820443_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qua!

11
.
0 Division of Water Resources
❑ Division of Sail and Water Conservation
❑ OtherAgency
Facility Number:
820443 Facility Status:
Active permit: AVVS820443
Denied Access
Inpaection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Sampson Region:
Fayetteville
Date of Visit:
07/29/2015 Entry Time: 06:00 pm
Exit Time: 7:00 pm incident #
Farm Name:
Farm #14 13514
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: Sr 1959 575 Shanghai Rd Harrelis NC 28444
Facility Status: 0 Compliant 0 Not Compliant integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34'46'24" Longitude: 78` 11' 52"
At dead end of Shanghi Rd. approx. 2 miles E. of Delway
Question Areas:
Discnrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Wayne O Sanderson Operator Certification Number: 17903
Secondary OIC(s):
On -Site Representative(s). Name Title Phone
24 hour contact name Mike Ammons Phone:
On-site representative Mike Ammons Phone :
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s)
Inspection Summary:
page: 1

N
Permit: AWS820443
Owner - Facility: Murphy -Brown LLC
Facility Number:
820443
Inspection Date: 07129/15
Inppection Type: Compliance Inspection
Reason for Visit:
Routine
Regulated Operations
Design Capacity
Current promotions
Swine
Swine - Farrow to Finish
1,200
Total Design Capacity:
1,200
Total SSLW:
1,700,400
Waste
„%ructures
Disignated
Observed
Type Identifier
Closed Date Start Date
Freeboard
Freeboard
Lagoon 1 15.30 54.00
Lagoon 3514
page: 2

Permit AWS8213443 Owner - Facility: Murphy -Brown LLC Facility Number 820443
Inspection Date: 07/29/15 Inpsecion Type Compliance Inspection Reason for Visit: Routine
Dischar es & Stream Impacts
Yes
No Na Ne
❑ 0 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?
❑
❑ ■
❑
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)
❑
1:10
❑
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
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 (Led large
❑
E ❑
❑
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?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
N ❑
❑
to roofed pits, dry stacks andlor wet stacks)
9 Does any part of the waste management system other than the waste structures require
❑
E ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Na
10 Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 0 ❑
maintenance or improvement?
11 Is there evidence of incorrect application?
❑ N ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (C u, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%11 t7 lbs ?
❑
Total Phosphorus?
[]
Failure to incorporate ma%re/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
[]
Application outside of application area?
❑
page: 3

Permit: AWS820443 fawner - Facility Murphy -Brown LLC Facility Number 82D443
Inspection Date: 07/29/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No Na Ne
Crop Type 1 Coastal Bermuda Grass
(Hay)
Crop Type 2 corn, Wheat, Soybeans
Crop Type 3 Small Grain Overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Awyvare
Soil Type 2
Goldsboro
Soil Type 3
Norfolk
Soil Type 4
Rains
Soil Type 5
Wagram
Soil Type 6
Woodington
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 ❑
❑
16 Is there a lack of properly operating waste application equipment?
❑
E ❑
❑
Records and Documents
Yes
No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20 Does the facility fail to have all components of the CAVVMP readily available?
❑
0 ❑
❑
It 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?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS820443 Owner- Facility : Murphy -Brown LLC Facility Number: 620443
Inspection Date: 07/29/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Na
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
Crop yields?
❑
❑
and report mortality rates that exceed normal rates?
120 Minute inspections?
❑
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
Monthly and 1" Rainfall Inspections
❑
❑
contact a regional Air Quality representative immediately,
Sludge Survey
❑
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
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
❑
0110
31. Do subsurface tile drains exist at the facility?
(NPDES only)?
M ❑
❑
If yes, check the appropriate box below.
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
M ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check the
❑
■ ❑
❑
appropriate box(es) below:
Other
Failure to complete annual sludge survey
❑
If Other, please specify
Failure to develop a POA for sludge levels
❑
32. Were any additional problems noted which cause non-compliance of the Permit or
Non-compliant sludge levels in any lagoon
❑
❑
CAWMP?
List structure(s) and date of first survey indicating non-compliance:
33. Did the Reviewer/Inspector fail to discuss review/inspection with on-site representative?
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
M ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■ ❑
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
M ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
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?
❑
M ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
M ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑
■ ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
M ❑
❑
page: 5

1
Division o! Water Resources
Division of Soil and Water Conservation
Outer Agency
Facility Number. 820443 Facility Status:
Inpsection Type: Compliance Inspection
Reason for Visit: Routine
Active Permit: AVVS820443 [-] Denied Access
Inactive Or Closed Date:
County: Sampson Region:
Fayetteville
Date of Visit: 10/2312014 Entry Time: 02:00 pm Exit Time: 3:00 pm Incident p
Farm Name: Farm #1413514 Owner Email:
Owner: Murphy -Brown LLC Phone: [phone]
Mailing Address: PO Box 487 Warsaw NC 28398
Physical Address: Sr 1959 575 Shanghai Rd Harrells NC 2B444
Facility Status:Murphy-Brown LLC
Compliant Not Compliant Integrator:
Location of Farm: Latitude: 34' 46 24" Longitude: 78° 11'52" Ic
At dead end of Shanghi Rd. approx. 2 miles E. of Delway
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application
Records and Documents Other issues
Certified Operator: Wayne O Sanderson Operator Certification Number: 17903
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Mike Ammons Phone :
On-site representative Mike Ammons Phone
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

