820341_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qua

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 820341 Facility Status:
Inspection Type: Compliance Inspection
Reason for Visit: Routine
Date of Visit03/2212017 Entry Time: 03:00 pm
Farm Name: Farm 3713
Active Permit- AWS820341
Inactive Or Closed Date:
County: Sampson Region:
Extt Time: 3:30 pm Incident #
Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 2493 Lisbon Rd Magnolia NC 28453
Facility Status: 0Compliant ❑ Not Compliant
Location of Farm:
Hwy. NC 903 on Sampson-Duplin Co. line approx. 10 miles W. of Magnolia
❑ Denied Access
Fayetteville
910-296-1800
Integrator Murphy -Brown LLC
Latitude: 34° 49' 16" Longitude: 78° 10' 47"
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Carl Graham Lamb Operator Certification Number: 26849
Secondary OIC(s):
OnSite Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone
On -site representative Mike Ammons Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Dale:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820341 Owner- Facility : Murphy -Brown LLC Facility Number, 820341
Inspection Date: 03/22/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
FffSwine - 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 44.00
page: 2

Permit: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number. 820341
Inspection Date: 03/22/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream ImINcts
Yes
No Na No
1. is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 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?
❑M
❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na 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
❑
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?
❑
01111
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 No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3.

0
Permit: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number. 820341
Inspection Date: 03/22/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes ko Na Me
Crop Type 1
Com, wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autryville loamy sand, o to
B% slopes
Soil Type 2
Lynn Haven sand
SoiI Type 3
Norfolk loamy sand, 0 to 2%
slopes
Soil Type 4
Woodington loamy sand
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
❑
E ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes
No Na 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?
❑
❑
❑
If yes, check the appropriate box below.
WUP7
❑
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: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number. 820341
Inspection Date: 03/22/17 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?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
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?
❑
0 ❑
❑
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 DWQ of emergency situations as required by Permit?
❑
E ❑
❑
(i.e., discharge, freeboard problems, over -application)
31, Do subsurface file drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
E ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
E ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
M ❑
❑
page: 5

Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number. 820341 Facility Status: Active
Inpsection Type: Compliance Inspection
Permit: AWS820341
inactive Or Closed Date:
Reason for Visit: Routine County: Sampson Region:
Date of Visit: 07/29/2015 Entry Time: 09:00 am Exit Time: 10:00 am
Farm Name: Farm 3713
Owner: Murphy -Brown LLC
❑ Denied Access
Fayetteville
910-2W1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 2493 Lisbon Rd Magnolia NC 28453
Facility Status: 0 Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34" 49' 16" Longitude: 78' 10' 47"
Hwy. NC 903 on Sampson-Duplin Co. tine approx. 10 miles W. of Magnolia
Question Areas:
Dischrge & Stream impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Incident #
Owner Email:
Phone:
Certified Operator: Wayne O Sanderson Operator Certification Number: 17903
Secondary OIC(s):
On -Site Representative(s):
Name Title Phone
24 hour contact name
Mike Ammons Phone ;
On -site representative
Mike Ammons Phone
Primary Inspector:
Robert Marble Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820341 Owner - Facility: Murphy -Brown LLC Facility Number: 820341
Inspection Date: 07/29/15 lnppection 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 53.00
page: 2

Permit: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number: 820341
Inspection Date: 07/29/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges 8c Stream Impacts
Yes No Na Na
i. 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)
❑
❑ N
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
N ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage 8 Treatment
Yas
Ny Na Ne
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 (l.e./ large
❑
E ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
E ❑
❑
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
❑
E ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
■ ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ E ❑ ❑
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 > 100/6/10 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: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number:
820341
Inspection Date: 07/29/15 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yes No Na Ne
Crop Type 1
Corn, Wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autryville
Soil Type 2
Lynn Haven sand
Soil Type 3
Norfolk
Soil Type 4
Woodington
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
❑ 0 ❑
❑
determination?
W. Does the facility lack adequate acreage for land application?
❑ M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑
❑
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?
❑ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number: 820341
Inspection Date: 07/29/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na Me
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?
❑
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 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?
❑
■ ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
N ❑
❑
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?
❑
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 ❑
❑
CAWM P?
33. Did the Reviewerllnspector fail to discuss reviewlinspection 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:
820341 Facility Status:
Active Permit: AWS820341
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County: Sampson Region:
Fayetteville
Date of visit:
1012312014 Entry Time: 07:00 am
Exit Time: 8:00 am Incident #
Farm Name:
Farm 3713
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 2493 Lisbon Rd Magnolia NC 28453
Facility Status: MCompliant ❑ Not Compliant Integrator Murphy -Brown LLC
Location of Farm.• Latitude: 34° 49' 16" Longitude: 78' 10' 47"
Hwy. NC 903 on Sampson-Duplin Co. line approx. 10 miles W. of Magnolia
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Wayne O Sanderson Operator Certification Number: 17903
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone
On -site representative Mike Ammons Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number: 820341
Inspection Date: 10/23/14 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 t 19.50 47.00
page: 2

