820340_INSPECTIONS_20171231

NUH I H CAHOLINA
Department of Environmental Qual

N Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 820340 Facility Status: Active permit: AWS820340 ❑ Denied Access
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Sampson Region:
Date of Visit: 09/22/2016 Entry Time: 03:00 pm Exit Time: 4:00 pm Incident #
Farm Name: 3111 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 1370 Junious Rd Sr 1901 Faison NC 28341
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 35' 05'
SR 1901 approx. 4 miles S. of Faison
Fayetteville
910-296-1800
Longitude: 78" 12' 24"
Question Areas:
0 Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents M 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 Inspector(s):
Inspection Summary:
page: 1

I
Permit: AWS820340 Owner -Facility: Murphy -Brown LLC Facility Number: 820340
Inspection Dale: 09/22/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
Swine - Farrow to Wean 2,411
Total Design Capacity: 2.411
Total SSLW: 1,043,963
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.50 57.00
page: 2

Permit: AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 09/22/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
DischaEges & Stream Impacts
Yes No Na Ne
1. Is any discharge observed from any part of the operation?
❑
0 0
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
[]
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage $ Treatment
Yes
No Na He
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 fl.e./ large
❑
❑
❑
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?
❑
[]
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10, Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
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/studge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 09/22/16 Inssection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Com, Wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro loamy sand, D to
2% slopes
Soil Type 2
Mg ram loamy sand, 6 to
6% slopes
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 Pian(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ M ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ 0 ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ ❑ ❑
18, Is there a lack of properly operating waste application equipment?
❑ M ❑ ❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ M ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ ■ ❑ ❑
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?
❑
page: 4

Permit: AWS820340 Owner- Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 09/22/16 Inspection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na 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?
❑
N ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
E ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
[]E
❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
0
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and dale of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Is uues
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,
❑
N ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
E ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
N ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
E ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

S 14
Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number:
820340 Facility Status:
Active Permit: AWS820340
Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Sampson Region:
Fayetteville
Date of visit:
1110512015 Entry Time: 02:00 pm
Exit Time: 3:00 pm Incident #
Farm Name:
3111
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
1370 Junious Rd Sr 1901
Faison NC 28341
Facility Status:
M r n .1-1 r c
--------__ Murphy-BrDwn LLC
Location of Farm: Latitude: 35- 05' Longitude: 78' 12' 24"
SR 1901 approx. 4 miles S. of Faison
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):
24 hour contact name
On -site representative
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Name
Mike Norris
Mike Norris
Title
Phone:
Phone :
Phone
Robert Marble Phone:
Date:
page: 1

Permit: AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 11/05/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean 2,411
Total Design Capacity: 2,411
Total SSLW: 1,043,963
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.50 40.00
page: 2

Permit: AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 11/05/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharggs & 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?
❑
0 ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
0 ❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
M ❑
0
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
■ ❑
❑
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 Q.e.l large
❑
M ❑
❑
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 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Applkation
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820340
Owner - Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 11/05/15
Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Com, wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro loamy sand, 0 to
2% slopes
Soil Type 2
Wagram loamy sand, 0 to
6% slopes
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?
❑
E ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes
No Na Ne
19, Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

i
Permit: AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 11/05/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No No No
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and i" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
E ❑
❑
appropriate box(es) below:
Failure to complete annual sludge surrey
❑
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:
28. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No No 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,
❑
E ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
N ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
E ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
820340
Facility Status: Active
Permit: AWS820340
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County:
Sampson Region:
Fayetteville
Date of Visit:
1211612014 Entry Time: 09:15 am Exit Time: 10:00 am Incident #
Farm Name:
3111
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
1370 Juntous Rd Sr 1901
Faison NC 28341
Facility Status:
MCompliant ❑
Not Compliant Integrator:
Murphy -Brown LLC
Location of Farm:
Latitude:
35' 05' Longitude:
78' 12' 24'
SR 1901 approx. 4 miles S. of Faison
Question Areas:
Dischrge & Stream Impacts
Records and Documents
Waste Col, Stor, & Treat Waste Application
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 Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 12/16/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
[] 5M e -Farrow to Wean 2,411
Total Design Capacity: 2,411
Total SSLW: 1,043,963
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.50 55.00
page: 2

