760031_Inspection_20200327

Date of Visit: I'S I Arrival Time: Departure Time: County:&YA* Region: VWO
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
,1/
Facility Contact: C*A_4 CA CY(A-Zi e_A,*" Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Phone: - -,-?, (y f sob
Integrator:
Certification Number O Ci
Certification Number:
Latitude:'�b 1� L Longitude:
r [ 0
_ y 3
Wean to Finish — La erDairy Cow
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish
- �! E `
[�Ab
Dairy Heifer
Farrow to Wean
011,11 -
`C
Dry Cow
Farrow to Feeder
E
l
Non-DairyiU
�.
Farrow to Finish
- Layers
�$
Beef StockerWON
Gilts
_ _ Non -Layers
Beef Feeder
Boars
_ Pullets
E'€
Beef Brood CowIrFj
,
�,.
d r
Turkeys
I ur ey Poults"g
l r
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
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
❑ 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
VY,
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: - "1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1
Identifier: W' 2D_U1_
Spillway?:
Structure 2 Structure 3
S
Structure 4 Structure 5
M No ❑ NA ❑ NE
❑No ❑NA ❑NE
Structure 6
Designed Freeboard (in):
Observed Freeboard (in): _
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No
❑ 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
❑ 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 � No
❑ 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 KNo
❑ 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): Co o n 1 I CA C1L hA [i 4
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 ❑ 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
IR No
❑ NA
❑ NE
Reauired 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, cheekthe-appropriate-box--below— Yes No ❑ NA ❑ NE
Waste Application Weekly Freeboard Waste Analysis Waste Transfer Weather Code
// Rainfall Stocking Crop Yield o-1.101V1i�aiite luep_ ec+»n� N Monthly and 1" Rainfall Inspections �S
—­
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes K No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes rXNo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit.
❑ Yes
qq'No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
[:]Yes
❑ No
ONA ❑ 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
'A No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
7�
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA ❑ NE
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?
❑ Yes
No
❑ NA ❑ NE
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
❑ Yes
No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
KNo
0 NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
4No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
MNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
(�No
❑ NA
❑ NE
"rC_t'Le_k' CAC, rv(As ky-
/
C�1n,�-cam-
�U MO, l l�({ Qv �dQ OP �0 �
f r CVtr V\j CoYlCcrrlNa% yqa4n�- �\Ao-V'Kc4zy fi-etbo'cri
"
V\c
U5
JA C� ► (�C\ C G %�'1 �t� Y 1 5�
Reviewer/Inspector Name:
Reviewer/Inspector S
Page 3 of 3
1F'1 LaU l-e-, Phone: —l1 �A-I
Date:
2 I201