820632_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quality
e..
.. -\."_.,., .. ,_,,_ ...... . , .... lf"• ~ IlL '" .... -~-·-···· ---~HC:? -1(-ru -18
Type of Visit: QoeOmpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Q..R6iitine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: [1'-<£".-:tkl Arrival Time:lj/,'00 I Departure Timed o;;;z...t)() I County: L~ Region: ,(bY
FarmNameo ~~'~/J<A-~ OwnerEman:
Owner Name: ~-~d_ dfr,/u;n Phone:
------------------------------
Mailing Address:
Physical Address:
Facility Contact: Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number: ..... /.c....h~:....:~::.....~£:......:fo:.__ ___ _
Back-up Operator: Certification Number:
Loca tion of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operat ion? 0 Yes g.-No DNA O NE
Discharge o ri ginated at: 0 Structure 0 Application Field 0 Other:
a . Was the conveyance man-made? DYes 0 No DNA ONE
b . Did the di scharge reach waters of the State? (If yes, notify DWR) DYes 0No DNA ONE
c. What is the est imated volume th at reached waters of th e State (gallons)?
d. Does th e dischar ge bypass th e wast e managemen t system? (If yes, notify DWR) D Yes 0No DNA O NE
2 . Is there evidence of a past disc harge from any pa rt of th e operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a disc harge?
Page I of3
D Yes
DYes
B-No DNA O NE
8-l'Jo DNA ONE
11411015 Continued
!'Facility Number: g;J.:.-(., 3'? I Date of Inspection: 11-s--J('
Waste Collection & Treatment \' i'4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
ldenti fier :
Spillway?:
Designed Freeboard (in): /9
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No
0 Yes 0 No
DNA ONE
DNA ONE
Structure 5 Structure 6
0 Yes 8'1W 0 NA 0 NE
0 Yes Etfio 0 NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental tbreat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Docs any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes G:TNo D NA 0 NE
0 Yes E:j"No 0 NA 0 NE
0 Yes (3-No 0 NA D NE
0 Yes j3""No DNA 0 NE
II . Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~ 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s):
13 . Soil Type(s):
14 . Do the receiving crops differ from those designated in theCA WMP?
I 5. 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?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Pennit readily available?
20. Does the facility fail to hav e all components of theCA WMP readily available? If yes, check
the appropriate box.
OwuP Ochccklists 0 Design D Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes (3-No DNA ONE
DYes Q.wo DNA ONE
DYes jd-No DNA ONE
0 Yes 8-No DNA ONE
0 Yes ~0 DNA ONE
0 Yes (J..lwo DNA ONE
0 Yes G-No DNA ONE
Oother:
DYes [J-fllo DNA ONE
0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
Poge 2of3
0 Yes [;}No 0 NA 0 NE
0 Yes [3-t-ro 0 NA 0 NE
21412015 Continued
·,
fFacility Number: /(?= -{752= I Date of Inspection: '.tf--::!:C-!K
24. Did the facility fail to calibrate waste application equipment as required by the pennit?
25. Is the facility out of compliance with pennit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes~ DNA ONE
DYes~ DNA ONE
D Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
D 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?
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 nonnal?
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
pennit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Application Field D Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the pennit 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?
D Yes Q-No D NA D NE
DYes G-No DNA D NE
D Yes G-No D NA D NE
D Yes B'No D NA 0 NE
DYes [d.-No DNA D NE
D Yes [3-No 0 NA D NE
DYes (3-No 0 NA D NE
D Yes [!3-No D NA D NE
DYes [d-No DNA D NE
cowue~~·(ref~r to .~:u~o.~FI~): ExiJ,~~~~ a~~:~~~~,,~~~we~ ~.nJVor ~~~ addi~,~:~~:reco~~~.e~ons c.~:·~~~r:other oommen~ .. ' ;.! . '!