Permit: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number: 820341
Inspection Date: 10/23/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na Ne
1. Is any discharge observed from any part of the operation?
❑
❑
❑
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)
❑
❑
❑
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 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.l large
❑
0110
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M . ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet slacks)
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
❑ ❑ ❑
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: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number: 820341
Inspection Date: 10/23/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No No No
Crop Type 1
Corn, Wheat, Soybeans
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autryville
Soil Type 2
Lynn Haven sand
Soil Type 3
Norfolk
Soil Type 4
Woodington
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
C7
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
N ❑
❑
Records and Documents
Yes
No No 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?
❑
■ ❑ ❑
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

Permit: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number: 820341
Inspection Date: 10/23/14 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?
❑
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?
❑
E ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
N ❑
❑
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,
❑
000
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
❑
❑
If yes, check the appropriate box below
Application Field ❑
Lagoon / Storage Pond ❑
Other ❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ ■ ❑ ❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with on -site representative? ❑ W ❑ ❑
34. Does the facility require a follow-up visit by same agency? ❑ E ❑ ❑
page: 5

M Division of Water Resources
El Division of Soil and Water Conservation
El Other Agency
Facility Number: 820341 Facility Status: Active
Permit: AWS820341
❑ Denied Access
Inppection Type: Compliance Inspection
Inactive Or Closed Date:
Reason for visit: Routine County:
Sampson Region:
Fayetteville
Date of Visit: 12118/2013 Entry Time: 01:00 pm Exit Time: 2:00 pm Incident #
Farm Name: Farm 3713
Owner Email:
Owner: Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address: 2493 Lisbon Rd
Magnolia NC 28453
Facility Status: N Compliant El Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm: Latitude:
34° 49' 16" Longitude:
78' 10' 47"
Hwy. NC 903 on Sampson-Duplin Co. line approx. 10 miles W. of Magnolia
Question Areas:
Dischrge 8 Stream Impacts Waste Col, 5tor, 8 Treat
Waste Application
Records and Documents Other Issues
Certified Operator: Cart Graham Lamb
Operator Certification Number:
26849
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons
Phone:
On -site representative Mike Ammons
Phone:
Primary Inspector: Robert Marble
Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number: 820341
Inspection Date: 12/18/13 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 Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.50
page: 2

Permit: AWS820341 Owner - Facility : Murphy -Brown LLC Facility Number: 820341
Inspection Date: 12/18/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Im acts
Yes No No 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 Slate (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No Na Na
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (LeJ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
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
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No No No
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 manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820341 Owner- Facility : Murphy -Brown LLC Facility Number: 620341
Inspection Date: 12/18/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste ARRlication
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
Autryville loamy sand, 0 to
6% slopes
Soil Type 2
Lynn Haven sand
Soil Type 3
Norfolk loamy sand, 0 to 2%
slopes
Soil Type 4
Woodington loamy sand
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?
❑ E ❑ ❑
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?
❑ E ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑ E ❑ ❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ E ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS820341 Owner- Facility : Murphy -Brown LLC Facility Number: 820341
Inspection Date: 12/18/13 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?
❑
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?
❑
MOD
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?
❑
■ ❑
❑
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
❑
M ❑
❑
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,
❑
M ❑
❑
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 the 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
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
M ❑
❑
page: 5

