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HomeMy WebLinkAbout820682_INSPECTIONS_201712311 NORTH CAROLINA Department of Environmental Quality • Division of Water Resources D Division of Soil and Water Conservation D other Agency Facility Number: 820682 Facility Status: Active Permit AWS820682 -------- lnpsection Type: Compliance Inspection Inactive Or Oosed Date: Region: -------Sampson Reason for VIsit Routine ------------------County: Date of VISit 03123/2017 Entry Time: 01:30pm Exit Time: 2:00pm Incident• Farm Name: Stafford Fann Owner Email: Owner: Murphy-Brown LLC Phone: Mailing Address: PO Box487 Warsaw NC 28398 Physical Address: Sr 1259 3316 Nonis Rd Gartand NC 28441 Facility Status: • Compliant D Not Compliant Integrator: Murphy-Brown LLC D Denied Access Fayetteville 910-296-1800 Location of Farm: Latitude: 34" 48' 56" Longitude: 78" 23' 11" From Garland, take US 701 towards Clinlon, tum left onto SR 1259 go 0.7 miles to fann entrance on left. Question Areas: • Dischrge & Stream Impacts • Waste Col, Stor, & Treat • Waste Application • Records and Documents • Other Issues Certified Operator: Robert T Young Operator Certification Number: 18461 Secondary O IC(s): On-$ite Reprasentative(s): Name Title Phone. 24 hour contad name Mike Ammons Phone : On-site representative Mike Ammons Phone: Primary Inspector: Robert Marble Phone: Inspector Signature: Date : Secondary lnspector(sJ: Inspection Summary: page: Permit: AVVS820682 Inspection Date: 03/23/17 Regulated Operations Swine I D Swine-Farrow to Wean Owner-Facil ity : Murphy-Brown LLC lnpsection Type: Compliance Inspection Design Capacity 4,878 Facility Number: Reason for Visit: 820682 Routine Current promotions Total Design Capacity: 4 ,878 2 ,112,174 Wsste Structures Type Identifier Closed Date '1ST STAGE 2ND STAGE Start Oate Total SSLW: Olslgnatad Freeboard Observed Freeboard 24.00 55.00 page: 2 Permit: AV\18820682 Inspection Date: 03123/17 Discharges & Stream Impacts Owner-Facility: Murphy-Brown LLC lnpsection Type: Compliance Inspection 1. Is any discharge observed from any part of the operation? Discharge originated at Structure Application Field Other a. Was conveyance man-made? b. Did discharge reach Waters of the State? (if yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d . Does discharge bypass the waste management system? (if yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? Facility Number: Reason tor Visit: 3. 1/Vere there any observable adverse impacts or potential adverse impacts to Waters of the State other than from a discharge? Waste Collection, Storage & Treatment 4. Is storage capacity less than adequate? If yes, is waste level into structural freeboard? 5. Are there any immediate threats to the integrity of any of the structures observed (I .e./large trees, severe erosion, seepage, etc.)? 6. Are there structures on-site that are not properly addressed and/or managed through a waste management or closure plan? 7 . Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (Not applicable 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 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. Excessive Pending? Hydraulic Overload? Frozen Ground? Heavy metals {Cu, Zn, etc)? PAN? Is PAN> 10%/10 lbs.? Total Phosphorus? Failure to incorporate manure/sludge into bare soil? Outside of acceptable crop window? Evidence of wind drift? Application outside of application area? 820682 Routine Yn NoNa Ne Yn NoNa Ne o•oo o•oo Yn NoNa Ne D D D D D D D 0 0 D D page: 3 Owner-Facility: Murphy-Brown LLC Facility Number: Permit: AVVS820682 Inspection Date: 03/23117 lnpsection Type: Compliance Inspection Reason for Visit: Wasta Application Crop Type 1 Crop Type 2 Crop Type 3 Crop Type 4 Crop Type 5 Crop Type 6 Soil Type 1 Soil Type 2 Soil Type 3 Soil Type 4 Soil Type 5 Soil Type 6 14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAWMP)? 15. Does the receiving crop and/or land application site need improvement? 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 19. Did the facility fail to have Certificate of Coverage and Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropriate box below. VVUP? Checklists? Design? Maps? Lease Agreements? Other? If Other, please specify 21 . Does record keeping need improvement? If yes, check the appropriate box below. waste Application? Weekly Freeboard? waste Analysis? Soil analysis? Waste Transfers? V\leather code? 820682 Routine Yn NoNa Ne Com, 'Mieat, Soybeans Autryville loamy sand, 0 to 6%!11opes Blanton sand, o 106% slopes Goldsboro loamy sand, 0 to 2% slopes Norfolk loamy sand, 0 to 2% slopes Yn NoNa Ne D D D D D D D D D D D D page: 4 . - Owner-Facility : Murphy-Brown LLC Facility Number: Permit: A\IVS820682 Inspection Date: 03123/17 lnpsection Type: Compliance Inspection Reason for Visit: Records and Documents Rainfall? Stocking? Crop yields? 120 Minute inspections? Monthly and 1" Rainfall Inspections Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below: Failure to complete annual sludge survey Failure to develop a POA for sludge levels Non-<:Ompliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-<:Ompliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report mortality rates that exceed normal rates? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit? (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 I Storage Pond Other If Other, please specify 32. 11\fere any additional problems noted which cause non-<:Ompliance of the Permit or CAWMP? 33. Did the Reviewerllnspector fail to discuss review/inspection with on-site representative? 34. Does the facility require a follow-up visit by same agency? 820682 Routine Its No Na Ne D D D Yn NoNa Ne D D D page: 5 • D D Division of Water Resources Division of Soil and Water Conservation Other Agency Facility Number. 820682 Facility Status: Active Permit: AWS820682 ------ Inactive Or Closed Date : 0 Denied Access lnpsection Type: Compliance Inspection Reason for Visit: Routine --------------------------------County: Sampson Region: Fayetteville ---------- Date of VIsit: 09/23/2015 Entry Time: 08 :00am Exit Time: 9:00am Incident# Farm Name: Stafford Farm Owner Email: --------------------------------- Owner: Murphy-Brown LLC Phone : 91Q-296-1800 Mailing Address: PO Box487 Warsaw NC 28398 Physical Address: Sr 1259 3316 Nonis Rd Garland NC 28441 Facility Status: • Compliant D Not Compliant Integrator: Murphy-Brown LLC Location of Farm: Latitude: 34 • 48 ' 56" Longitude: 78" 23' 11 " From Garland, take US 701towards Clinton, tum left onto SR 1259 go 0 .7 miles to farm entrance on left. Question Areas: • Dischrge & Stream Impacts • Waste Col, Stor. & Treat • Waste A pplication • Records and Documents • Other Issues Certified Operator: Robert T Young Operator Certification Number: 18461 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: Rober! Marble Phone : Inspector Signature: Date : Secondary lnspector(s): Inspection Summary: page: .• Permit: AWS820682 Inspection Date: 09/23115 Regulated Operations Swine 0 Swine -Farrow to Wean D Swine -Feeder to Finish 0 Swine ; Wean to Feeder Owner. Facility : Murphy-Brown LLC Facility Number: 820682 Jnpsection Type: Compliance Inspection Reaso n for Visit: Routine Design Capacity Currant promotions 4,462 1 ,224 500 Total Design Capacity: 6,186 2,112.286 Waste Structuras Type Identifier Closed Date Lagoon 1ST STAGE I Lagoon 2ND STAGE I SU!rt Date Total SSLW : Disignated Freeboard Observed Freeboard 25.00 81 .00 page : 2 Permit: AWS820682 Inspection Date : 09/23/15 Discharges & Stream Impacts Owner-Facility : Murphy-Brown LLC lnpsection Type: Compliance Inspection 1. Is any discharge observed from any part of the operat ion? Discharge originated at: Structure Application Field Other a . Was conveyance man-made? b. Did discharge reach Waters of the State? (if yes, notify DWQ) c . What is the estimated volume that reached waters of the State (gallons)? d . Does discharge bypass the waste management system? (if yes, notify DWQ) 2 . Is there evidence of a past discharge from any part of the operation? Faci lity Number: Reason for Visit: 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 4 . Is storage capacity less than adequate? If yes, is waste level into stnuctural freeboard ? 5. Are there any immediate threats to the integrity of any of the structures observed (I.e./large trees , severe erosion, seepage, etc.)? 6 . Are there stnuctures on-site that are not properly addressed and/or managed through a waste management or closure plan? 7 . Do any of the stnuctures need maintenance or improvement? 8 . Do any of the stnuctures lack adequate marke rs as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9 . Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers , setbac ks , or compliance alternatives t hat need maintenance or improvement? 11 . Is there evidence of incorrect applicat ion? If yes, check the appropriate box below . Excessive Pending? Hydraulic Overload? Frozen Ground? Heavy metals (Cu, Zn, etc)? PAN? Is PAN > 10%/10 lbs.? Total Phosphorus? Failure to incorporate manure/sludge into bare soil? Outside of acceptable crop window? Evidence of wind d rift? Application outside of application area? 820682 Routine Ye& No Na Ne Yes No N;;o Ne Yes No Na N! D D D D 0 D D 0 D D D page: 3 Owner -Facility : Murphy-Brown LLC Facility Number: Pennit: AWSB20682 Inspection Date: 09/23/15 lnpsection Type: Compliance Inspection Reason for Visit Waste Application Crop Type 1 Crop Type 2 Crop Type 3 Crop Type4 Crop Type 5 Crop Type 6 Soil Type 1 Soil Type 2 Soil Type 3 Soil Type4 Soil Type 5 Soil Type 6 14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAVIIMP)? 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 detennination? 17 . Does the facility lack adequate acreage for land application? 18 . Is there a lack of properly operating waste application equipment? Records and Documents 19. Did the facility fail to have Certificate of Coverage and Permit readily available? 20 . Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropriate box below . WUP? Checklists? Design? Maps? Lease Agreements? Other? If Other, please specify 21 . Does record keeping need improvement? If yes, c heck the appropriate box below . Waste Application? Weekly Freeboard? Waste Analysis? Soil analysi s? Waste Transfers ? Wea ther code ? 820682 Routine Yea No Na Ne Com, IMieat, Soybeans Aullyville loamy sand, 0 to 6% slopes Blanton sand. 0 to 6% slopes Goldsboro loamy !Nind, 0 to 2% slopes Norfolk loamy sand, 0 to 2% slopes Yes NoNe Ne D 0 0 0 0 0 D D D D 0 0 page: 4 Owner-Facility : Murphy-Brown LLC Facility Number: Permit: AWS820682 Inspection Date: 09/23/15 lnpsection Type: Compliance Inspection Reason for Visit: Records and Documents Rainfall? Stocking? Crop yields? 120 Minute inspections? Monthly and 1" Rainfall Inspections Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below: Failure to complete annual sludge survey Failure to develop a POA for sludge levels Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report mortality rates that exceed normal rates ? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediate ly. 30. Did the facility fail to notify regional DWQ of emerge ncy situations as required by 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 I Storage Pond Other If Other, please specify 32. Were any additional problems noted which cause non-compliance of the Permit or CAWMP? 33. Did the Reviewer/Inspector fail to discus s review/inspection with on-site representative? 34. Does the facility require a follow-up visit by same agency? 820682 Routine Yes No Na Ne D D 0 0 0 0 o •o o D •o D D D D Yes No Na Ne D D 0 o•oo o•oo o•oo page : 5 Division of Water Resources • D D Division of Soil and Water Conservation Other Agency Facility Number: 820682 Facility Status: Active Permit AWS820682 ------------------ lnpsectlon Type: Compliance Inspection Inactive Or Closed Date: Reason for Visit Routine --------------------------------Sampson Region: ----------County: Date of Visit: 08/19/2014 Farm Name: Stafford Farm Entry Time: 03:30pm Exit Time: 4:30pm Incident# Owner Email: ------------------------------------- Owner: Murphy-Brown LLC Phone: Mailing Address: PO Box487 Warsaw NC 28398 Physical Address: Sr 1259 3316 Norris Rd Garland NC 28441 Facility Status: • Compliant D Not Compliant Integrator: Mur phy-Brown LLC D Denied Access Fayetteville 910-296-1800 Location of Farm: Latitude: 34" 48' 56" Longitude: 78" 23' 11 " ------- From Gartand, take US 701 towards Clinton, tum left onto SR 1259 go 0.7 miles to farm entrance on left. Question Areas: • Dischrge & Stream Impacts • Waste Col. Stor. & Treat • Waste Appl ication • Records and Documents • Other Issues Certified Operator: Michael Richard Ammons Operator Certification Number: 985998 Secondary OIC(s): On-Site Representative(&): 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 lnspector(s): Inspection Summary: page: 1 Permit: AWS820682 Inspection Date: 08/19/14 Regulated Operations Swine 0 Swine-Farrow to Finish 0 Swine-Farrow to Wean 0 Swine -Feeder to Finish 0 Swine -Wean to Feeder Owner-Facility : Murphy-Brown LLC Faci lity Number: 820682 lnpsection Type: Compliance Inspection Reason fo r Visit Routine Design Capacity Current promotions Total Design Capacity: Waste Structures Type Identifier Closed Date liST STAGE 2ND STAGE Start Date T otaiSSLW: Disignated Freeboard Observed Freeboard page : 2 Permit AWS820682 Inspection Date: 08/19/14 Discharges & Stream Impacts Owner-Facility: Murphy-Brown LLC lnpsection Type: Compliance Inspection 1. Is any discharge observed from any part of the operation? Discharge originated at Structure Application Field Other a. Was conveyance man-made? b. Did discharge reach Waters of the State? (if yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (if yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? Facility Number: Reason for Visit: 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 4. Is storage capacity less than adequate? If yes, is waste level into structural freeboard? 5. Are there any immediate threats to the integrity of any of the structures observed (I.e./large trees, severe erosion, seepage, etc.)? 6. Are there structures on-site that are not properly addressed and/or managed through a waste management or closure plan? 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (Not applicable 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 10. Are there any required buffers, setbacks, or compliance alternatives that need mainte nance or improve ment? 11. Is there evidence o f incorrect application? If yes, check the appropriate box below. Excessive Pending? Hydraulic Overload? Frozen Ground? Heavy metals (Cu, Zn, etc)? PAN? Is PAN> 10%/10 lbs .? Total Phosphorus? Failure to incorporate manure/sludge into bare soil? Outside of acceptable c rop window? Evidence of wind drift? Applica tion outside of application area? 820682 Routine Yes No Na N& Yes No N!l Ne Y&5 NoNa N& 0 0 0 0 0 0 0 0 0 0 0 page: 3 Owner-Facility : Murphy-Brown LLC Facility Number: Permit: AWS8206B2 Inspection Date: 08/19/14 tnpsection Type: Compliance Inspection Reason for Visit: Waste Application Crop Type 1 Crop Type 2 Crop Type 3 Crop Type 4 Crop Type 5 Crop Type 6 Soil Type 1 Soil Type 2 Soil Type 3 Soil Type 4 Soil Type 5 Soil Type 6 14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAWMP)? 15. Does the receiving crop and/or land application site need improvement? 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 wa ste application equipment? Records and Documents 19. Did the facility fait to have Certificate of Coverage and Permit read ily available? 20 . Does the facility fail to have all components of t he CAWMP readily available? If yes, check the appropriate box below . WUP? Checklists ? Design? Maps? Lease Agreements? Other? If Oth e r , please specify 21 . Does re co rd kee ping need improvement? If yes, c heck the appropriate box below. Waste Application? Weekly Freeboard? Waste Analysis? Soi l analysis? Waste T ransfers ? Weather code? 820682 Routine Yes NoNa Nt Com, Wheat, Soybeans Aullyville loamy sand. 0 to 6% slopes Blanton sand, 0 to 6% slope$ Goldsboro loamy sand, 0 to 2% slopes Norfolk loamy sand, 0 to 2% slopes Yes NoNa Ne D 0 D D D 0 D D 0 D 0 D page : 4 Facility Number: Permit: AWS820682 Inspection Date: 08/19/14 Owner-Facility : Murphy-Brown LLC lnpsection Type: Compliance Inspection Reason for Visit: Records and Documents Rainfall? Stocking? Crop yields? 120 Minute inspections? Monthly and 1" Rainfall Inspections Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below: Failure to complete annual sludge survey Failure to develop a POA for sludge levels Non-compliant sludge levels in any lagoon list structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report mortality rates that exceed normal rates? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes , contact a regional Air Quality representative immediately . 30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes , check the appropriate box below. Applicat ion Field Lagoon I Storage Pond Other If Other, please specify 32 . Were any additional problems noted which cause non-compliance of the Permit or CAWMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with on-site representative? 