Usedrawmgs of facility to better explain sJtUiltions(nse add1tional pages as necessary)~_ · .. ·· ··[1, · :~· ··' -·
Reviewer/Inspector Name: ------.--~4-~'-..z;;..;-;.:-VZ::..L.-_._~~~:>-'L0..:.,.....__-:----:------------
Af$C ~~. ---=:cc:::-..._
Phone : 9;12-~~1 S:l
~~ Reviewer/Inspector Signature: Date:
Page3 of3 21412015
mpliance Inspection
Reason for Visit: ~ne 0 0 Referral 0 0 Other 0 Denied Access
Date ofVisit:J?#tf) 71 Arrival Time: I 0 , '1Jo Departure Time: I 12-~Q'j) I County:_?'~~ Region: d D
FarmName: 7if!?t~; ~~·..,__ Xt_./,.,.._ :t?--OwnerEmail:
Owner Name: ~-?1::P-5 ~J Jf.~_.f/d -Phone:
;;>
.Mailing Address:
Physical Address:
Facilit)· Contact: ,....da~ ~~'Y~ Title:
Onsite Representative: Integrator:
Phone: ,
!ht .--iZ*-v ,.
Certified Operator: Certification Number: I L. ?..;LL
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
L Is any discharge observed from any part of the operat io n? D Yes ~o DNA O NE
Discharge orig inated at : 0 Structure 0 Applicat ion Field 0 Oth er:
a. Wa s the conveyance man-made? 0 Yes 0 No D NA O NE
b . Did the disch arge reach wat ers ofthe State? (If yes, notify DWR) 0 Yes 0 No D NA O NE
c . What is th e estimated vo lume that reached wa ters of the State (gallons)?
d . Does the discharge bypass the waste management sys tem? (If yes , not ify DWR) 0 Yes 0 No DNA O NE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observab le adverse impacts or potential adverse impacts to the waters
of the State other than from a di scharge?
Page I of3
D Yes _jJ_No
D Yes ~o
DNA O NE
DNA O NE
Z/411015 Continued
.IFacilit)• Number: If?= -'§1.2--= !Date of Inspection: :P:i?!/-1 Z
1 Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Struct ure 4
Identifier:
Spillway?:
Designed Freeboard (in): !9-
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion. seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
)
0 Yes [2f.No 0 NA 0 NE
D Yes 0No DNA ONE
Structure 5 Structure 6
0 Yes !5;1 No 0 NA 0 NE
0 Yes !}!No D NA 0 N E
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?
8. Do any of the structures lack adequate markers as required by the permit?
(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 requi re
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fai I to secure and/or operate per the irrigation desih'll 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?
Required Rc{'ords & Do{'uments
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
0WUP Ochecklists D Design 0 Maps D Lease Agreements
22. Did the facility fai I to instal I and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equi pment?
Page 1 of3
0 Yes !>~:N o DNA 0 N E
0 Yes ~N o 0 NA 0 NE
0 Yes [)l N o 0 NA 0 NE
D Yes ~No D NA O N E
0 Yes (glNo
0 Yes ~"'lo
0 Yes ~No
0 Yes 0 No
0 Yes ~No
0 Yes ~No
0 Yes §No
O o the r:
~Y es 0No
D NA O N E
DNA O NE
D NA O NE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
D NA O N E
0 NA D NE
21412015 Continued
I Facility Number: ~ -k J b I I Date of Inspection: Jl -;zq---?P/j7
24. Did the faci lity fa il to calibrate waste application equipment as required by the permit?
25. Is th e facility o ut of compliance with permit conditions related to sludge? If yes, check
the appropriate box( es) below.
0-Yes 0 No
0 Yes ~No
DNA ONE
D NA ONE
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
Li st structure(s) and date of first survey indicating non-compliance:
2?. Did the facility fai l provide documentation of an actively certifi ed operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fai l 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 immediatel y.
30. Did the facility fa il to notify the Regional Office of emergency situations as required by the
perm it? (i.e., discharge, freeboard problems , over-application)
3 1. Do subsurface tile drains exist at the facility? If yes , check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non -compliance of th e permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss rev iew/inspe ction with an on-site representative?
34. Does the facility require a follow-up visit by the same age ncy?
DYes 12J_No DNA ONE
DYes J5a No DNA ONE
0 Yes d8lNo DNA ONE
0 Yes .&:3_ No DNA ONE
0 Yes (&_No DNA ONE
0 Yes f;aNo DNA ONE
DYes 18-.No DNA ONE
0 Yes J¥l No DNA ONE
DYes [2?No DNA ONE
Comments (refer to que5tion #): 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 necessary).
