310403_Compliance Evaluation Inspection_20200225

V vy � �-1 L—G�R a ,ram (= 9 I In
Division of Water Resources "
Facility Number � � � l�� 0• Division of`Soil and Water Conservation
0 Other Agency ,
type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
1eason for Visit: 0Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 7UJI Arrival Time: Departure Time: County: Region:
Farm Name: `(� �� n Owner Email:
Owner Name:
Mailing Address:
Phone:
Physical Address:. -
Facility Contact: D 16,1.e jC yi V4J y Title:
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Design'. Current
Swine Capacity Pop. "
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other,
Other
Latitude:
Phone: q f® Z°i a7� G 3 Z
Certification Number:
Certification Number:
" Design Current
Wet Poultry
Capacity Pop,
Layer
Non -Layer
o Design Current:',
Div Poultry
Capacity Pon:
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Longitude:
" Design Current"
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Wo ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[—]Yes
❑ No A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No �FA❑
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
No A
❑ 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 I of 3 21412015 Continued

Facility Number: jDate of Inspection: 2
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
Yes ❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes �Zo
❑ 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 IE2 o
❑ 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 reat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ 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 [Z�/No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 2 No ❑ 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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Q'Zo❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[3-ONo' ❑ NA
❑ NE
acres determination?
17. Does the facifity lack adequate acreage for land application?
❑ Yes
e NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
NA
❑ NE
Required Records & Documents
�
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
El Yes
r;0--`D
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. a es ❑ No ❑ NA ❑ NE
❑ Waste Applicatio ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall tocking ❑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 o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E�to ❑ NA
Page 2 of 3 21412015 Continued

Facility Number: 3 1 - 0 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E!rNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [o ' ❑ 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 ONo VIIA
❑NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes O`No/o 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 No ❑ NA
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 ❑ Yes �No[_] NA
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:
❑ Yes
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
❑ No ❑ NA
No ❑ NA
❑ NA
No ❑ NA
Comments (refer to question #): `Explain any YES answers and/or any additional recommendations or any other. comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
A f
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
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Ci\_1,_ J.\ . C�'. 4� i
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❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
Phone: q (13 S U (�
Date: 2- 1 -a� (
2/4/ 015