Permit: AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 12/16/14 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?
❑
❑
❑
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)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWO)
[]
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ 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
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No No Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
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 manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 12/16/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Com,Wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro loamy sand, 0 to
2% slopes
Soil Type 2
Wagram loamy sand,
o to
6% slopes
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?
❑ 0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ E ❑
❑
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?
❑ 0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑
❑
If yes, check the appropriate box below
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
Cl
Rainfall?
❑
page: 4

Permit: AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
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?
❑
0 ❑
[]
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
N ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26, Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
N ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon/ Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
N ❑
❑
CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑
N ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 820340 Facility Status: Active Permit: AWS820340
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine County: Sampson Region:
Date of Visit: 1211112013 EntryTime: 12:30 pm Exit Time: 1:30 pm Incident #
Farm Name: 3111 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 1370 Junious Rd Sr 1901 Faison NC 28341
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 35' 05' Longitude: 78' 12' 24"
SR 1901 approx. 4 miles S. of Faison
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other issues
❑ Denied Access
Fayetteville
910-2W 1800
Certified Operator: David Lee Edwards Operator Certification Number: 989988
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: Dale:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
inspection Date: 12/11/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
Swine - Farrow to Feeder
Total Design Capacity:
Total SSLW:
Waste Struc ures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.50
page: 2

1
Permit: AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 12/11/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
[]
Other
❑
a. Was conveyance man-made?
❑
❑ 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?
❑
01111
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
■ ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
■ ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 01111
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820340 Owner - Facility : Murphy -Brown LLC Facility Number: 820340
Inspection Date: 12/11/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Cam, Wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Goldsboro loamy sand, o to
2% slopes
Soil Type 2
Wagram loamy sand, 0 to
6% slopes
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
M ❑
❑
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 No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ M ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
r
page: 4

Permit: AWS820340 Owner- Facility : Murphy -Brown LLC Facility Number. 820340
Inspection Date: 12/11/13 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
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■ ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
M ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■ ❑
❑
Other Issues
Yes
No Na Ne
28, Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29, At the time of the inspection did the facility pose an odor or air quality concern? if yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
■ ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
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
❑
❑
❑
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?
❑
M ❑
❑
page: 5

Ii ype of visit: w c.ompuance inspection v operation tcevtew %,., ntrucrure r vatuanon L) t ecnmcai Assistance I
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral Q Emergency O Other 0 Denied Access
Date of Visit: Arrival Timer Departure Time: ;ap Iti County: v Region:
Farm Name: ! ( ( _ Owner Email:
Owner Name: 4"L L Phone:
Mailing Address:
Physical Address:
Facility Contact: t4t /VO"-+-, S Title:
Onsite Representative: N
Phone:
Integrator: W N
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Design
Current
Design Current
Swine Cap:aeity Pop.
Wet PoultrJ'
C> apac..ty
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
ia Cow
Wean to Feeder
Non -La er
I
i Calf
Feeder to Finish
" - " "'
Dai Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
ZO
D P�oulIFFy
Caaci
Po .
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
_..
Other
Turke Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes � No ❑ NA ❑ NE
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
4 NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system'? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
'® No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