(Type of Visit: 0 Compliance Inspection O Operation Review Q Structure Evaluation 0 Technical Assistance I
Reason for Visit: • Routine 0 Complaint 0 Follow-up 0 Referral 0 EmerQency 0 Other 0 Denied Access
Date of Visit: Arrival Time: a2s3p Departure Time: 3Jop County: " AJ Region: �V
Farm Name: 3 ! 3 Owner Email:
Owner Name: 44L Phone:
Mailing Address:
Physical Address:
Facility Contact: I Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone:
Integrator: l p 1q2oc"&',
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
!Design C
current
-
Design
Current
T.._ -...
Design Current
Swine
t apacEty _ Pop.
Wet'Poultry
Capty
Pop.
Cattle Capacity Pap.
Wean to Finish
Layer
I
Dairy Cow
Wean to Feeder
I jNon-Layer
I
Dairy Calf
Feeder to Finish
Dairy 1 Leifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D . I?oultr
Ca aci '
P,a
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
'aRe:J ...e_e a..,,._. .:i.M
': :.:. «'::�. _..iE:.:..-.
I 10ther
F✓T513'. rtf - _-.-
^.4e91. a.�'Y:ii"i'.'.�s�Ta.
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 F9 No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ NoLP
NA
❑ NE
❑ Yes
[:]No
® NA
❑ NE
❑ Yes
(R No
T
[DNA
❑ NE
❑ Yes
® No
[DNA
❑ NE
Page I of 3 21412011 Continued

(Type of Visit: vQ Compliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 12] Arrival Time: Departure Time: I ei1oDr.f County:;�)'Y OA j Region:
Farm Name: 3 -31 Owner Email:
Owner Name: AIUA44Phone:
Mailing Address:
Physical Address:
Facility Contact: /f?'1�►�y�..pHrj Title: Phone:
Onsite Representative: H Integrator: &:ta A?40c- L1
�0—.: e
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current�
Design Current
Design Current
Swme CapacityPop.
Wet�Poultry ,_Capacity Pop.
Cattle Capacity Pop.
Wean to Finish
La er `,
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
*=r
�' �� �Y
Design Nurrent
Dairy Heifer
Farrow to Wean
4
Dry Cow
Farrow to Feeder
D , �P,oul •� Ca acr P,o
Non -Dairy
Farrow to Finish
Beef Stocker
La ers
Gilts
Non -La ers
I Beef Feeder
Boars
Pullets
jBeef Brood Cow
Turkeys
Other
TurkeyPoults
Other I
Other .
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
r No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
© NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[:]Yes
[:]No
® NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
® NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
i
® No
❑ NA
❑ NE
of the State other than from a discharge?
`
Page I of 3 21412011 Continued

Facility Number: Date of Inspection: ii
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[)j No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
W NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 35 v
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?
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
0 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
10 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
gq No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
[T No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land 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 Acc able Crop Window
❑%Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop TYpe(s): _ , wr�'s"L.1 .
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
R_enuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
[�] No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
R] No
❑ NA
❑ NE
❑ Yes
[�j No
❑ NA
❑ NE
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [-]Yes [P 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 [?�No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �] No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: jDate of Inspection: TV j
..w.. t 4
waste 7ollecti6n & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
® No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
© NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
4
Observed Freeboard (in): 3�
;
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?
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)
f
9. Does any part of the waste management system other than the waste structures require
❑ Yes
8 No
❑ NA
❑ NE
maintenance or improvement?
F .;
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[!R 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 ofAtable CropWindow❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
cce
12. Crop Type(s): d rig , wk-,!, �S
13. Soil Type(s): !. y; No 141 NO
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?
r
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
r
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
[3 NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
E] Yes
[R. No
❑ NA
❑ NE
the appropriate box.
❑WUP []Checklists ❑Design ❑ Maps ❑ Lease Agreements [JOther:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA [] NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑yI 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
:eti}71.:ii}.rye s ���.�,: •, t'

Facili Number: ;t- - Date of Inspection-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ElYes j"� No ❑ NA ❑ NE
the appropriate box(es) below. T
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other lssues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
'Rec s re J i exec" rT��R j12►
1
SCE 0�;, �5131 I � 2.
Reviewer/Inspector Name:
Reviewerllnspector Signature:
Page 3 of 3
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes N No ❑ NA ❑ NE
❑ Yes 10 No ❑ NA ❑ NE
❑ Yes 1P No ❑ NA ❑ NE
❑ Yes No
❑ Yes No
❑ Yes FYI No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: %Q
Date:
2/4/20;1

r !
Facility Number: ,1 - 3 t j Date of Inspection: �[
24.-Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ PNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [!� No
the appropriate box(es) below. , ,
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ® No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No
,Other Issues
28. Did the facility fail to properly dispose of dead- animals with 24 hours and/or document' ❑ 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 [2 No
If yes, contact a regional Air Quality representative immediately.
.r30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No
permit? (i.e., discharge, freeboard problems, aver -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes No
Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No
t
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ® No
' r
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No
Comments (refer:to.question #): Explain anyfYES answers andlor any additional recommendations or, any other
Use drawings of facility to better expiain'situations (use additional pages as necessary)
11RP11 r-ds re
ReviewerAnspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ NA 0 NE
❑ NA ❑ NE
t
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
[DNA ❑ NE
❑ NA ❑ NE
❑ NA, ❑ NE
❑ NA ❑ NE
„ Phone:
Date: �
' ' 1
21412011