34. Does the facility require a follow-up visit by same agency? 820682 Routine Yes NoNa Nt D D D Yet No N! Ne D 0 D page: 5 ' Facility Number: 820682 -------- lnpsection Type: Compliance Inspection Reason for Visit: Routine • D D Division of Water Resources Division of Soil and Water Conservation Other Agency Facility Status: Active Pennit: AW$820682 Inactive Or Closed Date: Sampson ----------------------------County: Region: ------- Date of Visit: 10/1712013 Entry Time: 09:15 am Exit Time: 10:00 am Incident# Farm Name: Stafford Farm Owner Email: Owner: Murphy-Brown LLC Phone: Mailing Address: PO Box 467 Warsaw NC 28398 Physical Address: Sr 1259 3316 Norris Rd Garland NC 26441 Facility Status: • Compliant D Not Compliant Integrator: Murphy-Brown LLC 0 Denied Access Fayetteville 910-296-1600 Location of Farm: Latitude: 34 o 48' 56" Longitude: 78" 23' 11" From Garland, take US 701 towards Clinton. tum left onto SR 1259 go 0.7 miles to farm entrance on left. Question Areas: • Disctlrge & Stream Impacts • Waste Col. Stor, & Treat • Waste Application • Records and Documents • Other Issues Certified Operator: Danny Lee Tyner Operator Certification Number: 26715 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 lnspector(s): Inspection Summary: page: Permit: AWSB20682 Inspection Date: 10/17/13 Regulated Operations Swine D Swine-Farrow to Wean D Swine -Feeder to Finish D Swine -Wean to Feeder Owner-Facility : Murphy-Brown LLC Facility Number: 820682 lnpsection Type: Compliance Inspection Reason for Visit: Routine Design Capacity Current promotions Total Design Capacity: Waste Structures Type Identifier Closed Date I'ST STAGE 2ND STAGE Start Date Total SSLW: Disignated Freeboard Observed Freeboard page: 2 Permit: AW$820682 Inspection Date: 10117/13 Discharges & Stream Impacts Owner -Facility : Murphy-Brown LLC lnpsection Type: Compliance Inspection 1. Is any discharge observed from any part of the operation? Discharge originated at: Structure Application Field Other a. Was conveyance man-made? b. Did discharge reach Waters of the State? (if yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (if yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? Facility Number: Reason for Visit: 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 4 . Is storage capacity less than adequate? If yes, is waste level into structural freeboard? 5. Are there any immediate threats to the integrity of any of the structures observed (I.e./large trees, severe erosion, seepage, etc.)? 6. Are there structures on-site that are not properly addressed and/or managed through a waste management or closure plan? 7 . Do any of the structures need maintenance or improvement? 8 . Do any of the structures lack adequate markers as required by the permit? (Not applicable 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 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? 11 . Is there evidence of incorrect application? If yes, check the appropriate box below. Excessive Pending? Hydraulic Overload? Frozen Ground? Heavy metals (Cu, Zn , etc)? PAN? Is PAN> 10%/10 lbs.? Total Phosphorus? Failure to incorporate manure/sludge into bare soil? Outside of acceptable crop window? Evidence of wind drift? Application outside of application area? 820682 Routine Yes NoN! Ne Yn NoNa Ne Yes NoN! No 0 0 0 0 0 D 0 0 0 0 0 page: 3 Owner -Facility : Murphy-Brown LLC Facility Number: Permit: AWS820682 Inspection Date: 10/17/13 lnpsection Type: Compliance Inspection Reason for V isit: Waste Application Crop Type 1 Crop Type 2 Crop Type 3 CropType4 Crop Type 5 Crop Type 6 Soil Type 1 Soil Type 2 Soil Type 3 Soil Type4 Soil Type 5 Soi1Type6 14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAWMP)? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre 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 19. Did the facility fail to have Certificate of Coverage and Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropriate box below. WI.JP? Checklists? Design? Maps? Lease Agreements? Other? If Other, please specify 21 . Does record keeping need improvement? If yes, check the appropriate box below. Waste Application? Weekly Freeboard? Waste Analysis? Soil analysis? Waste Transfers? Weather code? 820682 Routine Yes NoN! Ne Com, VVheat. Soybeans A utryville loamy sand . o 10 6% &lopes Blanton sand. 0 to 6% slopes Goldsboro loamy sand, 0 to 2% slopes Norfolk loamy sand, 0 10 2% slopes Yes No N• Nt D 0 D 0 0 0 0 0 0 0 0 0 page : 4 .... Owner-Facility : Murphy-Brown LLC Facility Number: Permit: AWS8206B2 Inspection Date: 10/17/13 lnpsection Type: Compliance Inspection Reason for Visit: Records and Documents Rainfall? Stocking? Crop y ields? 120 Minute inspections? Monthly and 1" Rainfall Inspections Sludge Survey 22 . Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below: Failure to complete annual sludge survey Failure to develop a POA for sludge levels Non-compliant sludge levefs in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with in 24 hours and/or document and report mortality rates that exceed normal rates? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit? (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 I Storage Pond Other If Other, please specify 32. Were any additional problems noted which cause non-compliance of the Permit or CAWMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with on-site representative? 34. Does the facility require a follow-up visit by same agency? 820682 Routine 0 0 0 Yes No Nt He 0 D 0 page: 5 Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: e Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: I s -)-5-·rld Arrival Time :I fo :a:>,lh I Departure Time:l ro ~;?L)l~l County: ~c,.J Region: pf?v Farm Name: 5:lzr~ ~tV' Owner Email: Owner Name: ~1~~1~t1>o.:M 1 1l.c.-Phone: Mailing Address: Physical Address: ------------------------------------------- Facility Contact: -"-{\-~'-'~'-'"e=...;b~~tv\,~ti_N_;__ ____ Title: ----------Phone: Onsite Representative: Certified Operator: Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Application Field a. Was the conveyance man-made? 0 Other: 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)? Integrator: Jv1 ~J3n,_J"/\ Certification Number: '?.L..~~<55J.::..~_,_1_'5 _____ _ Certification Number: Longitude: DYes ~No DNA ONE DYes 0No ~NA ONE DYes 0No ~NA ONE d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No 09NA ONE 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? Page 1 of3 DYes ~No DYes ~No DNA ONE DNA ONE 214/2011 Continued ® Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance Reasonfor Visit: ® Routine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date o(Visit: 1.5 --J-5-r'ld Arrival Time:l fo!<tll1,._l Departure Time: I to ~;301..-1 County: ~~ Region: Farm Na:e'~-·~_5....&..,~-::-:/r;...,Jrl"-l'::::.:a.........l_p....::'&i:;.;.~...::::..l.-~----------- /'11~-forv,.M ,u:c. Owner Email: Owner Name: Phone: , ~ ;' .. ~ Mailing Address: r ,,. I' .,.. Physical Address: ------------------------------------------- -Facility Contact: _:;..M....:......:;~~.e_:::..·.::.;b;....!. =:.:--~O:::....:...N.:;;:_ ____ Title: ---------Phone: Certified Operator: Integrator: JV1 ~~IA)V\ Certification Number: 4.l....l.!.f6;:__:'}~9-~------ -Onsite Representative: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts ]":"is any discharge observed from any part of the operation? ., ..... Discharge originated at: 0 Suucture 0 Application Field 0 Other: DYes ~No DNA ONE DYes 0 No ~NA ONE ' a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0 N o ~NA ONE 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) 0 Ye s 0 N o (»NA ONE 2. l s 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? Page 1 of3 ' . .'"'" ... v · 0 Yes (~ N o DNA '• ONE I DYes liJ No DNA ONE I 214/2011 Continued ~ . -~ (. ·IFacilitr Number: I nate oflnspection: s=?.&:rz: Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: l ~ Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any ofthe structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? 0 Yes gJ No DNA D NE 0 Yes 0 No fill NA D NE StructureS Structure6 D Yes -g) No D NA 0 NE DYes ~No DNA ONE 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? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~No 0NA ONE 0 Yes ~No 0 NA 0 NE 0 Yes ~No 0 NA D NE D Yes ';a No D NA 0 NE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~ No D NA D NE 0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc .) D PAN D PAN> 10% or 10 lbs . D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): Cerf\ 1 ~-1 S~beu').5 13 . Soil Type(s): 4u I ~{?) t~A:)No-1\ 14. Do the receiving crops differ from those designated in theCA WMP? 