%
Permit: AWS820443
Owner - Facility : Murphy -Brown LLC
Facility Number:
820443
Inspection Date: 10/23/14
Inpsection Type: Compliance Inspection
Reason for Visit:
Routine
Regulated Operations
Design Capacity
Current promotions
Swine
El Swine - Farrow to Finish
1.200
Total Design Capacity:
1,200
Total SSLW:
1.700,400
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
agoon 1 19.30 60.00
.agoon 3514
page: 2

Permit: AWS820443 Owner - Facility : Murphy -Brawn LLC Facility Number: 820443
Inspection Date: 10/23/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
❑
Excessive Ponding?
Structure
❑
0 ❑
❑
Application Field
❑
❑
PAN?
Other
❑
❑
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
❑
0 ❑
❑
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection Storage & Treatment
Yes No Na Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
4. Is storage capacity less than adequate?
❑
0 ❑
❑
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
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
Heavy metals (Cu, Zn, etc)?
❑
PAN?
6. Are there structures on-site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
Failure to incorporate manure/sludge into bare soil?
❑
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
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN a 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: AWS820443 Owner - Facility : Murphy -Brown LLC Facility Number: 820443
Inspection Date: 10/23/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No Na Ne
Crop Type 1
Coastal Bermuda Grass
0 ❑
[❑
(Hay)
❑
Crop Type 2
Com, Wheat, Soybeans
Crop Type 3
Small Grain Overseed
Crop Type 4
WLIP?
Crop Type 5
Crop Type 6
❑
Soil Type 1
Autrpille
❑
Soil Type 2
Goldsboro
Maps?
Soil Type 3
Norfolk
Soil Type 4
Rains
Soil Type 5
Wagram
❑
Soil Type 6
Woodington
If Other, please specify
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ N ❑
❑
Management Plan(CAWMP)?
❑
N ❑
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ 0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ N ❑
❑
Records and Documents
Yes NQ Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
[❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
E ❑
❑
If yes, check the appropriate box below.
WLIP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
N ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

C
Permit: AWS820443 Owner - Facility : Murphy -Brown LLC Facility Number: 820443
Inspection Date: 10/23/14 1npsection 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
Crop yields?
❑
❑
and report mortality rates that exceed normal rates?
120 Minute inspections?
❑
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
Monthly and 1" Rainfall Inspections
❑
❑
contact a regional Air Quality representative immediately.
Sludge Survey
❑
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
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
❑
E ❑
❑
(NPDES only)?
0 ❑
❑
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?
001111
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
❑
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?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field ❑
Lagoon / Storage Pond ❑
Other ❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ E ❑ ❑
CAWMP?
33. Did the Reviewerlinspector fail to discuss review>Inspection with on-site representative? ❑ E ❑ ❑
34. Does the facility require a follow-up visit by same agency? ❑ 0 ❑ ❑
page: 5

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 820443 f=acility Status: Active
Permit: AWS820443
Denied Access
Inpsection Type: Compliance Inspection
Inactive Or Closed Date:
Mike Ammons Phone
Primary Inspector:
Reason for Visit: Routine County:
Sampson Region:
Fayetteville
Date of visit: 12/18/2013 Entry Time: 12:00 pm Exit Time: 1:00 pm Incident #
Farm Name: Farm #1413514
Owner Email:
Owner: Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address: PO Box 487
Warsaw NC 28398
Physical Address: Sr 1959 575 Shanghai Rd
Harrells NC 28444
Facility Status: Compliant ❑ Not Compliant Integrator:
Murphy -Brown LLC
Location of Farm: Latitude:
34'45'24" Longitude:
78" 11' 52'
At dead end of Shanghi Rd. approx. 2 miles E. of Delway
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator: Carl Graham Lamb Operator Certification Number: 26849
Secondary OIC(s):
On -Site Representative(sy
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: AWS82D443 Owner - Facility : Murphy -Brown LLC Facility Number: 820443
Inspection Date: 12/18/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
LPwine - Farrow to Finish
Total Design Capacity:
Total SSLW:
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
agoon 1 19.30
agoon 3514
page: 2

y
Permit: AWS820443 Owner - Facility : Murphy -Brown LLC Facility Number: 820443
Inspection Date: 12/18/13 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
01:11:1
❑
Discharge originated at:
❑
If yes, is waste level into structural freeboard?
❑
Structure
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
Application Field
❑
trees, severe erosion, seepage, etc.)?
❑
Other
❑
$. Are there structures on-site that are not properly addressed and/or managed through a
❑
a. Was conveyance man-made?
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na No
❑ M ❑ ❑
4. Is storage capacity less than adequate?
❑
M ❑
❑
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 (Le./ large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
❑
PAN?
❑
$. Are there structures on-site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
❑
Outside of acceptable crop window?
❑
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
❑
❑
❑
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%110 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: AWS820443 Owner - Facility : Murphy -Brown LLC Facility Number:
620443
Inspection Date: 12/18/13 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yes No Na He
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Small Grein Overseed
Crop Type 3
Com, Wheat, Soybeans
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Autryville loamy sand, 0 to
6% slopes
Soil Type 2
Goldsboro loamy sand, 0 to
2% slopes
Soil Type 3
Norfolk loamy sand, 2 to 6%
slopes
Soil Type 4
Rains sandy loam
Soil Type 5
Wagram loamy sand, o to
6% slopes
Soil Type 6
Woodington loamy sand
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ E ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ ■ ❑ ❑
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?
❑ ■ ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑ ■ ❑ ❑
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?
❑ 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?
0
Waste Analysis?
n
Soil analysis?
❑
Waste Transfers?
❑
page: 4

