820318_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Quaff

M Division of Wager Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
820318 Facility Status:
Inpsection Type:
Compliance Inspection
Reason for Visit:
Routine
Date of Visit.
03/22/2017 EntryTime: 11:00 am
Farm Name:
2703.
Owner
Murphy -Brown LLC
Active Permit: AWS820318 ❑ Denied Access
Inactive Or Closed Date:
County: Sampson Region:
Exit Time: 11:30 am Incident a
Owner Emall:
Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address:
Fayetteville
910-296-1800
Facility Status: Murphy -Brown LLC
Compliant Not Compliant Integrator
Location of Farm- Latitude: 34° 46' 60" Longitude: 78° i7' 13"
On the west side of SR 1130 approx. ,4 miles south of its intersection with SR 1003.
Question Areas:
Dischrge 8 Stream Impacts Waste Cal, Stor, 8 Treat Waste Application
Records and Documents Other Issues
Certified Operator: 3 Wayne O Sanderson Operator Certification Number: 17903
Secondary OIC(s):
On-S to Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone
On -site representative Mike Ammons Phone
Primary Inspector.
Inspector Signature:
Secondary lnspector(s):
Inspection Summary:
Robert Marble
Phone:
Date:
page: 1

Permit: AWS820318 Owner - Facility: Murphy -Brown LLC Facility Number. 820318
Inspection Date: 03/22/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
FSwine - Farrow to Wean 2,400
Total Design Capacity: 2,400
Total SSLW: 1,039,200
Waste Structures
Disignated observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00 43.00
page: 2

Permit: AWS620318 Owner - Facility : Murphy -Brown LLC Facility Number. 820318
Inspection Date: 03/22/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yea No Na He
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage S Treatment
Yes No Na Na
4. Is storage capacity less than adequate?
❑
■ ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yea 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 > 101Y6110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820318 Owner- Facility : Murphy -Brown LLC Facility Number. 820318
Inspection Date: 03/22/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Wagram loamy sand, 0 to
6% slopes
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
❑
❑
18. Is there a lack of property operating waste application equipment?
❑
E ❑
❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ E ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

W. 1
Permit: AWS820318 Owner - Facility: Murphy -Brown LLC Facility Number. 820318
Inspection Date: 03/22/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Stocking?
Crop yields?
120 Minute inspections?
Monthly and 1" Rainfall Inspections
Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
appropriate box(es) below:
Failure to complete annual sludge survey
Failure to develop a POA for sludge levels
Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
If yes, check the appropriate box below.
Application Field
Lagoon / Storage Pond
Other
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
CAWMP?
33. Did the Reviewerllnspector fall to discuss reviewl'inspection with on -site representative?
34. Does the facility require a follow-up visit by same agency?
Yea No Na Ne
El
El
❑N ❑ ❑
❑■❑❑
❑■❑❑
❑■❑❑
Yea No Na Ne
❑■❑❑
❑■❑❑
❑■❑❑
❑■❑❑
El
❑■❑❑
❑■❑❑
❑■❑❑
page: 5

! It
0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 820318 Facility Status: Active Permit: AWS820318 ❑ Denied Access
Inpsection Type:
Compliance Inspection
Reason for Visit:
Routine County:
Date of Visit:
07/29/2015 Entry Time: 10:00 am Exit Time: 11:1
Faun Name:
2703
Owner.
Murphy -Brown LLC
Inactive Or Closed Date:
Sampson Region: Fayetteville
im Incident#
Owner Email.,
Phone: [phone]
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address:
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34' 46' 60" Longitude: 78' 17' 13"
On the west side of SR 1130 approx. ,4 miles south of its intersection with SR 1003.
Question Areas:
Dischrge & Stream Impacts Waste Col, Slor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Wayne O Sanderson Operator Certification Number: 17903
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone:
On -site representative Mike Ammons Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

0
Permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number: 820318
Inspection Date: 07/29/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Farrow to Wean 2,400
Total Design Capacity: 2,400
Total SSLW: 1,039,200
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon t 19.00 1 42.00
page: 2

Permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number: 820318
Inspection Date: 07/29/15 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?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
[]
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
■ ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
N ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

