820442_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

Certified Operator: Bradley Devone Herring Operator Certification Number: 26545
Secondary OIC(s):
On -Site Representatiye(s}: Mame Title Phone
24 hour contact name Mike Norris Phone
On-site representative Mike Norns Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1
0 Division of Water Resources
Division of Soil and Water Conservation
El Other Agency
Facility Number:
820442
Facility Status: Active
Permit: AWS820 42
[] Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County:
Sampson Region:
Fayetteville
Date of Visit:
0912312016 Entry Time: 08:00 am Exit Time: 9:00 am Incident #
Farm Name:
Farm #10
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-29rr1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
2171 Brewer Rd
Faison NC 28341
Facility Status:
Compliant ❑
Not Compliant Integrator:
Murphy -Brown LLC
Location of Farm:
Latitude:
35` 06' Longitude:
78° t 1' 26"
SR 1900 approx. 4 miles
S, of Faison (dead end)
Question Areas:
Dischrge & stream Impacts
Waste Col, Slot, & Treat
Waste Application
Records and Documents
Other Issues
Certified Operator: Bradley Devone Herring Operator Certification Number: 26545
Secondary OIC(s):
On -Site Representatiye(s}: Mame Title Phone
24 hour contact name Mike Norris Phone
On-site representative Mike Norns Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820442 Owner -Facility: Murphy -Brawn LLC Facility Number: 820442
Inspection Date: 09/23/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean 3,927
Total Design Capacity: 3,927
Total SSLW: 1,700,391
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.50 44.00
Lagoon 3510
page: 2

I t
Permit: AWS820442 Owner - Facility : Murphy -Brown LLC Facility Number: 820442
Inspection Date: 09/23/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na Ne
❑ M ❑ ❑
1. Is any discharge observed from any part of the operation?
❑
0 [31:1
❑ M ❑ ❑
Discharge originated at:
Excessive Ponding?
❑
Structure
❑
Frozen Ground?
❑
Application Field
❑
PAN?
❑
Other
❑
Total Phosphorus?
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
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 Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (i.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on-site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820442 Owner- Facility : Murphy -Brown LLC Facility Number: 820442
Inspection Date: 09/23/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Appficabon
Yes No Na No
Crop Type 1
Com, Wheat, Soybeans
Crop Type 2
20. Does the facility fail to have all components of the CAWMP readily available?
Crop Type 3
M ❑ ❑
Crop Type 4
Crop Type 5
WUP?
Crop Type 6
Soil Type 1
Goldsboro loamy sand, 0 to
2% slopes
Soil Type 2
Norfolk loamy sand, 0 to 2%
Maps?
slopes
Soil Type 3
Rains sandy loam
Soil Type 4
Lynchburg sandy loam
Soil Type 5
❑
Soil Type 6
If Other, please specify
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ ❑ ❑
Management Plan(CAWMP)?
❑
15. Does the receiving crop and/or land application site need improvement?
❑ ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ M ❑ ❑
determination?
❑
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑ 0 ❑ ❑
Records and Documents
Yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
M ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
M ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS820442 Owner- Facility : Murphy -Brown LLC Facility Number: 820442
Inspection Date: 09/23/16 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
Stocking?
❑
❑
and report mortality rates that exceed normal rates?
Crop yields?
❑
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
120 Minute inspections?
❑
❑
contact a regional Air Quality representative immediately.
Monthly and 1" Rainfall Inspections
❑
30. Did the facility fail to notify regional DWO of emergency situations as required by Permit?
Sludge Survey
❑
❑
(i.e., discharge, freeboard problems, over -application)
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)?
Application Field
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
N ❑
❑
appropriate box(es) below:
If Other, please specify
Failure to complete annual sludge survey
❑
32. Were any additional problems noted which cause non-compliance of the Permit or
Failure to develop a POA for sludge levels
❑
❑
CAWMP?
Non-compliant sludge levels in any lagoon
❑
33. Did the ReviewerAnspector fail to discuss review/inspection with on-site representative?
List structure(s) and date of first survey indicating non-compliance:
■ ❑
❑
34. Does the facility require a follow-up visit by same agency?
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
N ❑
❑
Other Issues
Yes No Na Ne
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWO of emergency situations as required by Permit?
❑
0 ❑
❑
(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
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
N ❑
❑
CAWMP?
33. Did the ReviewerAnspector fail to discuss review/inspection with on-site representative?
❑
■ ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 2171 Brewer Rd Faison NC 28341
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 35° 06' Longitude: 78° 11'26"
SR 1900 approx. 4 miles S. of Faison (dead end)
Question Areas:
Dischrge 8 Stream Impacts Waste Col, Slor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Michael Leon Norris Operator Certification Number: 19861
Secondary OIC(s):
On -Site Representative(s)
24 hour contact name
On-site representative
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary -
Name
Mike Norris
Mike Norris
Title
Phone :
Phone:
Phone
Robert Marble Phone:
Date:
page: 1
0
Division of Water Resources
❑
Division of Soil and Water Conservation
❑
Other Agency
Facility Number:
820442
Facility
Status: Active Permit:
AWS820442
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Sampson
Region:
Fayetteville
Date of Visit:
11/05/2015 Entry Time:
03:00 pm Exit Time: 4:00 pm
Incident #
Farm Name:
Farm #10
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 2171 Brewer Rd Faison NC 28341
Facility Status: Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 35° 06' Longitude: 78° 11'26"
SR 1900 approx. 4 miles S. of Faison (dead end)
Question Areas:
Dischrge 8 Stream Impacts Waste Col, Slor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Michael Leon Norris Operator Certification Number: 19861
Secondary OIC(s):
On -Site Representative(s)
24 hour contact name
On-site representative
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary -
Name
Mike Norris
Mike Norris
Title
Phone :
Phone:
Phone
Robert Marble Phone:
Date:
page: 1

