820715_INSPECTIONS_20171231

NUH I H LAHULINA
Department of Environmental Quai

e- %
0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
820715 Facility Status:
Inpsection Type:
Compliance Inspection.
Reason for visit:
Routine
Date of visit:
03/24/2017 Entry Time: 09:00 am
Farm Name:
Carroll's Farm # 2096
Owner.
Murphy -Brown LLC
Active Permit: AWS820715 ❑ Denied Access
Inactive Or Closed Dale:
County: Sampson Region: Fayetteville
Flit Time: 10:00 am
Incident #
Owner Email:
Phone: [phone]
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 1144 Hayne Stretch Rd Autryville NC 28318
Facility Status: 0 Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm:
0.5 miles south of NC 24 on west side of SR 1255 (Hayne Stretch Road)
Question Areas:
Dischrge & Stream impacts
Records and Documents
Latitude: 34' 58' 01"
Waste Col, Stor, 8 Treat
Other issues
Longitude: 78' 35' 24"
0 Waste Application
Certified Operator: Robert T Young Operator Certification Number: 18461
Secondary O1C(s):
OnSlte 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: AWS820715 Owner - Facility : Murphy -Brown LLC Facility Number, 820715
Inspection Date: 03/24117 Inspection Type: Compliance Inspection Reason for Visit: Routine
Aboylaped Operations Design Capacity Current promotions
Swine
[] Swine - Feeder to Finish 14,080
Total Design Capacity: 14,080
Total SSLW : 1,900, 800
Waste Structures
Disignated observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
2096A
30.60
Lagoon
2096E
30.60
Lagoon
A
26.00
55.00
Lagoon
B
26.00
54.00
page: 2

1. %
Permit: AWS820715 Owner - Facility: Murphy -Brown LLC Facility Number. 820715
Inspection Date: 03/24/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
11013
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ ■
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (i.e./ large
❑
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?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Me
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
1 i. 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 Phosphor -us?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

f
Permit: AWS820715 Owner - Facility: Murphy -Brown LLC Facility Number: 820715
Inspection Date: 03/24/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Corn, wheat, soybeans
Crop Type 2
Coastal Bermuda Grass
(Pasture)
Crop Type 3
Small Grain Overseed
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
Lakeland
Soil Type 4
Rains sandy loam
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?
❑ N ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ E ❑
❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ N ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ N ❑
❑
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

r � �
I
Permit: AWS820715 Owner - Facility : Murphy -Brown LLC Facility Dumber. 820715
Inspection Date: 03/24/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na he
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
M ❑ ❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑ ❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑ ❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
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?
❑
❑ ❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑ ❑
Otherlssues
Yes No Na Na
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,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon I Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
❑
❑
page: 5

Division of Water Resources
of Soil and Water Conservation
❑Division
Other Agency
Facility Number-
820715
Facility Status: Active
permit: AWS820715
[] Denied Access
Inpsection Type:
Compliance Inspection
Inactive OrClosed Date:
Reason for Visit:
Routine
County:
Sampson Region:
Fayetteville
Date of Visit:
0912212015 Entry Time: 03:00 pm Exit Time: 4:00 pm Incident #
Farm Name:
Carroll's Farm # 2096
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
914-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
1144 Hayrte Stretch Rd
Autryville NC 28318
Facility Status:
Comptiant ❑
Not Compliant Integrator.
Murphy -Brown LLC
Location at Farm:
Latitude:
34' 58' 01" Longitude:
7a' 35' 24"
0.5 miles south of NC 24 on west side of SR 1255 (Hayne Stretch Road)
Question Areas:
Dischrge & Stream Impacts Waste Col. Star. & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Robert T Young Operator Certification Number: t$461
Secondary OIC(s):
On -Site Representative(s):
24 hour contact name
On -site representative
Primary Inspector:
Inspector Signature:
Secondary Inspector(s);
Inspection Summary:
Name Title
Mike Ammons
Mike Ammons
Robert Marble
Phone
Phone
Phone
Phone:
Dale:
page: 1

Permit: AWS820715 Owner - Facility : Murphy -Brown LLC Facility Number: 820715
Inspection Date: 09/22/15 Inssection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish 14,080
Total Design Capacity: 14,080
Total SSLW: 1,900,800
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
2096A
30.60
64.00
Lagoon
2096E
30.60
64.00
Lagoon
A
26.00
Lagoon
B
26.00
page: 2