7
Permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number:
Inspection Date: 07/29/15 Inpsection Type: Compliance Inspection Reason for Visit:
820318
Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Wagram
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
M ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
■ ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M ❑
❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
M ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
M ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page:
4

IV
Permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number: 820318
Inspection Date: 07/29/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No No No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
[l
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?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
■ ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a PDA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
[]
E ❑
❑
Other Issues
Yes No No No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

f 1
0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
820318 Facility Status:
Active Permit: AWS820318
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County: Sampson Region:
FayeEte011e
Date of Visit:
10/23/2014 Entry Time: 08:00 am
Exit Time: 9:00 am Incident #
Farm Name:
2703
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address:
Facility Status: 0 Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34' 46' 60" Longitude: 78' 17' 13"
On the west side of SR 1130 approx. ,4 miles south of its intersection with SR 1003,
Question Areas:
Dischrge & Stream Impacts
Records and Documents
Certified Operator: Wayne O Sanderson
Secondary OIC(s):
Waste Col, Stor, & Treat
Other Issues
Waste Application
Operator Certification Number: 17903
On -Site Representative(s):
Name Title Phone
24 hour contact name
Mike Ammons Phone :
On -site representative
Mike Ammons Phone:
Primary Inspector:
Robert Marble Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

r I
Permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number: 820318
Inspection pate: 10/23/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
❑ Swine - Farrow to Wean 2,400
Total Design Capacity: 2.400
Total SSLW: 1,039,200
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00 48.D0
page: 2

f I
Permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number: 820318
Inspection Date: 10/23/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
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
❑
0 ❑
❑
State other than from a discharge?
Waste Collection Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le.! large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
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 No
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%/10 lbs.?
❑
Total Phosphorus?
[]
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

r
Permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number: 820318
Inspection Date: 10/23/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes
No No No
Crop Type 1
coastal Bermuda Grass
(Nay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Wagram
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
E ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
N ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes
No_ No Me
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
No
❑
20. {toes 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?
❑
Rainfall?
❑
Stocking?
❑
page: 4

/ 4k
Permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number:
820318
Inspection Date: 10/23/14 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yes No Na Ne
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. if selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
N ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
E ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a PDA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No Na No
28, Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
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?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
■ ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewfinspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 820318 Facility Status: Active
permit: AWS820318
❑ Denied Access
Inpsection Type: Compliance Inspection
Inactive Or Closed Date:
Reason for visit: Routine County:
Sampson Region:
Fayetteville
Date of visit: 12/18/2013 Entry Time: 11:00 am Exit Time: 12:00 pm Incident #
Farm Name: 2703
Owner Email:
Owner: Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address:
Facility Status: 0Compliant ❑ Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm: Latitude:
34' 46' 60" Longitude:
78' 1T 13"
On the west side of SR 1130 approx. A miles south of its intersection with SR 1003.
Question Areas:
Dischrge & Stream Impacts Waste Cal, Star, & Treat
Waste Application
S Records and Documents Other Issues
Certified Operator: Carl Graham Lamb
Operator Certification Number:
26849
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons
Phone:
On -site representative Mike Ammons
Phone:
Primary inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
inspection Summary:
page: 1

permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number: 820318
Inspection Date: 12/18/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swi ne
❑ Swine - Farrow to Wean
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.0o
page: 2

Permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number: 820318
Inspection Date: 12/18/13 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?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
[]
❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes Na Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ []
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
0
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number: 820318
Inspection Date: 12/18/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Wagram loamy sand, 0 to
6% slopes
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
N ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
E ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
■ ❑
❑
Records and Documents
Yts
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
E ❑
❑
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?
❑
E ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS820318 Owner - Facility : Murphy -Brown LLC Facility Number: 820318
Inspection Date: 12/18/13 lnpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No No No
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
E ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
[]
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No N8 No
28. Did the facility fall to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
E ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fait to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
N ❑
❑
page: 5