}?!_,?~"'-C ;/fr,-.-.:;1-l£/.y'k::.4x~tf.b,
/11 1.,,--c 7'Y/J/,__,:;I-c;£ j,k)
(f) rfy.__ ;,.r-c. t:fi,rT-"_3-~ tr~~ _;g,.-iy
Reviewer/Inspe ctor Name :
Revi ewer/I nspector Signature :
Page3 of3
Phone : 9/tJ -:;5?:3=-o C> J
Date: L --;;?tf -:?f} 0
21412015
Reason for Visit: Denied Access
Date of Visit: I Zl-z-:..:Ptt I Arrival Time: I!// ~rr I Departure Time: 12. '3D Region:
Farm Name: _ _.,~_..t? ...... m~';J:"T--Q&~.::.;Y'~.......,o:;.L..~-=--~-~-"'-I?'t..-~-Jf./=:..__ __ _
p(~, ~~ ~;;--
Owner Email:
Owner Name: Phone:
Mailing Address:
PhysicaiAddr~s: -----------------------------------------------------------------------------------
Facility Contact: Phone: .......... ~.;.o;~r.,:;;u:C:;..::r.'.!....=..,.iP-"-_--'-z:;A...::c:fl';...:d.;:.,;'/?~...,:.......r ___ Title: --c..Lf:.._'4."""pc..,~ ... '7~,.:;:,.__....;;/" ____ _
Integrator: .z~ 5?&'A.ff Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharg~ and Stream Impacts
I . Is a ny discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field
a. Was the conveyance man-made?
D Other:
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated vo lume that reached waters of th e State (gallons)?
Certification Number:
Certification Number:
Longitude:
0 Yes [3-No
DYes DNo
DYes DNo
d . Does the discharge bypass the waste management system? (If yes, notifY DWR ) DYes DNo
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?
Page 1 of3
DYes IS-No
DYes Ci}No
DNA ONE
DNA ONE
D NA ONE
DNA ONE
DNA ONE
DNA ONE
214/2014 Continued
, !Facility Number: I Date of Inspection: L.f-7-/e/ {;. I
Waste CoUection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1V
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
D Yes ID No D NA D NE
DYes D No DNA D NE
StructureS Structure6
D Yes j29 No D NA D NE
DYes ~No DNA ONE
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?
8. Do any of the structures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
D Yes ~No D NA D NE
DYes gNo DNA ONE
DYes [gl_No DNA D NE
DYes (81No DNA D NE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. DYes ba No DNA D NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Appl ic ation Outside of Approved Area
12. Crop Type(s): Dert&t !&t/r'']lcd/5~e_J I wi ... ~
13. Soil Type(s): _..... 0 --.. ~~------------------------------------------------------------------------------
14. Do the receiving crops differ from those designated in theCA WMP?
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?
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
Page 1 of3
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes CtJ-No DNA ONE
DYes [E) No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
00ther:
DYes flJ No
DYes ~No DNA ONE
114/2014 Continued
a !Facility Number: !Date oflnspection: q-7-)o!b
. 24 . Did the fa cility fail to calibrate waste appl ication equipment as required by the permit?
' 25 . Is the facility out of compliance with pennit conditions related to sludge? If yes , check
the appropriate box(e s) below.
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Failure to compl ete annual sludge survey 0Failure to develop a POA for sludge levels
D 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?
2 7. Did the facility fa il to s ecure a phosphorus Jos s 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 th an normal?
29 . At the time of the inspection did the facil ity po se an odor or air quality concern?
If yes, contact a regional Air Quality representati ve immediately.
30. Did the facility fail t o notify the Regional Offi ce of emergency situation s 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.
DYes
DYes
DYes
DYes
DYes
DYes
0 Application Field 0 Lagoon/Storage Pond D Other: ------------------------
32. Were any additional problems noted which cause non-complian ce of the permit or CA WMP? DYes
33 . D id the Reviewer/Inspector fail to discuss rev iew/in spection with an on-site representative? DYes
34 . Does the facility require a follow-up visit by th e same agency? DYes
181 No DNA
[8}_No DNA
I1(J No DNA
~No DNA
~No DNA
[g_No DNA
lEJ No DNA
[81No DNA
~No DNA
Comments (refer to question #): E:~plain any YES answers and/or any additional recommendations or any other comments.
Use drawings offacility to better e:~plain situations (use additional_pages as necessary).