6
Permit: AWS820715 Owner - Facility : Murphy -Brown LLC Facility Number_ 820715
Inspection Date: 09/22/15 lnpsection 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?
E]
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 DWG})
❑
M ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
01111
State other than from a discharge?
Waste Collection, Storage & Treatment
Ygj
No WI No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6, Are there structures on -site that are not properly addressed and/or managed through a
❑
MEJ
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
$. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M. ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
�]
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 Ibs.?
❑
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: AWS820715 Owner - Facility Murphy -Brown LLC Facility Number 820715
Inspection Date: 09/22/15 Inpsection Type: Compliance Inspection reason for Visit Routine
Waste Application Yes No 4a Ne
Crop Type 1 Com, wheat. Soybeans
Crop Type 2 Coastal Bermuda Grass
(Pasture)
Crop Type 3 Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autryvdle loamy sand. 0 to
6% slopes
Soil Type 2
Lakeland
Soil Type 3
Lynn Haven sand
Soil Type 4
ruins sandy loam
Soil Type 5
Soil Type 5
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMi
15. Does the receiving crop and/or land application site need improvement?
❑
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17 Does the facility lack adequate acreage for land application?
❑
N ❑
❑
18. is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes
No No 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?
❑
N ❑
❑
If yes, check the appropriate box below
WU P?
[]
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
It Other, please specify
21. Does record keeping need improvement?
❑
0 ❑
❑
If yes, check the appropriate box below,
Waste Application?
❑
Weekiy Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS820715 Owner - Facility : Murphy -Brown LLC Facility Number: 820715
Inspection Date: 09/22/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Na
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?
❑
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?
❑
■ ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes
No Na Me
26. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
E ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
moo
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
[]
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
E ❑
❑
page: 5

0
Division of Water Resources
❑
Division of Soil and Water Conservation
❑
Other Agency
Facility Number
820715
Facility Status: Active
Permit: AWS820715
❑ Denied Access
Inppection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County:
Sampson Region_
Fayetteville
Date of visit:
08/20/2014 Entry Time:
02:30 pm Exit Time: 3:30
pm Incident #
Farm Name:
Carroll's Fans # 2096
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
91 D-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
1144 Hayne Stretch Rd
Au€ryvdle NC 28318
Facility Status:
Compliant ❑
Not
Compliant Integrator
Murphy -Brown LLC
Location of Farm:
Latitude:
34' 58' 01" Longitude:
78' 35' 24"
0.5 miles south of NC 24 on west side of SR 1255 (Rayne Stretch Road)
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor. & Treat
Records and Documents Other Issues
0 Waste Application
Certified Operator William Victor Sutton Operator Certification Number: 26076
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:
Inspector Signature:
Secondary Inspeclor(s):
Inspection Summary:
Robert Marble
Phone.
Date -

Permit: AWS820715 Owner - Facility : Murphy -Brown LLC Facility Number: 820715
Inspection Date: 08120/14 Inssection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
❑ Swine - Feeder to Finish
Total Design Capacity:��
Total SSLW:
Waste Structures observed
Disignated
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
2096A
30.60
Lagoon
2096E
30.60
Lagoon
A
26.00
Lagoon
B
26.00
page: 2

Permit: AWS820715 Owner - Facility : Murphy -Brown LLC Facility Number: 820715
Inspection Date: 08/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream impacts
Yes
No Na
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
0 ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
M ❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
M ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
01111
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 N
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
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
■ ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ■ ❑ ❑
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%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820715 Owner - Facility : Murphy -Brown LLC Facility Number: 820715
Inspection Date: 08/20/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No No No
Crop Type 1
Com, Wheat, Soybeans
Crop Type 2
Coastal Bermuda Grass
(Pasture)
Crop Type 3
Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autryville loamy sand, o to
6% slopes
Soil Type 2
Lakeland
Soil Type 3
Lynn haven sand
Soil Type 4
Rains sandy loam
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
E ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17, Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes No No Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ 01111
20. Does the facility fail to have all components of the CAWMP readily available?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

i .s
Permit: AWS820715 Owner - Facility : Murphy -Brown LLC Facility Number: 820715
Inspection Date: 08/20/14 Inssection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
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
❑
E ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
N ❑
❑
contact a regional Air Quality representative immediately.
30, Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon 1 Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
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?
❑
0 ❑
❑
page: 5

Ih f 1
0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑
Other Agency
Facility Number: 820715 Facility Status: Active Permit: AWS820715
Inspection Type: Compliance Inspection Inactive Or Closed Date:
Reason for visit: Routine County: Sampson Region:
Date of Visit: 10115/2013 Entry Time. 12:00 pm Exit Time: 1:00 pm Incident l
Farm Name: Carroll's Farm # 2096 Owner Email:
Owner: Murphy -Brown LLC Phone:
Mailing Address: PO Box 487 Warsaw NC 29398
Physical Address: 1144 Hayne Stretch Rd Autryville NC 28318
❑ Denied Access
Fayetteville
910-296-1800
Facility Status: 0Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34' 58' 01 Longitude: 78' 35' 24"
0.6 miles south of NC 24 on west side of SR 1255 (Rayne Stretch Road)
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Clifton Caniel Tyndall Operator Certification Number: 989946
Secondary OIC(s):
On -Site Representative(s):
24 hour contact name
On -site representative
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Name Title
Mike Ammons
Mike Ammons
Robert Marble
Phone:
Phone:
Phone
Phone:
Date:
page: 1

Permit: AWS820715 Owner - Facility : Murphy -Brown LLC Facility Number: 820715
Inspection Date: 10/15/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity
Current promotions
Swine
E] Swine - Feeder to Finish
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
2096A
30.60
Lagoon
2096B
30.60
Lagoon
A
26A0
Lagoon
B
26,00
page: 2