Permit: AWS820442
Owner - Facility: Murphy -Brown LLC
Facility Number:
826442
Inspection Date: 11/05/15
Inpsection Type: Compliance Inspection
Reason for Visit:
Routine
Regulated Operations
Design Capacity
Current promotions
Swine
Swine - Farrow to Wean
3,927
Total Design Capacity:
3,927
Total SSLW:
1,744,391
Waste Structures
Disignated
Observed
Type Identifier
Closed Date Start Date
Freeboard
Freeboard
Lagoon 1 19.50 47.00
Lagoon 3510
page: 2

Permit: AWS820442 Owner - Facility : Murphy -Brown LLC Facility Number: 820442
Inspection Date: 11/05/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na Ne
❑ 0 ❑ ❑
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Excessive Ponding?
❑
Structure
❑
Frozen Ground?
❑
Application Field
❑
PAN?
❑
Other
❑
Total Phosphorus?
❑
a. Was conveyance man-made?
❑
M ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
0 ❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
0 ❑
❑
Z 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 Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on-site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
& Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ 0 ❑ [❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS820442 Owner - Facility : Murphy -Brown LLC Facility Number: 820442
Inspection Date: 11/05/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na He
Crop Type 1
Com, Wheal, Soybeans
Crop Type 2
0 ❑
Crop Type 3
20. Does the facility fail to have all components of the CAWMP readily available?
Crop Type 4
0 ❑
Crop Type 5
If yes, check the appropriate box below.
Crop Type 6
Soil Type 1
Goldsboro loamy sand, 0 to
❑
2% slopes
Soil Type 2
Norfolk loamy sand, U to 2%
❑
slopes
Soil Type 3
Rains sandy loam
Soil Type 4
Lynchburg sandy loam
Soil Type 5
Maps?
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ M ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ ❑ ❑
determination?
If Other, please specify
17. Does the facility lack adequate acreage for land application?
❑ ■ ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑ M ❑ ❑
Records and Documents
Yes No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
[]
■ ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS820442 Owner - Facility: Murphy -Brown LLC Facility Number: 820442
Inspection Date: 11/05/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Stocking?
❑
E ❑
❑
Crop yields?
❑
120 Minute inspections?
❑
E ❑
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
E ❑
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
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:
❑
E ❑
❑
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to 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,
❑
E ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
E ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
NE -11]
If yes, check the appropriate box below.
Application Field
❑
Lagoon I Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewfinspection with on-site representative?
❑
E ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
820442 Facility Status:
active permit: AWS820442
Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County: Sampson Region:
Fayetteville
Date of Visit:
12/16/2014 EntryTime: 10:00 am
Exit Time: 10:45 am Incident #
Farm Name:
Farm #10
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 2171 Brewer Rd Faison NC 28341
Facility Status: 0 Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 35" 06' Longitude: 78° 11' 26"
SR 1900 approx. 4 miles S. of Faison (dead end)
Question Areas:
Dischrge & Stream impacts
Records and Documents
Waste Col, Stor, & Treat
■ Other Issues
Certified Operator: Bradley Devone Herring
Secondary OIC(s):
0 Waste Application
Operator Certification Number: 26545
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Norris Phone:
On-site representative Mike Norris Phone:
Primary Inspector: Robert Marble Phone:
Inspector signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS820442 Owner - Facility : Murphy -Brown LLC Facility Number: 820442
Inspection Date: 12/16/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean 3,927
Total Design Capacity: 3,927
Total SSLW: 1,700,391
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.50 40.00
Lagoon 3510
page: 2