rype or vtsir: w uompuance inspecnon v uperanon xevtew U Ntructure r:vaivanon U leenmcat Assistance i
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access Il
Date of Visit: Arrival Time: Departure Time: County: j) Region:' r7
Farm Name: 2 q d 3 I Owner Email:
Owner Name: / `y�44`"9oor, L-C Phone:
Mailing Address:
Physical Address:
Facility Contact: J ice. n y�S Title:
H
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone:
Integrator: MU -I.
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
11 la
Design
Current}
Design
Current
Design Current
Swine-
Capacity
Popp. 'Wet Poultry
Capacity
.Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dai Cow
Non -La er
Dai Calf
DairyHeifer
Design
C►urrent
D Cow
D , P,oul
Ca afi
P,o :r�
Non-Dai
Pullets
Beef Brood Cow
Turke s
Uther
Turke Poults
er Oth
Other
Wean to Feeder
Feeder to Finish
Farrow to Wean
Z �
Farrow to Feeder
Farrow to Finish
Discharges and Stream Impacts
l . Is any discharge observed from any part of the operation?
Discharge originated at: ❑Structure ❑Application Field
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? ([f yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes Og No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
[18 8 NA ❑ NE
NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑Yes ❑ No � NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑Yes � No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑Yes � No ❑ NA ❑ NE
of the State other than from a discharge?
Page l of 3 2/4/2011 Continued

Facili' Number: Z= Date of Insp ection: 3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Pq NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 0
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 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
N No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
1�] No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Ej 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 jCrop Window �^ -❑ Evidence of Wind Drift ❑�Application Outside of Approved Area
12. Crop TYPe(s): �-l�-IM Qi C�—e L6s C.�k 1��T, e�
13. Soil Type(s): Nab /
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Co No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [0 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [R 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 ® No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
Required Records _& Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No [] NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps [:]Lease Agreements [3 Other;
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes EP No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ 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 ® No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes IgNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
[] NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Racifity Number: 5P- Date of Inspection.* Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes jg 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 No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No
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?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
rVU T No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
� No
❑ NA
❑ NE
❑ Yes
W No
❑ NA
❑ NE
Phone: 9i TW
Date: 31 12--
2/4/2011

l'ype of visit: W Compliance inspection V uperation Keview V structure Evaluation V i ectinical Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up_ O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Q Departure Time: p�r County: S p prti Region:
Farm Name: C7t l �.7 Owner Email:
Owner Name: 4.4w,,, LL Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
`o
Title:
Phone: //��
Integrator:A4,0"�Y10&JbA_
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current 4
Design . Cnrrent
_ . Design Current
Swine �`'' Capac- Pap. Wet Poaltry
apacity Pop.
Cattle Capacity Pop.
Wean to Finish Layer
`' '
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
"' `"
Daiiy Heifer
yj
Farrow to Wean
Design Cnrrent
D Cow
Farrow to Feeder
D e P,oul@a
aci pop.
Non -Da'
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
113cef Feeder
Boars
Pullets
Beef Brood Cow
=
Turkeys
* `
Other _
Turkey Poults
3
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes R No ❑ NA ❑ NE
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 No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes FUI No ❑ NA ❑ NE
of the State other than from a discharge'?
Page l of 3 21412011 Continued

Facility Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Identifier: �^
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in):-
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
No ❑ NA ❑ NE
❑ No NA ❑ NE
Structure 6
❑ Yes ®No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes 0 No ❑ NA ❑ NE
waste management or closure plan? TT
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
M 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 l0 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):
Q�
Q
13. Soil Type(s): 'V
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
T
NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [:]Design [-]maps [:]Lease Agreements [jOther:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes R ] 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 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
Page 2 of 3
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
21412011 Continued

acili .Number: - 51 jDate of Inspection: A!
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 r" 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 provide documentation of an actively certified operator in charge? ❑ Yes [B No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No
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?
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ONE
V9 NA ❑ NE
❑ Yes [� No ❑ NA ❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes E] No
❑ Yes [P No
❑ Yes ® No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
to question #): Explain any YES -answers and/or any additional reeommendation Comments (refeUse drawings of facility to better explain situations=(use:additional pages as necessary). tiier�comments. ' ' �' r. s�orp'any a
yRMI.
\iis ak ?M/rr
Reviewer/Inspector Name:
ReviewerlInspector Signature:
Page 3 of 3
Phone: 91C'7 33 -73L�>
Date:
21412011