Permit: AWS820715 Owner - Facility : Murphy -Brown LLC Facility Number: 820715
Inspection Date: 10/15/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
DischaEges & Stream Im acts
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?
❑
❑ ■
❑
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)
❑
❑ N
❑
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 He
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
❑
N ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
❑
❑
to rooted pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ N ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

i
Permit: AWS820715 Owner - Facility: Murphy -Brown LLC Facility Number: 820715
Inspection Date: 10/15/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No No No
Clop Type 1
Com, Wheat, Soybeans
Crop Type 2
Coastal Bermuda Grass
(Pasture)
Crop Type 3
Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autryville loamy sand, o to
5% slopes
Soil Type 2
Lakeland
Soil Type 3
Lynn Haven sand
Soil Type 4
Rains sandy loam
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 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?
❑M
❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS820715 Owner- Facility : Murphy -Brown LLC Facility Number: 820715
Inspection Date: 10/15/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na Me
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■ ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDBS only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑M
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
■ ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
❑
Other Issues
Yes No Na Me
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
❑
❑
contact a regional Air Quality representative immediately.
30, Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
M ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
■ ❑
❑
page: 5

l'ype of Visit: IP Compliance Inspection U Operation Review U Structure Evaluation () Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1 5 �— Arrival Time: Departure Time; County: �l" Region:
Farm Name_ 1Vq 0C�t.ljrp� zy jt J Owner Email:
�Owner Name: 6'� c1� , U �� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
t
Onsite Representative: Integrator:
Certified Operator:�t 5��_ Certification Number: �G►o'l�
Back-up Operator: oke 471,ly,v.Gt Certification Number:
9'r�g
Location of Farm: Latitude: Longitude:
Dgn Cu nt Design Current Dn Current
$vvYne Capacity Pop Wet Pouttry Capacity Pop. Cattle 11JECC-3afflacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
I
jNon-LayCT I
Daig Calf
Feeder to Finish
. " Dairy Heifer
Design Current Dg Cow
Farrow to Wean
Farrow to Feeder
D . P.oultry Ca aci P,o Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
NJ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[:]No
[P NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does 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
tNo
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili ' Number: Date of Inspection: 5-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [A 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: 0
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):.
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes f p 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 [P No C] NA ❑ NE
waste management or closure plan? T
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 W No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes KM No [DNA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes M 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 ❑ F
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 Outsic of Ap roved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? 1
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
,A), _(01 . cl( 4_
❑ Yes
No
❑ NA
❑ NE
[:]Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
1P No
❑ NA
❑ NE
[:]Yes
® No
❑ NA
❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
[P No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
n No
❑ NA ❑ NE
the appropriate box.
T
❑WUP []Checklists []Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
® No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
1� No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
F!$j No
❑ NA ❑ NE
Page 2 of 3
21412011 Continued

FaciliNumber: - Date of Inspection: , Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Q9 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes j�No ❑ NA ❑ NE
the appropriate box(es) below. 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 Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No
[:]Yes No
❑NA ❑NE
❑ NA ❑ NE
❑ Yes W No ❑ NA ❑ NE
❑ Yes [P No ❑ NA ❑ NE
❑ Yes `P No ❑ NA ❑ NE
❑ Yes [�No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [�bNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 1� No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes EP No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessarv).
ReG£"J] J'a✓vi�U, Srr���Z�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:JL1 "1(?7 f i?j�jdl7
Date: S-2 1 1.Z
21412011

F/
N
l)Riiion of Water Quality
Facility Number � - ®Division of Soil and Water Conservation
® Other Agency
Type of visit: 9 Compliance Inspection 0 Operation Review p Structure Evaluation p Technical Assistance
Reason for Visit: 0 Routine O Complaint Q Follow-up Q Referral O Emergency O Other Q Denied Access
Date of visit: Arrival Time: Departure Time: County: 'WFSprl Region:
1
Farm Name: o2v"1 n� 63 CG-CoVII S' &'m,#2tfi6J Owner Email:
Owner Name: (�Y w�,i Phone:
Mailing Address:
Physical Address:
Facility Contact: M i firo'. is Title: Phone:
Onsite Representative: 61 Integrator:GIYQ�I,Z{—$+nEtd� , ac
Certified Operator:yl 4,bc 246A _-
Back-up Operator: A111(t 4b,„ 6VIS
Location of Farm:
Latitude:
Certification Number: 2,W 7�Q
Certification Number: 9 GS-q-! S
Longitude:
Desi n Current W „z
g 1, }'"
_
Design
�, x
Current Design Current
Swine -
Capacity Pop WetFPoultry
`Capacity
P p { "` a Ca�ttl Capacity Pop.
La cr
DairyCow
= Non —Layer
DairyCalf
ti _
` ' DairyHeifer
Design
Current' D Cow
Farrow to Feeder
_
D oulCa
acity
-Dai
Eo Nonry
La ers
j. Beef Stocker
- Non -Lavers
Beef Feeder
Boars
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑Structure ❑Application Field ❑Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes � No ❑ NA ❑ NE
[—]No
❑ Yes
❑ Yes [—]No
® NA ❑ NE
NA ❑ NELPP
[--]Yes
[—]No
[4NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
Page 1 of 3 2/4/2011 Continued

