820279_Routine Inspection_20241104

Certified Operator:
Back-up Operator:
Location of Farm:
l rype or visit: ,0 Compliance inspection V Operation Review U Structure Evaluation (_) Technical Assistance I
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: 0 Departure
Farm Name:,
Owner Name:
Mailing Address: V
Time: vQJ County:r! Region:/ed
Owner Email:
Phone:
Physical Address: �% /f y
Facility Contact: 1 h4zl C/J /'Z' 4e - Title: Phone:
OnsiteRepresentative: (w�,
if
Latitude:
Integrator: z
Certification Number:
Certification Number:
Longitude:
/7-Wy
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)
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 E]-No ❑ NA ❑ NE
❑ Yes _[E�No ❑ NA ❑ NE
Page I of 3
511212020 Continued

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
❑ 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:
Spillway?:
Designed Freeboard (in):
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
�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
Q'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
_[2,No
9. Does any part of the waste management system other than the waste structures require
❑ Yes
,ENo
❑ NA
❑ NE
maintenance or improvement?
Waste Aoulication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
allo
❑ 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 Acceep��taa�ble Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): lR�(//9,
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?
Reauired 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.
❑ VMP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
l"
❑ Yes Q No
❑ Yes -[2*o
❑ Yes 0-I o
❑ Yes _IQ -No
❑ Yes _Q�No
❑ Yes ,❑10
❑ Yes . o
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E�No
❑ 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?
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ Yes -e-No ❑ NA ❑ NE
❑ Yes ,Ea�No ❑ NA ❑ NE
Page 2 of 3 511212020 Continued

]Facility Number: - Date of Inspection: d( 2
24. Did the facility fail to calibrate waste application equipment as required by the permit? D Yes -[3 No D NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check D Yes .-e'No ❑ NA ❑ NE
the appropriate box(es) below.
Failure to complete annual sludge survey D 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.
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 Ej 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?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes
EffNo
M NA
D NE
Yes
dNo
DNA
MNE
El Yes eNo ❑ NA D NE
El Yes El No D NA D NE
Yes .[�rNo DNA NE
❑ Yes
&No
NA
D NE
Yes
E2-1Qo
D NA
D NE
❑ Yes
E]'�lo
D NA
NE
❑ Yes
la"No
NA
D NE
Phone:�d
Date:
511212020

raoarry rvo. /T/���'7n 9 Time In Time Out _
Farm Name /&47 N'C m lntegrara
Owner Site R43,
Jperator No.
Back-up No. _
COC Circle: General or NPDES
Dare
Des n
Current Desi Current I
Wean -Feed
Farrow - Feed
Wean- Finish
Farrow - Firiis`
Feed :Finish
Gilts /Boars
Farrow -.Wean
( I Other.
FREEBOARD: Design
Observed
Crap Yield
Rain Gauge
Soil Test
Weekly Freeboard _
Spray/Freeboar<Drop
Weather Codes
Wettable Acres
L'� Daily Rainfall
120 min Inspections
Sludge Survey `G' 9 l- /'
Calibration/GPM z 1% 11 o2Z
Waste Transfers
Rain Breaker
PLAT
1-in Inspections
Waste Analysis:
Date Nitrogen (N) Date Nitrogen (N)