Permit: AWS820443 Owner - Facility : Murphy -Brown LLC Facility Number: 820443
Inspection Date: 12/1 B113 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Weather code?
❑
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
Rainfall?
❑
❑
Stocking?
❑
Crop yields?
❑
❑
120 Minute inspections?
❑
contact a regional Air Quality representative immediately.
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
0 ❑
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)?
0 ❑
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑ ❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
E ❑ ❑
appropriate box(es) below:
Lagoon / Storage Pond
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:
32. Were any additional problems noted which cause non-compliance of the Permit or
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
0 ❑ ❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑ ❑
Other Issues
Yes
No Ne 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,
❑
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?
❑
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
❑
0 ❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with on-site representative?
❑
E ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
E ❑
❑
page: 5

Type of Visit: * Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:Arrival Time: A) , Departure Time: D IDS County: Region: /P�.D
Farm Name:Vjtq I - Fc I^2 14 Owner Email:
Owner Name: ''�"L�W Phone:
Mailing Address:
Physical Address:
Facility Contact: _/V�rlZe -17'� 05 Title: Phone:
Onsite Representative: U Integrator:u
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current '
_ ..
,Design„aCurrent
Design Cnrrea#
Swine.CavacityPop.
Wet Poultry
`Cap Eop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
Non -Layer
Dai Calf
Feeder to Finish
T -_'
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Farrow to Feeder
D . P,oul
Ca aci P,o .
Non-DaiTy
Farrow to Finish 7-00
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at-. ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify D WQ)
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)
1 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 ❑ NA ❑ NE
❑ Yes
❑ No
[;!� NA
❑ NE
❑ Yes
[:]No
1�1NA
❑ NE
❑ Yes [—]No
❑ Yes 1P No
❑ Yes "� No
EBNA
TT❑NA
❑ NE
❑NE
❑NA
❑NE
Page I of 3 2/4/2011 Continued

Facili Number: Date of Inspection:
2
❑ NA
❑ NE
❑ Yes
Waite Collection & Treatment
❑ NA
❑ NE
❑ Yes
P No
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
in 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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
` 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
❑ Yesj�
No
[:]NA
[-]NE
waste management or closure plan?
�
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[� No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �9 No ❑ NA
❑ 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 jCrop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area -�
12. Crop Type(s): �Ttt l 5 Nao , 5rn ` . rw,
13. Soil Type(s): 73 , ,-,p A-, iia 4j, Q<a 1 1jaA, , M6
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required 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.
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
(P No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
EPNo
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
[PNo
❑ NA
❑ NE
[:]Yes
P No
❑ NA
❑ NE
❑WUP ❑Checklists ❑Design [:]Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes V No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking [] Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes V No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Ir No
E] NA ❑NE
❑ Weather Code
❑ Sludge Survey
DNA ❑NE
❑NA ❑NE
Page 2 of 3 2/412011 Continued

JFacility Number: Z - Date of Ins ection:
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 [—]NA E]NE
the appropriate box(es) below.
[] Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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 tile drains exist at the facility? If yes, check the appropriate box below_
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
(refer to question ft Explain any YES answers and/or any addi
gs of facility to better explain situations (use additional pages as
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
7/6/fZ,
8 30 (12:
❑ YesIn No
❑ Yes No
❑ Yes No
[:]Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[:DNA ❑ NE
NA ❑ NE
[:]Yes ®No ❑ NA ❑ NE
[3Yes M No ❑ NA ❑ NE
❑ Yes FM No ❑ NA E]NE
❑ Yes MI No ❑ NA ❑ NE
ons or any other comments.
Phone:
Date:
2/4/2011

I
. . — i _ - I.
r ype oY visit: w 4.ompuance inspection V operation Review V structure Evaluation t ) I ethnical Assistance
Reason for Visit: 9 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date o(Visit:l Arrival Time: = Departure Time: County: Region:
Farm Name: Owner f 'M �� Owner Email:
Owner Name: �(IGY��t.f/f ��- Phone:
Mailing Address:
Physical Address:
Facility Contact: /f/ Title:
U
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Phone:
�q
Certification Number:
Certification Number:
Longitude:
Discharg s 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 A No ❑ NA ❑ NE
[:]Yes
Desegn Current-, Design 'Current;
Design Current
❑ NE
Swine y Capacity Pop
Wet, ult..
= Capactt* Pop P�
Cattle Capacity Pop.
Finish
7
Layer
Dai Cow
Feeder
]Non -Layer
Da' Calf
o Finish
Ereed
o Wean
to Feeder
Finish 2,OD
ur;
D ;Pal
La ers
"'Design Curredt
Ca act Po 'Non-Daito
Dai Heifer
D Cow
Beef Stocker
Non -La ers
Beef Feeder
Pullets
Turkc s
Beef Brood Cow
Turkc Poults
IS,
Other
Discharg s 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 A No ❑ NA ❑ NE
[:]Yes
❑ No
10 NA
❑ NE
[]Yes
❑ No
TNA
❑ NE
❑ Yes C] No
❑ Yes No
❑ Yes No
�} NA
❑ NE
❑` NA
[] NE
❑NA
❑NE
Page 1 of 3 1/4/2011 Continued

