commission parsvant to ZSA NCAC 67 .0001-.0005. - AL art
technical specialist must verity by as on -site inspection that all Applicable. �S3JC
design .and construction. standards and specifiratiarrs are met as installed _ands mb„yt-
that all applicable operation and maintenance srtrAla+-ems and specifications can
be met.
Altacugh the actual number of animals at the facility may vary from time to tilt- MI.=
%he design capacity of the waste handling system should be used to deter*Line if . =
a farm is subject to the certification requirsoent. For axampIs, if the rraste
system for a foadlat is designed to handle 300 hogs but the average poyulation
will be 200 hogs. than t_:e waste managemant system rmcuires a certification.
':21-is ce=tificatian is required by regulations „owe=.:.r.q ar.4-al :+aszze management
syscems adopted by the Environmental Management C-=aiision an :acomher 10.
1392 ('title ISA NCAC 2ii .0217) .
Cn the reverse side of this gage is the certification fa_, which r,,:s_ be
su-1=41_=ed to 0:.*S be_"ore new animals are stocked on --he fa_=. Assistance L--%
comiec_ng the form can be obtained from one of the local aq-_irsltural agencies
such as the soil and grater carservatior, district, the USCA-Soil Cansa_ •anon
Service, or the N.C. Cooperative Ex -tension Service. The fo^ should be sort to:
department of Envz_ortmant, Health and Nat-.:ral Resources
Oivision of =nv4_=or.=ercal Management _
Water Quality Section, Pla=%inq Branch
P.O. Sax 29535
Raleigh, N.C. 27626-CS35
Phone: [phone]�
S.eve W. Tedder, Chief
Water Qua1__y Sect an
Form :O: A=M 0134 Cate:�1f�3�
P.Q. 30X 29535. Rdeigh. Norrh CarCk,,.i 27426.C635 Teiephwe 4T4-733-7Ci5 FAX [phone]a%
An Ec.ua C000n i y Aftmicsrve Ac%m irr okpyrr SC% recyckw 10% poe-czraxner �coer

A 0