A
v/
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Q 1 Arri,al Time: Departure Time: County: Region:_
Farm Name: 1 m _ Owner Email:
Owner Name: Uwe 4tJc -r U—C Phone:
Mailing Address:
Physical Address:
Facility Contact: Carr Title: Phone No:
tt akywx, Onsite Representative: Integrator: -ma4-c
JJC} .,,
Certified Operator: n Oh Operator Certification Number: 1 ` `
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 n [—] ' [:] u Longitude: [__]'0'
i
Current
Swine Capacity Population
E4
Design Current
Wet Poultry Capacity Population
Resign
Cattle Capacity
Current
Population
❑ Wean to Finish
IEJ Layer I
Dairy Cow
❑ Wean to Feeder
IIIJ Non -La er
El Dairy
Calf
❑ Feeder to Finish
Dairy Heifer
Discharges &Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure ❑Application Field ❑Other
a. Was the conveyance man-made'?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes EPNo ❑ NA ❑ NE
❑ Yes
❑ No
[P NA
❑ NE
❑ Yes
❑ No
� NA
❑ NE
A
❑ NE
❑ Yes
❑ No
❑ Yes
� No
tA
❑ NE
❑ Yes
f� No
❑ NA
❑ NE
Page 1 of 3 I2/28/04 Continued

Facility Number:
Date of Inspection0�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 tructure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
0 No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
? No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Annlication
10. Are there any required buffers, setbacks, or compliance alternatives that need El yes No ❑ NA ❑ NE
maintenance/improvement? l
11. is there evidence of incorrect application? If yes, check the appropriate box below_ ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable 17�ptable Crop Window ❑ Evidencef❑
1of Wind Drift lApplication Outside off Areea�p,,�
12. Crop type(s) [ by � [ f'1 6 "ram- ' ~'�" �'�F i� i!Jv—'
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1�No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1� No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
1�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
R§No
❑ NA
❑ NE
p
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary).�£
Reviewer/Inspector Name ?Q .' Phone:
r3 Q
Reviewer/Inspector Signature: Date: l ;b
i
12128104 Continued

Facility Number: A S Date of Inspection
Required Records & Documents ((( II(
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes r No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP` readily available? If yes, check ❑ Yes IPNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 1�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
q�No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
�9 NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
EpNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
(] No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
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
Q5 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
{� No
❑ NA
❑ NE
'sA"dditiinalrComatents an&or Drawings = m i
Page 3 of 3 12128104

j
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: f7 vt Arrival Time: . 0 Departure Time: County: � Region: P=P
Farm Name: f�l� M OM) 5 1 Owner Email:
Owner Name: ' ux- ✓ TvM) ell U-C Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
l(
Onsite Representative:
Certified Operator: a
Back-up Operator:
Phone No:
,�/�/�
Integrator: ' `U_x-jq1t,-,'bK.J�, ux
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o = f = « Longitude: = o = s =
Design CurrenurrenSwine
Maurrent
Capaulation
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Dairy Calf
❑ Feeder to Finish
Dry Poultry
❑ Dairy Heifer
❑ Dry Cow
Farrow to Wean
Farrow to Feeder
❑ La ers
❑ Non -Dairy
❑ Farrow to Finish
❑Non -Layers
❑ Beef Stocker
❑ Gilts
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Turkeys
Beef Brood Co
Other
❑ Other
❑ Turkey Poults
❑ Other I
umber of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[FNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[P NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
�] NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA
❑ NE
other than from a discharge'?
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Struc re 1 Structure 2 Structure 3 Structure 4 Structure 5 tructure 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
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 0 No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 'n No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ yes 19 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ® No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11, is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes lij 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 Wind/ow /❑ Evidence of 4!444
WindDrift ❑ Application ,O(�utside oof,,Area%12. Crop type(s)L41�`tA.[ lYN-L�CCe;!R!Q C}{�SS ��QS1 i JM' "it lJws;e FA
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes,
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[p No
❑ NA
❑ NE
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17. Does the facility tack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18_ is there a lack of properly operating waste application equipment?
❑ Yes
Ep No
❑ NA
❑ NE
Comments (refer to question #) Explain any Y1rSanswers and/or any "recommi ndatmnstarany other comments.
;rry €
Use drawin of facility-to,better explain situations. (use additional+pages as necessary)i
Reviewerllnspectar Name `- '� Phone:
..Y
Reviewer/inspector Signature: Date:
12128104 Continued