I
lFacility Number: - ZX 3 Date of Inspection: k
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
M 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
❑ NA
Identifier:i
acres determination?
Spillway?:
17. Does the facility lack adequate acreage for land application?
❑ Yes
(j No
❑ NA
Designed Freeboard (in):
LS. Is there a lack of properly operating waste application equipment?
❑ Yes
[P No
❑ NA
Observed Freeboard (in):
Required Records & Documents
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
`P No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ YesNo
❑ NA
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
rgNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application'? If yes, check the appropriate box below. ❑ Yes PNo ❑ NA ❑ NE
Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN n PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Cropr Winindyow,,,�,. 1,❑�Evviid`ennce o Wind Drift /❑' Application
�Outside of Approved Area
12. Crop Type(s): S I i ►"�' G( �* �'h , �M •[9Y$ri► (/it�I' &1", 404
13. Soil Type(s): flc-f 91 LT'01q, ^9
14. Do the receiving crops differ from diose designated in the CAWMP?
❑ Yes
[13 No
0 NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
� No
❑ NA
[—]NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
� No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
(j No
❑ NA
❑ NE
LS. Is there a lack of properly operating waste application equipment?
❑ Yes
[P No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
MR No
0 NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ YesNo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes I$ No
Ej Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
0 N ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Faci1' Number: ,3 I Date of inspection: Q$
24.'Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes ® No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes E] No INA ❑ NE
90
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA
E] NE
and report mortality rates that were higher than normal?
i
T
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes [A No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes® No
P
C] NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes [)a No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ NA
❑ NE
Comments (r'efer to question #):Explain any YES answers andlor any a'dditiopal recommendations or any other comments.
Use drawings of f� aCllity to better egplain situations (use additron_a ppages as necessary,).
Reviewer/Inspector Name:
Phone:
Reviewer/Inspector Signature:
Date:
MOO///
Page 3 of 3
2/4/2011

Type of Visit i Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit *Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit:li fa /Q Arrival Time: C� `� Departure Time: !2; .t County: -"'t'r'i�A/ Region: �—
Farm Name: ''t Owner Email:
Owner Name: ,/✓1 t1c Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: h
Certified Operator -
5 Br„
Back-up Operator:
Phone No:
Integrator: W' r✓��
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = e =I = u Longitude: = o ❑ I
Design ° Current
Design Current
Design Current
Swine Capacity Population
Wet Poultry Capacity Population
C*attle 1111Mga.pacityZE,opulation
❑ Yes [ `�} No ❑ NA
❑ Wean to Finish
I ❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
El Dairy Calf
El Feeder to Finish
❑ Dai Heifer
El Farrow to Wean
Dry Poultry
El Dry Cow
El Farrow to Feeder
ElNon-Dairy
Farrow to Finish
❑ La ers
El Beef Stocker
Gilts
ElNon-Layers
El Beef Feeder
El Boars
El Pullets
El Beef Brood Cowl
-
❑ Turke s
Other
❑ Other
❑ Turkey Poults
Number of Structures:
100ther I
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 PNo E] NA [1 NE
❑ Yes ❑ No �NA
[:1NE
❑ Yes ❑ No TNA
❑ NE
❑ Yes ❑ No f.NA
El NE
❑ Yes [ `�} No ❑ NA
❑ NE
❑ Yes IgNo ❑ NA
❑ NE
Page 1 of 3 12/28/04 Continued

Fa jc Uty,,Number:� Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes J9 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑Yes ❑ No Cj�NA El NE
Stru ture 1 Structure 2 Structure 3 Structure 4 Structure 5 ttructure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): U
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
P No ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
❑ NE
15. Does the receiving crop and/or land application site need improvement?
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes
M No ❑ 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
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)
18. Is there a lack of properly operating waste application equipment?
❑ Yes
9. Does any part of the waste management system other than the waste structures require ❑ Yes
[q9 No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need Cl YesNo
ElNA
ElNE
mai ntenance/improvement?
I . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
ENo ❑ NA
❑ NE
ElExcessive Ponding ElHydraulic Overload ElFrozen Ground [:1Heavy Metals (Cu, Zn, etc.)
II
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Cr p Window ❑ Evidence of Wind Drift ❑ Application of Area
/Outside
12. Crop type(s) �Y? , 1.1 ��i,�` I Cw2C l; � q ��6
t .'40,bt?,rJ
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
EP.No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
79 No
❑ NA
❑ NE
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
V No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ANo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer til question #): Explain any YES ansi►ers4andlor any recommendations or'am other comments w
Use drawings of facility to better explain situations (use addMomal pages as necessary): r s
Reviewer/inspector ector Name ( T
p I . � -- --� Phone: �D 3 3- 3300
Reviewerllnspector Signature: Date: ,
12/2R/ 4 Continued

, Facility Number:92 Date of Inspection 1 4
Re aired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes .19 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. ❑ YesNo [--INA ❑ NE
ElWaste Application ElWeekly Freeboard E]Waste Analysis ❑ Soil Analysis ElWaste Transferst Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22, Did the facility fail to install and maintain a rain gauge?
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
25. 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-andlor Drawings:
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ NotA
A
❑ NE
❑ Yes
No
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yeso ❑ NA ElNE
ElYes tNo ❑ NA ❑ NE
❑ Yes No [:INA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes [No ❑ NA ❑ NE
Page 3 of 3 12/28/04

