820319_INSPECTIONS_20171231

2 VR
NORTH CAROLINA
Department of Environmental Qual

r
M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 820319 Facility Status: Active
Permit: AWS820319
❑ Denied Access
Inpsection Type: Compliance Inspection
Inactive Or Closed Date:
Reason for Visit: Routine County:
Sampson Region:
Fayetteville
Date of Visit: 11/05/2015 Entry Time: 01:00 pm Exit Time: 2:00 pm Incident #
Farm Name: 2702
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:
35' 05' Longitude:
78' 19' 57"
1.4 miles southwest of Keener. 3/4 mile west of intersection of SR 1771 and SR 1829.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator: Bradley Devone Herring Operator Certification Number: 26545
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Norris Phone:
On -site representative Mike Norris Phone
Primary Inspector: Robert Marble Phone:
inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820319 Owner - Facility : Murphy -Brawn LLC Facility Number: 820319
Inspection Date: 09/22/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No No Ne
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
❑
[]
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑0
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
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,
❑
N ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
00011
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field ❑
Lagoon 1 Storage Pond ❑
Other [j
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ M ❑ ❑
CAWMP?
33. Did the Reviewerlinspector fail to discuss review/inspection with on -site representative? ❑ M ❑ ❑
34. Does the facility require a follow-up visit by same agency? ❑ 0 ❑ ❑
page: 5

0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
820319 Facility Status:
Active permit: AWS820319
❑ Denied Access
Inpsection Type:
Compliance inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Sampson Region:
Fayetteville
Date of Visit: 09122/2016 Entry Time: 11:00 am Exit Time: 12:00 pm Incident #
Farm Name: 2702 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
910-296-1800
Physical Address:
Facility Status: Compliant ❑ Not Compliant Integrator: .Murphy -Brown LLC
Location of Farm: Latitude: 35` 05' Longitude: 78°.19- 57"
1.4 miles southwest of Keener. 314 mile west of intersection of SR 1771 and SR 1829,
Question Areas:
Dischrge 8 Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Bradley Devone Herring Operator Certification Number: 26545
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Norris Phone :
On -site representative Mike Norris Phone!
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Cale: 09/22/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
El 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 46.00
page: 2

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Date: 09/22/16 Inppection 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?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
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
❑
MEI
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures lack adequate markers as required by -the permit? (Not applicable
❑
MEJ
❑
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 Me
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ■ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%!10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Date: 09/22/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No Na No
Crop Type 1 Coastal Bermuda Grass
(Hay)
Crop Type 2 Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1 Norfolk loamy sand, 0 to 2%
slopes
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
N ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
❑
[]
16. Did the facility fail to secure and/or operate per the irrigation design or wettabte acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
[] N ❑ Cl
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?
0
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 620319
Inspection Date: 11/05/15 Inspection 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 49.00
page: 2

Permit: AWS820319 Owner - Facility : Murphy -Brawn LLC Facility Number: 820319
Inspection Date: 11/05/15 1npsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
0 ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑
❑
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)
E]
❑
❑
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 (Le./ large
❑
MEI
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11, Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
(]
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Date: 11/05/15 Inpsection Type: Compliance inspection Reason for Visit: Routine
Waste Application
Yes
No Na Ne
Crop Type 1
coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Norfolk
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
M ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
■ ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M ❑
❑
Records and Documents
Yes
No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ M ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
[]
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

i
Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Date: 11/05/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
M ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
M ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
M ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26, Did the facility fail to provide documentation of an actively certified operator in charge?
❑
M ❑
❑
2T Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
■ ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
M ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
M ❑
❑,
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewfinspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
M ❑
❑
page: 5