� CMS �S 91�olri _
- �` sE Iliviston of:Water' Quality —
Facility Number `� ®I]ivision of Soil aid Water; Conservation
® Other Age�n,cy
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: LF y/ '%�/// E Arrival Time: Departure Time: A County: jv Region:
Farm Name: 3713 ( Owner Email:
Owner Name: I'i(�!�"'7`(t7iJI� , �.� Phone:
Mailing Address:
Physical Address:
Facility Contact: t rt Title: Phone:
Onsite Representative: ' t Integrator -,of
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current Design Current Design Current
Sw ne Capac1ty4 Pop. Wet Poultlry Capacity Cattle Capacity Pop.
tk
Wean to Finish La er Dairy Cow
Wean to Feeder Non -La er _Dairy Calf
Feeder to Finish - Dairy Heifer
Farrow to Wean of r Design @ent Dry Cow
Farrow to Feeder D . Po.ult Ca acttyl'.o Non-Da
Farrow to Finish La ers Beef Stocker
Gilts Non -La ers Beef Feeder
Boars Pullets Beef Brood Cow
Turkeys
Turkey Poults
Other Other
Discharges and 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
M 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
0 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 I of 3 21412011 Continued

Facili Number: - sm I Date of Inspection: 28 !/
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
Q2 NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard ?J N
(in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
KR 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)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
_Wa_ste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[N No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
53 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
C&Th
12. Crop Type(s):
13. Soil Type(s): 1110 �` 6
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
� No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
M 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
0 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.
T
WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
2 1. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
P No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[PNo
❑ NA ❑ NE
23. If selected, did the facility fail to install and'maintain rainbreakers on irrigation equipment?
❑ Yes
EpNo
❑ NA ❑ NE
Page 2 of 3
21412011 Condnued

Facili Number: OX jDate of Inspection:
24, Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of fast survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
2$. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33_ Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
Reco•�CS hwip .� 9/1if I
Reviewer/]nspeetor Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes
;fl No
❑ NA
❑ NE
[-]Yes
[:]No
NA
❑ NE
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes [§ No ❑ NA E j NE
❑ Yes V No ❑ NA ❑ NE
❑ Yes V ►No ❑ NA ❑ NE
[:]Yes No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: g/0-1133-33oo
Date: 1r 701"
21412011

i
IType of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: o_ Arrival Time: fl.Qf7C[h Departure Time: i 0, 3o County:-�MBO^r Region: FIZO
Farm Name:
Owner Email:
Owner Name: _ r ` y VArO ` C Phone:
Mailing Address:
Physical Address:
Facility Contact: &:SE- Title: Phone No: a
Onsite Representative: Integrator: A
Certified Operator: Operator Certification Number: 1T�o
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: [--] o E:] ' 0 Longitude: = ° = {
Design C*urrent
Design Current
Design
C•urreat
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity
Population
❑ Wean to Finish
❑ La er
❑ DairyCow
❑ Wean to Feeder
❑ Non -Layer
❑ DairyCalf
❑ Feeder to Finish
❑ Dairy Heifer
Farrow to Wean .
Dry Poultry
❑ Dry Cow
Farrow to Feeder
❑ Layers
❑ Non -Dairy_
❑ Farrow to Finish
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
El Boars
❑ Pullets
❑ Beef Brood Cowl
I
❑ Turkeys
[7her
❑ Other
❑ Turkey PuuIts
❑ Other
Number of Structures:
ID
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
V No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
43 NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
[ONA
❑ 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
T NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
M No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
E:No
❑ NA
❑ NE
other than from a discharge?
ii
12128104
Continued

ti
Facility Number: — Date of Inspection / o
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑Yes
No [�NA ElNE
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
No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
El 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
N No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[PNo ❑ 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
0
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
[V9 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(
13. Soil type(s
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
Q1 No ❑ NA ❑ NE
[�No ❑ NA ❑ NE
[t] No ❑ NA ❑ NE
fp No ❑ NA ❑ NE
EP No ❑ NA ❑ NE
Comments (refer t question #): Explain any YES,,answers and/or any r commendathons or any other comments.
a _
Use drawings of facility to better explain situations: (use addttronal pagestas necessarv)�,��,:
ReviewerlInspector Name " ' ° " " Phone:
_�
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: 3 r Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes EPNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes J�j No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps
p ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No P NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
glNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
1PNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
El NA
El NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
[I Yes
[❑ No
�] NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
`�RNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
(P No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
ElNA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
5 No
❑ NA
❑ NE
12128104