Permit: AWS820442 Owner - Facility : Murphy -Brown LLC Facility Number: 820442
Inspection Date: 12/16/14 Inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No No Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
1, Is any discharge observed from any part of the operation?
❑
S ❑
❑
Discharge originated at:
If yes, check the appropriate box below.
Excessive Ponding?
Structure
❑
❑
Frozen Ground?
Application Field
❑
❑
PAN?
Other
❑
❑
Total Phosphorus?
a. Was conveyance man-made?
❑
❑ N
❑
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?
❑
N ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No No Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
■ ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on-site that are not properly addressed and/or managed through a
❑
N ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
E ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Nam
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
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 n 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: AWS820442
Owner -Facility: Murphy -Brown LLC Facility Number: 621)442
Inspection Date: 12/16/14
Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
res No Nam
Crop Type 1
Com, Wheat, Soybeans
Crop Type 2
Soil Type 3
Crop Type 3
If yes, check the appropriate box below.
Crop Type 4
Lynchburg sandy loam
Crop Type 5
WUP?
Crop Type 6
Soil Type 6
Soil Type 1
Goldsboro loamy sand, o to
Records and Documents
2% slopes
Soil Type 2
Nodoac loamy sand,
o to 2%
❑
slopes
❑
Soil Type 3
Rains sandy loam
If yes, check the appropriate box below.
Soil Type 4
Lynchburg sandy loam
Soil Type 5
WUP?
❑
Soil Type 6
Checklists?
14_ Do the receiving crops differ from those designated in the Certified Animal Waste
❑ s ❑
❑
Management Plan(CAWMP)?
❑
15. Does the receiving crop and/or land application site need improvement?
❑ ■ ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ M ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ M ❑
❑
Records and Documents
Yes No No�N
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 CAMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
E ❑
❑
If yes, check the appropriate box below_
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS820442 Owner - Facility : Murphy -Brown LLC Facility Number: 820442
Inspection Date: 12/16/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No No No
Stocking?
❑
0 ❑
❑
Crop yields?
❑
120 Minute inspections?
❑
K ❑
❑
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
❑
E ❑
❑
appropriate box(es) below:
❑
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
❑
❑
Non-compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
❑
0 ❑
❑
26_ Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes No No
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,
❑
K ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWO of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface Tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon/ Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
CAWM P?
33. Did the Reviewer/Inspector fall to discuss review/inspection with on-site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
N Cl
❑
page: 5

0
s
SR 1800 approx 4 mites S. of Faison (dead end)
Question Areas:
S Dischrge & Stream Impacts Waste Col, Stor, & Treat
Records and Documents Other Issues
0 Waste Application
Certified Operator: Michael Leon Norris Operator Certification Number 19861
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Noms Phone
.Onsite representative Mike Norris Phone
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Robert Marble
Phone:
Date:
page: 1
■
division of Water Resources
❑
Division of Soil and Water Conservation
11
Other Agency
Facility Number:
820442
Facility
Status: AOive
Permit: AWS820442
[] Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County:
Sampson Region:
Fayetteville
Date of visit:
12/11/2013 Entry Time:
01:30 pm Exit Time: 2:30 pm Incident #
Farm Name:
Farm #10
Owner Email -
Owner:
Murphy -Brown LLC
Phone:
910-296.1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
2171 Brewer Rd
Faison NC 28341
Facility Status:
Compliant
Not
Compliant Integrator.
Murphy -Brown LLC
Location of Farm:
Latitude:
35,06' Longitude:
78' 11' 26"
SR 1800 approx 4 mites S. of Faison (dead end)
Question Areas:
S Dischrge & Stream Impacts Waste Col, Stor, & Treat
Records and Documents Other Issues
0 Waste Application
Certified Operator: Michael Leon Norris Operator Certification Number 19861
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Noms Phone
.Onsite representative Mike Norris Phone
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
Robert Marble
Phone:
Date:
page: 1