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

-- i1 Division of Water Quality
iFacility Number ` 3/ Q Division of Soil and Water Conserve#ion
— Q Other Agency
Type of Visit 1P Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit *Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: t' 0 Arrival Time: Departure Time: �� Q County:'` Region: Eep
Farm Name: `a Owner Email:
Owner Name /Yi �(i1 ��W �'l— Phone:
Mailing Address:
Physical Address:
Facility Contact: calr-!' Title:
CI
Onsite Representative:
Certified Operator: Y�+a n� C),
Back-up Operator:
Phone No:
Integrator: / 4ypon
pCQ^Z_
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = = =" Longitude: [� ° = t
EMeDesign Current :-..n Current _
Swine Capacity Population Wet.PoultCapacty Populatia�p_
Design Current
Gee . Capacity Popuiatiion
❑ Wean to Finish
El Dairy Cow
❑ Wean to Feeder
❑Non -La er
Dry Poultry
❑ Dairy Calf
Feeder to Finish.-
Farrow to Wean oZ
Farrow to Feeder
°
-
Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
Beef Brood Co
❑ Farrow to Finish
❑ La ers
❑ Gilts
❑Non -La ers
❑ Boars
Other
❑ Other
❑ Pullets
- Turkeys
❑ Turkey Pouets
❑ Other
Number of Structures:
F ... .
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
o No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
f6NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
1p NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
f 9 NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
❑ Yes
�D No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
J�j No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes IpNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No PNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): S
5. Are there any immediate threats to the integrity of any of the structures observed? ❑Yes1Vo
kg
❑ 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
U2 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
fgNo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
Q;No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
bNo
❑ NA ❑ NE
maintenance/improvement?
1 I . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
PNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
Ac^cept(a'bl Crop Window l Evidence of Wind Drift ❑ Application` Outside of Area
❑ Outside ofAcceptable
fe
12. Crop h'Pe(s) -t 7T�L1 1"l R� �' `tss e� , �_m, h
13. Soil type(s) JA%Q,ak72,,s„
14. Do the receiving bops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[9 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
t No
❑ NA
❑ NE
MUsedraj
nts {referto�quesiton #) Etcplatn any YESanswers and/or any recommendat,ons,oraay other comments:
ings of fac tto�betterexptai2n situah'ous (use addittan lapagesrasnec ses}:
Reviewer/Inspector Name Phone: qA0
Reviewer/inspector Signature: Date: / 9
Page 2 of 3 12128104 Continued

Facility Number: g?A7318 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes � No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes hNo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps
p ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes n 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
nNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
KI No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
fi5 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
O[No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ONo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
51No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
VNo
❑ 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
R 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
D9 No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
�2No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
RINo
❑ NA
❑ NE
h
Page 3 of 3 12128104

.,® Division of Water Quality
Facility Number ��� O Division of Soil and Water Conservation
Other Agency
Type of Visit 0 Compliance Inspection O Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral Q Emergency Q Other ❑ Denied Access
Date of Visit: 1917 Arrival Time: �� Departure Time: i -��Qw County: 5AWLP�N Region:
Farm Name: ? 7 �3 r + Owner Email:
OwnerName: Abq� Phone:
Mailing Address:
Physical Address:
Facility Contact: r Title:
Onsite Representative. j 4
Certified Operator: WI C r\P UK
Back-up Operator:
Location of Farm:
Designf'Current
Swine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean .2_(o0
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Phone No:
Integrator• G1 d
Operator Certification Number: I T ! 03
Back-up Certification Number:
Latitude: = o = t = Longitude: ❑ e = 6 = it
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifej
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Cowl
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2, is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes W No ❑ NA ❑ NE
❑ Yes ❑ No [P NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes F No ❑ NA
❑ NE
❑ Yes fR No ❑ NA
❑ NE
12128104 Continued