Facili Number: - Date of Inspection:g(ola
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
to
O" NA
r
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_ C 4
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
W No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
fa No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes]
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs_ ❑ 'Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Drift ❑ Application
Outside of Approved Area
12. Crop Type(s): `QI1%f):v+
/W��,,ind
I
C�{�KJ]�¢�-A
13. Soil Type(s): AJt — -
` n
(&L
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
D Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[]] No
❑ NA
❑ NE
Re uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design [:]Maps [—]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes fA No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [] Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Mi No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [—]Yes ® No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e_, discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ NA ❑ NE
d NA ❑ NE
❑ NA C] NE
❑ NA ❑ NE
❑ Yes I& No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Reviewer/Inspector Name: hpl& *1 ,P Phone:
Reviewer/Inspector Signature: Date:
Page 3 of 3 2/4/2011

.1%
Type of Visit 0 Compliance Inspection Q Operation Review Q Structure Evaluation Q Technics! Assistance
Reason for Visit O Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other ❑Denied Access
� Date of Visit: /IS /F2!!U Arriva[ral Time: � j.. // Departure Time: t7a �► County: 4Region:
Farm Name: `_'Yy7^MdX1 Owner Email:
Owner Name: ► " t _A0 Phone:
Mailing Address:
Physical Address:
Facility Contact: / ' I!OOf�-d Title:
H
Onsite Representative: c
Certified Operator:
Back-up Operator:
fj/� Phone No: _ ,� r
Integrator• mom'- � ' r/ o t1.' e kc
Operator Certification Number: G;WY7�y
Back-up Certification Number: ! 6 W13
Location of Farm: Latitude: = =1 =6 Longitude: = ° 01 u
Design Current Design' Current
Swine Capacity Population Wet Poultry Capacity Population
Design Current
Cattle Capacity Population
❑ an to Finish
❑ La erµ�
Dairy Cow
❑ an to Feeder
❑Non -Layer
❑ Dairy Calf
Feeder to Finish,
it
VEILayers
❑ Dairy Heifer
El Farrow to Wean
❑ D Cow
❑ Farrow to Feeder
Non -Dairy❑
Farrow to Finish❑
Beef Stocker
❑ Beef Feeder ❑ Beef Brood Cowl
I
Number A tructures:
❑Non -La Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑Yes
PNo
❑NA
❑NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
1PNA
❑NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
NA
❑NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes]
No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

d -_
Facility Number: REMn
Date of Inspection Z O
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?
Structur 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 5 s�
5. Are there any immediate threats to the integrity of any of the structures observed?
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes No ❑ NA ❑ NE
❑ Yes rNo A ❑ NE
Structure 5 Sketure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes r, No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ yes { No ❑ NA ❑ NE
maintenance or improvement? y
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
] 1. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ 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
No
ElNA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
ElYes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
1p No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
IV No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment'?
❑ Yes
k] No
❑ NA
❑ NE
'Comments (refer to question #) Explain any YES answers and/or any recommendations.or any other comments
.Use drain s ofacility to better eg lain situations. (use additional pages as necessary)� ='
3; '
Reviewer/Inspector Name 1 Phone:
Reviewer/Inspector Signature: Date:
V
Page 2 of .3 12128104 ' Continued

1
Facility Number: — Date of inspection
Reuuired Records & Documents
19, Did the facility fail to have Certificate of Coverage & Permit readily available?
20, Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El other
14
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
❑ Yes qQNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
ONo ❑ 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?
Cl Yes
No ElNA
ENo
[INE
25. Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ONo ❑ NA ❑ NE
27, Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes 0 No ❑ NA ❑ NE
Other Issues.
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ONo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[ No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
rr
31, Did the facility tail 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
Qallo
❑ NA ❑ NE
33, Does facility require a follow-up visit by saute agency?
❑ Yes
Wo
❑ NA ❑ NE
Page 3 of 3 12128104

f 0 Division of Water Quality
'] l� _
Facility Number 8 a O Division of Soil and Water Conservation
- O Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I SIV11�/1Fgt I Arrival Time: (O, "Departure Time: ,�Q�J County: SQ•n4 PS0/✓ Region:
Farm Name: `tea"% Owner Email:
Owner Name: /1�tyT��fy,rh� <C Phone:
Mailing Address:
Physical Address:
Facility Contact: f rFn Or s Title:
n
Onsite Representative:
Certified Operator: Li (I 1 Qm Su+lnn
Back-up Operator: (VA t 14e 'HMN.Ons
Location of Farm:
Swine
Other
❑ Other
Latitude: 0
Phone No:
Integrator: MtWO�' NrVW t, r LCC"
Operator Certification Number:
Back-up Certification Number: 9 gs q9�
_Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
I JLJ Non -Laver
Dry Poultry
Poults
Dischar¢es & 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?
All Longitude: [-A n � ,
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: �;
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
1/
❑ Yes PMNo ❑ NA ❑ NE
❑ Yes ❑ No OA ❑ NE
❑ Yes ❑ No N&NA ❑ NE
❑ Yes ❑ No 12�NA ❑ NE
❑ Yes 1] No El NA El NE
El Yes l� No ❑ NA ❑ NE
12128104 Continued