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 theCA WMP readily available? lfyes, check the appropriate box. 0WUP 0Checklists 0 Design 0 Maps 0 Lease Agreements DYes ~No DNA DYes ;No DNA DYes No DNA DYes ~No DNA DYes (!tNo DNA DYes LfPNo DNA DYes ~No DNA 00ther: ONE ONE ONE ONE ONE ONE ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No DNA 0 NE 0 Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers 0 Weather Code 0 Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes rn No D NA 0 NE 23 . If se lec ted, did the facility fail to in stall and maintain rainbreakers on irrigation equipment? 0 Yes ~No DNA 0 NE Page 1 of3 114/1011 Continued . '. ·. ~~-~ -IFacilitf Number: I Date of Inspection: $'")..$ -[2, Waste CoUection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure4 Identifier: ' ~ Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes gjNo DNA ONE DYes 0No ~NA ONE Structure 5 Structure6 D Yes -g) No 0 NA D NE 0 Yes tEl No 0 NA D NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application , 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? ... _. DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE 0 Yes !p No DNA ONE ll)s there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~No 0 NA D NE D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals ~Cu, Zn, etc.) D PAN 0 PAN> 10% or 10 lbs. D Total Phosphorus 0 Failure to lncorpora;~ Manure/Sludge into Bare-Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): C'wt"\ l ~Is~-)~ 4v } b>{?; Go.fn, No-f\ 13. Soil Type(s): 14. Do the receiving crops differ from those designated in theCA WMP? 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? 1.8. Is there a lack of properly operating waste application equipment? r; 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 theCA WMP readily available? If yes, check DYes DYes DYes DYes DYes DYes DYes ~No (ENo 1 [iJ No I !i]No I ~No [11lNo ~No ' DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE' DNA ONE DNA ONE the appropriate box. OwuP Ocbecklists D Design 0 Maps 0 Lease Agreements OOther=----~----- 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No 0~~~0 NE D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather-Code """' ' 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge S~ey 22 . Did the facility fail to install and maintain a rain gauge? DYes [ENo DNA ONE 23 .lfselected, d id the faci lity fail to install and main tain rainbreakers on irrigation equipment? DYes [E) No DNA ONE Page1of3 21411011 Continued : ._i-'" . ~ ' ,. .. -. ._ ·:7 : ' .. ·!Facili!f Number: I Date of Inspection: ,£~1 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 appropriate box( es) below. D Yes li} No D NA 0 NE DYes ~No DNA ONE D Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels D 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. DYes [!]No DYes ~No DYes ~No DYes ~No 0 Yes ~No DYes La No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE D Application Field D Lagoon/Storage Pond 0 Other: ------------------------ 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 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? {Lf(-J5 v-t>V/~ S/2-'2...{17.-. ~;Jc ,;,~,{-&ut h·~ S-J~-{l- Reviewer!lnspector Name: Reviewer/Inspector Signature: Page3of3 DYes ~No DNA ONE DNA ONE DYes Phone: Date: qro-<(?/3 3~ s ./)--;-4 '2--------------------- 21412011 ~ .. I Date oflnspectioo: 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 appropriate box( es) below. · DYes DYes ~No ~No D N A DNA /.· 0~ .l CJNE D Failure to complete annual sludge survey D Failure to develop a POA for sludge levels D 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 ofthe'inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30:,Pid 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. D Application Field D Lagoon/Storage Pond D Other: DYes [}I No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes lB No DNA ONE ------------------------ 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? D Yes q1 No DNA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes rpNo DNA ONE 34. Does the facility require a follow -up visit by the same agency? DYes iSfj No DNA ONE Comments (refer to queStion #): Explain any :YES answers and/or any additional recommendiltions·<()r~~·i.Y~~~.er ccoiJ.i.iJ.i.~nt5:• "~·t''~'· ·.·· Use drawings offac:ility to better explain situatiolis(lise additional pages as necessary); / ; . ··· ·· .. ;;;:, ;,};~i(i~1J1'::t?!>~F;_: '.::'if,:;;;~ · ,.,(,) 5 ,_.,..;,·ewe~ S/7..tL/ 17- ~:/.e /,~ ,{-,,, frl )~ S.;<;~/-& Reviewer/In spector Nam e: Rev iewer/inspector Signature: Page3 of3 Ph one: Date: Cff0~((3~-3~ -"' .,/ }.-<; -11--------------------- l /412011 :•-"-~. ' ..... " • • ~ .. I lo o • : ··~·. ·-'· .. Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: 0 Follow·up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: ~ Arrival Time: I l)ll;ttij!l\ I Departure Time: I (.)5';«>pftt!\. I County: sS'tl!" P.>'DI'I Region: f!.l2iJ Farm Name: 2/q,f'...fz,yd £-~ Owner Email: Owner Name: ;Y/ltlr'/)~-hw11 J ~ Phone: Mailing Address: Physical Address: ------------------------------------------- Title: Phone: Facility Contact: /l1,'k-e. ~MOll\ S. __________ ... Onsite Representative: t I Certified Operator: Back·up Operator: Location of Farm: Latitude: Discharges and Stream Impacts I. Is any discharge observed from any part of the operation? Discharge originated at: D Structure 0 Application Field a. Was the conveyance man-made? D Other: b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that r~achcd waters of the State (gallons)? Integrator: ~~Wiz Certification Number: Certification Number: Longitude: DYes ~No DNA ONE DYes 0No pi! NA ONE DYes 0No JIDNA ONE d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No ~NA ONE 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? Page 1 of3 0 Yes 0 Yes I)IJ No DNA ONE II] No DNA ONE 214/2011 Continued I Date oflnspection: 1J..B/tl IFacilit); Number: .. . Waste CoUection & 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 Structure4 Identifier: I ~ Spillway?: Designed Freeboard (in): Jr ,, Observed Freeboard (in): 7lftl 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? 0 Yes ~No 0 Yes 0 No DNA ONE ~NA ONE StructureS Structure 6 0 Yes IXJ No 0 NA 0 NE 0 Yes ~ No 0 NA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes DYes DYes DYes 1M] No DNA ONE ~No DNA ONE ~No DNA ONE Ejl No DNA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~No D NA D NE 0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12.CropType(s)' Q.....,l Wlvt..d-;.sr 13. SoH Type(s)' Ahl eo~ (;p"" AtP 14. Do the receiving crops differ from those designated in theCA WMP? 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 des ign or wettable acres determination? Page 2 of3 DYes DYes DYes ~No ~No ~No 0 Yes ~No DYes ~No DYes ~No DYes r:61 No Oother: DYes ~No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 214/2011 Continued I!••IUtjj,Numbor: e;;l., -c:Q .;:2_ I I oat• oflospecfloo: ~· 24. Did the facility fail to calibrate waste application equipment as required by the penni; 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. DYes ~No DNA ONE DYes ~No DNA ONE 0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels 0 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? 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. 0 Application Field 0 Lagoon/Storage Pond 0 Other: DYes ~No DNA ONE DYes 0No [ENA ONE DYes lXJ No DNA ONE DYes !)a No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE ------------------------ 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 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? 12f~s r:ell~~ t:t{t:t{(<· 5~ ~ ~ c;;f t:t{ -z'b(r 1 ~ Reviewer/Inspector Name: Reviewerllnspector Signature: Page 3 of3 DYes !)iJ No DNA ONE DYes [igNo DNA ONE Phone: ~(()-L{J$.--;; J¢ Date: -~.........:V~:....;..._'/1 __ 114/2011 ~ \') -~ ~~ rl "' ~ ~-~ ~ ~ ~ ~ ,_ .. Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access Date of Visit: ll~f'20(col Arrh·al Timed Of!((#-I Departure Time: I m:@..... I County: 5t1-'MBON Region: FRO Farm Name: ~ fM WM Owner Email: -------------- Owner Name: }1ud/(2L 'll'10{A41 • £1.(_ Phone: I I Mailing Address: ----------------------------------------- Physical Address:----------------------------------------- Facility Contact: (V\1 /L.e. ~.