Type of Visit 49 Compliance Inspection Q Operation Review U Structure Evaluation Q Technical Assistance
Reason for Visit 4MRoutine 0 Complaint 0 Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: -` /J �+ Departure Time: County: _ s6A1 Region: - r:_!!2,
Farm Name: Owner Email:
Owner Name: � P bw N = �t� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
U
Onsite Representative:� ` �
Certified Operator: _vt/iuime_
Back-up Operator:
Phone No:
Integrator: _ ®1?)t�n� {LC
L / / 0 Operator Certification Number: 3
Back-up Certification Number:
Location of Farm: Latitude: [= O = = « Longitude: = o ❑ 6 0 6i
F_
Desir n
MINNesign
Current_ Design Current
Swine Capacity Population
Wet Poultry
Capacity Population Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑Dai Cow
❑ Wean to Feeder
❑Non -La er
❑Dai Calf
❑ Feeder to Finish
1 ❑Dai Heifer
Farrow to Wean
Dry Poultry
: ❑ Dry Cow
Farrow to Feeder
❑ Layers
- ❑Non -Dairy
❑ Farrow to Finish
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑Beef Brood Co
❑ Turkeys
Other
❑ Other
❑ Turkey Poults'
❑Other
Number of Structures:
Wim
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
WA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
CPNA
❑ 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
r�No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
'�No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: Date of Inspection r 9
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes PNo ❑ NA ❑ NE
a. 1f yes, is waste level into the structural freeboard? ❑ Yes PNo ❑ NA ❑ NE
Strucrre 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): u
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes bg No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ElNA ElNE
(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 FoNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:1 Yes F0No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes EDNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1�1 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
tp No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
(I No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
PNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
$1 No
❑ NA
❑ NE
'. .
Comments {refer to questtou #) Faplatn any YES:answers aud/or�any recommendations or apy ether comments.
r�'��,, �
_Use drawings of:facility to mx Yk io - ( - pages as necessary): etter ex lain+sitoahons: use. additintial� -
T
Reviewer/inspector Name @ Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

+ Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropimte box.
❑ WUP [-I Checklists El Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 'Ej No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes W No ❑ NA ❑ NE
24_ Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 10No ❑ 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 A No ❑ NA ❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
(9 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
%3 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
V 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
V1 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
§d No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�j No
❑ NA
❑ NE
Page 3 of 3 12,128104