[JFacility'Number: ,? - jDate of Inspection: iq3j/Js'
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NAtm ❑ 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): of
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan? TT
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes M No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 4,0 No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes f� No ❑ NA ❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 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 Approved Area
12. Crop Type(s):
a
r
13. Soil Type(s): �
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes EP No 0 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
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 j No
❑ NA
❑ NE
the appropriate box.
TT
❑WUP ❑Checklists ❑Design [:]Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes T] No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E� No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes L�No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: Dspection: /o u f
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 1P No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes GM 1 No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes np No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes \ No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
R No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[`] No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[H No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
QN No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
I] No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
It] No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
E� No
❑ NA
❑ NE
Comments (refer to question ff): Explain any YES answers and/or any additional recommendations or any other comments.
Use draw - wings -of facility to better explain situations (use additional pages as necessary_
2GeY'd�5 �P.ur /o /I1
✓1st m" to fzr�l.
Reviewer/Inspector Name:
ReviewerlInspector Signature:
Page 3 of 3
Phone; /033' ao
Date: I DL74
Al
2/4, 011

J Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
IReason for Visit * Routine 0 Coqlpfooi 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Dehied Access
qo
Date of Visit: �T �1 b 1 Arrival Time: Departure Time: ' county: Region:/T/
Farm Name: 1-7' 1 1 I Owner Email:
Owner Name: U-C Phone:
Mailing Address:
Physical Address:
Facility Contact: uT r Title:
h
Onsite Representative:
n
Certified Operator: _ 1 O M M
Back-up Operator:
Location of Farm:
Phone No:
Integrator: r"'] �
Operator Certification Number: l��g
Back-up Certification Number:
Latitude: = o = ` = Longitude: = 0 0 A ❑ is
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
Design Current
Cagle Capacity Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
Feeder
❑Non -Layer
El Dairy Calf
ILa
Finish
20019
ers
❑ DairyHeifer
KFarrow Wean
fA Feeder
El Finish
GOO
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Non -La ers
❑Beef Feeder
❑ Pullets
El Turkeys
Other ❑ Turkey Poults
Other ElOther
L
ElBeef Brood Co
u Nmber 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? (I f 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 9 No ❑ NA ❑ NE
[I Yes
❑No
[(iNA
El NE
❑ Yes
❑ No
[�6NA
❑ NE
PNA
❑NE
El Yes
El No
❑ Yes
[�No
❑ NA
❑ NE
Dyes
1�No
[I NA
❑NE
Page I of 12128104 Continued

Facilit3rNumber: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier. 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes '! No
❑ Yes ❑ No
Structure 5
El NA El NE
tpNA ❑ NE
Structure 6
❑ Yes �No ElNA ElNE
❑ Yes © No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes � No
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 100/6 or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soi:
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
❑NA ❑NE
❑ NA ❑ NE
12. Crop type(s) (o-rw
13.
Soil type(s) Wq
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1P No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
No
ElNA
❑ 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
4[No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
[fLNo
❑ NA
❑ NE
Cottitnents (refer to question #): Explain any YES' answers and/or any recommendations or any otherecco�mments.
Use drarrin s of facili to better explain sitnateotis:' use' additional a es:as necessa j • .
AL
ReviewerlInspector Name � �� Phone:
ReviewerlInspector Signature: Date:
12128104 Continued

Facility Number: ea — Wfl Date of Inspection D o
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes cE�No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes MNo C] NA ❑ NE
the appropriate box. ElWUp ❑ Checklists ElDesign ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes � No ❑ NA El NE
El Waste Application El Weekly Freeboard El Waste Analysis El Soil Analysis El 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
IAdditionalComments•and/or Drawings'
❑ Yes J�No ❑ NA ❑ NE
[I Yes
❑ No
P NA
❑ NE
❑ Yes
InNo
❑ NA
❑ NE
❑ Yes
No
I --]NA
❑ NE
ElYes
No
❑ NA
El NE
El Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
fil No
❑ NA
❑ NE
❑ Yes 'ER No ❑ NA ❑ NE
Page 3 of 3 12128104