&"r'f" ~ S Title: ------------Phone No:--------- Onsite Representath•e: ""?'o:--t_l________________ Integrator: Mu.,rp~-Pno~~ L- GN_ ~'~-----------Operator Certification Number: re, 59Bi Certified Operator: Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts l. Is any discharge observed from any part of the operation? DYes ~No DNA ONE Discharge originated at: D Structure D Application Field D 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 I of 3 DYes 0No ~NA ONE DYes 0No ~NA ONE I DYes 0No (ZPNA ONE DYes ~No DNA ONE DYes ~No DNA ONE 12/28104 Continued ' • I Facility Number: @ibs;i\ j Date of Inspection I rq'ii{lo I Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: r -z._ Spillway?: DYes ~No DNA ONE DYes D No )l~NA ONE Structure 5 Structure 6 DesignedFreeboard(in): ___ .,...,.,. _____ __,....,.,.. ___________________________ _ "lull 7£Ut Observed Freeboard (in): _ __:.o'-......;...1.:...._ __ ---"~I....._ _______________ -------------- 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) DYes pNo DNA ONE 6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE 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? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes .~No DNA ONE DYes ~No DNA ONE DYes fJNo DNA ONE DYes ~No DNA ONE 11. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes ~No DNA 0 NE 0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area 12. Crop type(s) (flrt'\ t W~af I~ bew S 13. Soil type(s) k! 6,~7 f:,~ 1\,bfl: 14. Do the receiving crops differ from those designated in theCA WMP? DYes 15. Does the receiving crop and/or land application site need improvement? DYes 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? ~\s(~ Con.~ lo-Z'6-(0, J2&~c.:. v-eJr'~ ID~1-tO , Reviewer/Inspector Name Reviewer/Inspector Signature: DYes Date: 'fi'No DNA D NE ~No DNA ONE ~NoD NA D NE ~No DNA ONE ONE Continued ' l I Facility Number: es. -6@ I I Date of Inspection I t~(lf(r () I Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If ye s, check the appropriate box. 0 WUP D Checklists D Design D Maps 0 Other 21 . Does record keeping need improvement? If yes , check the appropriate box below. DYes ~No DNA ONE DYes 0 No ~NA ONE 0 Yes ~No DNA ONE 0 Waste Application 0 Weekly Freeboard D Waste Analysis D Soil An aly sis D Waste Transfers 0 Annual Certification D Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain In spection s 0 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 rain breakers 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 C AWMP ? 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or doc ument 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 representati ve? 33. Does facility require a follow-up visit by same agency? 3of3 DYes ~No DNA ONE DYes Q9 No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes ~N o D NA ONE DYes ~No D NA O N E DYes ~No D NA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No D NA ONE ~~: .. 'f',.. ~ , " ~::-. . • ~ .. · -~ 11/28/04 Type of Visit • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access Arrival Time: l¢'i:.JO(J Departure Time: I $ll'O:;;;ohcounty: ~/',k),J Region: F(l.fJ .) Farm Name: '-...........,,__~~ ~,., Owner Email: --------------- Owner Name: 84?{~ -/j~wvt L( C Phone: MailingAddress: ---------------------------------------------------------------------- Physical Address:------------------------------------------------------------- Facility Contact: ~ .... ~ "' . _,._/.!d::.....&.::....~~L-,;.;5-c.:IVIt.lll'h'j"..&...J:C...:'-Lf _____ Title: --------------------Phone No: ---------- Integrator: AJ~.v<o( -ftr.n&J ,.,_ Ll G , ~ 0 ' Onsite Representative: -------------------------- Certified Operator: ~ f~.:....,__________ Operator Certification Number: 9 lj.>'(EJ I Back-up Operator: ----------------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts I. Is any di scharge observed from any part of the operation? DYes ~No DNA ONE Discharge originated at: D Structure D Application Field 0 Other a. Was the conveyance man-made? b. Did th e discharge reach waters of the State? (lfyes, 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 op eration ? 3 . Were there any adverse impac ts or potential adverse impacts to the Waters of th e State other than from a discharge? DYes 0No ~NA ONE DYes 0No ~NA ONE I DYes 0No ~NA ONE DYes i9No DNA ONE DYes QfNo DNA ONE 12128104 Continued ~ J Facility Number: 6;l-6Bfl.l Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus hea"')' rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structllre 1 Structure 2 Structure 3 Structure 4 DYes IXiJNo 0 NA ONE DYes 0No ~A ONE Structure 5 Structure 6 Identifier: ___ ...JA~--____ _.!?~------------------------- Spillway?: Designed Freeboard (in): ---'----:-: ~77v-flu a Observed Freeboard (in): __ ...:;-=-'7::::.__.:..._ _____ ..::0~7!..__ ------------------------ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) DYes Q9No DNA ONE 6. Are there structures on-site which are not properly addressed and/or managed DYes f29No DNA ONE 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? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ~No DNA ONE DYes l}aNo DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE 11. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes D9 No DNA D NE D Excessive Ponding D Hydraulic Ov~rload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area 12. Crop type(s) ~t'\ I kJWC S~t/4-:5 13. Soil type(s) b/5, (>.8. 6!A, j{h fb If 1 14. Do the receiving crops differ from those designated in theCA WMP? 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? 1 7. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reviewer/Inspector Name Reviewer/Inspector Signatu.-e: DYes !)a No DNA ONE DYes ~No DNA ONE DYes ~No 0 NA 0 NE DYes ~No DNA ONE DYes ~No DNA ONE I Facility Number: 8:l.'¥8j Date of Inspection ~ Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. D WUP 0 Checklists 0 Design 0 Maps 0 Other DYes 99No DNA ONE DYes ~No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes l,!No DNA D NE D Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections D Monthly and 1" Rain Inspections D Weather Code 22. Did the facility fail to install and maintain a rain gauge? . 23. If selected, <lid 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 operdtor in charge? 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? Otber Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 33. Does facility require a follow-up visit by same agency? DYes ~0 DNA ONE DYes ~No DNA ONE DYes (ilNo DNA ONE DYes ~No DNA ONE DYes ~No DNA O NE DYes []I No DNA ONE DYes QtNo DNA ONE DYes $'No DNA ONE DYes ~No DNA ONE DYes I» No DNA ONE DYes [!!No DNA ONE 11118104 •· Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: b Arrival Time: I Q1.'gtQ;J Departure Time: l1o ..'/.)~I County: Region: F/!0 j Farm Name: _ ___;Sld~· ~f£rc_:__LZ.!.-LJ~...JFtlfL....;.;;;_;_Il1.;..:..___________ Owner Email: -------------- Owner Name: ,M IAKphy--~WY'. 1 Ll£__ _____ _ Phone: Mailing Address: ----------------------------------------- Physical Address:----------------------------------------- Facility Contact: ______________ Title: -----------Phone No:--------- Onsite Representative: -------------------Integrator: fJ\UNp hy -Brown,LlL Certified Operator: ~e... i:"UYlner.___________ Operator Certification Number: CJBS?f!/:1 Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discha rges & Stre am Impacts I. Is any discharge o bs erved fro m any part o f the operati on? D Yes ~0 Di scharge originated at: 0 S tructure D Applic ation F ield 0 Other a. Was the co nveyan ce man -mad e? DYes 0No b. Did the dis charge reac h waters of the State? (lfye s, notify DWQ) DYes 0No c . What is th e estim ated vo lume th at reac hed w aters o f the Sta te (g all ons )? d. Docs di scharge bypas s the waste manage ment sy stem? (If yes , notify DW Q) DYes 0No 2. Is the re evide nce of a past di sc harge from any part of the operation? 3. W ere th ere an y ad verse impacts o r potenti a l adverse impacts to th e Waters of the State other than fro m a di sc harge? Page 1 of 3 DYes pNo DYes ~o 1 2118104 DNA ONE ltfNA ONE (BNA ONE liJNA ONE DNA ONE DNA ONE Continued I Facility Number: St?:"-f.f):?-1 Date of Inspection Waste CoUection & 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? DYes ~o DNA ONE DYes DNo ~A ONE Identifier: Spillway?: ~~a; A )."%-B--S-tru_c_tu_re_3 ____ s_tru_c_tu-re_4 ____ s_tru-ct_u_re_s ____ s_tru_c_tu_re_6_ Designed Freeboard (in): ----":7""------,---------------------------- Observed Freeboard (in): ___ :2._0_11 __ -----l-WJ.a.. L.u ________ ------------------ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes t§No DNA ONE DYes ~No DNA ONE 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? DYes ~No DNA ONE 8. Do any of the stuctures Jack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 0 Yes 0 No DNA ONE 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes rpNo DNA ONE D Yes Q9 No D NA D NE II. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes !!:) No DNA 0 NE D Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN 0 PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area 12. Croptype(s) Corn I Whe_q}.-1 ~twaOS 13. Soil type(s) ~"1\.le*) 8\~n:f.oB, (Thld.s~, ~,tYb{k-:~l)A ,1Jo8 14. Do the receiving crops differ from those designated in theCA WMP? DYes 15. Does the receiving crop and/or land application site need improvement? DYes 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?D Yes 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reviewer/Inspector Name Reviewer/Inspector Signature: DYes DYes ISCJ No DNA fQNo DNA j2gNo DNA ~No DNA IKJNo DNA ONE ONE ONE ONE ONE Pagel of 3 12/18104 Continued I Facility Number: e" -002.1 Date of Inspection IJ2jlqrfiJ I Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropirate box. 0 WUP 0 Checklists D Design 0 Maps 0 Other 21. Does record keeping need improvement? 1 f yes, check the appropriate box below. 0 Yes £11No 0 NA 0 NE 0 Yes 1¥3 No 0 NA 0 NE 0 Yes l!JNo 0 NA 0 NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification D Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and 1" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes 99No DNA ONE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes ij]No DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes IZ3No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~No DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes l19No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE Otber Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes ~No DNA ONE 29 . Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes rEI No DNA ONE and report the mortality rates that were higher than normal? 30. At t~e time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE 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 DYes ~No DNA ONE Gen era l Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes fPNo DNA ONE 33. Does facility require a follow-up visit by same agency? DYes DNA ONE Page 3 of 3 12118104 ; - IFacility Number I II e Division of Water Quality Bc;a. H ~;J. 0 Division of Soil and Water Conservation ·-. 0 Otber Agency J Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit e Routine Ocomplaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access I I DateofVisit: I 8/L3/ot I Arrival Timed oBISoqJ,neparture T ime: l1~:30f'1kl County: ~S'.o~ Region: ft2.lJ r r 1 Farm Name: Sk~ ~r"'\ Owner Email: ------------- Owner Name: Mwr~-~WV1 Phone: Mailing Address: ---------------------------------------- Physic al Address:---------------------------------------- Facility Contact: __.R'-=;~~::::;,._-=-==S~M..:...!..I;._tl-,:........; _____ Title: -----------Phone No:--------- Integrator: tftJ.¥fry Bro~n Operator Certification Number: qBl!Jf~ Ge.v T a.," e.v ,, Onsite Representative: ------------------ Certifi ed Operator: Back-up Operator: fl..'cl..a.r-J s~,-~:....___ ___ _ Back-up Certification Number: :26~ Location of Farm: Latitude: D OD 'D " Longitude: D OD 'D " Swine ID Wean to Fini sh [g Wean to Feeder 81. Feeder to Fini sh ~ Farrow to Wean 0 Farrow to Feeder D Farrow to Fin ish 0Gilts 0 Boars . -·- Other lg Other Design Capacity 500 12~"1 U.I.J b).. Discharges & Stream Impacts Current Population : ! I Wet Poultry 10 Layer Dry Poultry 0 Ll!)'crs 0 Non-Layers 0 Pullets 0 Turkeys D Turkey Poults OOther ., '· ····-·- I . Is any di scharge observ ed from any part of th e operation? De sign Current Capacity Population I I I Discharge ori g inated at: 0 Structure D Application Field D Othe r a. Wa s the conveya nce man -made? b. Did th e di scharge reach waters of the State? (If ye s , notify DWQ ) Design Current Cattle Capacity Population O D~iryCow 0 Dairy Calf 0 Dl!i!Y_ Heife1 0 DryCow D Non-Dai!)' i 0 Beef Stocker I I D Beef Feeder D Beef Brood Cow --*- Number of Structures: 8:]; D Yes ~No DNA O NE D Yes 0 No IQ NA O NE D Yes 0 No ~NA O NE c . Wh at is the esti mate d volume that reached waters of the State (ga ll ons)? I d . Does di scharge bypass the waste management sys tem? {If yes, notify DWQ) 2 . Js there evidence of a past disc harge from a ny part of the operation? 3 . Were there any adverse impac ts or pot enti a l adverse impacts to the Wa ters of th e State other than from a di scharge? DYes 0 No 1BNA O NE D Yes rBNo D NA O NE D Yes tl-No D NA O N E 12128104 Continued I .i . "). I Facility Number: 13~~6 ~~ Date of Inspection Waste Collection & Treatment 4 . Is storage capacity (structural plus storm storage plus hea vy rainfall) less than adequate? a. If yes, is waste leve l into the structural freeboard? Structure l Structure 2 Structure 3 Structure 4 DYes ~No DNA ONE DYes 0No ~NA ONE Structure 5 Structure 6 Identifier: I _ __.....;:l::;.;:.. __________________ -------------- Spillway?: Designed Freeboard (in): ----~----,:-..,....,..7'7'"------------------------------~;> B4}" Observed Freeboard (in): --..a~~l,_ __ ----=::;....,J-'---------------------------- 5 . Are there any immediate threats to the integrity of any of the structures observed?. (ic/large trees , severe erosion, seepage, etc.) DYes ~No DNA ONE 6 . Are there structures on-site which arc not properly addressed and/or managed 0 Yes ~ No 0 NA 0 NE through a waste management or closure plan? If any of questions 4..() were answered yes, and tbe situation poses an immediate public health or environmental threat, notify DWQ 7. Do any ofthe structures need maintenan ce o r improvement? 0 Yes IS-No 0 NA 0 NE 8. Do any of the stuctures lack adequate markers as required by the permit? 0 Yes fB No 0 NA 0 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 requi re maintenance or improvement? DYes T!JNo DNA ONE Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ~No DNA ONE I I. Is there evidence of incorrect application? If yes, c heck the appropriate box below. 0 Yes ~No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or l O lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12 . Crop typc(s) Ct>v-" f a,Jke..af I ~~S: 13. Soil type(s) k, w()~ SoB, f?g, Ale A J GoAJ 8"') Ly, ,Jo/3 14 . Do the receiving crops differ from those designated in the CAWMP? DYes ~No 15 . Does the receiving crop and/or land application site need improvement? DYes llSJ No 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detcrrnination?O Yes f!l No 17 . Does the facility lack adequate acreage for land application? 18 . Is there a lack of properly operating waste appl ication equipment? DYes ~No DYes ~No Comments (refer to question #): Explain any YES answers and/or any recommendations or any otber comments. Use drawings of facility to better explain situations. (use additional pages as necessary): Reviewerflnspector Name Reviewerflnspector Signature: Date: DNA DNA DNA DNA DNA ONE ONE ONE ONE ONE 12/28104 Continued t ·' , . ..... I Facility Number: e:;. =le ?"' Date of Inspection lo/~{o71 Required Records & Documents 19 . Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have aJI components of theCA WMP readily available? If yes, check the appropirate box . 0 WUP 0 Checklists D Design 0 Maps 0 Other D Yes ~No DNA ONE DYes ~No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes SNo 0 NA 0 NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soi l Analysi s 0 Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections D Monthly and l" Rain Inspections 0 Weather Code 22 . Did the facility fail to install and maintain a rain gauge? DYes JQNo DNA ONE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes fi9No DNA ONE 24. Did the facility fail to calibrate waste application .equipment as required by the permit? D Yes 6?:1No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? D Yes iji)No DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes ijlNo DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes lB. No DNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the pennit orCA WMP? DYes liNo DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes l:iJ No DNA ONE 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? DYes KINo DNA ONE If yes, contact a regional Air Quality representative inunediately 31. Did the facility fail to notify the regional office of emergency s ituations a s required by D Yes ~No DNA O NE General Permit? (iel discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -s ite representative? DYes ~No DNA ONE 33. Does facility require a follow-up visit by same agency? DYes PQNo DNA ONE Additional Comments and/or Drawings: • - -.... 