6
Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 820319 Facility Status: Active
Inppection Type: Compliance Inspection
Permit: AWS820319 ❑ Denied Access
Inactive Or Closed Date:
Reason for Visit: Routine County: Sampson
Date of Visit: 12/16/2014 Entry Time: 08:30 am Exit Time: 9:15 am
Farm Name: 2702
Owner: Murphy -Brown LLC
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address:
Region: Fayetteville
Incident #
Owner Email:
Phone: [phone]
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 350 05' Longitude: 78° 19' 57'
1 A miles southwest of Keener. 314 mile west of intersection of SR 1771 and SR 1829.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Bradley Devone Herring Operator Certification Number: 26545
Secondary OIC(s):
On -Site Representative(s):
Name Title Phone
24 hour contact name
Mike Norris Phone:
On -site representative
Mike Norris Phone:
Primary Inspector:
Robert Marble Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Date: i2/1fi114 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 49.00
page: 2

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Date: 12/15/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ N
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ N
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ E
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
N ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0011
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na No
4, Is storage capacity less than adequate?
❑
N ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
■ ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
■ ❑
0
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
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
❑
N ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ N ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ N ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN n 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

a
Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Date: 12/16/14 Inssection Type: Compliance inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grain Dvenseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Norfolk loamy sand, 0 to 2%
slopes
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
■ ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
E ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
N ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes
No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
E ❑
❑
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?
❑N
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Date: 12/16/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
M ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
M ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
■ ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
■ ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
M ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29, At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWO of emergency situations as required by Permit?
❑
■ ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon I Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
■ ❑
❑
CAWMP?
33. Did the Reviewerlinspector fail to discuss reviewlinspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
820319 Facility Status:
Active Permit: AWS820319
❑ Denied Access
Inpsection Type:
Compliance inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Sampson Region:
Fayetteville
Date of Visit:
12/11/2013 Entry Time: 08:30 am
Exit Time: 9:30 am Incident #
Farm Name:
2702
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address:
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 35' 05' Longitude: 78° 19' 57"
1.4 miles southwest of Keener. 314 mile west of intersection of SR 1771 and SR 1829.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Ronald James Taylor Operator Certification Number: 27466
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Norris Phone
On -site representative Mike Norris Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: _ _ _ Date:
Secondary lnspector(s):
Inspection Summary:
page: 1

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Date: 12/11/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Farrow to Wean
Total Design Capacity:
Total SSLW:
Waste StructLires
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00
page: 2

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Date: 12/11/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges 8 Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
■ ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
EIN
❑
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
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Led 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?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any pare of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Me
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
[] E ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
[]
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number: 820319
Inspection Date: 12/11/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Wast@ Application Yes N9 Na No
Crop Type 1 Coastal Bermuda Grass
(Hay)
Crop Type 2 Small Grain Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1 Norfolk loamy sand, 0 to 2%
slopes
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
E ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
❑
❑
18. Is there a lack of properly 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?
❑
E ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
E ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
[]
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page 4

Permit: AWS820319 Owner - Facility : Murphy -Brown LLC Facility Number:
820319
Inspection Date: 12/11/13 Inssection Type: Compliance Inspection Reason for Visit:
Routine
Records and Documents
Yes No Na No
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
M ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
[]
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
moo
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?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
S ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
j]
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
M ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Type of Visit: p Compliance inspection V Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: • Routine O Complaint 0 Follow-up Q Referral O Emergency 0 Other O Denied Access
Date of Visit: 1 C ? 17,1 Arrival Departure Time:F County: Region:
Farm Name: nC 1DZ I Owner Email:
Owner Name: Gam" U_C Phone:
Mailing Address:
Physical Address:
/,,� /A� t I
Facility Contact: !' � P-e Title: Phone:
Onsite Representative: K Integrator: �.
!�
Certified Operator: Oh / � z? " Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current - Design Current
Swine Capacity i'op. Wet Poultry Capacity Pop.
Wean to Finish La er
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
-Layer
Dairy Calf
U
D . P,oult , Ca aci P,o P.
Layers
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Non -Layers
Beef Feeder
Pullets
Beef Brood Cow
Other
I_jOther
Turkeys
Turkey Poults
10ther
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes T No 0 NA ❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes ❑ No M NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: Date of Inspection: 7 2Z 2
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:^
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes M No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [ No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit'? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops 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
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP []Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement'? If yes, check the appropriate box below. ❑ Yes�rapnsfers
No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: Date of inspection: t'Lr
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes P No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes j� No ❑ NA ❑ NE
the appropriate box(es) below. eu
❑ 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 [Io
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
❑ Yes No
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes PbNo
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes M No
permit'? (i.e., discharge, freeboard problems, over -application)
T
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes C&No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 119 No
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ® No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ?EJ No
❑NA ❑NE
NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Comments (refeUse drawings of facility to better explain situations (use additional`;'pages as necessary). -�s otb' (refer to question ft Explain any: YES answers and/or, any additional-recommendationr any o er, comments.
g
r
`7 13 1 Z,
e i/rjr�
Reviewerllnspector Name:
Reviewerllnspector Signature:
Page 3 of 3
Phone: ^3 goo
Date: 7 77 l �L_
214,12011