Facility Number: 'jj Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus'heavy rainfall) less than adequate?
[:]Yes 9] No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
NA
P
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: A 13
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): , Isp Y 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes [�No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes 0 No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
T Do any of the structures need maintenance or improvement? ❑ Yes PNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes V No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? IV
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 No ❑ NA ❑ NF
maintenance/improvement?
11. 1s there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes R No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Gr^i L-)La k+ — S p r c 1 , �L1GKyLL l t'rTt .' r SY�Q 1' { 6;V C ,Q
,n
13. Soil type(s) T ' �901 �.� V , r� 24i 5 �• rt� �[''-r„ l�L ` ''� -
14. Do the receiving crops differ from those designated in the CAWMP? 1 ❑ Yes t No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes �] No ❑ NA ❑ NE
IT Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ Yes No
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):
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Name AA. Phone: We— t{ -3 m
Reviewer/inspector Signature: Date: S 1
«,Z451u4 uonttnuea

, i
Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ W Tp ❑ Checklists ❑ Design ❑ Maps ❑ Other
❑ Yes Ep No ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes L No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
&3 No
❑ NA
❑ NE
❑ Yes
UNo
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
5NNo
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes �9 No ❑ NA ❑ NE
❑ Yes 59 No ❑ NA ❑ NE
❑ Yes 09 No ❑ NA ❑ NE
❑ Yes Dd No ❑ NA ❑ NE
❑ Yes
PNo
❑ NA
❑ NE
❑ Yes
t1No
❑ NA
❑ NE
12128104

Kadlity Number �!
"V Division of Water Quality
0 Division of Soil and Water Conservation
Q Other Agency
Type of Visit '¢Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit WRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of r Visit: 7 Arrival Time:
Departure TimeCnun Region' D
Farm Name: t � • ° 041't`1 *F �� b Owner Email:
Owner Name: — ' , 1 �l w W' Phone:
Mailing Address:
Physical Address:
Facility Contact: M, L kQ— U-Dii"'l'�QO Title: UK) Tyl Phone No:l n -
Onsite Representative: ri Q- MIntegrator: rn —
VV t�
Certified Operator: tx1 i) Operator Certification Number: a
Back-up Operator: Mike lryl Back-up Certification Number:
Location of Farm: Latitude: EDo =, EDLongitude: ❑° E- =
Swine
❑ Wean to Finish
_❑ Wean to Feeder
,Feeder to Finish
Q Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
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 ves, 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 14 No ❑ NA ❑ NE
❑ Yes
❑ No
RNA
❑ NE
❑ Yes
❑ No
NA
❑ NE
NA
❑ NE
❑ Yes
❑ No
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
K No
❑ NA
❑ NE
12128104 Continued

Date of Inspection tu I—
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?
Facility.Numher: =t
El NA El NE
❑ NA ❑ NE
Structuresn 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: c fii c�
Spillway?:
Designed Freeboard (in): .2(0�
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
' /I
❑ Yes I No
❑ Yes 0 No
(te arge trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes C9 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? A Yes ❑ No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes NiNo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes KNO
ElNA ❑ NE
❑ Excessive Pending [IHydraulic Overload ❑ Frozen Ground ElHeavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or ]0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12_ Crop type(s)
13. Soil type(s)
14. Do the receiving
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
Cl Yes No
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes MNo
17. Does the facility lack adequate acreage for land application? ❑ Yes 4No
18. Is there a lack of properly operating waste application equipment`? ❑ Yes W No
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):
❑NA El NE
❑ NA ❑ NE
❑NA ❑NE
❑NA El NE
❑NA ❑NE
t: rt,A t
4�> o_& *D 6c ► -p-_ a4-Roo
cw3 �60"S -arc Gi t
u .
N1
1 ce I n,.p
row an larA 4 ,
Reviewer/inspector Name=#-1Q5�I KZ �[©�,t Phone:" -A' 1Q'1 �.7
Reviewer/Inspector Signature: Date:
12128104 Continued

'Facility Number:, —7 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes XNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropiiate box. ❑ W P ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes j 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 `@ No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ONA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
o
❑ 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
J�j 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
[P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
PNo
❑ 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
09 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
PNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
M No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[gNo
❑ NA
❑ NE
nal Comments and/or
12128104

Facility-NoS� `l 1 Time In Time Out Date
Farm Name _ �� _ Integrator__
Owner Vn - Site Rep ! t
Operator W SU v.� No. cl D (3- 6
Back-up . / V�~� _ No. 0 J
COC Circle: ener^ or NPDES
Design
Current
Design
Current
Wean — Feed
Farrow — Feed
We —
Farrow — Finish
Feed — Finis
Gilts/ Boars
Farrow — Wean I
Others
FREEBOARD: Design
Observed
Crop Yield [/
ace 'P_co
q4�- 6111<
Rain Gauge k
Soil Test � U W ttable Acres
Weekly Freeboard Daily Rainfall
Spray/Freeboard
Weather Codes
Waste Analysis:
120 min Inspections
Date Nitrogen (N)
z3 l 2 •S
Z Q
Sludge Surveyy t--
Calibration/GPM 1
Waste Transfers
Rain Breaker
PLAT �+
1-in Inspections
Date Nitrogen (N)
1 l_ o
/. 3 t s
/I I.Y 1- Z
Pull/Field
it
Crop
Pan
Window
104
Y
Q
Z
u YA3�
f
r rr�
0
-1 Lin
&hhoy
j�j

