310362_Compliance Evaluation Inspection_20200213

QP Division of Water Resources
FNutnber = ® °O Division of Soil a
acilitynd Water Conservation
• O 'Other Agency
Type of Visit: Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency O Other, O Denied Access
Date of Visit: ] Arrival Time: Departure Time:® County: Region:
Farm Name: aj + Q r Owner Email: b N C 5 M C 110i74 p'
�1
Owner Name: Phone:�� J
Mailing Address:
Physical Address:
t
Facility Contact: CgG� ,S t-A IA Title:
Onsite Representative:
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
Other ,
Other
Phone: 9� 10 of 3 S�C� 2-W
Integrator:
Certification Number:
CertificatiWn Number:
Latitude: Longitude:
'Design. Current.,
Wet-Poultry Capacity ` Pop.
Layer
Non -Layer
a "Design y Current
Dry PoOltry • Canacity Pon. ° ' .
Layers
Non -Layers
Pullets -
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? '
Design - Current•
'Cattle Cii acityy.r Ppp.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[:]Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
ETNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
[:]No
YN
❑ 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
ZNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
0 NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
�ZO
NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: 3- Date of Inspection: 2�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes To ❑ N ❑ 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: [ Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Io ❑ 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 E 2eo ❑ NA
❑ NE
waste management or closure plan?
l t eat, notify DWR
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environm;No
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 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 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. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑Yes
N ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑Yes
No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
io ❑ 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?
❑ Yes
No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes EXo ❑ 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 No ❑ NA ❑ NE
❑ Waste 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 ❑
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

Facility Number: - Date of inspection: .2 1 `?73
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 to ❑ 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 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No TA ❑ 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?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
[:]Yes
dNo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
L E
❑ Yes EZ /�;
❑ Yes FNo
❑ Yes
❑ NA ❑ NE
❑NA ONE
❑ NA ❑ NE
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).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: qlo /—I 6 -7 2- I
Date: J— to,
2/ /2015