300003_Compliance Evaluation Inspection_20230424

Division of Water Resources
Facility Number - ® Division of Soil and Water Conservation
0 Other Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine O Complaint 0 Follow-up O Referral O Emergency 0 Other 0 Denied Access
Date of Visit: t Arrival Time: Departure Time: County:� � Region: ^4
t
Farm Name Ley- 1 Owner Email:
Owner Name: al 4y, Phone:
Mailing Address: I �j � ) �� Q-A . 01�b c l 1 e NC- �)-162�0
Physical Address: U
Facility Contact: wak Title: Phone:
Onsite Representative: Integrator:
Certified Operator: �/ Certification Number:
Back-up Operator: Certification Number:
, tt Q o �q!
Location of Farm: Latitude: <-` Lon U c gitude: 0 1
Design Current Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish Layer Dairy Cow
Wean to Feeder Non-Layer Dairy Calf
Feeder to Finish Dairy Heifer
Farrow to Wean Design Current Dry Cow
Farrow to Feeder Dry Poultry Capacity Pop. Non-Dais
Farrow to Finish Layers Beef Stocker
Gilts Non-Layers Beef Feeder
Boars Pullets Beef Brood Cow
Turkeys
Other Turkey Poults
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 ❑ NA ❑ NE
of the State other than fi•om a discharge?
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Facility Number: jDate of Inspection:
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 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: (�S
Spillway?:
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 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 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): hay aSAJ>✓(L'
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? ❑ YesLN
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 No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes,check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
Waste Application Weekly �]Waste Analysis n c^ ^a�___. cs i� ❑ a [A Weather Code
Rainfall Stocking �Freeboard 120 Minute Inspections Monthly and 1" Rainfall Inspections , ,��`�RP c�
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 14 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 511212020 Continued

Facility Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? _ ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ( NA ❑ NE
the appropriate box(es)below. JX
❑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 No ❑ 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 IX No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments(refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations(use additional pages as necessary).
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Reviewer/Inspector Name: &(S X CCG CA'C'yo Phone:' I_
Reviewer/Inspector Signature: Date:
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