260073_routine_20230908

Type of Visit: P. Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Q Routine O Complaint O Follow-up O Referral O Emergency O Other
' O Denied Access
V& Date of Visit: Arrival Time: ® Departure Time: County: ( 9 lfifi Region:
Farm Name: 0 ft ,9 rrn Owner Email:
Owner Name: 4 N� Lu&/f 3 I omm ON I Phone:
Mailing Address:
Physical Address:
Facility Contact: LOA11 t/uP� Title: wJ o"iQ Phone:
Onsite Representative: �Q i 9 C� Integrator: rlp�
Certified Operator: � '
���► � Certification Number: p� D�/ 77
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Calrrent :
Deslgu Current
-Desi'964, Current nE
Swine
�s
Capacity ]Pop
Wet Poultry
_:Capacity A Pop -
Cattle
Capacity Pop
Wean to Finish
I
ILayer
I
Dairy Cow
Wean to FeederI
lNon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
"` Design ;Currrent °
Dry Cow
Farrow to Feeder
DryI?oultry
---Capac t Pop
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
=
Turkeys
b
Other
-
Turkey Poults
=;
Other
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?
❑ Yes No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
,1
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)
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 4 No ❑ NA ❑ NE
❑ Yes 'O,No ❑ NA ❑ NE
❑ Yes \ 'eNo ❑ NA ❑ NE
Page I of 3 511212020 Continued

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Facility Number: I I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Q No
25. Is the facility out of compliance with permit condition's related to sludge? If yes, check ❑ Yes Q\\No
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 `l No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes \ �No
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:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
V
❑ Yes o
❑ Yes No
❑ Yes �No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes MNo ❑ NA ❑ NE
❑ Yes 1] o ❑ NA ❑ NE
❑ Yes �] No ❑ NA ❑ NE
TZ
Sludge Ii-2.9-�
Phone:
Reviewer/Inspector Signature:
Page 3 of 3
Date:
511212020