S Division of Water � uality
IFaeility= Number Q Di�4sion of Soil and Fater Conservation
a Other Agency
Type of Visit *Compliance Inspection O Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine 0 Complaint 0 Follow up Q Referral Q Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time:l QQj•'30[zt� Departure Time: Ci.'c2� County: Region:
Farm Name: IM 3���1 _ Owner Email:
Owner Name: _Azvv "l ac Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: L Phone
%No:
Onsite Representative: Integrator: f ►�L�'0►''4r 4tva)ill ac
Certified Operator: �Qn Operator Certification Number: M03
r 03
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 00 [= i F-1" Longitude: =0 01 ="
Design Current
$wine Capacity Papulation
❑ Wean to Finish
Design Current
Wet Poultry Capacity Population
❑ Layer
De agn C►urrent
Cattle Capacity Population
❑ Dai Cow
❑ NA
❑ Wean to Feeder 1
10 Non -Layer I I
❑ Dairy Calf
❑ Feeder to Finish
a. Was the conveyance man-made?
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Yes
❑ Non -Dairy
Farrow to Finish
❑ Layers
11-1
❑ Beef Stocker
Gilts
Non -Layers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl
[:]No
❑ Turkeys
❑ NE
t)ther
❑ Turkey Poults
P No
❑ Other
❑ Other
Number of Struehsres:
Discharges & Stream lm acts
1. Is any discharge observed from any part of the operation?
❑ Yes
10 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
EP NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
[P 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
§3 NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
P No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
f� No
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Facility; Number: 8 Date of Inspection l� b
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No IR NA ❑ NE
Structure 5 Structure 6
Identifier:
❑ Yes
CR No
Spillway?:
❑ NE
15. Does the receiving crop and/or land application site need improvement?
Designed Freeboard (in):
[P No
❑ NA
Observed Freeboard (in):
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
5. Are there any inunediate threats to the integrity of any of the structures observed? ❑ Yes
P No
❑ NA EINE
(ief large trees, severe erosion, seepage, etc.)
❑ Yes
No
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?
1p No
❑ NA
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 ❑ NF
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
MNo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes
E No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
tffNo
❑ NA ❑ NE
maintenance/improvement?
U. . 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 I
,
12. Crop type(
13. Soil type(s
14. Do the receiving crops differ from those`designated in the CAWM P? v
❑ Yes
CR 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
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
1p No
❑ NA
❑ NE
Comments (refer to question #}: Ezplatn any YES ans�iers and/or any recommenJ.
dations ori anv othercommen
�1
Use drawings of facility to better explain situations..(use'additioaal•pages"as necessary)
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone:
Date:
12/28/04 Continued

Facility Number: — t f Date of Inspection
Re uired Records & Documents !
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [�6No ❑ 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
® 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
b No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
'IF 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
19 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
�U No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
ED NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?❑ Yes [� No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes ® No ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ 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 1!)INo [:INA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes 1P No ❑ NA ❑ NE
12118/04

I. I
Date of Visit: LM&OArrival Time: a ,� Departure Time:
Farm Name: Own
Owner Name: r AVw LLC Ph
Mailing Address:
Physical Address:
Access
County: Region:
er Email:
one:
Facility Contact: Title:��II Phone No: — _
Onsite Representative: Integrator: _ALI& _&Uz/1 , LUC
Certified Operator: w1241 r-'hO b, 51YJ Operator Certification Number:/ 7903
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =0
='
=64 Longitude: =0=, = u
�� D�esgu
Current
DesiKg�n Cren#
= Design Current
SwuteCapacity
Population Wet Poultry
purl
Capacity PoR lation
Cattle Capacity Population
to Finish
a. Was the conveyance man-made?
❑ Yes
❑ No
[� NA
❑ Dai Cow
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
FOWealn
to Feeder
NA
❑ NE
❑ Dai Calf
❑Feeder to Finish❑
6Nonn-Layer
Dai Heifer
Farrow to Wean
NA
*`" �`
❑ D Cow
❑ Farrow to Feeder`"
El Non -Dairy
Farrow to Finish
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Beef Stocker
❑ Gilts❑
❑ NA
❑ NE
Beef Feeder
❑ Boars
❑ Beef Brood Cow
OtherMM. "
��
12/28104
Continued
❑ Other
Number,of�Struetures:
Discharges & Stream Impacts
FONon-Lay La ers avers
❑Pullets
❑Turke s
❑ Turke Poults
❑ Other
Type of Visit 40 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit O Routine o Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied
I . Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[� NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
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
12/28104
Continued

Facility Number: Date of Inspection
❑ Yes
No
Waste Collection & Treatment
❑ NE
15. Does the receiving crop and/or land application site need improvement?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Ej No ❑ NA EINE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No F NA ❑ NE
Stru ture 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
[PNo
❑ NA
Spillway?:
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Designed Freeboard (in):
❑ NA
❑ NE
Observed Freeboard (in): _ 58
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ YesIPNo
ElNA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
P No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
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 Avolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
1p No ❑ NA ❑ NE
maintenance/improvement?
l 1 _ Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
F No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
A
12. Crop type(s;
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? w? '�'b
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�_61 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
(P No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[PNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
19 No
❑ NA
❑ NE
+Comments q a )' Explain any YES ans 1a any osnuiendations or any o he�comt e� t
fer to ueshon°#
Use,drawtngs of fac�ty to better -explain sl ons (iseaintioiages S, !
r
Reviewer/Inspector Name f
Phone: / �3
Reviewer/Inspector Signatur
Date:
Page 2 of 3 12/28/04 Continued