Division of Water Quality
Facility Number 3 O Division of Soil and Water Conservation
- Other Agency
Type of Visit 4S Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Q'r Arrival Time: �3 Departure Time: .`Q% County: S�fT ps� Region:
1
Farm Name: �,n rl r 3 iiOwner Email:
Owner Name: /` f[ ai q brow') Phone:
T`—'
Mailing Address:
Physical Address:
Facility Contact: 1Trf� Cat-r Title:
Onsite Representative:
Certified Operator: Sa `I S
Back-up Operator:
AA Phone No:
Integrator:. M�P�3 V/nW/R Operator Certification Number: lrn03
Back-up Certification Number:
Location of Farm: Latitude: 0 0 0 6 0 Longitude: = ° = I = "
Design .Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
14 Farrow to Wean 1
El Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other -
F
La er
Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ 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?
;n R Current:
pity PSopulaton
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: ED
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 10 No ❑ NA ❑ NE
❑ Yes
❑ No
[� NA
❑ NE
❑ Yes
❑ No
T NA
❑ NE
[a NA
❑ NE
❑ Yes
❑ No
El Yes
No
[I NA
El NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: SEM
Date of Inspection 10MV-021 I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 1P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No �§NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
R No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
&No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[V No
❑ NA
❑ NE
R. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
$3 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
f� 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
(S No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu., Zn, etc.)
❑ PAN ❑ PAN > l0% 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) CIr- n Lj
fYL;
13.
Soil type(s) %j,,.j 0
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
[;9 No
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
W No
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
rO No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
AL
Reviewer/Inspector Name Phone: 0 T 3-33oo
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 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VI No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 99 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
�@ No
❑ NA
❑ NE
23_
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
El No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
53 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
KI No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[H No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
Cl NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
RINo
❑ 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
MNo
❑ 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
ER No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
@ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
/r+
Date of Visit: Arrival V Time:/.� f? Departure Time: /0: 3Q2 County: t Region:
IN Farm Name: P1 71J1 \ l Owner Email:
a
Owner Name:
Mailing Address:
Phone:
Physical Address:
Facility Contact: ��a� Title: Phone No:
!t
Onsite Representative:
Certified Operator:
Back-up Operator:
Integrator: !VILA� pr4zik_ _
Operator Certiticadon Number:
Back-up Certification Number:
Location of Farm: Latitude: = o = & 0 Longitude: 0 ° ❑ 1 ❑
Design
Current
Design
Current
Design Current
Swine
Capacity
Population
Wet Poultry. Capacity
Population,^
C►attle
Capacity Population
❑ Wean to Finish
❑ Layer
❑Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
❑Dairy Calf
El Feeder to Finish
Dry Poultry
❑Dairy Heifer
❑ Dry Cow
EP Farrow to Wean
❑ Farrow to Feeder
— .5: -
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
,, El Non -Dairy
❑ Beef Stocker
El Beef Feeder
❑ Beef Brood Cowl
El Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Turkey Poults
❑ Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1, Is any discharge observed from any part of the operation?
❑ Yes
P No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
EP 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
[RNA
ElNE
2. Is there evidence of a past discharge from any part of the operation?
ElYes
(9 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
MNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Co► dnued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [--]Yes [�No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No (P NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 3113 ll
Spillway?:
Designed Freeboard (in): 19rS
ll
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ yes
P 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
KI No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
�No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ yes
N No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
U No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
WNo ❑ NA ❑ NE
maintenance/improvement?
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 I 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
n�Outside of Area
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift El Application
12. Crop type(s) �YVj -A O w I I W kt4) �
� l
r ! y 14 IJ-
13. Soil type(s) f J0041
.712 L-gndA6
� r v
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
[4 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
1P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
-J�j No
❑ NA
❑ NE
Comments (refer to question ft 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 I Phone: i10)
Reviewer/Inspector Signature: Date:
�
Page 2 of 3 1 Zr28/U4 Continued

Facility Number: a__3 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
05 No
❑ NA ❑ NE
20. Does the facility fail to have ail components of the CAWMP readily available? If yes, check
❑ Yes
10 No
❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[FNo
❑ 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
® 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
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30_
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
M 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
P No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Type of Visit ®-Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit B Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 14 � Arrival Time: 1 = Departure Time: County: Region:
Farm Name: Faj,^" 2,((3. Owner Email:
Owner Name: , vrA — Dry �,� 1,L�_ _ Phone:
Mailing Address: ,.Po C
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: r Integrator:
Certified Operator: LA I SQ Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = I 0 N Longitude: = o = , = u
Design Current Design Current Design Current
Swine Capacity Population Wet PoultryCapacity Population Cattle Capacity Population
❑
Wean to Finish
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
Farrow to Feeder
49
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
❑ Layer
Non-Layet
j Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Puults
❑ 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?
❑ Daia Cow
❑ DaiEy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: _U
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?
d>
❑ Yes ;6No ❑ NA ❑ NE
❑ Yes
❑ No
fXNA
❑ NE
❑ Yes
❑ No
[�NA
❑ NE
ENA
❑ NE
❑ Yes
❑ No
❑ Yes
t9 No
❑ NA
❑ NE
❑ Yes
�9 No
❑ NA
❑ NE
12128104 Continued

4
Facility Number: BZ — 3y( Date of Inspection G
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?
fitnieture 1 Structure 2 Structure 3 Structure 4
Identifier: '~ 0
Spillway?: /0
Designed Freeboard (in):
Observed Freeboard (in): 173
❑ Yes % 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 Vq No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) ��,,rr
6. Are there structures on -site which are not properly addressed and/or managed El Yes L4 No ❑ NA ❑ NE
through a waste management or closure plan?
1f 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? 9—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 KNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes KNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes JRMo ❑ 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 Drifl ❑ 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
[No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
KI No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑
Yes
RNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
C&No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
®-No
❑ NA
❑ NE
. —r"4t L4C-- & -4 P its S i w *(ram 'At 0191K
Reviewer/Inspector Name Phone: M—Y ale —MYr
Reviewer/Inspector Signature: Date: 0�
12428104 Continued

