760065_Inspection_20190821

for Visit:
O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Z��/ / (�f _1Arrival � c Time: � Departure Time: County: Je Region: Lkzw
Farm Name: Rnl6i rAi Pcc(,, IC Ivio Owner Email: / Owner Name: R"A k (0 Phone: �j��� ID�G' l q^7
Mailing Address: qp.; 111I . ije `i _ kike- 6I-i NC 21^% 2©-3
Physical Address:
Facility Contact: J,�Jr61A) H O� Title:
Onsite Representative:
Certified Operator: N JA
Back-up Operator:
Location of Farm:
Latitude:
Phone 1
Integrator:
Certification Number:
Certification Number:
Longitude:
u
.-1�
�'r ► Tuy�
T D
em— -b
'Ea
� -Ave`F,�
,
I
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -La er
' Dairy Calf
Feeder to Finish
t
Dairy Heifer
Farrow to Wean
ill
I� Dry Cow
Farrow to Feeder
�,
Non-Dal t
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
I X Beef Feeder
2 0
Ii
Boars
Pullets
lBeefBroodCow
Turke s
t{
Turke PoultsOther
11111i
?:i
�$�?
4fI 10 klllii
GS(
iu
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?
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 [pL No ❑ NA ❑ NE
[—]Yes ❑ No
❑ Yes ❑ No
[:]Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facility Number: c& Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P�,No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [:]Yes [:]No ❑ NA ❑ NE
StCucture 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 0 L
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 5Q 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 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No
V A
rLAN
❑ NE
❑ Excessive Pending ❑ 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): N
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
§] NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
X NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Pb 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
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
KNo
❑ 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, the app opri to box below.
Yes
❑ No
❑ NA
❑ NE
application ` b �.__hk Waste Analysis is
] Waste Transfers
'❑'F�atimT-eede
Rainfall Stocking ❑ Crop Yield Monthly and 1" 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
,��❑
A NA
❑ NE
Page 2 of 3
21412015 Continued

Facility Number: Date of Inspection: $ I
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes ❑ No 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?
❑ Yes
❑ No
A NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
JQ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ 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
�] No
❑ 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
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
No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWNIP?
❑ Yes
No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
t�
IX I No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[A No
❑ NA ❑ NE
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Reviewer/Inspector
Reviewer/Inspector Signature:
Page 3 of 3
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Phone: �j��j
Date: v 1 ,1 `7,0
214 2015