Facility Number: — Date of Inspection
Required Records & Documents Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes f6oNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes J)d 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 JU 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 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes W No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
M No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
qNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
�d No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�9 No
❑ NA
❑ NE
Other Issues
AL
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
gNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
91 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
F�ClNo
❑ 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 Drawutgs
; w
AL
Page 3 of 3 12/28/04

Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
- 0 Other Agency
Type of Visit f Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit I@ Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: (i �Ar�rival Time: � Q Departure Time: �l r County: � Region:
Farm Name: �/j�/'j ? `>< I Owner Email:
Owner Name: t ' `UWA L-7 13YOW )n Phone:
Mailing Address:
Physical Address: /
Facility Contact: i A,_" Title:
Onsite Representative: 1(
Certified Operator: W0.11 h n _tSo�1
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
Phone No: [Q�
Integrator:_ d 1✓t'DG�YI
Operator Certification Number: 1 % 909_
Back-up Certification Number:
Latitude: ❑ o ❑ I ❑ Longitude: ❑ ©= E ❑ W
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -La vers
❑ Pullets
❑ Turkeys
❑ Turke Pouits
❑ Other
Discharges & Stream Impacts
I . 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)
Design Current
Cattle Capacity Population
❑ Dairy Cow
E313airy Calf
❑ Dairy Heifer
❑ Dry Cow
❑
Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ITU
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any pan 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 r No ❑ NA ❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes P No ❑ NA
❑ NE
❑ Yes 10 No ❑ NA
❑ NE
12128/04 Continued

COX �� `t 7
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
0 No
❑ NA ❑ NE
Facility Number: Date of Inspection B 2
11.
Is there evidence of incorrect application? If yes, check the appropriate box below_ ❑ Yes
Waste Collection & Treatment
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
El NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
WI NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
O, No
Spillway?:
15.
Does the receiving crop and/or land application site need improvement? ElYes
III No
❑ NA ❑ NE
Designed Freeboard (in):
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
G9No
❑ NA ❑ NE
17.
Observed Freeboard (in): b
No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
5. Are there any immediate threats to the integrity of any of the structures observed?Q�
❑Yes
F No
❑ NA
El E
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
16No
❑ 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 enviranmentahreat, notify DWQ
VA
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 6 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 f9 No ❑ NA ❑ NE
maintenance or improvement?
Waste Aoolication
10.
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
0 No
❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below_ ❑ Yes
[ONo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] O 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) vl (,� L -o m [7►-
13.
Soil type(s) {ro o B itiQ
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
O, No
[INA [:1 NE
15.
Does the receiving crop and/or land application site need improvement? ElYes
III No
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
G9No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name Phone:
Reviewer/inspector Signature: Date: 0
12/28104 Continued

Facility Number:Now
Date of Inspection
Required Records & Documents
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 JS No ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑Checklists ❑Design El maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [9 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
® No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[61 No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
19 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
allo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
in No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
[--]Yes
0 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
Z 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
23 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
19 No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[0 No
❑ NA
❑ NE
Comments and/or Drawings:
12/28/04

Type of Visit 46 Compliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency Q Other ❑ Denied Access
Date of Visit: ffT_TqHL7] Arrival Time: Departure Time: County: O Region:
Farm Name: !" M l � Sl Lf T Owner Email:
Owner Name: r " i w`' ' ""1 brn ui V1_ Phone:
Mailing Address:
Physical Address: _ "
Facility Contact: C7,a4 Title:
�r
Onsite Representative:
Certified Operator:
Back-up Operator:
�j
Phone No: Q
Integrator: ALIS
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: [=O
[=,
=11 Longitude: =()=,
°❑, ❑ is
�`�"' fid,; f P
Design Current Design Current Design Carrent
Swine Ca aci Po elation Wet Poult '"'
p ty p ry "Capacty,Popul$tian�. ,wattle Capacity Population
❑ Wean to Finish ❑ La er ❑ Dairy Cow
❑ Wean to Feeder ❑Non -La er ti El Dairy Calf
❑ Feeder Finish
x, A ❑ Dai Heifer
to
❑ Farrow to Wean :. ❑ Dry Cow
Dry Poultry .
❑ Farrow to Feeder '° "F' ❑ Non -Dairy
Farrow to Finish I ❑ Layers ❑ Beef Stocker
El Gilts ❑ Non -Layer
s ❑ Beef Feeder
❑ Boars ❑ Pullets
❑ ❑ Beef Brood Co
Turkc s
— t
Other �.
❑ Turkey Poults
ElOther ❑ Other Number of Structures:
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d, Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes IFI No ❑ NA FINE
❑ Yes
❑ No
V:
ry
❑ Yes
❑ No
�`�"' fid,; f P
Design Current Design Current Design Carrent
Swine Ca aci Po elation Wet Poult '"'
p ty p ry "Capacty,Popul$tian�. ,wattle Capacity Population
❑ Wean to Finish ❑ La er ❑ Dairy Cow
❑ Wean to Feeder ❑Non -La er ti El Dairy Calf
❑ Feeder Finish
x, A ❑ Dai Heifer
to
❑ Farrow to Wean :. ❑ Dry Cow
Dry Poultry .
❑ Farrow to Feeder '° "F' ❑ Non -Dairy
Farrow to Finish I ❑ Layers ❑ Beef Stocker
El Gilts ❑ Non -Layer
s ❑ Beef Feeder
❑ Boars ❑ Pullets
❑ ❑ Beef Brood Co
Turkc s
— t
Other �.
❑ Turkey Poults
ElOther ❑ Other Number of Structures:
Discharges & Stream Impacts
I . 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?
Page 1 of 3
❑ Yes IFI No ❑ NA FINE
❑ Yes
❑ No
q!FNA
❑ NE
❑ Yes
❑ No
4NA
❑ NE
UNA
❑ NE
❑ Yes
❑ No
❑ Yes
Fj No
❑ NA
❑ NE
❑ Yes
TKNo
ElNA
ElNE
12/28/04 Continued