12128/04 • Division of Water Quality 0 Division of Soil and Water Conservation 0 Other Agency . 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Type of Visit e Compliance Inspection Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: ll0/31/i)b I ArrivaiTime: I ut/1 ~ I Departure Time: II/ 9 r I County: s~ Region: F{JO Farm Name: S+a.~ Ei1rM Owner Email: -------------- Owner Name: t¥ttlifk M [tu-fh-=S ____ _ Phone: Mailing Address: ----------------------------------------- Physical Address:----------------------------------------- Facility Contact: Title: ----------.....-T Phone No: --------- Onsite Representative: P.~o.v-e/ SIY\.1 :Jh Integrator: M i.LY'f~~ Certified Operator: Gem Ta..n nJ?.:( Operator Certification Number: 9'g 5'9 8 9 Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Wet Poultry Discharges & Stream Impacts I. Is any discharge observed from any part of the operation? DYes lpNo DNA ONE Discharge originated at: D Structure D Application Field 0 Other a. Was the conveyance man-made? b . Did the discharge reach wate rs ofthc State? (If yes, notify DWQ) c . What is the estimated volume th at reached waters of th e State (gallons)'? d. Docs discharge bypass the was te management system? (If yes, notify DWQ) 2. Is there eviden ce of a past discharge from any part of th e operation? 3. Were there any adverse impacts or potential adverse impac ts to the Waters of the State oth er than from a di sc harge? Page 1 of3 DYes DNo ~NA ONE DYes 0No jNA ONE DYes DNo Jf'NA ONE DYes ~No DNA ONE DYes ~No DNA ONE 11128/04 Continued I Factli·~ Number: {0~ -68;..1 Date oflnspection I /~I Waste CoUection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes ~No DNA ONE DYes ~No DNA ONE Structure 5 Structure 6 Identifier: ___ ,_/ ____ ..:.:;L __________________________ ------- Spillway?: Designed Freeboard (in):------------..,...---------------------------- 11 o.~'' Observed Freeboard (in): --4-f-..~9[.,_ _____ ____:::~:::...._....:..._ __ -------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? 0 Yes ,S1No DNA D NE DYes .t!No DNA ONE If any of questions 4-6 were answered yes, and tbe situation poses an immediate public health or environmental tbreat, notify DWQ 7. Doanyofthestructuresneedmaintenanceorimprovement? DYes tjl'No DNA ONE 8. Do any of the stuctures lack adequate markers as required by the penn it? (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 maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ~No DNA ONE DYes ~No DNA ONE DYes -B!No DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes BNo 0 NA D NE D Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12. Croptype(s) (o-n ~RQVlS' 0£ oa-:.* 13. Soil type(s) t:) !.(. 6 , Gv A 1, Ja .& . N a 6 r i I 14. Do the receiving crops differ from those designated in theCA WMP? 0 Yes "fJ No DNA 0 NE 15. Does the receiving crop and/or land application site need improvement? DYes ~No DNA ONE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? DYes ~NoD N~ D NE 17. Does the facility lack adequate acreage for land application? Dvcs WNo DNA ONE 18. Is there a lack of properly operating waste application equipment? DYes rtJNo DNA ONE Reviewer/Inspector Name ~ffi.9.~rM~~~~:ft~C&~£!i§~~2(:j~@~'li!JJrBj~~ Reviewer/Inspector Signature: Page 2 of3 Continued .J I Facility Number: ~-6@ Required Records & Documents Date of Inspection {ib~ I I 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check the appropriate box. D WUP 0 Checklists 0 Desibrn 0 Maps D Other DYes 1eNo DNA ONE DYes mNo DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes --l8 No D NA D NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Annual Certification D Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 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 s urvey as required by the pennit? 26. Did the facility fail to have an actively certified operator in charge? 27. Did the facility fai l to secure a phosphorus loss assessment (PLAT) certification? Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 29 . Did the facility fai l 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 Genera l Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/i nspection with an on-site representative? 33. Does facility require a follow-up visit by same agency? Addjtio~~~ Comments arid/or Drawings:·· .. ·;·· '~ Poge3 of3 ·-· •.. ····. DYes ~No DNA ONE DYes ~No DNA ONE DYes (SNo DNA ONE DYes ~No DNA ONE DYes 5aJNo DNA ONE DYes ~No DNA ONE DYes l;i!No DNA D NE D Yes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes flJNo DNA ONE 1:: /:·· .: :~~:~;~~~i~-~·:·~~:. ; ... r- -..... 12/28104 Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit : 10iar:6d Arri\·al Time: I ,J},' 3c) Departure Time: 13.31 .,.Joool County: .5e ..._, ~0"" 1 Region: F€0 Farm Name: .S b-. Pf.?.: rei fi1v-Owner Email: -------------- Owner Name: M. LlVf('l fi,.,_ ~· {.,_ h..;:ll~r~~:e:o=--r.._ _______ _ Mailing Address: p () ''t>o )' ~ r I &us< !-Ia { . Phone: NC Physical Address:~~--------------------------------------- Facility Contact: R:c (~,,../ $";~:fl..... Title: -----------PhoneNo: ________ _ Onsite Representative: 'f2.·altvd S:.,: f~ Certified Operator: G fH '{1 J:. ~ n fJ;c:. __________ _ Integrator:---------------- Operator Certification Number: 1.£5-1 H Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts 1. Is any discharge observed from any part of the operati on? DYes (g"N o DNA ONE Discharge originated at: D Structure 0 Application Field 0 Other a . Was the conveyance man-made? b. Did th e discharge reach waters of th e State? {If yes , notify DWQ) c. What is t he estimated volume that reached waters o f 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? DYes 0No DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE DYes ~0 DNA ONE DYes dNo DNA ONE 12/28104 Continued !Facility Number: f;L -6 8'2l Date oflnspection lt>r-t~poJr Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) Jess than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: ,2 Spillway?: ;;.., ... i ¥~c Designed Freeboard (in): L j. to'' Observed Freeboard (in): ~ u ,, 2'/,.,. 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~o DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 ·, DYes UJ'No DNA ONE 0 Yes cif"No DNA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? 0 Yes f:Y'No 0 NA D NE DYes GJ'No DNA ONE 0 Yes lliNo 0 NA 0 NE DYes DNA ONE 11. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~No ~0 DNA ONE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn. etc.) 0 PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12.Croptype(s) {}l~~,_ itJ~~ ..... + Sc.:.1 6e..,,.s 13. Soil type(s) An B cg{! A lo .. .,J3 14. Do the receiving crops differ from those designated in the CA WMP? 15. Does the receiving crop and/or land application site need improvement? DYes DYes 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination! D Yes 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reviewer/Inspector Name Reviewer/Inspector Signature: DYes DYes Date: 12128104 ~0 DNA ONE ONE llaNo rn'No gz DNA DNA ONE DNA ONE DNA ONE I Facility Number: ~ l... -t,ilJ Date of Inspection lcs--:c~-t.i.Si Required Records & Docu·ments 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropirate box. D WUP' 0 Checklists 0 De;ign 0 Maps 0 Other DYes ~o DNA ONE DYes ~ DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes 0 No 0 NA 0 NE D Waste Application 0 ~ldy Freebe&rd D Waste /',Haly3is D St!!lil !d'la!ysis 0 Waste Transfers !:Q.,tifriuai Cernncation D-RaiefttH D Suwkjng. 0 C-f6p Yield"'" 0 121LM-inttte htspectioos 0 ~and I" Rain Inspections Dweat~er Ca~e 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rain breakers 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 orCA WMP? 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 33. Does facility require a follow-up visit by same agency? . ·. DYes Q-'No DNA ONE DYes (!?No DNA ONE DYes CB'No DNA ONE DYes C3'No DNA ONE DYes CM"No DNA ONE DYes @"No DNA ONE DYes ~0 DNA ONE DYes ~0 DNA ONE DYes Crl'No DNA ONE DYes B'No DNA ONE DYes gNo DNA ONE DYes ~0 DNA ONE , .... ,. .. -~ .. ,.,~ ;~~-··.· ~ 12128104 e Compliance Inspection 0 Operation Review 0 Lagoon Evaluation Reason for Visit • Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access Facility Number I ~ 2. H 'a~ i I Date or Visit: I '=t-/1/ol{ I Trme: I ' : f !f( L--------------------....1. lo Not Operational 0 Below Threshold If-Permitted l!l Certified C Conditionally Certified C Registered Date Last Operated or Above Threshold: ···················--·· Farm Name: ·····-~-~ffi.d.._ ... r.A.C~.---·--··--·-... · ... -····-..................... County: _ .......... ~ ~~~..Q.~----··-·---·-·-·-· Owner Name: .............. M_.