010028_Inspection_20201027

Type of Visit: W Compliance Inspection V Operation Review V ,tructure Evaluation U l echmcal Assistance I
Reason for Visit::' (Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time:'^ ` Departure Time: County:, I r 1Aft Region:, A�
Farm Name: A Car( � n W i l i G�rd� Owner Email: \
Owner Name: A _ D1 . a 1-A Phone:
Mailing Address: � 15 /� yid l ?w I V l� I
Physical Address:
Facility Contact: Car L�y 1 l l 0!r Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:�b� ` 3L1 ��
Integrator:
Certification Number:
Certification Number:
1 I l�
1
Ga �y I � /�
Latitude: 35 O `T Longitude: I
[-i Ix d � /YLA ( 128(. 7 �rn ran � _
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
x No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ 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
0 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

Facifi Number: Of jDate of Inspection: I 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 09 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
1,/
Structure 1 Structure 2 Structure 3
V Identifier: v S 1" a —
Spillway?:
wo—
Designed Freeboard (in): _
Observed Freeboard (in):-
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
Structure 4 Structure 5 Structure 6
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
1% No
❑ NA
❑ NE
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?
�Q Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
CKNo
❑ 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
CKNo
❑ 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] No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
X No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
[" NA
❑ NE
acres determination?
7N
17. Does the facility lack adequate acreage for land application?
❑ Yes
JW No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
EA 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
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
21. Does record keeping need improvement? If yes, checkjtLe appropriate box below.
Yes
❑ No
❑ NA
❑ NE
4Waste Application Weekly Freeboard ❑ Waste Analysis �cSLs
Weather Code
Rainfall ocki g Monthly d V Rainfall
`
Inspectio
22. Did the facility fail to inst and maintain a rain gauge? t
Yes
No
❑ NA
❑ NE
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

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