Type of Visit 40 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine 0 Complaint O Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit:
Arrival Time:
��r ti
Departure Time:
County: __
Region:
3111
Farm Name: Owner Email -
Owner Name: MLL'yA I— Q iJ l owl', Uf_— Phone: _
Mailing Address:
Physical Address:
Facility Contact: cw'eA l.G 4--r Title:
C4
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No• Q
Integrator:'ti,
Jr tjA_j �f�i"f�V3r'1 uL
Operator Certification Number: A?5g
ee
Back-up Certification Number:
Location of Farm: Latitude: = o ET =1 " Longitude: = o = f [� +g
Swine
Design Current
Capacity Population
Design
Wet Poultry Capacity
C+urrent Design Cnnrent
Population Cattleiogapacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
10 Non -Layer I
❑ Da' Calf
❑ Feeder to Finish
❑ Farrow to Wean
Dry Poultry
❑ Dairy Heifer
❑ Dry Cow
❑ Non
arrow to Feeder
-Dairy
❑ Beef Stocker
❑Beef Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
❑ Beef Brood Cowl
Number of Structures:
Other
❑ Other
Discharees & Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
MNo
❑ NA
[:IN E
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
T NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
10NA
❑ 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
INNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
'�bNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
qNo
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [:]No WA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 9tructure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): L
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ElNE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ONO ❑ 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 RNo ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 'L?--yNo ❑ 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 El NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o ❑ NA ❑ NE
maintenance/improvement? {
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 1�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in`tfte CAWMP?
❑ Yes
PNo ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Comments (refer to question #): Explain'any YES,answerss and/or any recomffiendattons�or any other comments.
Use drawings of facility. to better explain. situations (use additional pages�as necessary.) x F
L
Reviewer/Inspector Name f F€ Phone: Q 35r3
Reviewer/Inspector Signature: Date:
12128104 Continued

} Facility Number: Date of inspection
Required Records & Documents / r
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 'No [INA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ElYes �No ❑ NA ❑ NE
the appropriate box. ElWUP ElChecklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EpNo ❑ 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
[2PNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
ElYes
[INo
two
LNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�lo
El NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
o
ElNA
ElNE
26.
Did the facility fail to have an actively certified operator in charge?
ElYes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
PNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with anon -site representative?
❑ Yes
[ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
Jallo
❑ NA
❑ NE
12128104

j
Type of Visit i♦ Compliance Inspection U Operation Review U Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Zl Arrival Time: Departure Time: County: _ .>���dN Region:
Farm Name: �(Owner Email:
Owner Name: 14CW12h!! —1$r-nf,)" LLC- _. _ Phone:
Mailing Address:
Physical Address:
Facility Contact: �` �i C(-ft� _ Title:
Onsite Representative: N
Certified Operator: fornmv D, t^ ,e
Back-up Operator:
Phone No:
Integrator:1.U'%1���t,�%Y1 u-C
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: =1 e = I = u Longitude: = ° 0 t = u
Design Current
Design Current
Design Current
Svv_ine
�1 tv
Ca aci Po ulat'on
p'�
Wet PoultryPo ulation
pass.
Cattle
Capacity Population
❑ Layer
❑ Dairy Cow
❑ Wean to Finish
❑ Wean to Feeder
❑ Non -Layer
❑ Dairy Calf
❑ Feeder to Finish
❑ DairyHeifer
El Farrow to Wean
Dryl?outtry 4
El D Cow
Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
��.
Other.
❑ Turkey Poults
x
❑ Other J
10 Other ;`
!Number of Structures:
_ ..Y:Jkk`e'YIF ... "::, i,.... - rt,�ll;:'
B4u6s..:.aa. N ..Y....,, d.-:'�:L x „-A T .. •YiE+x- uL i..k"+i'IintivR -
-wH'
Discharges & Stream Impacts
Is any discharge observed from any part of the operation? ❑ Yes FNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
❑ Yes
❑ No
fpNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
❑ No
&NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
o
ElNA
ElNE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

w Facility Number:-3TQ Date of Inspection !
1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
�To
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
�71SIA
❑ 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
El 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
f9 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 -J;p 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
E)No
❑ NA
❑ NE
maintenance or improvement?
Waste Apptication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
P�rNo
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes R3No ❑ 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/1Acceptable
,Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) CN M ,J` ICI _43-,6.n5
11�qg Mill
v
14. Do the receiving crops differ from those designated in the CAWMP?
El Yes
o
El NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ *o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
W No
❑ NA
❑ NE
NX
Comments�(refe�r tueson #} Eaplau� any�YES nswers,andlor�any ecommendateonsor any other comments.
Use drawings oftfaciLtyto ;better. explatn>situat,ons us additional a as necessa
P g�.Yi)
� a k ¢c W
AL
T
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date: if & Lon
Page 2 of 3 12128104 Continued