Type or visit: W t-ompuanee inspection v vperarnon xeview V nrrucrure Lvaiunnon V iecnmcaiASSISrance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: d N f Arrival Time:ZL Departure Time: ounty: P Region:
Farm Name: 7D A f Owner Email:
Owner Name: kYJ Phone:
Mailing Address:
Physical Address:
r—
Facility Contact: M i Title: Phone:
Onsite Representative: Integrator:,AL1 , 4_
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Currentr Design Current" Design Current
Swine Capacity l;op : - Wedoultry Capacity{ Pop Cattle Capacity Pop.
Wean to Finish Layer Dai Cow
Wean to Feeder I iNon-Layer Dairy Calf
Feeder to Finish: 4 +; Dairy Heifer
Farrow to Wean �, _ F - Design CurrentDry Cow
Farrow to Feeder _ D Poul Ca aettvP,o Non -Dairy
Farrow to Finish Layers Beef Stocker
Gilts Non -Layers Beef Feeder
Boars Pullets Beef Brood Cow
Turkeys
Otheurkey Poults
F-Fo-ffi-er 10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes f] No [] NA ❑ NE
[:]Yes [—]No
[:]Yes [—]No
❑ Yes
[-]No
❑ Yes
M No
❑ Yes
fQ No
TNA ❑ NE
[ffl NA ONE
® NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: Date of Inspection: 1 III
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? 0 Yes X No NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?. -
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �2 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 bi 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 E@ 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) T
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [� No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
F-1 Outside of Acceptable Crop Window n Evidence of Wind Drift n Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
T1 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?
TT
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
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tr sfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: Date of inspection: e
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
QgNo
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
[P No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[PNo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
V No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29_ At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes �qNo ❑ NA ❑ NE
❑ Yes `tom No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
[-]Yes No
❑ Yes © No
❑ Yes ® No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question f Explain any YES answers and/or any additional recommendations or any other com_ m_ en'ts. °!
Use: drawings of facility to better explain,situations (use additional pages as necessary),. _
J
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: q ��
Date: �0
21412011

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance 1
Reason for Visit *Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access I
Date of Visit: � �0 � Arrival Time: I // fif,L� I Departure Time: County: SIT�''r ��N Region:
Farm Name: I dA Owner Email:
Owner Name: MU4ro _t&01A;4� L Phone:
Mailing Address:
Physical Address
Facility Contact: Title: �J� ,,PfhoneNo:
Onsite Representative: 14 Integrator: Any.I If
Certified Operator: V%C su4nn Operator Certification Number:.%u ��
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =' =' [--] Longitude: = ° =' = "
Design Current
Design Current
Design •urrent
Swine Capacity Population
Wet Poultry Capacity Population
Cattle
Capacity Population
❑ Wean to Finish
10 Layer
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
1
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
55 Farrow to Wean
Dry Poultry
❑ Dry Cow
El Farrow to Feeder
❑ Layers
❑ Non -Dairy
El Farrow to Finish
❑ Beef Stocker
Gilts
ElNon-La ers
ElBeef Feeder
EBoars
❑ Pullets
❑Beef $rood Co
El Turkeys
Other
❑ Turkey Poults
FEET Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 'No ElNA ❑ NE
❑ Yes ❑ No EP NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes Jr No ❑ NA
❑ NE
❑ Yes 1P No ❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number:
Date of Inspection 1 0
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?
StruI
ure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _ S3 k
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 [jNo ❑ NA ❑ NE
❑ Yes ❑ No P NA ❑ NE
Structure 5 Structure 6
❑ Yes
IpNo
❑ NA
❑ NE
❑ Yes
to No
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes IF No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [] No ❑ 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 [] No ❑ NA ❑ NE
maintenance or improvement? 1
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes] No ❑ NA ❑ NE
maintenance/improvement? 1
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ "total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ EEvvidence Wind Drift El Application Outside of Area
12. Crop type(s)
13. Soil type(s) /JOI-
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
lb. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑Ye, [ No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes O No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes §] No ❑ NA ❑ NE
( fir; question ; } . .,.',
Comments refer to # : Explain any YES answers and/or any recommendations or any other comments jaw ,
Use drarvmgs of facility to better explain situations. {use,additional pages as necessary): -
Reviewer/inspector Name =: Phone: 3
Reviewer/inspector Signature: Date: 1 D
12128104 Continued

