620004_Inspection_20190412

1 PIS a 01' j 4oct �
U Division of Water Resources
Facility Number O Division of Soil and Water Conservation
46
O Other;Agency
Type of visit: (DXompliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: OLLRoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: !i Arrival Time: U i Departure Time: ,' �. County: hI L �"a41q( Region: �9l
Farm Name:y t��5us; j� Owner Email:
Owner Name: (�� ✓ :�,s. Phone:
Mailing Address:
Physical Address: f. / e�✓Y� �' j
Facility Contact: Title: Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
oars
Other
Other
T1
Latitude:
Integrator:n�
Certification Number: 711 y X
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
:2(; I^.I JNon-Layer
Design Current
Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: _
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
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)
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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ED-No ❑ NA ❑ NE
❑ Yes ❑ No
[—]Yes ❑ No
❑ Yes ❑ No
❑ Yes D No
❑ Yes [tea
[� NA ❑ NE
©-NA ❑ NE
[�A ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facili Number: - Date of inspection:
Waste Collection & Treatment
4. A storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
0'o
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
®CIA ❑ 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]-No
❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes �To ❑ 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
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑moo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ©_ble ❑ 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 Q-W' ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ©>a- ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Q-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): r Cale_ � C�� u-e-
13. Soil Type(s): V =E V l
14. Do the receiving crops differ from those designated in the CAWMP? D4es o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? 90(es o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable Yes o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes o ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?k�des ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage &Permit readily available? Y s ❑-No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check /Yes M-No- ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
2I. Does record keeping need im rovement? If yes, check the appropriate box below. �s 0 No ❑ NA ❑ NE
❑Waste Application Weekly Freeboard Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
El 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 []3<o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes ❑ No �A ❑ NE
Page 2 of 3 21412015 Continued

Facilil.y Number: T5 k jDate of Inspection: / a •n f
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 es ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
allure 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 OTIo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ©-N—A— ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes EjKo ❑ NA ❑ NE
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?
❑ Yes 0-lqo-- ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
0 Yes 0 No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes �❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes 0-Ro ❑ NA 0 NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes ❑ ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes EJv ❑ NA ❑ NE
Comments (refer to question #)': I lExplain aay YES answers and/or any additional recommeddntions orzany other comments.
Use drawings of facilityto better.explain situations (use additional pages as necessary).
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Reviewer/Inspector Name: Nt
Reviewer/Inspector Signature:
Page 3 of 3
Phone�- !U—H3,�'!_j�j
Date: I
21412015