820274_Inspection_20190507

Division of Water Resources
Facility Number:° ,._ 0 Division of'Soil and Water Conservation
' 0 Other.Agency,
of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
in for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: '� ' County:
Farm Name: A4 H Ael- I Owner Email:
Owner Name: `�`l•gct 4 Phone:
Mailing Address:
Physical Address:
Facility Contact: VzcA_0 / r-"L�2'e�Title:
Onsite Representative: �(
Phone:
Integrator: -y ,"c: f(
Region:
Certified Operator: n h �' �� �� fi Certification Number: l0 d )- z-,L Z—
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
-Design . Current Design f Current..
Swine Capacity, Pop., 'Wet Poultry .u° Capacity. Pop. Cattle'
Wean to Finish Layer
Wean to Feeder I INon-Layer
Feeder to Finish
Farrow to Wean ° Design ` Current.,
Farrow to Feeder Dry Poultry Cat acit r Pop.
Farrow to Finish
Gilts
Boars
Other
Other
Layers
Non -Layers
Pullets
Turkeys
Turkey Pouets
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
ant.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
El Yes E]_Nv--❑NA ❑NE
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No ©-fqA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters Yes
No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facilify Number: - Date of Inspection: yq, c
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
M_N�D`❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No `© NA-
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E?f-Ncr— ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWR
C7. o any of the structures need maintenance or improvement?
es n-No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
I-1 90 ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
� ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑-W ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �(, SG )4;v
11'
13. Soil Type(s): .� c�'� CCC, iVti�l :c /i I n '✓Ui eR
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
[J-N8.
❑ NA
❑ NE
❑ Yes
E3-N6-
❑ NA
❑ NE
❑ Yes
❑-le-
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes [2-go- ❑ NA ❑ NE
❑ Yes E3 o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ WUP ❑ Checklists ❑ Design [:]Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [D No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes []'No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes dNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection:
Z4. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
E]-NV—_❑ NA ❑ NE
E3-No ❑ NA ❑ NE
❑ Yes 19-No-- ❑ NA ❑ NE
❑ Yes ©-N ❑ NA ❑ NE
[:]Yes NA ❑ NE
❑ Yes [�o ❑ NA ❑ NE
❑ Yes EJ-1,4-o— ❑ NA ❑ NE
[:]Yes �o ❑ NA ❑ NE
❑ Yes ❑—No— ❑ NA ❑ NE
❑ Yes [ -No ❑ NA ❑ NE
[::]Yes O-No ❑ NA ❑ NE
Reviewer/Inspector Signature: C oC l
vI / Date: OkcG�
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