Facility Number: qV Date of Inspection L S -1 `D
a
Waste Collection & Treatment
T
Reviewer/inspector Name t
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?
El Yes
No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure
4 Structure
5
Structure 6
Identifier: 3 p W l
Spillway?:
Designed Freeboard (in):
u
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[�] No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
P] No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes�ZJ
No
El NA F-1NE
(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
S No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA ❑ NE
mai ntenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > I0% 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) GWh . W 6j,j f S &-n'+ude� ZQ,r
64' �='&rxs.,.% CJi[�is0W:A
,, ��
13. Soil type(s) )k' A- B7 _l Q,�,-
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
K No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[9 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
EKNo
❑ NA ❑ NE
'Comments (refer to question ff): 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)
a
T
Reviewer/inspector Name t
hone
LO)q-33 3 ?DOj�Jlo�L P
Reviewerllnspector Signature:
Date: S "1 ftb
Page 2 of3 12128104 Continued

Facility Number: _ %fLAW
F Date of Inspection Y
Re wired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 91 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 [�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 J�No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P 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
® No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
P] No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
WNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Ep No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
(jNo
❑ 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
0 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
W No
❑ NA
EINE
Additional Comments and/or Drawings:
AL
Page 3 yea f3 12128104

Division ol: Water Quality
E==Eacilitymber $rL � � t{ 3 � Division oi' Soil and Water Coaseryafiou
Q Other Agenn°
Type of Visit ® 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:�Z1 = i Departure Time: bb County: d►. Region:
Farm Name: �,T Owner Email:
Owner Name:.... rO 6j!!%9G of ��_ �_ G. Phone:
Mailing Address: _ (O.SLS P_ ,-Ik
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Title:
Phone No:
Integrator* (tv rt71-ire._
Operator Certification Number: f
Back-up Certification Number:
Location of Farm: Latitude: ET
E=1' 0 " Longitude: ❑ 6 ❑ { 0 u
Swine
Design Current Design - Current
Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish i ❑ Layer
❑ Wean to Feeder on-Layet
❑ Feeder to Finish I
❑ Farrow to Wean
❑ Farrow to Feeder
G�Varrow to Finish (20a
❑ Gilts
❑ Boars
Other y _
❑ Other
Discharges & Stream Impacts
„Dry Poultry,
❑
Layers
❑ Non -La ers
❑ Pullets
❑
Turkeys
❑
Turkey Poults
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy Cow
DDairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑
Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures: ELI
1. Is any discharge observed from any part of the operation?
❑ Yes
C5No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
LfNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
9NA
❑ 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
UK NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes UNo ❑ NA ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes PNo ❑ NA ❑ NE
other than from a discharge?
12/78/04 Continued

I
Facility Number:
Date of Inspection �
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2
Identifier: - {
Spillway?: ✓� 4
Designed Freeboard (in):
Observed Freeboard (in):
Structure 3 . Structure 4
❑ Yes KNo ❑ NA ❑ NE
❑ Yes -gNo XNA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
tj No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
RfNo
❑ NA
❑ NE
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
E� 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
K 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
9No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
KNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
RNo
[INA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) - e -a► s C 0. E
w� . [`
S
S
13. Soil type(s) v $
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
[9 No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑ Yes
�RNo
[:INA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
RfNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
R No
❑ NA
❑ NE
Reviewer/Inspector Name ; {lam , "; j ?' Phone: J() r{6yo —lSri/
Reviewer/Inspector Signature: Date:
12/28/04 Continued

Facility Number: 8 —It& Date of Inspection �o
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes KNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? 1Iyes, check ❑ Yes Z No ❑ NA ❑ NE
the appropirate box.
❑ WUPr ❑ Checklisl�❑ DesigtY❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 6 No ❑ NA ❑ NE
❑ Waste ApplicatiLv' ❑ Weekly Freeboard❑ Waste Analysis❑ Soil AnalysisvE] Waste Transfers ❑ Annual Certification
❑ Rainfqjy❑ Stocking❑ Crop Yield --El 120 Minute Inspectiorw—❑ Monthly and 1" Rain Inspections ❑ Weather Code &--
22, Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal'?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit'? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency'?
Addttional Comments and/or Drawings: _
❑ Yes
UVo
❑ NA
❑ NE
❑ Yes
K[No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
[gNo
❑ NA
❑ NE
❑ Yes
X No
❑ NA
❑ NE
❑ Yes
9No
❑ NA
❑ NE
❑ Yes ®-No ❑ NA ❑ NE
❑ Yes 6No ❑ NA EINE
❑ Yes [.No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
K] No
❑ NA
❑ NE
❑ Yes
U.No
❑ NA
❑ NE
12/28/04