r
Facility Number: — Date of Inspection l7 0
Renuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 1PNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
ElWaste Application ❑ Weekly Freeboard ❑ Waste Analysis ElSoil Analysis [IWaste 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
V No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
[INA
ElNE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
ElYes
1P No
1❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
1� 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
[;E�No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[� No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
ClNA
ElNE
If yes, contact a regional Air Quality representative immediately
TO
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
P No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[P No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�5 No
❑ NA
❑ NE
Additional Comments andlor Drawings.t+d=tn
Page 3 of 3 12/2"4

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: lq 2 b Arrival Time: Departure Time: b County: A` Region:
Farm Name: Zoo- I I Owner Email:
Owner Name: t�n ac Phone:
Mailing Address:
Physical Address:
Facility Contact: " ` Title: A Phone No:
Onsite Representative: IntegratorA (tro ­9 Avw CA (tc
Certified Operator: Wr �4 Operator Certification Number: LQ4076
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =o =& =61 Longitude: =o =' 0 «
Design C*urrenk
Design Current
Desig1.n Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
10 Layer
I
❑ Dairy Cow
❑ Wean to Feeder
❑ Nan -La er
I
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
,.)L
Dry Poultry
❑ Dry Cow
Farrow to Wean
Farrow to Feeder
❑ La ers
❑ Non -Dairy
❑ Farrow to Finish
❑Non -La ers
❑Pullets
❑ Beef Stocker
❑ Beef Feeder
ElSeef Brood Co
Gilts
El Boars
El Turke s
Other
❑ Turke Poults
❑ Other
Mumr of Structures:
_ETOther
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
❑ Yes
❑ No
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
53 NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
09 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
V No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: Date of Inspection It7
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 9NA ❑ 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
ElNA ElNE
(ie/ large trees, severe erosion, seepage, etc,)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
,P 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
r�No
❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
(ffNo
❑ 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 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) C� 'W &-a ) r .5 , lJrZ�il ow-r-'42W ,
13. Soil type(s) _-AkrI
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
EP No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
1P No
❑ NA
❑ NE
IT Does the facility lack adequate acreage for land application?
❑ Yes
P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
to No
❑ NA
❑ NE
Comments (refer to question #} Explain any'YESyansv►°ers and/or an . recomme_ndattons roan her comments
g t p { pages Use drawzn s of facility to better ex lain sttnat�ons�use addttianal
i
Reviewer/Inspector Name ;;. Phone: !0
Reviewer/Inspector Signature: Date:
1212104 Continued

- Facility Number: — Date of Inspection Zq
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 V] No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EB 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 M No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
82 NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
V No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
E? No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
&LNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
�SPNA
❑ 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
1p 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
H 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
q No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
0 No
❑ NA
❑ NE
12128104

