010010_Compliance Evaluation Inspection_20211202

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 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County:4LTdyU1 Region:
Farm Name: ���IQ V V !FM-MS Owner Email:
Owner Name: C e' SQCCA Phone:
Mailing Address: -7-2 6(n o NL��/
Physical Address: I
Facility Contact: �I 6 Title: Phone/��k I "
Onsite Representative: / Integrator:
Certified Operator: V Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: y
D l 11 Longitude:
Design Current Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish L
ayer DairyCow
Wean to Feeder Dairy Calf
Feeder to Finish Dairy Heifer
Farrow to Wean Design Current Dry Cow
Farrow to Feeder Dry Poultry Capacity Pop. Non-Dairy
Farrow to Finish Layers Beef Stocker
Gilts Non-Layers Beef Feeder
Boars Pullets Beef Brood Cow
Turkeys
Other Turkey Poults
Other Other
DischarEes 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 0 NE
b. Did the discharge reach waters of the State? (If yes,notify DWR) ❑ Yes ❑ No ❑ NA 0 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 N Yes 0 No ❑ NA ❑ NE
of the State other than from a discharge?
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Facili Number: - Date of inspection:
Waste Collection&Treatment
4. Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑ Yes No ❑ NA ❑ N E
a. If yes,is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure 1 Struc�tu�r/e�Q2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard(in):
Observed Freeboard(in): 1
5.Are there any immediate threats to the integrity of any of the structures observed? 0 Yes 19 No ❑ NA ❑ NE
(i.e.,large trees, severe erosion,seepage,etc.) 7�
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? VYes ❑ 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? Vy
Waste Application
10. Are there any required buffers,setbacks,or compliance alternatives that need ❑ Yes ❑ No ❑ NA ANE
maintenance or improvement?
11. Is there evidence of incorrect land application?If yes,check the appropriate box below. ❑ Yes ❑ No ❑ NA 14 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 ❑ 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 ❑ 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 CXNE
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 y NE
❑Waste Application ❑Weekly Freeboard ❑Waste Analysis ❑Soil Analysis ❑Waste Transfers ❑Weather Code
❑Rainfall [:]Stocking ❑Crop Yield ❑120 Minute Inspections ❑Monthly and 1" Rainfall Inspections ❑Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA N NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? [—] Yes ❑ No X NA ❑NE
Page 2 of 3 511212020 Continued

Facili Number: U t - Date 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.
❑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 [� No ❑ N A ❑ N F�
27.Did the facility fail to secure a phosphorus loss assessments(PLAT)certification? ❑ Yes ] No ❑ NA ❑ N F.
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes Na�IVI NA ❑ N F
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 0 NA ❑ N F,
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) 7�
31.Do subsurface tile drains exist at the facility?If yes,check the appropriate box below. ❑ Yes ❑ No IX 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? 'X Y�e 9
No ❑ NA ❑ 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 pages as necessary).
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Reviewer/Inspector Name: G��- �^' �l Phone:eML: :L �"�—
Reviewer/Inspector Signa Date: 'a
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