Facility Number: Date of Inspection Z O
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes nNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAW MP readily available? If yes, check ❑ Yes �&No ❑ NA ❑ NE
the approprrate box. ❑ WUP&] Checklist! ❑ Desi gw--❑ Ma ftf❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
❑ Waste Application❑ Weekly Freeboar&-'o Waste AnalysisY❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall//❑ Stockinfl"'❑ Crop Yieldw❑ 120 Minute Inspections"[] Monthly and 1" Rain lnspections— ❑ 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 CA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31 _ Did the facility fail to notify the regional office of emergency situations as required by
General 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?
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
C No
❑ NA
❑ NE
❑ Yes
R1 No
❑ NA
❑ NE
❑ Yes
[KNo
❑ NA
❑ NE
❑ Yes
DINo
❑ NA
❑ NE
❑ Yes
6No
❑ NA
❑ NE
❑ Yes B-No ❑ NA ❑ NE
❑ Yes Wo ❑ NA ❑ NE
❑ Yes 29No ❑ NA ❑ NE
❑ Yes L(No ❑ NA ❑ NE
❑ Yes
9 No
❑ NA
❑ NE
❑ Yes
%-No
❑ NA
❑ NE
AdditioQal Ca""tEtmentsiand/or^Di•awin s ,�'
Z L. P I e�� �,� we„v 4 LC � a o-� '► +r- a,..-s +� i�-er-t�.S .
12128104

.... r.... .. 'i:-F .... z...3��"^..- r-_._.ci,..,. �>--• ., r _.,
Type of Visit ® Compliance inspection O Operation Review C) Lagoon Evaluation
Reason for Visit *Routine 0 Complaint 0 Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: �a 1� Ow Time:
Facility- Number t
L -- — —rO Not O erational Q Below Threshold
Permitted M Certified [3 Conditionalh- Certified M Registered Date Last Operated or Above Threshold:
Farm Name A40-p„ 3113 County: 5&Tr.%J11A Pi Fko
Owner Name:
Mailing Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: _W�•va,_ .�
Location of Farm:
Phone No:
Phone No:
lute=rator- � 1' w
Operator Certification Number: f / 74a
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 9 � Longitude ' �• OK
Design Current
Swine ranarittPnnnintinn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
[ffFarrov- to Feeder
BP6
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Ca acitf Po ulation Cattle Ca ach Population
❑ Laver I I ID Da
❑ Non -Laver I I IQ Non-Dair
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon area 10SPrav Field Area
.Holding Ponds / Solid Traps � ❑ No Liquid Waste Management Svstem --
Discharges & Stream Impacts
I. is any discharge observed from any part of the operation?
❑ Yes EFNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notifi- DWQ) El Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min? V 14—
d. Does discharge bypass a lagoon system? (If ves, notify DWQ) ❑ Yes ❑ No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes P No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes WNo
Waste Collection 8 Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes j gNo
Structure 1 Structure ? Structure 3 Structure 4 Structure ; Structure 6
Identifier:
Freeboard (inches):
05103101 Conrirued

Facility Number: lrj_ — 3yf I Date of Inspection (o/
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage. etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
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 Ievel
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop tape '{raw S-id.., . w�► aA4`1 so..Odras
13. Do the receiving crops differ with those designated in the Certified Animal
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
aste Management Plan (CAWMP)?
16. Is there a lack of adequate waste application equipment?
ftuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems. over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
❑ Yes ® No
❑ Yes [j] No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes No
❑ Yes ® No
❑ Yes ® No
❑ Yes N No
❑ Yes ®No
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes (] No
❑ Yes ® No
❑ Yes [ No
❑ Yes
❑ Yes
❑ Yes
❑ Yes
10 No
® No
[B No
M No
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
Comments (refer to "question #) Explain any YES answers-andlor.-any recommendatsous or any utlt wmrnei►ts: X ' --
Use diraw*tn s of fardttito better ex. lard setnattons use addttxonal es as netessa ) �❑
(
ry , p r 1� Fte1d Conv Final Notes
ni o p``--u �.•, P i 4 as b �tL �oN c o f�.'. r �a. w. �-i,;. s S egao iu 4.er-'ora
j,i Ll
{"ate f'•Y �j � ��
H,
Reviewer/Inspector Name -
Reviewer/Inspector Signature: Date: 4
05103101 d / Continued

