760023_Compliance Evaluation Inspection_20180323

-713
Division of Water Resource'
Facility:Number ��,�1 Division.of Soil anti Water! Pervafion
ill s
0 Other Ageneyk ;
Type of Visit: 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 J0 Denied Access
Date of Visit: Arrival Time: % C O Departure Time: ® County: h Region: W6
Farm Name: L ,d L Ql V' 1/ Owner Email:.
T'T7..._..
i
Owner Name: Cil I �-�Olr L�U-t� L I Y) Phone:
Mailing Address: ag &:1 , y l d 1 Q
Physical Address:
Facility Contact: C ,� 1 r� Title:
Onsite Representative:
Certified Operator:
Phone: 336 — 667 alp i'
Integrator:
Certification Number: iZ i I,
Back-up Operator: Certification Number:
Location of Farm: Latitude: ��Q� 43 f Longitude: %q"sZ_' .39
US 311 Sooo Ce6l oar- S� . ex IK v r'V) Z-- W i 31 I -8 06,
n L cch n "bQw -y R. o A
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Layer
Non -La er
Design Current
Dry Poultry Capacity Pop.
Layers
Non -La ers
Pullets
Turkeys
Turkey Poults
Other
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?
''Desi n Cur- snt
,,ra g
Cattle Capaci pop.
Dairy Cow
00
-Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes
%No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
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
[:]Yes No
❑ Yes [ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

5
Facility Number: jDate of Inspection:,_
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard?
%% Structure 1 Structure 2 Structure 3
�,./ IAntifier: P
Spillway?:
Designed Freeboard (in):
❑ Yes
No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 4 Structure 5 Structure 6
Observed Freeboard (in): _72
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 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 [ 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?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes lNo ❑ 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 Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
Type(s):
13. Soil V
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E$No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ 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
99 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
bjrNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
P�<o
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
21 oes record keeping need improvement? I
Analysis
Yes
p. /.a
❑ No
❑ NA ❑ NE
❑ Weather Code
Waste Application Weekly Freeboard E3 waste Analysis oil
,�
ainfall E2stocking ❑ Crop Yield ions [0"'Monthly and V Rainfall Inspections
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
❑ NE
Page 2 of 3
21412015 Continued

off'
Facili Number: - Date of inspection: 3
24. Did the facilityfail to calibrate waste a iucation equipment as re required b the permit? YesXNo NANE
ppq Y P ❑ ❑ ❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No [�'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 provide documentation of an actively certified operator in charge? ❑ Yes [U'No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes N3440 ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes rS;;'No ❑ NA ❑ NE
and report mortality rates that were higher than normal? YN
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.
PApplication 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?
o 1, SC> l I +e_s+S d ue' 1 11 2 Ot ? .
a Cat i brad- bv\ Joe- i9L a ► a, i n t 9�
ULV_
❑ Yes o ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
AYes ❑ No ❑ NA ❑ NE
[:]Yes
� No
❑ NA
❑ NE
❑ Yes
&rNo
7WNo
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
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Reviewer/Inspector Name:
Reviewer/Inspector Signatu:
Page 3 of 3 r /A4_"'A'u0 -& LA-
Phone:.-WA-7711P — % 9
Date: �� Z 1.201