530004_Compliance Evaluation Inspection_20190722

,S�Mivision of Water Resources
Facility Numberj j- - O Division of Soil and Water Conservation
O Other Agency
Type of Visit: Comp ' nce Inspection Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: rf . Arrival Time: Departure Time: County:
Farm Name: J ?e{JLC r Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: Liz "'C 1c<2.s
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Doan to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Phone:
Title:
Latitude:
Phone:
Integrator: /n g S
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Pullets
Poults
Design Current
Longitude:
Region:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ YesNo NA ❑ NE
Discharge originated at: El Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes�N;o,,Q
❑ NA E] NE
b. Did the discharge reach waters of the State? (if yes, notify DWR) ❑ Yes 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) ❑ YesNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation'? ❑ YesrNo
❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [] Yes❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 1/412015 Corrtitrued

Facility Number: r - p t4 Date of Ins ection:7— 22 f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ YesNo NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes o ❑ NA E]NE
Structure 1 Structure 2
Identifier:
Spillway?:
Designed Freeboard (in):
Structure 3 Structure 4 Structure 5 Structure 6
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
Yes No NA
No
F-1NA
❑
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
N
❑ NA
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?
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmenta real, 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 o ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ NE
18. Is there a lack of properly operating; waste application equipment?
9. Does any part of the waste management system other than the waste structures require
❑ Yes No ❑ NA
❑ NE
maintenance or improvement?
Required Records & Documents
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes 2fNo NA
❑ NE
maintenance or improvement?
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
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): i /bar z rrz
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?❑Yes
No
F-1NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
N
❑ NA
❑ NE
16. Did the facility fail to secure andior 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
FZNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes❑
NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
rNo
❑ 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 a ❑ 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? ❑ Yeso F] NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 21412015 Continued

Facili Number: 3 - OV 71 Datc of Ins ection:
❑ No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ YesN
❑ NA
❑ NE
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?
❑ YesVNo
NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
NA
❑ NE
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 ❑ 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?
(] 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
Comments (refer to question ft 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 necessarv).
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Reviewerrinspector Name:
Reviewer' Inspector Signature! 1 G
Page 3 of 3
Phone:
Date:
1/4/1015