.N
Facility Number 3
t__
-iftf — \d 11 % . IZH)ivision of Water Quality
Q Division of Soil and Water Conservation
Q Other Agency �.
Type of Visit [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: +.lam Arrival Time: ® Departure Time: L3 N Q County: Region:
Farm Name:
Owner Email:
Owner Name: S'qr r �� �'1 C� Phone:
Mailing Address:
Physical Address:
Facility Contact: fty-k—L \Jul f1(11 QnS_, Title: , Phone Nog I C) C;29 CoW{
Onsite Representative: fy�c W F \ Integrator: ' +'J
Certified Operator: W s `i a. i-- Sk a, Operator Certification Number:
Back-up Operator: J r f l Q M m4"O Back-up Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
arrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Latitude: =' =' =" Longitude: = ° 0' = "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouits
❑ Other
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
.. *4
Design 'Current..",!
Cattle Capacity, : Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes `V No ❑ NA [_1 NE
❑ Yes
❑ No k] NA
❑ NE
❑ Yes
❑ No A NA
❑ NE
❑ Yes
❑ No/ --IQ NA
❑ NE
❑ Yes
AD No ❑ NA
❑ NE
❑ Yes
_,� No ❑ NA
❑ NE
12128104 Continued

Facility Number: -� R I Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ' ;QNo ❑ NA ❑ NE
a. I f yes, is waste level into the structural freeboard? ❑ Yes Z)No ❑ NA ❑ NE
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ko
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ANo
❑ 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 t9.No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes )6No
❑ NA ❑ NE
maintenance/improvement?
II. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes'b"KNo
❑ 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
Crop Window El Evidence of Wind Drifi El Application Outside of Area
❑ Outside of Acc&�ryt
12. Crop type(s) — r J[rn al U/.S ,
�
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
ElYes
[-ANo
❑ 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 lack adequate acreage for land application?
❑ Yes
W No
❑ NA
❑ NE
IS. Is there a lack of properly operating waste application equipment?
❑ Yes
A No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name C tus—ri KE LAW
�'YT Phone: j
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 Wo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes NNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crap Yield ❑ 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections ❑
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
AN.
❑ NA
❑ NE
23_
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
[RNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
N No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
0 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
i9NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes A No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes 'ENo ❑ 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 [RNo El NA El NE
General Permit? (ic/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes P No ❑ NA ❑ NE
12a8/04

Facility No �) l y Time in
Farm Name 1 a
Time Out
Integrator
Date
Owner y - Site Rep
Operator W V No. aZ {}
Back-up �•,.-�� No_ _ qbp r Qtj�
COC Circle: G eraDI or NPDES
Desi n
Current
Design
Current
Wean -- Feed
Farrow - Feed
Wean - Finish
Farrow - Finish
Feed - Finish
Gilts 1 Boars
arrow - a
Others
FREEBOARD: Design
Observed
Crop Yield ✓
Rain Gauge
Soil Test
Weekly Freeboard
Spray/Freeboard Drop
Weather Codes
Wettable Acres
Sludge Survey
✓ 3, I�
Calibration/GPM /
Waste Transfers
Rain Breaker
PLAT "~
Daily Rainfall 1-in Inspections
I� rSz
_ 120 min Inspections
Waste Analysis:
Date Nitrogen (N)
Z
S a5
Date Nitrogen (N)
Pull/Field Soil Crop Pan Window

Facility Number 3�
40 Division of Water Quality
O Division of Soil and Water Conservation ���FFFIII
Q Other Agency
Type of Visit 0 Compliance Inspection Q Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: S 6 Arrival Time: �•` !h Departure Time: 3�
Farm Name: _ ParM -702 Own
County: Shp" P.saA) Region: r-ow
er Email:
Owner Name: _ FA ' Phone:
Mailing Address:
Physical Address:
Facility Contact: l r11 kQ 4n n, 0+3i Title:
a
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
integrator: Ll�ld
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0 [= , ❑ Longitude: ❑ o ❑ ` = "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Laver
Dry Poultry
U 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 Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: FFI
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No [ NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes i No ❑ NA
❑ NE
El Yes VNo ❑ NA
❑ NE
12128104 Continued

