090176_Structure Evaluation Inspection_20181002

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Structure Evaluation inspection
Facility Number: -- / 7(e Date: j 0
Time in: f/ 33 Time-out: ( �-<<
Farm Name: /! ()urn F n) Farm 911 address:
• Owner Name: l t�� C(--. ?���( Phone
Facility Contact:
Onsite Representative: Integrator:
Certified Operator: V Cert. Number
Is storage capacity less than adequate? Yes �No
If yes is waste level into the structural freeboard? Yes No
Was non-compliant level reported to DWR y`t� POA received c -5_5
Structure: 1 2 - 3 V 4 5 6
Identifier:
•
Spillway?
•
Designed Freeboard (in.):
Observed Freeboard (in.):
• Are there any immediate threats to the integrity of any of the structures
observed? Yes No
Do any structures lack adequate markers as required by the permit? Yes No --'
Does any part of the wasterrianagement system need repair Yes No .�
Condition of field's . ' -
Condition of receiving crop. roe,'(-)
"
Comments: e
• L