Facility Number: — 3 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes '0 No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n [I Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes JgNo ❑ 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 Cade
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 [WNo ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�3 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[EbNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
M No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
; B 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
BNo
❑ 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
ANo
❑ 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
,9 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�B'No
❑ NA
❑ NE
Page 3 of 3 12128104

Division of Water Quality
Facility Number O Division of Soil and Water Conservation
,[
— - 0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: r[ `3( a7 Arrival Time: %(� W Departure Time: t7`7 County: -Smi�a Region: Fn�
Farm Name: 3 1 I 1 y Owner Email:
Owner Name: Mwr064 Wm -OW h Phone:
Mailing Address:
Physical Address: nn
Facility Contact: Title: Phone No:
Onsite Representative: Integrator: M Ulf � J nrr
Certified Operator: ►'\ �� ,, „_ Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: e ❑ f 0 u Longitude: = ° u
Swine
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
Current" Design Current
Population Wet Poultry Capacity Population
�' ❑ La er
❑ Non -La et
Other
❑ Other '
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
;; 'De§ign aEurrent,
Cattle Capacity -Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stoeket
❑ 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 �Io ❑ NA ❑ NE
❑ Yes ❑ No [ NA ❑ NE
❑ Yes ❑ No i NA ❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes 1P No ❑ NA ❑ NE
❑ Yes TP No Cl NA ❑ NE
12128104 Continued

Facilitv Number: — Date of Inspection 7 b�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'? El Yes rNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No P NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: l
Spillway?:
Designed Freeboard (in):
lr
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes IRNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes IrNo ❑ 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 r3No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Po ❑ 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 ElNA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ yes Wo ❑ NA El NE
maintenance/improvement? J `
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes E f No El NA ❑ NE
El Excessive Ponding ❑ Hydraulic Overload El Frozen Ground El 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 jWiindoow ElEvidence of Wind Drift ❑ Application Outside of Area
�0..1
12. Crop type(s) U f' A 1VIJ
13.
Soil type(s) 0.
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Q5No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
TNo
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
E�kNo
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
TNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
r�No
❑ NA
❑ NE
Comments (refer to question #f): 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 Namemt!'M it Phone: (y 10) W'33 - 33 CD
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: —5, VDate of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes FNo [I NA El NE
20. Does the facility fail to have all components of the CA WM P readily available? If yes, check [I Yes 5 No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Desig
n El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes FINo ❑ 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
I No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
tl No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
In 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
19 No
[I NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
F] No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
F1 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
JK3 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
)S No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32_
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33_
Does facility require a follow-up visit by same agency?
❑ Yes
&S No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Type of Visit 0 Compliance Inspection Q Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up Q Referral 0 Emergency 0 Other ❑Denied Access
Date of Visit: ® Arrival Time: Departure Time: -3=JO County: Region: 1"—
Farm Name: _ -4)11 bil 16 Owner Email:
Owner Name: !Y �/j tAW W F' Phone:
Mauling Address:
Physical Address:
Facility Contact: _�+ 1r Title: Phone No:
Onsite Representative: Integrator: M AVOW L'i
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = g = Longitude: = n = I = u
Design C•urrentDesign
^Current
Design Current
Swine
Capacity Population
.,.W .
Wet Poultrys Capacity Population
Cattle Capacity Population
❑ an
❑ La er
El Dairy Cow
❑ on -Layer
El Dairy Calf
El Dairy Heifer
D . Poult r
❑ D Cow
❑
❑ La ers
❑
❑ Non -La ers
❑ Beef Feeder
El Pullets
❑ Beef Brood Co
ElTurke s
Other
El Turkey Poults
❑ Other
❑ Other
Number of Structures:
to Finish
❑ an to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
OCSO ;i �
&Stream Impacts
1.
Is any discharge observed from any part of the operation?
[-I Yes
®No
❑ NA
❑ NE
Discharge originated at: ❑Structure El Application Field El Other
a. Was the conveyance man-made?
[-I Yes
❑ No
� NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
❑ No
� NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑Yes
❑ No
� NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑Yes
4 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
�9 No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: $6L Date of Inspection-R-=
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
M7 No ElNA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ZJ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): S Ca
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
(� No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
5 No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
�@ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
Ifl 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
V3 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
US No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
19. Is there a lack of properly operating waste application equipment?
❑ Yes
JgNo
❑ NA
❑ NE
Comments (refer to question #f): Explain any YES answers and/or any recommendations or Iany other comments
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name I � 1 T19 0L Phone: //b) VTV-?At�:'
Reviewer/Inspector Signature: Date: B 7�
Page 2 of 3 12128104 Continued