Facility Number: — 9
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: I
Spillway?:
Designed Freeboard (in):
i
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?
El Yes MNo El NA ❑NE
❑ Yes o P NA ❑ NE
Structure Structure 6
❑ Yes 99 No El NA El NE
❑ Yes g5No ❑ 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 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [P No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 'E] 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)y�.�4A(�� C]✓�U _ A
�
13. Soil typeN
s) p
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [P No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ;0 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 V9 No ❑ NA ❑ NE
Comments (refer to question #}: Explain any.YES answers and/or`any recommendations or any other comments
Ilse drawings of facility to better explain situations. (use additionif.pages as necessary):
Reviewer/inspector Name �. f (fj(�,r� j 0aA I Phone:
Reviewerllnspector Signature: Hate:
Page 2 of 3 12,128104 Continued

Facility Number: rP_3171 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes F No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 1�1 No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists El Design El Maps [I 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
�p No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
® No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�3 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
19 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
W 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
K] No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
K] No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
fig No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Division of Water Quality �cL
Facility Number l O Division of Soil and Water Conservation
Other Agency
Type of Visit OCoZutine
ce Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I l IJglp I Arrival "Time. Departure Time: County:
Farm Name: D Z Owner Email:
Owner Name: r ` S 6 Phone: _
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: ti x'L
Certified Operator:
Back-up Operator:
RegX: (?_ J
Phone No:
Integrator: B01 p v Q
Operator Certification Number: l�
Back-up Certification Number:
Location of Farm: Latitude: = o = 6 =46 Longitude: = o = 1 = u
Design
Current
Design Current
Design Current
Swine
Capacity
Population
Wet Poultry
Capacity Peop lotion
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
0 aia Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Daia Calf
❑ Feeder to Finish
-
I,i
a
❑ Dairy Heifer
d)
Marrow to Wean
9369
_
Dry Poultry
❑ Dry Cow
❑ Non-Dai
❑ Beef Stocker
❑ Farrow to Feeder
❑ La
❑ Farrow to Finish ers
❑ Gilts Non-ts ers
❑ Beef Feeder
❑ Boars
El Pullets
❑ Beef Brood Cow
y _ _ ,_ ...
❑ Turkeys
O#her ❑ Turkey i'oults
m
Number of Structures:gi
❑ Other ❑ Other
Discharges &Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes ❑ No
)WNA
❑ 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 ❑ Nol'�UIA
❑ 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 )6 No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: a— 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 1
Identifier:
Structure 2 Structure 3 Structure 4
❑ Yes ANo ❑ NA ❑ NE
❑ Yes ❑ No A ❑ NE
Structure 5 tructure 6
Spillway?:
sz
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? [:]Yes �o ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes *c, ❑ 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
Xko
❑ NA
❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yeso
El NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
__
PN
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
)XNo
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
)d No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 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. Croptype(s)e-gym �rcL L Soy_ urn C^1fa:vn ,n�rQi n G'lrr+
v -
13. Soil type(s) Nby-' Q [
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes Pao
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ONo
❑ 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?
O
❑ Yesrao
[I NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
El Yes
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other
Use drawings of facility to better explain situations. (use additional pages as necessary):: c
a
Reviewer/Inspector NameI Phone:9
O 3 330
Reviewer/Inspector Signature: Date:
Page 2of3
12128704 Conh[nued

Facility Number: Z)_— Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Vo
XXXNNN��/// ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes *o ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design El maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes �eNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections ❑
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes fSL'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 XNo
❑ 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 �Fo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes XNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes o ❑ NA ❑ NE
and report the mortality rates that were higher than normal? �f
30. At the time of the inspection did the facility pose an odor or air quality concern? ElYes QQNo El NA [IN E
If yes, contact a regional Air Quality representative immediately ,K
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes �CNo ❑ 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 Wo ❑ NA ❑ NE
Page 3 of 3 12128104