r<-
Division of Water Quality - - -
Faeility Number Q Division of Soil and Water Conservation -
Q Other Agency
Type of Visit * Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I 'ql6'IUI - I Arrival Time: Departure Time: /Df County: Region: Fla
Farm Name; A I m � 07k5 Owner Email:
Owner Name: m Phone:
Mailing Address:
Physical Address:
Facility Contact:
0141 t4m"'20/25* Title:
u
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Other
❑ Other
,/
,y /Phone No:
Integrator: Integrator: ! " l ,
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 O❑ g 0 i/ Longitude: Q° a 1= 16
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
_I IEJ Non -Layer
Dry Poultry
Non -La
Pullets
Turkev�
Poults
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'!
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy-Neifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: ®,
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'!
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'!
❑ Yes (' No ❑ NA ❑ NE
❑ Yes
❑ No
[P NA
❑ NE
❑ Yes
❑ No
7NA
❑ NE
[DNA
❑ NE
❑ Yes
❑ No
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
V] No
❑ NA
❑ NE
12128104 Condzined

Facility dumber: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes T
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: L]
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.) l
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 F 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 W No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes D9 No ❑ NA ❑ NE
maintenance/improvement?
l l . Is there evidence of incorrect application? If yes, check the appropriate box below, ❑ Yes J9 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 El Application Outside of Area
12. Crop type(s) �M� 1'CcS`�' C9,rr1J�VX,*7 r.,W C.,�tt1
13. Soil type(s)
-.I_ D.. - r
r 4 i f 1
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
f)No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
®No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
'Comments (refer to question ft Explain any YES answers and/or any recommendations or any other40mments
Use drawings: of facility to: better explain situations. {use'addti(nalpages. as necessary):
Reviewer/inspector Name I l1 Phone: / ` -71- 3300
Reviewerlinspector Signature: Date: 5 Q7
Page 2 of 3 12128104 Continued

• 4
Facility Number: ( Date of Inspection
Required Records & Documents �r
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes T
No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes y
No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes M No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[N No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
"" No
ElNA
ElNE
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
l] 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
[8 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
EP No
❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
P No
❑ NA ❑ NE
Additional Comments and/or Drawings:
1,;..
i
T
Page 3 of 3 12128104

64
Type of Visit Com 'ance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other ❑ Denied Access
Date of Visit:LIU (qu Arrival Time: l Departure Time: E�� County?
Farm Name:
�yN 0 ` 6 Owner Email:
Owner Nam�
'`e"-* r0 L U, „t-cp Phone:
Mailing Address:
Physical Address:
Regioni:��
Facility Contact: _` ' `�'�—rn�InS _ Title: LI V I" 1 Phone No: « b��
Onsite RepresentativeU + k_p, Wl titrf noyis Integrator:
4 qc�
Certified Operator: ' 1.� -t' f l� S Operator Certification Number: `
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 O ❑ d ❑ Longitude: 0 0 ❑ 4 ❑ "
Design
Current
Design Current
Design Current
Swine
Capacity
Population
Wet Poultty Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
iry Cow
❑ an to Feeder
❑Non -La er
iry Calf
eeder to Finish
1y.6W
A,'=; -
❑ Dairy Heifer
❑ Farrow to Wean
❑ Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
Dry Poultry 3 -:
�ay�
❑ La ers
❑Non -La Non -Layers
El Pullets
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑Beef Feeder
❑Beef Brood Cow
Other
❑ Other
y M„
❑ Turkeys
❑ Turkey Poults
❑ Other
4
Numberaaf'Stii'uctures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes �410 ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made? ❑ Yes ❑ No �QA
[INE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ElNo A ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No 19NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ❑ NA ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes XAo ❑ NA ❑ NE
other than from a discharge?
Page 1 of 3 12128104 Continued

Facility Number: , Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ YesNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ NoApqA ❑ NE
Structu 1 Struc e 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
G
Observed Freeboard (in):?
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 'KNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes qo ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Vo ❑ 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 El NA [I NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o
maintenance/improvement? `��/��/���VV1111
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes `�I 0
El Excessive Ponding El Hydraulic Overload ❑ Frozen Ground El Heavy Metals (Cu, Zn, etc.) "' ���JJJ
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s
13. Soil type(s)
❑NA El NE
❑NA El NE
14. Do the receiving crops differ from those designated in the CA WMP? V V
❑ Yes XNo
ElNA
ElNE
15. Does the receiving crop and/or land application site need improvement?
El)Yes o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes � No
[-INAEl
NE
17. Does the facility lack adequate acreage for land application?
❑ Yes XNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes XNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name 6uSTy �]� - Phone [ � y,-3 33c�D
Reviewer/Inspector Signatur Date:
1 "Sc G VJ J 1 L/L6/V4 LUriiirg"C"

Facility Number. 'a =11 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes io ElNA ElNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes o ❑ NA ❑ NE
the appropriate box. ❑ WOp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ia ❑ 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 Cade
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
3 L 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 o
❑ NA
❑ NE
❑ Yes
o
❑ NA
❑ NE
❑ Yes
/ o
❑ NA
❑ NE
❑ Yes
Zko
❑ NA
❑ NE
❑ Yes
No
El NA
❑ NE
❑ Yes
o
❑ NA
❑ NE
❑ Yes
o
//4o
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
ONO
El NA
El NE
❑ Yes
"&Vo
❑ NA
❑ NE
❑ Yes
0�oo
❑ NA
❑ NE
❑ Yes
'Wo
❑ NA
❑ NE
Additional. Comments and/or Drawi4gs:
Page 3 of 3 I2/18/04

