670009_Compliance Evaluation Inspection_20200615

Division of Water -Resources
Facility` Number . ®- n, Divisioof Soil and Water Conservation .
0 Other Agency
Type of Visit: ®-Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ® Routine O Complaint 0 Follow-up O Referral O Emergency 0 Other 0 Denied Access
r
Date of Visit: 1: Arrival Time: Departure Time: County:
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Farm Name: rj Owner Email:
k�
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ��//�� Title:
Onsite Representative: � � i Q h 1Z -A:j ft,/
Certified Operator:
Back-up' Operator:
T.nvniinn of Fnrm- Latitude:
Region:
Phone: �� q�" I Z Lt 0
Integrator:
Certification Number:
Certification Number:
Longitude:.
Design Current : ° Design' Current °
Swine Capacity Pop. Wet Poultry Capacity ° Pop. °
Wean to Finish
Wean to Feeder
IWO
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to. Finish
Gilts
Boars
Other
Other
Layer
Non -Layer
Design.- Current `
Dry Poultry Capacity POD.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current °
Cattle-'— ° Capacity Top. -
Dairy Cow
Dairy Calf
Dairy Heifer
i
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
24o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
- a. Was the conveyance man-made?
❑ Yes
❑ No
[3-1qA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
E2"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
2r&A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: jDate of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 2 o ❑ 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:_
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 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 threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑'l�lo ❑ 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 ff 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
©'No ❑ 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
No Q 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
]'NO 1 NA
[;-N-
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yeso
❑ 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
21Z ❑ NA
❑ NE
❑ Waste Application . ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
s
❑ 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
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No ❑ NA -®
NEE
Page 2 of 3
21412015 Continued

Facility Number: 115 1- Date of Ins ection:
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, checkE4'e's ❑ No ❑ 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: I7 0 o S-2 �� i -� oeW
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes 10 ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? /� ❑ Yes ❑ No ��A❑ 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:
❑ Yes [/�No ❑ NA ❑ NE
❑ Yes �To ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA 'a
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
❑ NE
No
❑ NA
❑ NE
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional pages as necessary).
120
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ci eCAr�
�1v,�_A, c'Y\
Reviewer/Inspector Name:
.'\,I,e v)-e
Reviewer/Inspector Signature:
Page 3 of 3
Phone:,--,-, (nl 2- 0- 3 �; ) v
Date: '—
2,1/2015