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/Inspector Name: Phone: 9-ID-tf!J-550°
Re viewer/In spector Signature: Date : L/-7-;?-o/ b
Page3 of3 1/1111014
Reason for Visit:
Date of Visit: I J-t..~!5J Arrival Timed / D•, oi/ I Departure Time:IJ;;z 1, l.{_r I County: 7'-Region: FJ!O
Fa•mName: J"Pfl17 ~"'-F'>~ ~ Owne•EmaU:
Owner Name: :z/em,e{ :>fp;;::.c-_r:o,/ /JJA;-*"'-Phone:
Mailing Address:
Physical Address: -------------------------------------------
Facility Contact: Phone:
Certified Operator:
>
Integrator: $1)1"~,-_
Certification Number: / t, 7.?-(_,
Onsite Representative:
Back-up Operator: Certification ·Number:
Location of Farm: Latitude: Longitude:
Discharees and Stream Impacts
I. Is any discharge observed from any part of the operation? DYes g.N'o DNA ONE
Discharge originated at: 0 Structure D Application Field D Other:
a. Was the conveyance man-made? DYes 0No DNA ONE
b. Did the discharge reach waters of the State? (Ifyes, notifY DWR) DYes 0No DNA ONE
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) DYes QNo DNA ONE
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?
Pagel of3
DYes
DYes
~No DNA ONE
~No DNA ONE
214/2014 Continued
·!Facility Number: !nate of Inspection: '3--zf -Jr
Waste CoUection & Treatment
.\ 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosio n, seepage, etc.)
6. Are there structures on-site wh ich are not properly ad dre ssed and/or managed through a
waste management or closure plan?
0 Yes 5 No 0 NA 0 NE
DYes 0 No DNA ONE
StructureS Structure 6
DYes ~No DNA ONE
0 Yes ~No 0 NA O NE
If any of questions 4-6 were answered yes, and the situation poses an imme diate public health or e nvironmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8 . Do any of the structures lack adequate markers as require d b y the permit?
(not appl icable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste st ru ctures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes U?J No 0 NA 0 NE
D Yes ~N o 0 NA 0 NE
II. Is th ere evidence of in correc t land a ppli catio n? If yes, check the ap propriate box below. 0 Yes [3.-No 0 NA 0 NE
0 Excessive Ponding 0 Hydrauli c Overload 0 Frozen Ground D Heavy Metals (Cu , Zn, etc.)
0 PAN 0 PA N> 10% o r 10 lbs. 0 Tota l Phosphoru s 0 Fai lure to Incorporate Manure/S lud ge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
tHropType(s) :Z,; 'fX/'»1,/,._ (lh?_u~TY./ !.-erJ.17k~LwL_../.
13. Soil Type(s): __
14 . Do the receiving crops differ from those designated in theCA WMP?
15 . Does the receiving crop and/or land application site need improvement?
16. Did the fac ility fail to secure and/or operate per the irrigation design or wettab le
acres determination?
Page 2 of3
D Yes ~0
DYes ~0
0 Yes ~0
DYes li?l.No
D Yes ~N o
D Yes g) No
D Yes fi9_ No
0 0 ther:
D Yes ~No
DNA ONE
D NA O NE
D NA O NE
DNA ONE
DNA ONE
D NA O NE
DNA ONE
2/4/2011 Continued
I Facility Number: Q -t?bl I Date of Inspection: =:5=Z -/.::r-
24. Did the facility fail to calibrate waste appli cation equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes ~No DNA ONE
DYes fl9-No DNA ONE
0 Failure to complete annual sludge survey DFailure to develop a POA for sludge levels
0 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 con c ern?
If yes, contact a regional Air Quality representative immediately.
30. Did the fa cility fail to notify the Regional Office of emergency situations as requ ired by the
permit? (i .e., discharge, freeboard problems , over-application)
0 Yes !3-No 0 NA 0 NE
0 Yes il9-No 0 NA 0 NE
0Ycs .£gNo DNA ONE
DYes ~No DNA ONE
D Yes [8} No 0 NA D NE
0 Yes [g!No 0 NA 0 NE 31. Do subsurface tile drains exi st at the fac ility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
33. Did the Reviewer/Inspector fail to di scuss review/inspect ion with an o n-s ite represen tative?
34. Does the facility require a follow-up visit by the same agency?
DYes {li.No DNA 0 NE
0 Yes .lBl No 0 NA 0 NE
DYes ~No QNA ONE
Comments (refer to question #): 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 necessary).
