310095_Inspection_20181004

t Division',of WaterRes ources 4_. -
Thciill'ithNumber, � �-�� � O Division of SoU and Water Conservation- =
O Other Agency.--'
type of Visit: O Compliance Inspection 0 Operation Review tructure Evaluation O Technical Assistance
teason for Visit: O Routine O Complaint Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: d - /E j Arrival Time: ? Departure Time: County:
Farm Name: 2,33 33 1-3 10 -13 Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Design, Current
Swine ' Capacity pop.
Al
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Other
Other
Discharnes and Stream Impacts
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Region:
Design Current Design ,Current
Wet Poultry Capacity Pop. = Cattle Capacity Pop.
La er
Non -La er
Design Current
�,Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turke s
Turkey Poults
Other
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
1. Is any discharge observed from any part of the operation? W' Yes ❑ No ❑ NA ❑ NE/
Discharge originated at: ❑ Structure M Application Field ❑ Other: �Gyjp��i/� ,`n T:P,�� �'Arir►r fh OV/�(
a. Was the conveyance man-made? ❑ Yes .2 No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes P 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?
Wf Yes
❑ No
❑ NA
❑ NE
❑ Yes
10 No
❑ NA
❑ NE
❑ Yes
I No
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

Facili Number: - Date of Inspection: 10�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
X 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: 1 cy2
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
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
Og 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 KNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes JM No ❑ NA 0 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? IM
Waste Apnlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes TNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [V 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 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
ONE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
Z] NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
0 Yes
❑ No
❑ NA
4 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
[a NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
�c] 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
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
❑ No
❑ NA
NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
�' NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
�ff NE
Page 2 of 3
21412015 Continued

Facili Nymber: 1 - 61 jDate of Inspection: p - 4-
24 Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes ❑ No
❑ NA N3 NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes ❑ No
❑ NA [XTNE
the appropriate box(6s) 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
❑ NA ONE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes ❑ No
❑ NA ONE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ❑ No
❑ NA ONE
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
❑ NA M 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 ❑ No
9
❑ 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 ❑ No
❑ NA k NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWW?
❑ Yes ❑ No
❑ NA ONE
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?
❑ Yes 0 No
❑ NA ❑ NE
Cori eats (rcfer.to gaestion-#)::rEzplain.aoyYES`answer and/o =any',additional recommendations or'any:other. 6nufients.
a
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Reviewer/InspectorName: Phone: �l�''77C- 7d
Reviewer/Inspector Signature: Date: l0 7`-l�
Page 3 of 3 21412015