820520_Routine Inspection_20231023

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Type of Visit: Z7Compliance 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: TJ % Arrival Time: Departure Time: 3d County: Region: ��C)
Farm Name: r� 5..., y Owner Email: --
Owner Name: 96,,-6-- LPhone:
Mailing Address:
Physical Address:
Facility Contact: -" L GC_ Title:
OnsiteRepresentative: tl
Certified Operator: G e
Back-up Operator: 91
Location of Farm: Latitude:
Phone:
Integrator:
Certification Number:
/ lXJ�`7i
Certification Number:
Longitude:
Discharees and Stream Impacts
I. Is any discharge observed from any part of the operation? Ej Yes _o NA NE
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 ❑ No NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA NE
❑ Yes 2-IQb ❑ NA NE
Ej Yes E�-No Ej NA M NE
Page I of 3 511212020 Continued

Facili Number: Date of Inspection: U
3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes_17j'(Io
❑ 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: l
Spillway?:
Designed Freeboard (in): l
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes—Q-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 �Plo
❑ 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 ,.e-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 �Q-No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes -Ea-No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes _E3-1Vo
❑ 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 AcceptableCrop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): oiz'ac4A Ac- c 6� U z ems O.S
13. Soil Type(s): 14 u
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes if -No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes_j:]-No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes _:J 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 _L;-No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes _Q-No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes _-La 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_ j . o ❑ NA ❑ 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 Q'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: - 37 d
Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ffrNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ayes ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey IzFailure 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: 66 /�`J /? 3 6-7 S6
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes E3^No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes J:�VNo ❑ NA ❑ NE
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?
i
?) A04�� lt_�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
❑ Yes
o ❑ NA ❑ NE
❑ Yes ❑-No ❑ NA ❑ NE
❑ Yes .E Ko ❑ NA ❑ NE
❑ Yesj No
❑ NA
❑ NE
❑ Yes _2'go
❑ NA
❑ NE
❑ Yes _ No
❑ NA
❑ NE
❑ Yes _E]-No
❑ NA
❑ NE
Phone: 9/0 6-3S"-t92vs—
Date: to b-31?-3
Page 3 of 3 511212020

FACILIF'f #: ,2-5Z�o FARM NAME: v
DUE EVERY 5 YEARS
B(PERIATION DATE
CURRENT NUMBER OF ANIMAL
010 CARD YES OR NO
PERMIT (ng)
NUMBER OF ANIMALS
WASTE UTILIZATION PLAN (WUIP) (#20)
SOIL TYPES
CROP TYPES
- ODOR CONTROL CHECKLIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (mzi)
-GOOD FOR 0 DAYS BEFORE OR AFTER
9f
DATE NITROGEN LEVEL
DATE 3 Z.3 NITROGEN LEVEL y
DATE ` l 21 NITROGEN LEVEL
EVERY 3 YEARS:
P-1 (NO MORE THEN 400)
PH (Note i 4er Iev )
Cu2N (NO MORE THEN 8000)
(IF PEANUTS NO MORE THEN 300)
SOIL RiEPORT (i)
DATE & Z77 (E-JL I
Not over PAN CROP TYPES
FLOW RATES
Not over PAN CROP TYPES
FLOW RATES
IRR2 Xi)
NITROGEN (N)
NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
LAGOON

CALBRIATION (s24)
- EACH REEL SHOULD BE CALIBRATED EVERY OTHER YEAR
- DATE OF CALIBRATION
- FLOW RATES
RAIN FALL�zt)
-INITIAL AFTER 1' RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED POA NEEDED.
SLUDGE(#z &25)
-DUE EVERY YEAR: DATE /0 /
0:,21']_P: % RATIO OF SLUDGE
0: P: % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE
0: P: % RATIO OF SLUDGE
OTHER FORMS (#22 AND 421)
RAIN BREAKER FORM CROP YEILDS MORTALITY
*If fields are grazed there will be no crop yields
VISUAL CHECK
FOUNDATION OR PIT LEAKS PIPE LEAKS_ LAGOON SEEPAGE LAGOON BARE
AREAS— TREES OR GRASS NEED TO BE REMOVED EROSION DITCHES
WINTER CROP(OVERSEEDED) HARVESTED FIELDS_ GOOD HEALTHY CORPS_ CORRECT
CROPS NO PONDING REELS_ FEED BINS_ LAGOON GARBAGE
Bermuda grass: Opens March 1�t- Ends September 30th
Small Grain Over seed: Opens October 1-t-Ends March 31�
Corn: Opens February 15t - Ends June 30t
Cotton: Opens March 15w-Ends August lit
Rye: Opens September 1�-Ends March 31A
Oats: Opens September IBC- Ends April 15w
Wheat: Opens September 1st - Ends April 30i
Soybeans: Opens April 1st -Ends September 15�
Fescue: Opens August 1st -Ends July 31�
Sorghum Hay: Opens March 15t - Ends August 31 st