Permit: AWS820442 Owner - Facility : Murphy -Brown LLC Facility Number: 820442
Inspection Date: 12/11/13 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine -Farrow to Wean
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.50
Lagoon 3510
page: 2

k I
Permit: AWS820442 Owner - Facility: Murphy -Brown LLC Facility Number: 820442
Inspection Date: 12/11/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
❑ M ❑ ❑
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
❑
Excessive Ponding?
❑
Structure
❑
M ❑
❑
Application Field
❑
PAN?
❑
Other
❑
M ❑
❑
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)?
❑
0 ❑
❑
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ M
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
■ ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
`res
No Na No
❑ M ❑ ❑
4. Is storage capacity less than adequate?
❑
U ❑
❑
If yes, is waste level into structural freeboard?
❑
Excessive Ponding?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
❑
PAN?
❑
6. Are there structures on-site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
[]
Outside of acceptable crop window?
❑
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
B. 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
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ■ ❑ ❑
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

4
Permit: AWS820442
Owner - Facility : Murphy -Brown LLC Facility Number: 820442
Inspection Date: 12/11/13
Inpsection Type: Compliance inspection Reason for Visit: Routine
Waste Application
Yes No Na No
Crop Type 1
Corn, wheat, Soybeans
Crop Type 2
❑
Crop Type 3
Rains sandy
Crop Type 4
❑
Crop Type 5
Lynchburg sandy loam
Crop Type 6
Soil Type 5
Soil Type 1
Goldsboro loamy sand, 0 to
If yes, check the appropriate box below
WUP?
2% slopes
Checklists?
Soil Type 2
Norfolk loamy sand,
0 to 2%
Maps?
slopes
Lease Agreements?
❑
Soil Type 3
Rains sandy
loam
❑
Soil Type 4
Lynchburg sandy loam
Weather code?
Soil Type 5
Rainfall?
❑
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?
❑
M ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
M ❑
C]
Records and Documents
Yes
No Na He
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?
❑
M ❑
❑
If yes, check the appropriate box below
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ M ❑ [❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
El
Rainfall?
❑
page: 4

Permit: AWS820442 Owner - Facility : Murphy -Brown LLC Facility Number: 820442
Inspection Date: 12/11/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
No Na Ne
Stocking?
❑
❑
0 ❑
Crop yields?
[]
120 Minute inspections?
❑
❑
0 ❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
❑
01:111
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
■ ❑
❑
(NPDES only)?
If yes, check the appropriate box below.
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
N ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Other
❑
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:
33. Did the Reviewerlinspector fail to discuss review/inspection with on-site representative?
❑
N ❑
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
E ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes
No Na Ne
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,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
01:111
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
■ ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
CAWMP?
33. Did the Reviewerlinspector fail to discuss review/inspection with on-site representative?
❑
N ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

ow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: O 2J 1 Arrival Time:1&7,�� Departure Time: County: !9 /V Region: Age_
Farm Name: .1510 1 Owner Email:
Owner Name: UL Phone:
Mailing Address:
Physical Address:
Facility Contact: r '' l'+^ r� ^ Title: Phone:
N
Onsite Representative:
Certified Operator:
Integrator: �✓
Certification Number -
Back -up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
I -
Turkeys
Turkey Poults
❑Yes ❑ No
[:]Yes
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation'?
Discharge originated at: E] Structure E] Application Field F-1 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 P No E] NA E] NE
❑No
❑ Yes No
❑Yes No
NA ❑ NF
NA ❑ NE
❑Yes [—]No
�] NA ❑ NE
❑ NA ❑ Ni~
❑ NA ❑ NE
Page l of 3 1/4120I1
Continued
Llypeof visit; f!Compliance inspection VOperation Keview UStructureP:valua6on VTechnical Assistance
ason for Visit: 0 Routine Q Complaint Q Foll
zzw
Destg i Carrera Desiurrent
Swine Capaeiry PpxWei Poultry -`,Casty -attle Capacity Pop.
ryPop
Wean to Finish Layer - Dairy Cow
Wean to Feeder I jNon-Layer I Dairy Calf
Feeder to Finish -;LL - ="" Dai Heifer
Farrow to Wean Design Gurrent6 D Caw
Farrow to Feeder, InIDa r N,'aPo' *�� -Dairy
1) . P�oult . a
La era Beef Stocker
Farrow to Finish)ABO I
Gilts Beef Feeder
Non -Layers
Boars Beef Brood Cow
Pullets
Other
Other Other
Fey. _�_—'-NL ..:. r-:Rrr��. I.. -
I -
Turkeys
Turkey Poults
❑Yes ❑ No
[:]Yes
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation'?
Discharge originated at: E] Structure E] Application Field F-1 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 P No E] NA E] NE
❑No
❑ Yes No
❑Yes No
NA ❑ NF
NA ❑ NE
❑Yes [—]No
�] NA ❑ NE
❑ NA ❑ Ni~
❑ NA ❑ NE
Page l of 3 1/4120I1
Continued
Llypeof visit; f!Compliance inspection VOperation Keview UStructureP:valua6on VTechnical Assistance
ason for Visit: 0 Routine Q Complaint Q Foll