Type of Visit .0 Compliance Inspection Q Operation Review U Structure Evaluation Q Technical Assistance
Reason for Visit aRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: fl Arrival Time: Departure Time: �� County: Sd"L Region: J
Farm Name: _12- -3-6 2- - __ _— Owner Email:
Owner Name: _ fM ff ,5 -FOCJS Phone:
Mailing Address: 80 _l 1_ ___ _ . �O� A,U �2 8t
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:ryitvvr5
Back-up Operator:
Phone No:
Integrator: _ x4LMP r+-5i-_ t ..
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: 1__1 o ❑ T I--] Longitude: E] ° E:J ' ❑ u
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
oD
2 S ;o
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other--- - _ — --
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
urkey 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 Heifer
❑ 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 Z No ❑ NA ❑ NE
❑ Yes
❑ No
SNA
❑ NE
El Yes
❑ No
L{NA
❑ NE
❑ NE
❑ Yes
❑ No
❑ Yes
, 1No
❑ NA
❑ NE
ElYes
N N.
❑ NA
❑ NE
12128104 Continued

Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Struc�re 1. Structure 2
Identifier:
Spillway?:
KO
Designed Freeboard (in):
Observed Freeboard (in):
33
Structure 3 Structure 4
❑ Yes ;Q No ❑ NA ❑ NE
❑ Yes ❑ No ERNA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ff 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
KNo
❑ 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
T1,No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
AgNo
❑ 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
5 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Lj�No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
25,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 Drifl ❑ Application Outside of Area
s
12. Crop type(s)r►-,•vr�lX — ! vzR' . k :114^ -f;lac
— C. ?.c
(
U
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�Q No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ANo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination -❑ Yes KNo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes 93 No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 6No ❑ NA ❑ NE
Comments (refer to question #): EXplain any YES answers and/or any recommendations or, any, rotlicricommeats.
Use drawings of facility to better explain situations. (use additions! pages as necessary):
Reviewer/]nspector Name _ p _ Phone: --f Sy/
Reviewer inspector Signature: Date: 1D
12128104 Candnued

IV Number: f3 2 — 3i� Date of Inspection $ r?
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes KNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Z.No ❑ NA ❑ NE
the appropirate box.
❑ Wig ❑ Checklists El Design ❑Maps' El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ,E4,No ❑ NA ❑ NE
❑ Waste Application' ❑ Weekly Freeboard' ❑ Waste Analysiw ❑ Soil Analysia,' ❑ Waste Transfers ❑ Annual Certification
❑ Rainfalls ❑ 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
BNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
EjNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ANo
❑ NA
❑ NE
25_
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
QNo
❑ 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
0 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
,BNo
❑ 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
EffNo
❑ 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
t,No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
®.No
❑ NA
❑ NE
Additional Comments and/b'pDrawings,:
12128104

Type of Visit S Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Facilitv lumber
Date of Visit: �%'d�' Time: / 3d
a? 3] 9
ro Not Operational 0 Below Threshold
CF Permitted ED Certified ❑ Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: f# a 7 Q 02 County: Sty r... F 2 b
Owner Name:
;failing Address:
Phone No:
Facility- Contact: Title: Phone No:
Onsite Representative: + Integrator. 1"01r ��, _ 13r o W tit
Certified Operator: fl.' � i a n c Operator Certification Number:
Location of farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 04 0" Longitude • 0 �K
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Po ulation Cattle Capacity Population
❑ wean to Feeder 1 10 Laver I I❑ Dairy
El Feeder to Finish ❑ Non -laver ❑ Non -Dairy
® Farrow to Wear o O
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ goy Total SSLW
Number of Lagoons I / I IL_..i Subsurface Drain
Holding Ponds / Solid Traps ❑ No Liquid Waste
Discharges & Stream 1_mn2cts
I- Is anv discharge observed from any part of the operation?
Discharge orininaied at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes. notify DWQ)
c. if discharge is observed. what is the estimated flow in Pal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2_ Is there evidence of past discharge from any pan of the operation?
Area 7ILI Spray Field.
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection S Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
ldentifier:
Freeboard (inches):
0510310I
❑ Yes [2 No
❑ Yes ❑ No
❑ Yes ❑ No
N/A
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes [9 No
Structure 6
Continued