Facility No. ), 1 I Time In Time Out
Farm Name ,� (43
Owner C [ V1 C.
Operator m
Back-up
COC l�
Circle: General
Integrator
,u - b
Date
Site Re r"\ L_tNiMA)'Z,_-)
No.
No. _
or PDES
Design
Current
Design
Current
Wean — Feed
Farrow -- Feed
Wean — Finish
Farrow — Finish
eed - Finr
d g Q
Gilts 1 Boars
Farrow — can
Others
FREEBOARD: Design 'a"PJ e" ed
Sludge Survey` Calibration/GPM
Crop Yield f� Waste Transfers
Rain Gauge
�,
Soil Test V i W
Weekly Freeboard
Spray/Freeboard Drop
Weather Codes
Waste Analysis:
Rain Breaker
PLAT
Wettable Acres
Daily Rainfall tom— yin Inspections
120 min Thspections
Date Nitrogen (N)
Z
4/ Z.
Date Nitrogen (N)
i7
Pull/Field Soil Crop Pan Window
v�
if
U

Type of Visit *Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral Q Emergency O Other ❑ Denied Access
Date of Visit: \ �$ O Arrival Time: ' S = lJr Departure Time: County: Region: �
Farm Name: 6-90 ,Skr� 0 160 Owner Email:
Owner Name: C acr-A '5 F�J 5 �- Phone:
Mailing Address: 617K-+57 -__ &X kcl ,
Physical Address:
Facility Contact:
Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No: p
Integrator: Are " `J►'�„ _mm
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o ❑ d ❑ Longitude: = 0 0 I = W
Swine
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
IV0601if
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑Other
Design Current Design Current
Capacity Population. Wet Poultry Capacity Population
❑ La er
❑ Non -La er
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made`?
Design Current
Cattle Capacity Population
❑ Daia Cow
i
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
I
❑ Beef Brood Cowl
I
Number of Structures: EI
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 �4.No ❑ NA ❑ NE
❑ Yes
❑ No
9NA
❑ NE
❑ Yes
❑ No
aNA
❑ NE
5[9NA
❑ NE
❑ Yes
❑ No
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
allo
❑ NA
❑ NE
12128104 Continued

+acility.Number: 81
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
❑ NA ❑ NE
0 NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: A
Spillway?: W& S
Designed Freeboard (in): - I Of [ot
Observed Freeboard (in): .Jc d
❑ Yes 0 No
❑ Yes *No
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
KNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
�q No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[(No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
I0. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
RSNo
❑ NA
❑ NE
maintenance/improvement?
I I - Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes %To ❑ 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)
13. Soil type(s) Zyc
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes O,No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
ERYes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'![] Yes
®No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
'RNo
❑ NA
❑ NE
I S. Is there a lack of properly operating waste application equipment? ❑ Yes
69No
❑ NA
❑ NE
5, —tV& 3`k7e,�
OF VW_1.VA1t_
Reviewer/Inspector Name
Reviewer/Inspector Signature:
-b 6__ �0 let- 900a C lM o--
Phone: q n —
Date: q 12-A /O. 1;-
I2128104 Continued

' Y /
'Facility Number: Date of Inspection52LV;ii
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes fKNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check 9-Yes ❑ No ❑ NA ❑ NE
the appropirate box. id WUP ❑ Checklists ❑ Desi r g ❑Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below_ ❑ Yes ® No ❑ NA ❑ NE
❑ Waste Applicatior ❑ Weekly Freeboar4o"D Waste Analysi+4'10 Soil Analysis❑ Waste Transfers ❑ Annual Certification
❑ Rainfall/❑ Stocking❑ Crop Yield,' ❑ 120 Minute Inspectiong' ❑ Monthly and I" Rain Inspections ❑ Weather Codet-
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes (9 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
[5fNo
❑ 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
KNo
ElNA
❑ 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
[3 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
[A 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
0 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[9No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Zd, -T4 a-_--L,R a cA" OC- a- o%wU P, W4 It
cri- - s;fe/ a.. d Au-r d -(-- s
P t e as,e ��.+ -kt-}y,,.# IruvP ► `ti _
12128104

i
Type of Visit ® Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit ® Routine 0 Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number �j./� [fate of Visit: I.7y/ay Time: Z+ � Q a
Not O erational Q Below Thr hold
ED-Permitted ❑ Certified O Conditionaliv Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: F2 • ►+-� '� s?o 9� Count.: Sex rw a.. FII`0
Owner lame: Phone N0:
Mailing Address:
Facilih• Contact: Title: Phone No:
Onsite Representative: C3 Integrator:
Certified Operator: %2 C7 1&r ,+•- Operator Certification Number: ca SS?�
Location of Farm:
M Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0` • 0" Longitude 0' 0=
Deli =Cure ent Design Current- w Current w
Strine Ca aciri . Po ulation ;PoubyN- Ca ad& -,:Po Matson Cattle , Ci acrtr Po` ulstion
❑ Wean to Feeder ❑ Layer ED
Dairy® Feeder to Finish M.O.F� ❑ Non -Layer Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other, I_
❑rowFinish Total Design>Capackv "
-
❑ Boars :.:'' TotsISSM
1►'umI►er o%f Lagoons _'. ® ❑ Subsurface Drains Present ❑ La ooe Area ❑ spray Field Area
Holding Ponds Saud Traps --� ❑ No Li uid Waste Mana Manage
System
Discharges & Stream ImRacts
1. Is any discharge observed from any part of the operation?
❑ Yes R No
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. notify DWQ) ❑ yes ❑ No
c. If discharge is obsen•ed, what is the estimated flow in gallmin? _ "/A
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
M aste Collection 8• Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ spillway ❑ Yes M No
Stricture I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: A,
Freeboard (inches):
05103101 Continued
4

