780072_Routine Inspection_20240430

Type of visit: AD -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: O Departure Time: %r County: /4
Farm Name: Owner Email:
Owner Name: �. S� Phone:
Mailing Address:
Physical Address:
Facility Contact: ��d O Title:
Onsite Representative:
Integrator:
Phone:
Region: %�
Certified Operator: '5-27� Certification Number: /S�1206_
Back-up Operator:
Location of Farm:
Latitude:
_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?
Certification Number:
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:
❑ Yeses❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes 12-No ❑ NA ❑ NE
❑ Yes Q No ❑ NA ❑ NE
Page 1 of.? 511212020 Continued

Facility Number: - % Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes ETNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes J[2 No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure
6
Identifier:
Spillway?:
Designed Freeboard (in): /
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes „E'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 E� 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. Db any of the structures need maintenance or improvement?
-Eres ❑ 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 ,[3Qo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes ..[31Qb
❑ 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 Accepp+taable, Crop ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
/Window
12. Crop Type(s): (�Lc�} J �Iaj W�/L Gs
13. Soil Type(s): W �O
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes_Q-No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ID -No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes [2-No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes C7FNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑" Ro
❑ NA
❑ NE
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.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑ Yes J2'No [—]NA ❑ NE
[—]Yes ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes-.Ej'�o
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" 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 JEJN'o
❑ Yes ZIAo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: 7 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes E:H o
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes E2,IQo
❑ 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?
❑ Yes _[2,IQo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes _® o
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes [3No
❑ 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 „1:�IVo
❑ 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 [3-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 J® 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 EjNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes 4�]o
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes -2--�o
❑ NA
❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: (/y -i rl l�i5�
Date:
511212020

raauty NO. Time In _ Time Out
Farm Name I>n
Integrator
Owner
Site FCac.
Operator No
Back-up
No.
HOC Circle: General or NPDES
FREEBOARD: Design
Observed
Crop Yield
Rain Gauge
Soil Test % Wettable Acres
Weekly Freeboard ✓ Daily Rainfall -4_,
Spray/Freeboard Drop
Weather Codes _iG 120 min Inspections 1�
Waste Analyses:
Date Nitrogen (N)
P
0
v
Date
rd-r 9r
Sludge Survey.- JLd 7
Calibration/GPM 7 < l/I / >-j
Waste Transfers
Rain Breaker
PLAT
1-in Inspections
Date Nitrogen (N)
31�/��