Reviewer/Inspector Name:
R eviewer/In spector Signature:
Page 3 of3
Phone : /Zp---r/J..:r-33bO
Da te: 3-ID -15
114/2011
0 Denied Access
Date of Visit: 13;1.3-1.31 Arrival Time: I J/ .'If S Region:
Farm Name:;.._..~..Ti-"-'m=.L..:..'r-+-..:..IJ1~~~~..t.t.l/:.~.l.;..h-__ .:....fZr..::....:.r...:..~-'--7 ___ _ Owner Email:
Owner Name: rzk;,~ 5~~d Phone:
Mailing Address:
PhysicalAddress: --------------------------------------------------------------------------------------
Facility Contact: ~,-;, ~4....._
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field
a. Was the conveyance man-made?
0 Other:
b. Did the discharge reach waters of the State? (If yes , notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: /?1~ ""'"~ )
Certification Number: / C, 7 ;:L~
Certification Number:
Longitude:
0 Yes !3-.No DNA ONE
0 Yes 0No DNA ONE
0 Yes 0No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) 0 Yes 0No DNA ONE
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?
Page 1 of3
0 Yes
DYes
~0 DNA ONE
(2fNo DNA ONE
214/2011 Continued
I Facility Number: IDate of Inspection: 3-t.,-/0 13 I
• Waste Collection & Treatment
4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less th an adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): I?
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any ofthe structures observed?
(i .e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -s ite which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes ~ No 0 NA 0 NE
0 Yes 0 No 0 NA 0 NE
Structure 5 Structure 6
0 Yes (EI No 0 NA 0 NE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(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 requ ire
maintenance or improvement ?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes [2J No
0 Yes [flg No
0 Yes (B.No
DNA ONE
DNA ONE
DNA ONE
DYes ~No DNA ONE
II . Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes 129-No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Fro zen Gro und 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Applicat ion Outside of Approved Area
12. Crop Type(s): $r:rc~ lo .,...,..,.f;."e"',J I wt.e-~'7.-?e:s
13. Soil Type(s): J>ul: JL<'"",f / r&;f > •
14. Do the receiving crops differ from those designat ed in theCA WMP?
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
ac re s determination ?
Pagel of3
0 Yes S No DNA ONE
DYes 18 No DNA ONE
DYes (BNo DNA ONE
0 Yes [B No DNA ONE
0 Yes ~No DNA ONE
DNA ONE
DNA ONE
214120 I I Continued
!Facility Number: l Date oflnspection: '} -/3 -.e&> !31
l 24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with penn it conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes [)g..No
0 Yes [Bl No
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey 0 Failure to develop a POA for s lud ge levels
0 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 properl y dispose of dead animals with 24 hours and/or document
and report mortality rates th at were higher than nonnal?
29 . At the tim e 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
pennit? (i .e ., di scharge, freeboard probl e ms , over-application)
0 Yes (MNo 0 NA 0 NE
DYes ~No DNA ONE
0 Yes ~No DNA ONE
0 Yes 8No DNA ONE
0 Yes ~No DNA ONE
0 Yes (gNo DNA ONE 31. Do subsurface tile drains exist a t the facility? lfyes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which ca use non-compliance of the penn it orCA WMP?
33. Did the Rcviewerllnspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
0 Yes l2rNo
0 Yes [)§No
0 Yes [29--No
DNA ONE
DNA ONE
DNA ONE
Comments (refer to question#): 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 necessary).
Reviewer/In spector Name: ff~ G="/;1fi:.--
~· Reviewer/Inspector Si gnature: ~
Page 3 of3
Phone: cpo -I(IJ-3.30o
Date: 3-J 3 -iJo/3
214/20 11
Date of Visit: I /{--/ o:1~rrival Time: I II ' 0 t? I Departure Time:l //: '-(jiCounty: .>..~ Region: E!Zv
Farm Name: p ~n 7 hf.,.fJ,. :-~ -@ ~"""'--~/. Owner Email:
OwnerName: d~~$ f;x;;-~ IPfdu;...--Phone:
Mailing Address:
Facility Contact:
Physical Address:
~~:~::::~~2:~~:~:::~:P?:~~~:~~~~-T-i-tl-e:--~---~--~--~-------------P-b-on_e_: __________________ _
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure D Application Field 0 Other:
a . Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes , noti fy DWQ)
c . What is the estimated vo lume that reached waters of the State (gallons)?
Integrator: lt!v~ §vfJ~_d""-­
Certification Number:
Certification Number: /(.;737-
Longitude:
DYes !29-No DNA ONE
0 Yes 0No DNA ONE
DYes 0 No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, noti fy DWQ) DYes 0No DNA ONE
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 di sc harge?