Facility Number: S L- 96 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes W No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® 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 Z} No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall []Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [$j No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes V1 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[Z] No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
[RNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
KI No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[F[No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
® No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
91 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
09 No
❑ NA
❑ NE
Additional Comments and/or Drawings:;
AL
w
Page 3 of 3 12128104

Type of Visit 4D Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit JO Routine 0 Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: 51q Arrival Time: Departure Time: County: Region:
Farm Name: _ �ci _ tf Owner Email:
Owner Name: AlL� L- — 1-M �L� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
t �^
Certified Operator: pc'�
Back-up Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number: `'I
Back-up Certification Number:
Latitude: = o = 0 4 Longitude: = o = , ="
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population : Cattle
❑ Wean to Finish
i
❑ Wean to Feeder
ElFeeder to Finish
❑ Farrow to Wean
[KFarrow to Feeder Z4—v02-IS-1 jj
❑ Farrow to Finish
❑ Gilts
❑ Boars
vrner -
❑ Other
❑ La er
❑ Non -La ei
Dry Poultry
Non-L,
Pullets
L_I 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
Capacity. Population
❑ Dairy Cow
❑ Daja 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 P No ❑ NA ❑ NE
❑ Yes
❑ No
[.NA
❑ NE
❑ Yes
❑ No
0 NA
❑ NE
[9NA
❑ NE
❑ Yes
❑ No
❑ Yes
�No
El NA
El NE
❑ Yes
K,No
❑ NA
❑ NE
12128104 Continued

Facility Number:
Date of Inspection 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?
Structure I Structure 2 Structure 3
Identifier: --- I
Spillway?: w D
Designed Freeboard (in): ,l7, S
Observed Freeboard (in): ``?]
Structure 4
❑ Yes P No ❑ NA ❑ NE
❑ Yes ❑ No �9NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [�'No ❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc_)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes �? No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes tgNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 14 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 ERNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ,E�[No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes PNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I 0 Ibs ❑ Totai Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) C:c:"rh - �"t ca .� �c � �.5 :4JV-e.N_:�_
/ p i
13. Soil type(s) ['gin 1f\% p
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ,RNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Ef 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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes PS No ❑ NA ❑ NE
❑ Yes ®-No ❑ NA ❑ NE
Reviewer/Inspector Name `` ti >' ? Phone: �/4 / Y
«/ - S
Reviewer/Inspector Signature: Date: O
12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes M�o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes XNo ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists El Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes fg[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
A No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
JRNo
❑ 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
R 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
R No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[4 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
C?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
PkNo
❑ 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? (ic/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
RNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
JQ'No
❑ NA
❑ NE
Acldi'd6"I'Comtnents and/or Drawings: o f £
12128104

