820469_Inspection_20190304

• Facilit%y Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes To ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ®-16 ❑ 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?
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?
s 5 -- I -1 !2-- 19-
Reviewer/Inspector Name:
Reviewer/Inspector Signatun
Page 3 of 3
[:]yes
�o
❑ NA
❑ NE
❑ Yes
❑-lo
❑ NA
❑ NE
❑ Yes
0],<
❑ NA
❑ NE
[:]Yes No ❑ NA ❑ NE
❑ Yes ]"No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
[Y�o
❑ NA
❑ NE
❑ Yes
[13' Rio
❑ NA
❑ NE
❑ Yes
E24
❑ NA
❑ NE
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c
Phone:
Date: if 6t
21412015

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Type of Visit: ompliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: 1 /o Departure Time: L County: sJ�
Farm Name: r"-"r* , 2Q� l� Owner Email:
Owner Name: v— cvpt Phone:
Mailing Address:
Physical Address:
Facility Contact: j Ko- Nall 1, 5 Title:
Onsite Representative:
Certified Operator: m + vt J ✓-64
Back-up Operator:
Location of Farm:
Latitude:
Region:f
Phone:
Integrator: ��`*� `
Certification Number: � e�� 90
Certification Number:
Longitude:
Design Current ' �` Design> CureDesign Current
1 '3w>ne Capac>ty P,op�
Wet Boultry "CapacityCa'ttle�� rapacity Plop r
t ��
�
Layer
i
I"','
.
Non Layer
.
{
Design* tC1ur>±ent
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z
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Dry i;oultry Ca a`c"ity Po�
yt
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a r
w ,;
Other
t
�:.
Wean to Finish '
Wean to Feeder
Feeder to Finish
ID
0 + �
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Discharges and Stream Impacts
-
Layers
Non -Layers
Pullets
r
Turkeys
�
Turkey Poults
Other
--�
Dairy Cow
Dairy Calf
.,
Dairy Heifer
'
D Cow
Non -Dairy
?
Beef Stocker
�
s
Beef Feeder
���
Beef Brood Cow
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1. Is any discharge observed from any part of the operation?
❑ Yes
�
❑ NA
❑ NE
Discharge originated at, ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
OVA
❑ 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
U MF
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
�o
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2015 Continued

Facilify Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Identifier:
Spillway?:
d-go ❑ NA ❑ NE
❑ No DT1A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Designed Freeboard (in):
Observed Freeboard (in): I
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?
❑ Yes E]-`90 ❑ NA ❑ NE
❑ Yes 0-1 0 ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental t reat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes 1' No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes &No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes Er' -No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 10 ❑ NA ❑ NE
mamtenance 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 II ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): C -� 5 L �1s c c �3
13. Soil Type(s): LA`-' i 1y j Sri..
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ONo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ED No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes "NNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
❑ Yes DNo ❑ NA ❑ NE
❑ Yes ❑' o ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes CDXo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design [:]Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes D�lo
❑ 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 Fj No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412015 Continued