Page 1 of3
DYes
DYes
j29No DNA ONE
[21-No DNA ONE
21412011 Continued
!Facility Number: &;'L I nate of Inspection: lj-tt> -I?-I
·, Waste Collection & Treatment
4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): (CJ
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes !29. No 0 NA 0 NE
0 Yes 0 No 0 NA 0 NE
Structure 5 Structure 6
DYes ~No DNA O NE
0 Yes {2i-No 0 NA 0 NE
If any of questions 4-6 were answered yes, and tbe situation poses an immediate public bealth or environmental tbreat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet s tacks)
9. Does a ny part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No
DYes .13-No
DYes ~No
DNA ONE
D NA ONE
D NA ONE
DYes ,®No 0 NA D NE
II . Is there evidence of incorrect land application? If yes, check the appropriate box bel ow. D Yes J29-No D NA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy M etals {Cu , Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
I 2. Crop Type(s): -~"' /ot:/~/3v>r J2
13. Soi l Type(s): _ ___..:!..$-=D:..::'CB::....._ ___________________________ _
I 4 . Do the receiving crops differ from those design a ted in the CA WMP?
15. Does the receiving crop and/or land application s ite need improvement?
16 . Did the facility fail to secure and/or o perate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land appli cation?
18 . Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certifi cat e of Coverage & Permit readily available?
20 . Does the facility fail to have all co mpone nts of the CA WMP readily available? If yes, check
th e a ppropriate box. ·
Owup 0 c heck li sts 0 Design 0 Maps 0 Lease Agreements
D Yes
D Yes
DYes
DYes
DYes
DYes
DYes
O other:
~No DNA O NE
~No DNA ONE
~No DNA ONE
~No DNA ONE
~No D NA ONE
(&No DNA ONE
~No DNA ONE
21 . Does record keepin g need improve ment? If yes, c heck the appropriate box below. 0 Yes ~No 0 NA 0 NE
0 Waste Application 0 Weekl y Freeboard 0 Waste Analysis 0 Soil Analys is 0 Waste Transfers 0 W eather C ode
0 Rainfall 0Stocking 0 Crop Yield 0120 Minute Inspections 0 Monthly and I " Rainfall ins pec ti o ns D Sludge Survey
22 . Did the fac ility fai l to in sta ll and mainta in a r a in gauge? 0 Yes ~N o 0 NA 0 NE
23 . If selected, did the fa c ility fail to in s tall a nd maintain r ainbreakers on irrigation equipment?
Pagelof3
DYes ~N o DNA ONE
214/2011 Continued
!Facility Number: I Date oflnspection: 4 _, 0 -r ;:z..--1
' 24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes !21No
DYes ~No
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
D 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.
0 Application Field D Lagoon/Storage Pond 0 Other:
DYes ~No DNA ONE
DYes IKJ No 0 NA 0 NE
D Yes [;(] No 0 NA 0 NE
DYes !EJ No 0 NA D NE
DYes [3}._No DNA 0 NE
DYes ~No DNA ONE
------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
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?
DYes ~No
DYes ~No
DYes ~o
DNA ONE
DNA ONE
DNA ONE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additio~;~al pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
Phone: 9/()--Jf.JS -]3'0 0
Date: Lj-lrf)--/ ?-
21412011
·-
ompliance Inspection 0 Operation Review 0 Technical Assistance
Reason for Visit ~e 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
DateofVisit: I.J-IJ-/1 I ArrivaiTimed //.'/5'""' I DepartureTime: I£2/0Z] I County: .. ~,......_.. Region: ff--"'{)
Farm Name: ~ l?k.-4-th... f7:t ,;I'Y'-;z_=z:t:== Owner Email: ------------
Owner Name: ~P-? .:f~Yd *-/0,_.__ Phone:
Mailing Address: -----------------------------------------
Physical Address :------------------------------------____ _
Title: Facility Contact: Ji•nn o..-,....---z;;:;nt-=r-~~ PboneNo: ________________ __
Integrator:~~ Onsite Representative: .,,.i~.0.~;.,o~"""""""....::::::...._ ____________ _
Certified Operator: __ ........c.zh-n-""--=· :...c..z...~:.7:::;::::;,L--_.....,a,dr;:.LZ..:...ft~~~-=-----­
Back-up Operator: --------------------
Operator Certification Number: ---------
Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I . Is any di scharge observed from any part of the operat ion ? DYes Ji!No DNA ONE
Discharge origin ated at: 0 Stru cture D App li cation Field 0 Other
a . Was the conveyance man-made?
b. Did the discharge reach waters of th e State? (If yes, notify DWQ)
c. What is the estimated volume th at reached waters of the State (gallons)?
d . Does discharge bypass th e waste mana ge ment system? (If yes , notify DWQ)
2. Is th e re evi dence of a past discharge from any part of the operation?
3. Were there any a dverse impacts or potential adverse impacts to the Wate rs of the State
other th an from a di sch arge?
