010012_Inspection_20191101

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Type of Visit: p Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: I,Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:I I l I 1°1 Arrival Time:I 1 ' O, Departure Time:IXR: County: Region:�SLO
Farm Name: LI na 1�-1 Dal Ill.{ 1, V1 C.• Owner Email:
Owner Name: VV • -3-01-• (rl V\GI eJ Phone: 2' 6-31 b -j7'7 y
Mailing Address: I • ►I\ a .Q.l I al'vk_
Physical Address:
Facility Contact: �t d ,..—,r 4 I P Title: Phonee: 2 3'— 'j1 k- CA 3
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: 35° ,rj 3' 59I t' Longitude: 7 1° V-1' 5-0"
I/C'87 CD +-b E.Gr ►shoo Chi I-h 1112d• ,1rr- () I '(a ►u: ovi0.),
' •%.
Wean to Finish -- Layer '�,Dai Cow e°
•Wean to Feeder -- a Non Layer •Dai Calf �� -=
Feeder to Finish -- e _-: Dai Heifer -- `
•Farrow to Wean -- I -m D Cow --
Farrow to Feeder �� � � _ .Non-Dai
Farrow to Finish Layers Beef Stocker
-.Gilts Non-Layers -.Beef Feeder
Boars -- Pullets •Beef Brood Cow --
� Turkeys ter° �'
€E �<
_n" w,� a.��`� � Turkey Poults ����,r ,�ffic�� � � �: �-���� �' �z��� .
Other 1+ 1 Other
— x, , aa ,gam � ? ���=,a �� _,,, .,_� _ �: �„ : _ a <, _
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes NrNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No El NA ❑ 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 rgNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes Ticis.No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2015 Continued

'Facility Number: a ( - 'Date of Inspection: till f
20 lei
Waste Collection&Treatment
4. Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑ Yes rg No ❑ NA ❑ 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: l/J S p
Spillway?:
Designed Freeboard(in):
Observed Freeboard(in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes tNo ❑ 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 [ No ❑ NA El NE
waste management or closure plan? TT''
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 IXNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 1XNo ❑ 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 IX No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10.Are there any required buffers,setbacks,or compliance alternatives that need ❑ Yes jNo ❑ 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 0 Heavy Metals(Cu,Zn,etc.)
❑ PAN 0 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): C6r ,Sl la / Corn 3YZUV <�Y ) W n vukc..k
13. Soil Type(s): U
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No 0 NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes No ❑ 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 ZNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes,check ❑ Yes g No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? , , - .. Yes ❑ No ❑ NA ❑ NE
Waste Application Weekly Freeboard El Waste Analy is — AWeather Code
Rainfall ` i Stocking,,Crop Yield r '-. . '. - Monthly and 1" Rainfall Inspections -R-Sfutige-Sitio.‘e3iL—
22.Did the facility fail to install and maintain a rain gauge? ❑ Yes ] No ❑ NA El NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes 70 No Vi NA ❑ NE
Page 2 of 3 2/4/2015 Continued

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