Type of Visit • Compliance Inspection O Operation Review O Lagoon Evaluation f
Reason for Visit • Routine O Complaint O Fallow up O Emergency Notification O Other ❑ Denied Access
Facility Number ,Z tfv Uate of Visit: Time: = ��
rO Not Operational C Bellow Threshold
® Permitted ® Certified [3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
�t3G 3j ..1._. County F 6
saw, sc�:.i IL
FarmName:....._...W_.........._._.........._._............................__...._...._..._.--------...._ ......................�.._.».............____......._............�.
Owner Name: - ---...._.................... Phone No:
Mailing Address: .............................................
W.W—�
Facility Contact: .......... _.... _. _._._...._._ Title ---- —___. Phone No:
OnsiterRepresentative:
Cer fled Operator.----..�1�r,E.�. ----.W .. L% � _ ...._. Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 " Longitude ' 4 66
Dischames & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes [A No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a_ If discharge is observed, was the conveyance than -trade? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min? Al /A
d_ Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2- Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes Mo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes & No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier: ... _.............. _.__.. ---.._ .
Freeboard (inches):
12112103 Continued

Facility Number: Ra, —,31 O Date of Inspection
Reauired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes E9 No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
Yes 51 No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes W No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
IN No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes -M No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
[[No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
28. Does facility require a follow-up visit by same agency?
❑ Yes
No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
O No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
13 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
12/l2103

Facility Number. ?,2 — 3 n Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [M No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes No �
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [V No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes Qj No
elevation markings?
Waste Annlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes [4 No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes Qj No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type / '7 OLu �.- _s �o c� 6 a.c��7 . W ea (SA
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [A 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 [A No
15. Does the receiving crop need improvement? ❑ Yes ® No
16. Is there a lack of adequate waste application equipment? ❑ Yes P No
Odor Issues
IT Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes gg No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? CO Yes ❑ No
19. Is there any evidence of wind drift during land application? (i.e_ residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes IJ No
Air Quality representative immediately.
se drawrngs'of fac�Lty Lo better zxplatn situaog;w. (use,aumtwna[ pages as necessary T.� Field Copy ❑Final Notes
a�..�-,�:. r`.. -- ...:'-•s. __�__-._.__R_. °.. �s?�,r-zr ,.a �_,.,,..;�=s-..a�.<:.. �. ...� --5�'e�.��„a s_�S ..�,�:,.�.-s.�"�-'s-.K�
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Reviewer/InspectorName
ReviewerAN spector Signature: Date: 6 % D

Site Requires Immediate Attention. _9L _
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE. _( I 1-z-- , 1995
Time: '
Farm Narnr,/Owner:: arm Ckr�0 L-%eJq _* 11
Mailing Address: Po B o x 4 9�' -1 yV fap=s Ok w , t� c_ z$3 -k$
County: 5 P M-e 5 *�
Integrator: Phone: 'kto t 7-%3 _ 3&00
On Site Representative: Phone:
Physical Address/Location: SR 1�o t 5w ofA.saN
Type of Operation: Swine X. Poultry Cattle
Design Capacity: Number of Anirnals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude:
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of l Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes or No Actual Freeboard: _Ft. o Inches
Was any seepage observed from the lagoon(s)? Yes o No Was any erosion observed? Yes or No
Is adequate land available for spray? es r No Is the cover crop adequate? Yes or No
Crop(s) being utilized:
Does the facility meet $CS minimurn setback criteria? 200 Feet from Dwellings Ye r No
100 Feet from Wells? Ye r No
Is the animal waste stockpiled within 100 Feet of USGS Blot Line Suearn? Yes or T�o
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or&o
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o No If Yes, Please Explain_
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes r No
Additional Comments: tZ��st�. �,• EoLI..,,a RM? `s �Q be A
Inspector Name
cc: Facility Assessment Unit
Signature
Use Attachments if Needed.

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