Facility plumber: $,;L —311 Date of inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage. etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do anv of the structures need maintenance/improvement?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes ® No
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes F(I No
❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes (0 No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload El Yes ©No
12. Crop type D e r rr t.LCec. g r a z c l S G m
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes Oa No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ® No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP. checklists, design, maps, etc.) ❑ Yes [UNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ® No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ® No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes [M No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes No
24. Does facility require a follow-up visit by same agency? 14 Yes ,}�No
25. Were any additional problems noted which cause noncompliance of the Certified Ak MP? ❑ Yes Ie51 No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Commeuts (refer to;,�uestion #) Eiplaun any YES aastEers antilor any recbmtrieadatioas;or aay;ather cflrntnents. �- x � -
-
Use draaiabs of faC�ij[rty to better explain srtnadoas._(ase sddtteoaal pages as necessary) = Field Copv ❑ Final Notes i
a-`�,� sel,
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Reviewer/lnspector Name
Reviewer/Inspector Signature: Date:
05103101
Continued

Site Requires Immediate Attenti9n:
Facility No. z
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS S= VISITATION RECORD
DATE: ��� Z� 1995
Time: ��
Farm Nan
Mailing A
County: �on
Integrator: Carroll Foods Phone:
On Site Representative: Phone:
Physical Address/Location:_. _ , al :5 A 0"_ /5,9-!4
Type of Operation: Swine __�Z Poultry Cattle e
Design Capacity: Number of Animals on Site: &w X-I W16 fit/
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: ' Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm
(approximately 1 Foot + 7 inches) )S)or No Actual Freeboard:�Ft. Inches
Was any seepage observed from the lagoon(s)? Yes of v Was any erosion observed? Yes or(go)
Is adequate land available for spray? es r No Is the cover crop adequate? 0 or No
Crop(s) being utilized:
Does the facility meet SCS mi-ilnimum setback criteria? 200 Feet from Dwellings? a or No
100 Feet from Wells? es r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or Zo'
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or N2
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or 0 If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? 'e or No
Additional Comments:
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.
event

FORTH CAROLINA DEPART MST OF =VIROMCEN ,EALTET & NA=RAI. RFZOURC_'S
DIVISION AP MIRQtOMi—AL
Fayetteville Regional Office
Animal Operation Complia :ce Inspection Pars
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All questions answered negatively will be discussed in suf£icie.nt de tail in
the Coments Section to enable the deemed Fermittee to perforce the appropriate
m
corrections:
�CrzQx z
Animal Operation Tyne:
Eo=SeS, cattle, sine poult--g, or sheep
szc"^ION Iz
Y i N { COYE ENTS
I. Does the n=ber and type of animal meet or exceed
the (.0217) citeria? (Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
poultry (30,000 birds with liquid waste
system) ] .
2. Does this facility meet criteria for
Animal Operatics REGISTRATFOr.
3. Are am i m als confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a CYRTIFM AN129AL
WAS ?SANAGZMENT PLAN?
S. Does this facility maintain waste management
records (Vol=es of manure, land applied,
spray irrigated on specific acraage With
specific cover cop)?
fi. Does this facility meet the SCS minimum
setback criteria for neighbcrir_g houses,
wells, etc?

Y I N) COPV'.r�` � 5
Field Site Management
1. Is animal waste stockpiled or lagoon
Con.st_ucticn within 3 CO ft. of a USGS
Hap Blue Lire Strear?
2. is ar_inal waste land applied or spray
irrigated Within 25 it. of a USGS Map
Blue Line Stream?
3. Does this facility have adequate acreage
on wrioh to apply the waste?
4. Does the land application'Site have a
cover crcp in accordance with tLe
C�TIP2CATIOH PLA.'i?
S. Is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other si=ilar asa.z-zade devices?
6. Dees the animal waste management at this
far= adhere to Hest Management Practices
- (-:4' } of the approved
7. Does animal waste lagoon bane sufficient
freeboard? Haw much? (Approximately )
S. Is the general Condition of this CkFO facility,
including manaye=er_t a.^.c: opZation,
5atisiactory?
S2CITION 1V