1
Site Requires immediate Attention: NO
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMBN"T
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: -7 L %-z- _!, 1995
Time:
Farm Name/Owner:
a4 w., oV
t 3
Mailing Address:
Po S d'X Lt
N c-
7-83
County:
S PM? s o
Integrator:
Phone: R to
! z--.� _ 3 &0 0
On Site Representative:
Phone:
Physical Address/Location-
�-t z _fie
sR \o 42:2
Type of Operation: Swine
?� poultry
Cattle
Design Capacity:
Number of Animals on Site: zo ¢o sue, -ro FAw
DEM Certification Number:
ACE
DEM Certification Number:
ACNEW
Latitude:
Longitude:
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches)Yes r No Actual Freeboard: Wit. o Inches
Was any seepage observed from the 1 oon(s)? Yes o No Was any erosion observed? Yes o io
Is adequate land available for spray? a or No Is the cover crop adequate? Y r No
Crop(s) being utilized:
Does the facility n;ect SCS minimum setback criteria? 200 Feet from
No
100 Feet from Wells? Ye or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes OG
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or(9 If Yes, Please Explain_
Does the facility maintain adequate waste management records (voices of manure, land applied,
spray irrigated on specific acreage with cover crop) (De-S
or No
AdditionAl Comments: F o gy a w +s r sum P s _ m%JL-ts )E �Ok
,1
- 1-' k!l k�,«-+r am
Inspector Name
V_ i
Si gnatu
cc: Facility Assessment Unit
Use Attachments if Needed.

�,� � •rrr f� � « • r.• t �r
1p
c rrrj " itrf r Y �` / •
► rrr /
rtrr �r�1 -lie
� / �y .}� , ''r7 � �Klf � Air � o `►.
1ir1 .. j r �,, +err o k —' •
f rt� r,' ^ 5� � y� •
4T
�-} � err% `'• ^ ,?� o � .�
rrr' 6; •rn
p �-{ ::, ,1 . � } �`.o• rot k,r TRH
toll r 1 r
O
+� ram; lrT % •rrr 1
rrr
r r 1 +r i
rt`r Irrl4r 3 No 4f
of
"• if'� : �' ;'s ilplf , r ire
as
r �
' Rif rf r
Pat

Site Requires Immediate Attention: 140
Facility No.
DIVISION OF.ENVMONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: _I%'z-- 1995
Time:
Farm Name/Owner"
OF
c+a-Vr-o L-%aR 14
Mailing Address:
Po R e!y' 49S_l
N cr
1-83 -tg
County:
S qM? s o
Integrator: 3Ra w ws of
Phone: "L to
/ zg.3 r -t & o 0
On Site Representatives
�n�*ti4 V�r+so.� _ Phone:
Physical Address/Location:
s R 19s �at
_ s �, Roil afE
�► t of
Type of Operation: Swine
> Poultry
Cattle
Design Capacity:
Number of Animals on Site: lzoo
DEM Certification Number:
ACE
DEM Certification Number:
ACNEW
Latitude: Longitude: ,
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) Yes No Actual Freeboard: _fit. p Inches
Was any seepage observed from the 1 oon(s)? Yes o No Was any erosion observed? Yes No
Is adequate land available for spray. Yes r No Is the cover crop adequate? Yes r No
Crop(s) being utilized:
Does the facility mect SCS minimum setback criteria? 200 Feet from Dwellingsl Yet or No
100 Feet from Wells? es or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o Na
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes MS
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes 019 If Yes, Please Explain.
Does the facility maintain adequate waste management rec ds (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? yes or No
Additional Comments:
K.* t<ru+"�mot"
Inspector Name
1. i
cc: Facility Assessment Unit
Use Attachments if Needed.

BROWN'S
F CARO�lNA �f
FARM 14 - sAMPsoN COUN y
1200 FARROW To FINISH FARM
_ rv�,
f
I
DIRECT CM: FRAM MINION TAKE HIQiKAY-1 421 70Wa)6 EELWAY, PAST DELWAY TAKE 7M NEXT�
ROAD TO THE LEFT' STATE RAOD # 1959, FARM WILL HE AT ME RM Off' M FDW
ON THE IUT. FROM WRSAW TAKE: WY. # 117 TO MAMOLIA, TURN RMU AT
Mnf�"-TA M R # 1003 70 DEFY, TMM A LET ON 70 HWY. # 421, THEN TAM