820274_Inspection_20190507 (2)

Division of Water Resources
Facility Number Z Q Division of Soil and Water Conservation :'
O Other•Agency
Type of Visit: Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Eteason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ► Arrival Time: 11;1 Departure Time: 110fols County: lid
Farm Name: �( �� f e&-' l Owner Email:
Owner Name: n k l} C �'�J` J Phone:
I
Mailing Address:
Physical Address:
Facility Contact:Title:
Onsite Representative: c i
Certified Operator: a5n
Back-up Operator:
Location of Farm:
Swine " t
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
Other
Latitude:
Region: �`
Phone:
Integrator: �/ r
Certification Number: 7 Z
Certification Number:
Longitude:
,sign Current
DesignCurrent
lacity` -t'' Wet,Poult>ty.
Capaciiy 'Pop.
Cattle r '
Layer
Dairy Cow..
Non -Layer
Dairy Calf
5
Dairy Heifer
Designs°.Current, '°
Dry Cow
Dry Poultry
,Capacity, 'Pop:
Non -Dairy
Layers
Beef Stocker
Non -Layers Beef Feeder
Pullets Beef Brood Cow
Turkeys
Turkey Poults
Other
Discharses and Stream Impacts �
1. Is any discharge observed from any part of the operation? ❑ Yes u 1V o ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No E11KA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
[:]Yes
❑ No
( 'NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑1 o
❑ 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 I of 3 Qe--3-U 3 0,�s
21412015 Continued

Facility Number: - Z ZY Date of Inspection: 7 V, &-iz
Waste Collection & Treatment
4.'Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
D`go�EJNA
0 NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No �
❑ NE
Structure l 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
❑ 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
El No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment�tat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
rNo❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes `No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 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): 13 :!57;, G---V
�i F'1
13. Soil Type(s): iq - )0 %c�
14. Do the receiving crops differ from those designated in the CAWMP?
0 Yes E No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
0 Yes No
❑ NA
0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes To
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
0 Yes El-Ko
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
0 Yes No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily
Yes No
NA
available?
❑ e
❑
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
Does record keeping need improvement? If yes, check the appropriate box belo
QWaste
es R
❑ NA ❑ NE
Application ❑ Weekly Freeboard ❑ Waste Analysis Soil Analysis
Waste Transfers
Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes [ No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ❑ No
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

aq
Facility Number: - Z 7r- Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [a -No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [::]Yes ' N� ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA ❑ NE
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?
Clt(� 4"a-, V11 SL 17
C'�X
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes []'No ❑ NA ❑ NE
❑ Yes Ef No
❑ Yes El"No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes Ej"No ❑ NA ❑ NE
❑ Yes 2�� o ❑ NA ❑ NE
Yeso ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
If 7
Phone)w-'U3-333
Date: j N U
2141201