Date of Inspection
Facility Number:
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 WNA ❑ 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
CONo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
[-]Yes
[RNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
allo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
19 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s)UA P2* ryl,_ a Na-ze t Srl, .
13.
Soil type(s) UAS
14,
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
J9 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
[P No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name ` J✓�p�'(a Phone: 7 O f
Reviewer/Inspector Signature: Date: W.120,7
«IL6/U4 C,Onnnuea

Facility Number: Sa--3E Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 1P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes F9 No ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Ei No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [4 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[19 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
E5 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
&No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
J0 No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
L^1 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
J!9 No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
C5No
❑ NA
❑ NE
Additional Comments and/or Drawings:
IZ/28104

Type of Visit 49 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up Q Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: = vf-� Departure Time: LS !� County: SG�I Region:
Farm Name: 27 Q 3 o 7o 3 lJ Owner Email:
Owner Name: r E uy'P V �W Phone:
Mailing Address:
Physical Address:
Facility Contact: _ t�`QGi "a` r Title: Phone No:
r
L
Onsite Representative: Integrator: LU-P ,-O W o
u
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [:D o =' = " Longitude: a ° 0 i = "
Swine
❑ Wean to Finish
❑ Wean to Feeder
Design
Capacity
Current
Population
4 Design Current
Wet�Po�tliry Capacity Population
❑ La er
❑Non -La er
Design Current
Cattle Capacity Population
❑ Da' Cow
❑ Da' Calf
❑ Feeder to Finish
'r'`
Da' Heifer
.:r_�* . r
DryPoultry
❑ D Cow
El
❑ Non -Dairy
[] La ers
❑ Beef Stocker
❑ Non -Layers
Beef Feeder
❑ Pullets
❑ Beef Brood Cow
Other
x 4 t �.
= �,Y.z
❑ Turke s
❑ Turke Poults,
• —
❑ Other
❑ Other
Nu ber of Structures:
--
Farrow to Wean
�{'(Ob
Farrow to Feeder
❑ Farrow to Finish
PE3Gilts Boars
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
e. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes Vf No ❑ NA ❑ NE
❑ Yes
❑ No
� NA
El NE
❑ Yes
❑ No
P NA
❑ NE
[� NA
❑ NE
❑ Yes
❑ No
El Yes
P9No
❑NA
❑NE
❑ Yes
y No
❑ NA
❑ NE
12128104 Continued

Facility Number: 3
Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes M No ❑ NA ❑ NE
❑ Yes [P No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ® No ❑ NA ❑ NE
El Yes Q0No El NA ❑NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 117 No El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes A No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
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 [A No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [3 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 6"J4
13. Soil type(s) 4ka
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [,RNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes V3 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes [,9 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
E" No
❑ NA
❑ NE
❑ Yes
6 No
❑ NA
❑ NE
Comments (refer to questionExplain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better eapfain situations. (use additional pages as necessary,):
Reviewer/Inspector Name i Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: — 3 r Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [�,No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [jINo ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps
p ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes JM 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 y No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [V No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [�No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes Eallo ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ® No ❑ NA ❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
Q NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[4 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
0 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
® No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[� No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[3 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency'?
❑ Yes
® No
❑ NA
❑ NE
Additional Comments and/or Drawrngk"
Page 3 of 3 12128104

Facility Number: — Date of Inspection ®� b
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 JO NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
❑ No
❑ NA NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
❑ No
❑ NA ® NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
❑ No
❑ NA NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
❑ No
❑ NA NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
❑ No
❑ NA NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
❑ No
❑ NA NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. Yes
❑ 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 J4 Evidence of Wind Drift Application Outside of Area
12. Crop type(s) __,3e. rM tja f.� a u 1,
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
ET NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
J@ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[]
Yes
❑ No
❑ NA
[KNE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
ER NE
I S. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
[NNE
f�ral•� �- GG':j�l lldrJia��� l�/'� ,$`fir d,-; f-+ f,1 �G aj-.-��1 �&9 ' 4
f><ra✓ Ctr ors AID
�,srt j � �� p�S .SDta+•t c�S �C !.!/ci j � i v�'t- sf't� l� �,G S'� f��,� ..-��
Reviewer/Inspector Name; �� L Phone:/�� /�j •7
Reviewer/Inspector Signature: Date: 3` f 7 :�17
12128104 Continued