[Fadlity Number: Date of Inspection: B ?i
No
❑ NA
❑ NE
❑ Yes
Waste Collection & Treatment
❑ NA
❑ NE
❑ Yes
No
91
4. Is storage capacity (structural plus stone storage plus heavy rainfall) less than adequate?
❑ Yes
�1 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
�5NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
?I No
(DNA
❑ 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
[A No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
D NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[ No
❑ NA
❑ NE
maintenance or improvement?
T
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
RD 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 n Evidence of Wind Drift n Application Outside of Approved
Area
12, Crop Type(s):
13. Soil Type(s):
14. 1O the receiving crops diner tom those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of property operating waste application equipment?
Reguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
U Yes V No U NA U NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes Q9 No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
91
DNA
❑ NE
❑WUP ❑Checklists ❑ Design p Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes If No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes $4 No
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'? ❑ Yes Id No
E] NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Ifachity Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes (] No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ YesNo E]NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
25. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other issues
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 concerts?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CA" P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes]
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes jP No
❑ Yes No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[DNA ❑NE
❑ Yes No 0 NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Phone: ?10-V33-3300
Date: jok, f
2142011

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0��Other
__ nn [IDenied Access
Date of Visit: Arrival Time: �' Departure Time: � � County: SAMek � Region:
Farm Name: V'01 Owner Email:
i -
Owner Name:
Mailing Address:
Physical Address: %/��
Facility Contact: 6✓ -t- Title:
Onsite Representative: k
Certified Operator: I Or�•r►► Jnr+�e
Back-up Operator:
Phone:
Phone No: ����++
Integrator k C�
l.&
Operator Certification Number: 18
Back-up Certification Number:
Location of Farm: Latitude: El e = ' = « Longitude: Q ° = I 0 u
Design Current
Design CirreaRt
Design Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Yes E;bNo ❑ NA
❑ Dai Cow
❑ Wean to Feeder
❑Non -La er
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
Farrow to Finish Rio
❑ La ers
❑ Beef Stocker
Gilts
❑Non -La ers
E] Beef Feeder
❑ Boars❑
❑ Pullets
❑ Beef Brood Cow
Turkeys
Other
❑ Other
❑ Turkey Poults
Number of Structures:
❑
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
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 ONo ❑ NA ❑ NE
❑ Yes ❑ No [PNA
ll
El NE
El Yes El No NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes Ir No ❑ NA
❑ NE
❑ Yes E;bNo ❑ NA
❑ NE
page 1 of 3 12/28/04 Continued

Facility Number:4,191Date of Inspection Q
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure i Structure 2 Structure 3 Structure 4
Identifier I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
❑ Yes Vo
❑ Yes No
Structure 5
❑ NA ❑ NE
�
NA [__1 NE
S ucture 6
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
[-INA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
❑ Yes
EP No
❑ NA
❑ NE
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?
❑ Yes
5No
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement`?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement`?
❑ Yesro" No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10%ori 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
$ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
EP No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
to No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application'?
❑ Yes
5No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
V No
❑ NA
❑ NE
qtr y
Comrn61' s (refer to question #): Explain any YES answers and/or an} recommendations or any-othe er o ments iV
Use draH tngsof facilityto better explain situations (use'addttional;pages as necessary): wig'
A.
Reviewer/inspector Name
Phone 3
3
Reviewer/Inspector Signature:
Date:
�D
12/28/04 Continued

Facility Number: — Date of Inspection ( D
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists ❑Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ YesNo [:1 NA [__1 NE
❑ Waste Application ❑ Weekly Freeboard El Waste Analysis ❑ Soil Analysis El Waste Transfers Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No ❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ YesjNo
o NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
ElYeso
[INA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
ElYeso
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes rkNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes R,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 ,qNo ❑ 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 RINo ❑ 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 A No ❑ NA ❑ NE
Page 3 of 3 12/28/04

