260002_Routine_20231027

Facility No. 2-U - 09 Time In Time Out
Farts Name �Date
{7 r (� N� tntegrata
Owner T t�cb 1 I�I�
Site tie::
eratgl� i QhQiz 4f1J1re
-jr No.12t'yq ` Gp. uii Pit. S�b
Sack -up No. 'DI '7
crec.K
CDC Circle: General , or NPOES Otwuf
FREEBOARD: Design
Observed J
Crop Yield
Rain Gauge
Soil Test Wettable Acres
Weekly Freeboard Daily Rainfall
Spray/Freeboard Drop
Weather Codes 120 min Inspections
Waste Analysis.
Date Nitrogen (N)
br-11 , tDPN dOWN,
Dtf f-I pe, T IIqNs
Sludge Survey
Calibration/GPM /
Waste Transfers
Rain Breaker
PLAT
1-in inspections
Date Nitrogen (N)

Facility Number %(d U Division of Soil and Water Conservation
0 Other Agency
Type of Visit: O 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: a Arrival Time: Departure Time: urn
County: C11 ]U MRegion: fKO
Farm Name: lb Owner Email:
Owner Name: j ect0e -N nG Phone:
Mailing Address:
Physical Address:
Facility Contact ,Wine,( I Q ro w Title:
Onsite Representative: (AMIL
IL
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Latitude:
Phone:
t''I�
Integrator: M E
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
D
Farrow to Feeder
Farrow to Finish
Hilts
Boars
Other
Other
Design Current
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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes y No ❑ NA ❑ NE
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes P
No ❑ NA ❑ NE
❑ Yes )❑ No ❑ NA ❑ NE
Page I of 3 511212020 Continued

waste couecuon & i reatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: I
Spillway?: No
Designed Freeboard (in): I I
Observed Freeboard (in): f3 Q
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?
❑ Yes No ❑ NA ❑ NE
❑ Yes k
No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
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? T`
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 1�No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes qNo ❑ 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 �cropp Window [:]Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): &- ` I e - Sq
13. Soil Type(s):
14. Do the receiving crops differ from.those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑WUP ❑Checklists El Design ❑ Maps [:]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Weekly Freeboard ElWaste Analysis ❑ Soil Analysis ElWaste Tra fers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes 'q No
❑ Yes ❑'TNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 511212020 Continued

w. vla the facility fail to calibrate waste application equipment as required by the permit? Yes E]�No ❑ NA Ej NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check El Yes [] No 0 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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.
[] Yes
Q No
EDNA
NE
Yes
QNo
NA
NE
❑ Yes
Q,No
NA
NE
Yes [:] No NA NE
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)
Yes [:jNo 0 NA NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes Q 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 Q No NA NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
Yes Q No NA NE
34. Does the facility require a follow-up visit by the same agency?
I1 Yes M No n NA M XTU
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 necessarvl_
ovu&?d has
plo-f�+ed
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
1
Phone:
Date:
511212020