k
Facilin- lumber t! Dale of Visit: Time:
ro >\ot O erational Q Below Threshold
® Permitted ® Certified ❑ Conditionally- Certified OR 'istered Date Last Operated or Above Threshold:
Farm Name: A 4t en3S 1 y Counrv: — 12 JA a ��?
Owner Name: Phone No:
Mailing Address:
Facility Contact:��77 Title: Phone No:
K
Onsite Representative: _ Q ;{`- inteugrator:_�...
Certified Operator. %aJeae _ _ ��aue^r r�wi Operator Certification Number:
Location of Farm:
®Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' Longitude 0 �•
Design Current
Swine 1'anae4ft. Pnnielatinn
0 Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
® Farrow to Finish /.2 oe / x o A
❑ Gilts
❑ Boars
Design Current Design Current
Poultn' Capacity Population Cattle Capacity Population
❑ Laver Q Dairy
❑ Non -Laver ❑ Non -Dain,
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10
Spray Field Area
Holding Ponds / Solid Traps 10 No Liquid Waste Management System
Discharges & Stream ignpacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Fill No
Discharge originated at: ❑ Lagoon [] Spray Field ❑ Other
a. if discaar_e is observed, was the conveyance man -trade?
Q Yes
❑ No
b. If discharge is obsen-ed. did it reach NI ater of the State? (if yes. notify DWQ)
❑yes
❑ Na
c. If discharee is observed. what is the estimated flow in eaUrnin?
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 Raters of the State other than from a discharge?
❑ Yes
® No
Waste CLAlection S Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier_
Freeboard (inches): 3
05/03101
Continued

5
..
Facility Number: a — 14413
Date of Inspection
5. are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered res, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes M No
❑ Yes R1 No
® Yes ❑ No
® Yes © No
❑ Yes Qd No
❑ Yes M No
❑ Yes ®No
12. Crop type -- ori c!Q Is dL' / r�, e��.�v �!� `�11d►al� �L# 14, Sr+a.ttf 4�'4iaJ.
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 [V No
b) Does the facility need a wettable acre determination? ❑ Yes 3No
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? ❑ Yes No
16. 1s there a tack of adequate waste application equipment? ❑ Yes No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ® No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ W -UP, checklists_ design, maps, etc.) ❑ Yes No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes [A No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes Q0 No
22- Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application) ❑ Yes 5 No
23. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? ❑ Yes $1 No
24. Does facility require a follow-up visit by same agency? ❑ Yes ly No
25. Were any additional problems noted which cause noncompliance of the Certified AAWl ? Q Yes �B No
Q No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
-
CamriientsA(reier ta`questian fl): �Exphun:_any YE5 ansi-ers and!©r any_reeammeudstions.or any-athei- oommeuts.._-._- ��
._:...
Else drawin s of f i to;better.,e_X W t situations: (ase a" tt nal pages necessary)
g dtty ,.. s Field Conv ❑ Final Notes
_ •
ss7_ Gbalos" & +o w6rk s►AJ Gres,era 'M 101,= .. wdzAvv, k.�dEj to c+ 1
Reviewer/Inspector ]Same -.
Reviewerllnspector Signature: Date: L 1.2 Hey
05103/01 0 f Continued

ion of Water Quality T Z
Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0Compli ce Inspection C) Operation Review O Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
cility Number Date of Visit: Time:
Not O erationaf Below Threshold
Permitted 0 Certified O Conditionally Certified ©Registered Date Last Operated or Above Threshold:
r
Farm Name l-��,� Counts':
Owner Name: Phone No:
Mailing Address:
Facility Contact: I Title:
Onsite Representative:- t� Bic i ft
Certified Operator: ��S7ilh���
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 OK Longitude a °
Design Current
nwme C:a actty Yo ulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I ❑ Dairy I
❑ Non -La er ❑ Non-Dairyt
❑ Other
Total Design Capacity
U Gilts
❑ Boars I J Total SSLW
Number of Lagoons
Holding Ponds / Solid Traps
Subsurface Drains Present
No Liquid Waste Managen
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a, If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State'? (if yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2_ Is there evidence of past discharge fiom 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?
NVa to C-oliggoon & Treatment
4, Is storage capacity (freeboard plus storm storage) less than adequate? Cl Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05/03/01
Field Area
❑ YesNo
ElYes N
EI Yes No
❑ Yes EfN
❑ Yes
❑ YesN
ElYes 5No
Structure 6
Continued

Facility Number: z— — V4�31 Date of Inspection
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
I !_ is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
S
13. Do the receiving crop differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
K a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15_ Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Reguired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
2l. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did ReviewerAnspeclor fail to discuss review/inspection with on-site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes No
❑ Yes 2rNo
❑ Yes No
❑ Yes ;�o
oo
❑ Yes
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes o
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes ;�<
❑ Yes
❑ Yes Po
El Yes
.
❑ Yes
❑ Yes �No
❑ Yes �T
❑ Yes No
05/03/01 Continued