,II
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time- d Departure Time: �' County: %" 1 �Vj
-,
Farm Name: M ✓ � Owner Email:
Owncr Name: ��_� Ur' Phone:
Mailing Address;
Physical Address:
Region: EEO
Facility Contact: &—P1i a_y� Title: Phone No:
!' I 1�7t..� +n
Onsite Representative: JA integrator: (,tiL�V3 Ll—c
Certified Operator: Of"( Loh. Operator Certification Number: 109M
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 =I 0 H Longitude: =00c
°0c =46
Design Current
Design Current
Design Current
S�s'ine Capacity 1'opu1ation
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ layer
❑ Cow
a. Was the conveyance man-made?
❑ Yes
❑ Wean to Feeder
❑ Non -Layer
❑ NE
-Dairy
❑ Dairy Calf
❑ Yes
❑ No
❑ Feeder to Finish L I
❑ NE
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑Dry Cow
❑ Yes
❑ No
❑ Farrow to Feeder
❑ NE
❑ Non -Dairy
ElYes
Farrow to Finish /
❑ Layers
❑ Beef Stocker
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Gilts
❑ Non -Layers
❑Beef Feeder
❑ NE
Boars
Elu
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
12/28/04
Continued
Other
❑ Turkey Poults
NumSer of Structures:
❑ Other
❑
Other
Discharges & Stream Em acts
1. Is any discharge observed from any pan of the operation?
❑ Yes
�No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[7NA
❑ 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 ofa past discharge from any part of the operation?
ElYes
�No
lNA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
'0 No
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Facility l\`umher: Date of Inspection I D
❑ Yes
T No
❑ NA
Waste Collection & Treatment
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1�No
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
VNo
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
ENA ElNE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: r
❑ Yes
® No
Spillway?:
❑ NE
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑Yes
No
El NA [I NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
o No
❑ NA EINE
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 Avalication
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
1P 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
T No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1�No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
9 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
1P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
�,.- ., a
Comments refer to question 9): Explain an Al$ answe��' and/or any recommend at1o,—nments. q
Use dramngs'of facility fo better explain situation(u
s se nal pages as necessaryj•
4
Reviewer/Inspector Name T' Phone:
Reviewer/inspector Signature: ALA&Date: 1 D
12128104 Continued
1

. Facility Number: q Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ YesNo ElNA [:1NE
the appropriate box. ElWUP [:1Checklists [:1Design ❑ Maps ElOther 9
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes I 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 o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No R NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
J�No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�] No
[:1 NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
[I Yes
fgN0
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
'jVNA
❑ NE
Other issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
LpFNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes
JP No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewerfinspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
-
AddittonalComme -. .. Jim
ntsand/ar,Drags
12/28/04
12/28/04

I
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 10 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 2/ Arrival Time: Departure Time: County: SAMP_Sa Region:
Farm Name: rn�� - „ _ Owner Email:
OwnerName: , Phone:
Mailing Address:
Physical Address:
Facility Contact: S=4 Title:
tl
Onsite Representative:
Certified Operator: Tp y'ny%'%—0• d2 n r l"lle
Back-up Operator:
Integrator:
Phone No:
- f ak. in, LLC
Operator Certification Number:
Back-up Certification Number:
Location of Farts: Latitude: =0 =1 ="
Longitude: =0=1 0
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Dest�gtt �' Current 1 Design Current Design Cttrrent
Swine
Ca act 1?o elation Wet Poult .
P... ty , P
Ca act } P elation
p`t:p
Cattle Ca act Po elation
❑ Wean to Finish
10 Layer
��
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -laver I
I
❑ Dairy Calf
❑ Feeder to Finish
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
~" "
El DaiHeifer
❑ Farrow to Wean
0 i
Dry Pry
"-'
❑ D Cow
❑ Farrow to Feeder
'" -
❑ Non -Dairy
Farrow to Finish
p ❑ Layers
F�NA
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
No
❑Beef Feeder
El Boars
El Pullets
❑ Yes
❑ Beef Brood Cow,
Other) T#'
❑ Turkeys
❑ Turkey Poults
other than from a discharge?
❑ Other
1.1020ther
Number of Structures:
12128/04
Continued
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes
F1 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
§3NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
F�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?
T
Page 1 of 3
12128/04
Continued