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes No
Closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes 1P No
S. Does any part of the waste management system other than waste structures require maintenancelimprovernent? ❑ Yes (3 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ` ] No
elevation markings?
Waste Application
10. Are there any buffers that need maintenanmrunprovement? ❑ Yes 14 No
11. Is there evidence of over application? If yes, check the appropriate box below. Cl Yes IS No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Berrv%LAdm tTa..1Ce 'J Sa..bin.fs. Ceres. �f�.�s Sr+,.tl Qa•at"M
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [� No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes qNo
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes [Q No
15. Does the receiving crop need improvement? ❑ Yes qNo
16. Is there a lack of adequate waste application equipment? ❑ Yes q No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ❑ Yes qNo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes qNo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes [ No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes No
Aix Quality representative immediately.

Facility Number: p,Z — 7!S Date of Inspection
Re uired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.)
❑ Yes
] No
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[] No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24_ Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
j No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems, over application)
❑ Yes
® No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
fiD No
28. Does facility require a follow-up visit by same agency?
❑ Yes
W No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) Yes ❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes J No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes F No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes QI No
❑ Stocking Form ❑ Crap Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit-
12/12103

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
1W Routine O Complaint O Follow-up of DWO inspection O Hollow -up of DSWC review O Other
Date of Inspection
Facility Number Z, Time of Inspection � 24 hr. (hh:mm)
© Registered Certified [3 Applied for Permit APerruitted 113 Not Operational I Date Last Operated
Farm Name: .420 (�4 County: ........ .,f}'?"� �. Q'! ...............................
Owner Name: ...................................rt".. O.. t S �Ooo�S .. Phone No: Z9 —... ..f..................................
I ..................... �...........................,...................
Facility Contact:.../_jCA �1..... 4.!"-4 6 ...................... Title:..ftt...✓..t-... .......................... Phone No:................ .............................
Mailing Address:..-. ..... ps.p. 6 � . � 0. l. 2T(3 a..-...?I.-..A�................................ .�..
Onsite Representative ....................... ............
rr a �' a S p..................................................................................... Integrator
Certified Operator:........................................................................... Operator Certification Number:..................... ........
Location of Farm:
Z C
G
Latitude ' ' fc Longitude • u6 GL
Poultrv�'
❑ Wean to Feeder
❑Layer
Feeder to Finish
❑ Non -Layer
El Farrow to Wean"
❑ Farrow to Feeder
:.
❑ Other
❑ Farrow to Finish
�.
Total Desk;
, n� 7
Fay
❑ Gilts
❑ Boars
ota1=SSL-W ,t
§. �j Z 'tjLJ Subsurface Drains Present
No Liquid Waste Managen
Lagoon Area I❑ Spray Field Area
General
I.
Are there any buffers that need maintenancelimprovement?
Cl Yes
0 No
2.
Is any discharge observed from any part of the operation?
❑ Yes
RtNo
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 Surface Water? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
❑ No
3.
Is there evidence of past discharge from any part of the operation?
❑ Yes
[ No I
4.
Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
No
5.
Does any part of the waste management system (other than lagoons holding ponds) require
❑ Yes
5(No r
maintenance/improvement?
6-
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7.
Did the facility fail to have a certified operator in responsible charge'!
❑ Yes
o
7/25/97

' acelity Number: -7/s
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes A
No
Structures La oons Holdin Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes �No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(fit): .......................................................................................................................................................................................................................
10. Is seepage observed from any of the structures?
❑ Yes
No
It. is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
No
12. Do any of the structures need maintenancelimprovement?
❑ Yes
No
(if any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
I
No
Waste Application
14. Is there physical evidence of over application?
❑ Yes
No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type..................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
ANo
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
JqNo .
18. Does the receiving crop need improvement?
❑ Yes
No
19. Is there a lack of available waste application equipment?
❑ Yes
No
�o
20. Does facilityrequire a follow-up visit b same
eq p y agency.
❑ Yes
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
P No
22. Does record keeping need improvement?
❑ Yes
KNo
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
0 No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
4No
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
C,No
No:viatations-otc deficiencies. were, noted,during this.visit.: You:wiu recei�e:iio.ftirtfier
:�:•correspQndenceativutthis:visit:•:•:�:: ;-:�:•:•.-:•:�:•::•: ••.•:•:•:: .•. .......
�kiS FS a
f Ue i Fri
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: 11149 _. (J. 14a 4�` /z Date: %-