Facility Number: f Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? []Yes ❑ No ❑ NA WNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA aNE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA 0 NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
® NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
® NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
Cl NA
ONE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑.Yes
❑ No
❑ NA
R) 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
❑ No
❑ NA
EINE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
ONE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
P NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
®No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems_ over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
NNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
FU No
too
❑ NA
❑ NE
Addi6oaal ct)raments and/or Drawings ? ;
l
wt e M r e , tl a � -T�t � t,t f', ,� � � ��T
7.�
12128104

Division of Water Quality
iFaciiity Number s�Z i $ Q Division of soil and Water Conservation
0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 0n'C Arrival Time: � Departure Time: Z ; i{ County: Region:
Farm Name: 0 10 3 Owner Email:
Owner Name:. C"-** iL Is _ ' S+P S T+_r_ p Ph`on�e:,
Mailing Address: _ Pa gene wA�� A . NC
Physical Address:
Facility Contact:
Title:
Onsite Representative:
Certified Operator: �L*J nu,r�5,.�
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
® Farrow to Wean
Z
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Phone No:
Integrator: r+�!.
Operator Certification Number: 4a
Back-up Certification Number:
Latitude: 00 [ =1 Longitude: ❑° = =
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
1)f
Design Current,...
Cattle Capacity :Population:
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cow
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 [9No ❑ NA ❑ NE
❑ Yes
❑ No
YNA
❑ NE
❑ Yes
❑ No
® NA
❑ NE
ERNA
❑ NE
❑ Yes
❑ No
❑ Yes
[$No
❑ NA
❑ NE
❑ Yes
R No
❑ NA
❑ NE
12128104 Continued

Facility Number: - 3[ Date of Inspection 7
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?: ri O
Designed Freeboard (in): -i 9
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
® No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
A 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
JR No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? [I Yes
� No
El NA El 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
6 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
iQ No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
JgNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ FAN ❑ PAN > l0% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) l�rryc+� qrz� �/ j S'^'l• s c-�u .. - �jrtt C�
- — — -
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
LK No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[SNo
❑ NA
❑ NE
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`[]
Yes
0 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
allo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
KNo
❑ NA
❑ NE
- �..�n;
Ise d;rawings of facility to befter eirpiam. situations (use additYonal pagesas)'n ec`essary):
- -b Gorret�r- b #JX 04-zp .s �y r, -D F crc—
Reviewertinspector Name Phone:
Reviewer/inspector Signature: Date: -Z' 8 hi
11/18104 Continued

Facility Number: —gig Date of inspection o
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 09No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available'? If yes, check ❑ Yes 9No ❑ NA ❑ NE
the appropirate box- ElWU� ❑ Checklists sigh [�7a s p ❑ ❑ De Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes &'No ❑ NA ❑ NE
❑ Waste Applicatiow' ❑ Weekly Freeboat>d'❑ Waste Analysior ❑ Soil Analysis—❑ Waste Transfers ❑ Annual CertificatiotX
❑ Rainfag- ❑ Stocking-- ❑ Crop Yio}d ❑ 120 Minute Inspections— ❑ Monthly and I" Rain Inspections ❑ Weather Coder-
22_ Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit'?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other issues
28. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal'?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Pen -nit'? (ic/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
f4 No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
C9 No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
D§ No
❑ NA
❑ NE
❑ Yes
&No
❑ NA
❑ NE
❑ Yes allo ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
❑ Yes KNo ❑ NA ❑ NE
❑ Yes 9 No ❑ NA ❑ NE
❑ Yes
R No
❑ NA
❑ NE
❑ Yes
D3:,No
❑ NA
❑ NE
"iiio, niil:Comments and/or Drawings:
12128104