VacilityNumber: Date of Inspection tl 1/-t1f�J1
❑ Yes
§allo
❑ NA
Waste Collection & Treatment
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
W No
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
bNo [INA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ® NA
❑ NE
Structure i Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
❑ Yes
W No
❑ NA
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ,3,2 1'
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
JP 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
C&No [:INA
❑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
0 No ❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
10 No ❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
P9 No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[P No ❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
V1 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
C''rop Window El Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s) n . U li 50u �tk5
1
13. Soil type(s) 6 I
m d s bio r.h kw -n — [4-7
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
§allo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
W No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
$ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
F�j No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
W No
❑ NA
❑ NE
Comments (refer to question #): 1;xplsin any Yoh answers and/or any recommendations or any other comments.
Use drawings of facility to better explain sitnations. {use additional pages as necessary):
Reviewer/Inspector Name P ,iT Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12/28/04 - ' Continued

Facility Number:—L� Date of Inspection2_f/i7J"il
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No [JNA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield [:1120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
EINE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
n No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
;,No
❑ NA
EINE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification`?
El Yes
�No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CA WM P?
❑ Yes
pa No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
KLNo
❑ 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
ANo
❑ 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
P No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
XbNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
;& No
❑ NA
❑ NE
Additional;Comments and/or Drawings::
Page 3 of 3 12128104

• Division or Water Quality
Facility Number ®' �- 0 Division of Soil and Water Conservation
- 0 Other Agency
Type of Visit • Compliance Inspection Q Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit O Routine 0 Complaint 0 Follow up Q Referral 0 Emergency O Other ❑ Denied Access
Date of Visit: 31 b1 I Arrival Time: Q Departure Time: County:
Farm Name: 3SI offt-- Owner Email:
Owner Name: {d(' !7 n Y 61`W61`Wyl Phone:
Mailing Address:
Region:
Physical Address: an
Facility Contact: G-'(� rr _ Title: Phone No:
Onsite Representative: ( Integrator: Y
Certified Operator: na Operator Certification Number: 012t(l)(0
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
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: [-_—] o E:D ' ❑ Longitude: [--]'o a' ❑ "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
I❑ Non -La et
Dry Poultry
❑
Layers
❑
Non -Layers
❑ Pullets
❑ Turkevs
❑
Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man -trade?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current'
Cattle Capacity :P6pulati6*.
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ DTy Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes T;No ❑ NA ❑ NE
❑ Yes ❑ No [ NA
l
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes [Pwo ❑ NA
❑ NE
[:]Yes O No ❑ NA ❑ NE
12/28/04 Continued

Facility Number:2—
Waste Collection & Treatment
Date of Inspection
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ,MNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?:
Is there evidence of incorrect application'? If yes, check the appropriate box below. ❑ Yes
fTNo
❑ NA ❑ NE
Designed Freeboard (in):
❑ PAN ❑ PAN > 10% or ] 0 lbs [:]Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
Observed Freeboard (in):
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift El Application Outside of Area
S. 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.)
14_
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
Wo
❑ NA
❑ NE
through a waste management or closure plan?
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] 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
WNo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
1P No
❑ NA
❑ NE
(Not applicable to roofed pits, dry statics and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
V No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ YesNo
ElNA
[:1NE
maintenance/improvement?
11.
Is there evidence of incorrect application'? If yes, check the appropriate box below. ❑ Yes
fTNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [I Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] 0 lbs [:]Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift El Application Outside of Area
12.
Crop types) G-rK S + S
13.
Soil type(s) N o k,� Q I U1
14_
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
10 No
❑ NA ❑ NE
15,
Does the receiving crop and/or land application site need improvement? ❑ Yes
P No
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
�No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
[ONo
❑ NA ❑ NE
1$_
Is there a lack of properly operating waste application equipment? ❑ Yes
PNo
❑ NA ❑ NE
f Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
IUse drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date: d'l
12/29104 Continued

facility Number: Date of Inspection
Re wired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes J] 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 appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
19 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
El No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
P No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative'?
❑ Yes
[� No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
t
r
12/28/04

