330029_Compliance Evaluation Inspection_20220617

cility umber
Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
LType of Visit: p Compliance Inspection
Reason for Visit: Routine 0 Complaint
Date of Visit: lip
! lam` Arrival Time:
Farm Name: OS
U
Operation Review 0 Structure Evaluation 0 Technical Assistance
0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Departure Time:
Owner Email:
Phone:
County:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
integrator:
Phone:
Certification Number:
Certification Number:
Longitude:
•
•
•
•
•
Swine
Wean to Finish
Wean to Feeder
Design Current
Capacity Pop.
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
rem
kihrom
wria
ming
Design Current
Wet Poultry Capacity Pop.
Layer
Non -Layer
Dr
Poultr
■mom
■
■
■
■
Non -La ers
Pullets
Turke Faults
Design Current
Ca
aci Po
-
Other
Cattle
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
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?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes yj No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No D NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes jNo ❑ NA ❑ NE
❑ Yes 'No ❑ NA ❑ NE
Page 1 of 3
5/12/2020 Continued

'Facility Number:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Date of Inspection:IT#X71--
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?
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? D Yes [ij No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? D Yes dNo ❑ 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 di 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 dNo ❑ 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):
❑ Yes J No ❑ NA ❑ NE
❑ Yes IA No ❑NA ❑NE
14. Do the receiving crops differ from those designated in the CAWMP? El Yes ZfNo ❑ 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 In 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 ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VI No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design El Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application El Weekly Freeboard [K Waste Analysis 0 Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" 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 eNo ❑ NA ❑ NE
Page 2 of 3 5/12/2020 Continued

I Facility Number: 2 - [Date of Inspection: (a i
24. Did the facility fail to calibrate waste application equipment as required by the permi ? ❑ Yes VP No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Fr 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:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Er No ❑ NA El NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes VI 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 J No ❑ NA El 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. El Yes dNo ❑ NA ❑ NE
❑ Application Field El Lagoon/Storage Pond El Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes EiNo ❑ NA El NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes if No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ErNo ❑ NA El NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations use additional pa es as necessary).
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Reviewers Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
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Phone: ad V�
Date: 4J)7I
9
S/12/ 020