Type of Visit ® Compliance inspection O Operation Review O Lagoon Evaluation I
Reason for Visit ® Routine Q Complaint Q Follow up O Emergency Notification Q Other ❑ Denied Access
Dale of Visit: �a 1� Time: . Sd
Facility Number 8 3 8
Tot O erational 0 Below Threshold
® Permitted ® Certified [3 Conditionalh- Certified ❑ Registered Date Last Operated or above Threshold:
Farm Name: — —�4ry� -7 % 03 Coun#y: _ Sa.w, j2 SoA _ Fao
a
Owner Name:
Mailing .address:
Facility- Contact: Title:
Onsite Representative: Qd B,1141-
Certified Operator: Wc�rt� s4..s•re..+
Location of Farm:
Phone No:
Phone No:
integrator- /11"IAA f — Brojenta-
Operator Certification Number: 21 /,7403
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ° 0" Longitude ' �• 0"
Design Current Design Current Design Current
Swine Capacity Population lation Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑Laver ❑ Dairy
ElFeeder to Finish 1 10 Non -Laver I I ❑ Non -Dairy
© Farrow to 11 "ean y 00
ElFarrow to Feeder Other
El
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons
Holding Ponds / Solid Traps
Subsurface Drains Present
AreaY
Discharges 8 Stream Impacts
I - is any discharge observed from any part of the operation?
❑ Yes W No
Discharge originared at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. 1f discharge is observed, did it reach Water of the State? (if ves, notifv DWQ) ❑Yes ❑ No
c, if discharge is observed.. what is the estimated flow in gai/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 ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ spillway ❑ Yes No
Structure 1 Structure 2 Structure 3 Structure 4 Structure ; Structure 6
Identifier: /
Freeboard (inches): ^ 3Y
05/03/0I Connnreed

Facility Number: Vol — 3 1d9
Date of inspection •t! ��
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7- Do any of the structures need maintenance/improvement?
❑ Yes W No
❑ Yes [9] No
❑ Yes P No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [j) No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes EP No
N1'aste Anplication
10- Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Pondin/g❑ PAN A❑ Hydraulic Overload ❑ Yes ® No
12_ Crop type L7Gri+s.t�a► %%•T_ % S..,a f f `ar¢iru �f7Ct�+sa► Ctazcwls
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
14- a) Does the facility lack adequate acreage for land application? ❑ Yes W No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement? ❑ Yes ®No
16. Is there a lack of adequate waste application equipment? ❑ Yes © No
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP. checklists, design, maps, etc_)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
M No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
KI No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit_
Comments .(refer to -question #) _Explain anv YES'answers_andlor.any recomznt&6it6tes'ar aov other commtnts. F
Use"draaris gs of fa ditty to:beiter expFielain siivations. (use a'tlditi6021 pages as neresssarv)... w _
Cottiv 0 Final Notes
-id w-
L`oa.,F:..4 -!^n tva,IL ois Ioa.s scat, an 1c9oa&a 6cLjks,
Reviewer/Inspector Name_-
ReviewerlInspector Signature: e&&Mr= Date:
0510310I a . - ' j Continued

Site Requires Immediate Attention:
Facility No. 8 Z- 3 is
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: away Zs , 1995
Time: l - 5 t
Farm Name/Owner:
Mailing Address: �o :3 ox a �,P •-�� �= gs� v•� R s �, w N _ 3� �3
County: S 0.M P S O N -- -
Integrator: CrRRQL-t-S fooas Phone: q ko o % -t t
On Site Representative: ��, +r�.sti Phone: �l a - 59a 0 kl-t! _
Physical Address/Location: \� if SM to o 5 3 0
Type of Operation: Swine X Poultry Cattle
Design Capacity: Number of Animals on Site: `2-tdd
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 0Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately l Foot + 7 inches) Yes r No Freeboard: Ft. ---inches
Was any seepage observed from the oon(s)? Yes or�as any erosion ob ed? Yes or
Is adequate land available for spray? Ye or No Is the cover crop adequate? es r No
Crop(s) being utilized: c_oCOS--
Does the facility meet SC5 minimum setback criteria? 200 Feet from DwellingYeS..br No
100 Feet from Wellsres
r o
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream?NoIs animal waste land applied or spray irrigated within 25 Feet of a USGS M' e: Yes o No
Is animal waste discharged into water of state by man-made ditch, flushing system, or other
similar man-made devices? Yes o No If Yes, Please Explain.
Does the facility maintain adequate waste management reger� (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes r No
Additional Comments:_ - rc�-��b�,._, �o we •. Lk V kkA
--
MtcHASL W tc.VCw-R
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.