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: Arrival Time: : Q7 Departure Time: County: Region:
Farm Name: j ! ��o 0 "TOwner Email:
Owner Name:Phone:
Mailing Address:
Physical Address:
Facility Contact: -+r r Title: Phone No:
[tW1
Onsite Representative: Integrator: _MLWP
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: a o 1:3 =" Longitude: =0=1
o❑1 r] {s
See aCapacity
Design CNrrertt-
Popu mat! ' Wet P,ctti4try
Design Current' r r. Design Current
Capacity Popes! hon Cattle Capacity Popu[atiou
❑ Wean to Finish
❑ La er
[] Dairy Cow
❑ Wean to Feeder
- ❑ Non -Layer
❑ Dairy Calf
❑ Feeder to Finish
E Qo r ❑ Dairy Heifer
❑Farrow to Wean
D P ult Y' " �+ ❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
Farrow to FinishLaers
❑ Yes
❑ Beef Stocker
❑ Gilts
❑ NE
>f ❑Beef Feeder
❑ Boars
❑ Beef Brood Cowl
Other
Turke s
Turkey Poults
❑ Other
Other
Number of Structures:
Discharges & Stream Im acts
❑
© Non -Layers
Pullets
❑
❑
❑
1. Is any discharge observed from any part of the operation?
❑ Yes
V9 No
[INA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[:1 No
(� NA
r
❑ 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
WNo
❑ NA
[__1 NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
F No
❑ NA
El NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [P No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No O NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in);
Observed Freeboard (in):d_u
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ YesNo E]NA ElNE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes ® No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ® No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ yes R No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes N No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes J9 No ❑ NA [3 NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
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
29 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
P9 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
Comments (refer to question #f): Explain. any YES answers and/or`eny recommendations or any other cominentsL:
Use drawings of facility to better explain situations. (use additional ages as necessary): ' W
_
a
Reviewer/Inspector Name �w-
Phone• ON 733'
Reviewer/Inspector Signature:
Date: fj–fc�"D6
Page 2 of 3 1 — 12/28/04 Continued

NL
Facility Number: -rl— Date of Inspection
Required Records & Documents
14. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes rO No ❑ NA C1NE
20. Does the facility fail to have all components of the CAWW readily available? If yes, check ❑ Yes 7' No ❑ NA ElNE
the appropriate box. [:1WUP [IChecklists E__1Design [71Maps ElOther
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes KI No ❑ NA EINE
❑ 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 EP No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes KI No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes P No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes 09 No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
6 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�NA
El NE
Other Issues
/&No
28" Were any additional problems noted which cause non-compliance of the permit or CAWM P?
❑ Yes
1A No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Q] 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
P No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to noiify 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
�i No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
P No
❑ NA
❑ NE
Page 3 of 3 12/28/04

Type of visit 40 Compliance Inspection U Operation Review O Structure Evaluation O 'technical Assistance
Reason for Visit la Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of visit: Q Arrival Time:�Departure Time: County:e�� Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative:
Certified Operator: E, ..4t
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
i
�dJ
Phone No:
Integrator: ,Vt.r[~iP —mit!►.t
Operator Certification Number:iY
Back-up Certification Number:
Latitude: [—] o [—] ' = " Longitude: = o =, 0
Design Current Design Current
CapacityPopulation Wet Poultry Capacity Population
_ ❑ Layer
❑ Non -La et
❑
- Dry Poultry
Layers
❑
Non -Layers
❑ Pullets
❑ Turke s
Other ❑ Turkex Poults
❑ Other i 10Other
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 .
❑ Daity Cal€
❑
Dairy Heifer
❑Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl I
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 QTNo ❑ NA ❑ NE
❑ Yes
❑ No
[r_4 NA
❑ NE
❑ Yes
❑ No
�SNA
❑ NE
C�JNA
❑ NE
❑ Yes
❑ No
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
V No
❑ NA
❑ NE
12/28/04 Continued

Facility Number: — i(
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2
Identifier "
Spillway?: ilyo
Designed Freeboard (in):
Observed Freeboard (in): �3
Structure 3 Structure 4
❑ Yes [3 -No ❑ NA ❑ NE
❑ Yes ❑ No 91 NA ❑ NE
Structure 5 Structure 6
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_)
T
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
5Z 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
P No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
�d 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
,QNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
[�tNo
❑ 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) e, c j (..�r� [ [,—sk —cj r-- wx_
s
— —
13. Soil type(s)(,VIf�! F -e- , i
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P] No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
J__ No
[INA El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[]
Yes
%No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
9 No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ETNo
❑ NA ❑ NE
Reviewer/inspector Name �'. phone:
Reviewer/Inspector Signature: ( Date:
12/28/04 Continued

•Facility Number: — L(Y Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes EgNo ❑ 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 appropirate box_
❑ WUP El Checklists El Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes s? -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?
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
[ R No
❑ NA
❑ NE
❑ Yes
E,No
❑ NA
❑ NE
❑ Yes
© No
❑ NA
❑ NE
❑ Yes
91 No
❑ NA
❑ NE
❑ Yes
F&I No
❑ NA
❑ NE
❑ Yes PNo [:INA ❑ NE
❑ Yes 9No ❑ NA ❑ NE
❑ Yes 1ANo ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
] No
❑ NA
❑ NE
[:]Yes
t],No
❑ NA
❑ NE
12/28/04