~.!-~~-· .B..r.:o.tJ.L'e:-.... --··-·------····--·-·· Phone No: ......... 1/0 -Z-.8.~.::-2-1 tL--·----· Mailing Address: .......... f~ .. Q.: ....... ~.~------:7.-~----·-·-·-·-·--·-····--······-·-·-·-.. .&2.S.e-... .±JiJ1~ ........ /Y ... '=-. ............... -.. :?::I?J!J.£PJ. .. Facility Contact: ,_g~~-~----~~J.~ ............ Title: ................................................................ Phone No: __ 'J.!P. .. -~--=--?.!..! .. ~ ... . Onsite Representative: ..... RJ.cJt...~-~.i.-::f:f6:......................................... Integrator: ........... MLLLp..h.¥-.:: ..... &a..w ... ~-- Certified Operator: .......... l2.~~~i.-th.____________________________ Operator Certification Number:·--~-'! s-Co fL ....... Location of Farm: Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: 0 Lagoon 0 Spray Field 0 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 ga!/min? d . Does discharge bypass a lagoon system? (If yes, notify DWQ) 2. Is there evidence of 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? Waste Collection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? 0 Spillway Identifier: Freeboard (inches ): 12112103 Structure 1 Structure 2 Structure 3 Structure 4 ... .l.~t...~. ·--~---~ ................................................................... .. \~ 5'l Structure 5 DYes ~No DYes ONo DYes ONo DYes ONo DYes ~No DYes !)(No DYes ~No Structure 6 Continued IFacilitYNumber: 82. -~0z.l Date of Inspection I J=/ 1 Joe( I 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? 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(unprovement? II. Is there evidence of over application? If yes, check the appropriate box below. 0 Excessive Ponding 0 PAN 0 Hydraulic Overload 0 Frozen Ground 0 Copper and/or Zinc 12. Crop type ~rll' 1 w~eA..-\- 1 .So'f\>~s 13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)? 14. a) Does the facility lack adequate acreage for land application? b) Does the facility need a wettable acre determination? c) This facility is pended for a wettable acre determination? 15. Does the receiving crop need improvement? 16. Is there a lack of adequate waste application equipment? Odor Issues 17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below liquid level of lagoon or storage pond with no agitation? 18. Are there any dead animals not disposed of properly within 24 hours? 19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, roads, building structure, and/or public property) 20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. lS". ~r, ce.. \ ao~ ~ ~ Cor"' . DYes ~o DYes 9INo DYes ~No DYes JnNo DYes !XNo DYes JSNo DYes J2'-No DYes laNo DYes lSI. No DYes SNo DYes ~No DYes !)I No DYes RJNo DYes ONo DYes SNo DYes ~No DYes ~No '"=t. W"\ ~c... U1f::f1 ~ wt:eJs al~ k~~ ~r';-.~ \-\ e~ wee.k.. Reviewer/Inspector Name Reviewer/Inspector Signature: Date: :til /o '{ 12112103 Continued I Facili~ Number: 82--h~~ Date of Inspection I ?l:b /o'll ' Reguired Records & Documents 21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? 22. Does the facility fail to have all com~onents of the Certified Animal Waste Management Plan readily available? (iel ~ecklistY,desi¢mal*("etc.) 23. Does record keeping need improvement? If yes, check the appropriate box below. D Waste Applicatio¥0 Freeboarv'D Waste Analysik"""O Soil SamplinV 24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 25. Did the facility fail to have a actively certified operator in charge? 26. Fail to notify regional DWQ of emergency situations as required by General Permit? (iel discharge, freeboard problems, over application) 27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? 28. Does facility require a follow-up visit by same agency? 29. Were any additional problems noted which cause noncompliance of the Certified A WMP? NPDES Pennitted Facilities 30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) 31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 32. Did the facility fail to install and maintain a rain gauge? 33. Did the facility fail to conduct an annual sludge survey? 34. Did the facility fail to calibrate waste application equipment? 35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. 0 Stocking Fo~O Crop Yield FoM D RainfaV'Q Inspection After I" Rai~ D 120 Minute InspectioV' D Annual Certification Fo~ 12/12103 DYes RNo DYes afNo DYes ~No DYes JaNo DYes Lll.No DYes it No DYes IX No DYes IJNo DYes ~No t!'Yes DNo DYes IS No DYes t8No DYes ~No DYes ~0 DYes ~No "'~:Z~;~i.~. -~'i-t~~ 0 Follow-up of DSWC review I I· Date of Inspection 19-f'-t:z I 2.2.. H ~821 Facility Number I Time of Inspection I ll: Drl> 124 hr. (hh:mm) 0 Registered 0 AppUed for Permit Farm Status: • Certified · 0 Permitted Total Time (in fraction of hours I (ex:1.25 for 1 h r 15 m in)) Spent on Review _J I or Inspection (includes travel and processin~) 0 Not Operational Date Last Operated: ····--··--··--····-·--··--·-·-····-·-·-······--···-····--··--···--····-····--····· Farm Name: --~£d&.e=---.. -----·--·-----County: ___ .....J]r~-r..2.v ...... ----·-·- Land Owner Name: . ..&44-~--~~ .. --····-··... Phone No{_z(~J.. ;?.if:(.-.?..~!./ ..... _ ..... -...... -. Facility Conctact: ----~ .. ~_&~-····-Title: -··-. ·····-···--·--·-Phone No: ( ?/__~.2-~~f--~"(_.s-_~ Mailing Address: ____ _e._ ~-~_B~_.?..£.::~ ... ,.k..r.:f:_.~~--/ f.. C!: ....... :J.P..Zfr.f. ..... -.. ··-····--····--···· -····-····-······ Onsite l_tepresentatin: ___ ..G~ .. &~~---···--··-· .. ··-··--Integrator: ..111'«/''r-~~ Certified Operator: -··-···G.:?~ .. .£~~--·-··· .. --····--····-·· Operator Certification Number: ..L.f(.z;z. .?..-····-· Location of Farm: Genera) I . Are there any buff~ that need maintenance/improvement? 2. Is any disc harge observed from any part of th e operation? D ischarge originated at: 0 Lagoon 0 Spray field 0 Other a. If discharge is observL-d, was the conveya nce man-made? b . If discharge is observed, did it reach Surface Water? (If ye s, notify DWQ) c. If di scharge is observed, what is the e stima ted flow in gaVmin? d. Does di scharge bypass a lagoon system? (If yes, noti fY DWQ) 3. Is th ere evid ence of past discharge from any part ofthe operation? 4 . Were there any adverse impacts to the waters of the State other than from a discharge? 5. Does a ny part of the waste management syste m (other than lagoons/holding ponds) require 4/30/9 7 maintenance/improvement? 0 Yes 81No D Yes ~No 0 Yes 2JNo 0 Yes ,.&.No 0 Yes ,181No D Yes .&No DYes Q.No D Yes JaNo Continued on back IF acility Number: .. ..i'~ -.a.z__J 6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 7. Did the facility fail to have a certified operator in responsible charge? 8. Are there lagoons or storage ponds on site which need to be properly closed? Structures (La::oons and/or Boldin:: Ponds) 9. Is storage capacity (freeboard plus stonn storage) Jess than adequate? Freeboard (ft): Structure 1 Structure 2 Snucture 3 ··-I f:.~J _z. / ---·· 10. Is seepage observed from any of the structW'es? Structure 4 11. Is erosion, or any other threats to the integrity of any of the structures observed? 12. Do any of the structures need maintenance/improvement? (If any of questions 9-12 was answered yes, and the situation poses an immediate public bea1tb or environmental threat, notify DWQ) 13. Do any of the structures lack adequate minimum or maximum liquid level markers? Waste Application 14. Is there physical evidence of over application? Structure 5 -.. --·--· (If in excess of WMP, or runoff entering waters of the State, notify DWQ) 15. Crop type __ {Z.L_··--·-·-·-··-···-·:··-····--····--······ .. -·····--····-········--·····-·-···---·:··--····-~--:··--····- 16 . Do the receiving crops differ with those designated in the Animal Waste Management Plan (A WMP)? 17. Does the facility have a lack of adequate acreage for land application? 18 . Does the receiving crop need improvement? 19. Is there a lack of available waste application equipment? 20. Does facility require a follow-up visit by same agency? 21 . Did Reviewer/Inspector fail to discuss reviewfmspection with on-site representative? For Certifird Facilities Only 22. Does the fa ci lity fail to have a copy of the Animal Waste Management Plan readily available? 23. Were any additional problems noted which cause noncompliance of the Certified A WMP? 24. Does record keeping need improvement? cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit DY~ ~No DYes 18No DYes ~No 'SYes 0No Structure 6 -····----- DYes E!No DYes NNo DYes SNo DYes B)No D Yes IH'No JaYes 0No D Yes IQ'No !lYes DNo ·~Yes 0 No DYes ,181 No DYes tsJNo t)a'Yes ONo DYes 8No DYes SNo 4/30/97