Page I of 3
DYes 0 No DNA ONE
DYes 0 No DNA ONE
DYes 0No DNA ONE
DYes l2a No DNA ONE
DYes ~No DNA ONE
12128104 Continued
-~ zM ···
\
I Facility Number: Jf2.r b14-Date oflnspection I 3-i)-I) I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes , is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes 3No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:------------------------------------------
Spillway?:
Designed Freeboard (in): _ _..dCL...;@!:C:-__ --------------------------------
Observed Freeboard (in): _---=::£7-;..._0 ___ ------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/large trees, severe erosion, seepage, etc.)
DYes i)JNo 0 NA 0 NE
6. Are there structures on-site which are not properly addressed and/or managed DYes IX.No 0 NA 0 N E
through a 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 DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(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 requ ire
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
DYes ~N o DNA ONE
DYes 1:3-No DNA 0 NE
DYes ~No DNA O NE
II. Is there evidence of incorrect application? Ifyes, check the appropriate box below. D Yes g}.No 0 NA 0 NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (C u, Zn , etc.)
D PAN D PAN> 10% or 10 lbs D Total Phosphorus 0 Failure to Inco rpo rate Manure/Sl udge in to Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 App li cation Outside of Area
12. Croptype(s) Der~/tJre;rt~e-/ /w£J?~~
13. Soil type(s) ---.:Z~o~?lf~------------------------------
14. Do the receiving crops differ from those designated in the CA WMP? DYes f8l No DNA ONE
15. Does the receiving crop and/or land application site need improvement? D Y es ~No D N A ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detenninati on?D Y es ~N o DNA ONE
17. Does the facility lack adequate acreage for land application? DYes [B.. No DNA ONE
18. Is there a lack of properly operating waste application equipment? DYes ~N o DNA ONE
..
Comments (refer to~question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings offaCility to better explain situations. (use additional pages as necessary):
.. ...
I-
I-... ----~
Reviewer/Inspector Name I I
__ , ---. Gi-~ .?E~j ..._ _I Phone: 9/v --¢_;7-J:so o
Reviewer/Inspector Signature: -....2:::2/~ .;'Zd I{_ (_-~-~ / Date:
Pagel of 3 11128/04 Contmued
I Facility Number: o---tJJ-Dat e of In sp ection I ]=-11-1/ I
R equired R ecords & Doc u men ts
19. Did the facility fail to have Certi fica te of Coverage & Pennit readily a va ilable ?
20. Does the facility fai l to have all compone nts of the CAWMP read ily avai lab le ? If yes, c heck
the a pp ropirate box . 0 WUP 0 C hecklists 0 Des ign 0 M aps D Other
D Yes !E-No D NA 0 NE
D Yes ~No D NA O NE
2 1. Does record keep ing n eed improvement? If yes , check the a ppropriate box below. D Ye s Gl._No DNA D NE
D Waste A pplicatio n 0 Weekl y Freeboard 0 Waste Analysis 0 So il Ana lysis D Was te Transfers 0 Annual Certi fi cation
D Rai nfall 0 Stocking D Crop Yie ld 0 120 Minute In spections 0 Monthly and I" Rain Ins pections 0 Weather Code
22 . Did the facility fai l to install and ma intain a rain gauge? D Yes tiNo DNA O NE
23. If selec ted, did th e facility fai l t o in stall and maintain ra inbreakers on irri gati on e qu i pment? D Yes fi'l_No D NA O NE
24. Did the facility fa il to calibrate waste appl ication equipment as required by the pennit'! D Yes ~No D NA O NE
25. D id the fa c ility fa il to conduct a s ludge survey a s required by the pennit? D Yes I)Q.No D NA O NE
26. Did the facility fail to have a n ac tively certi fi ed operator in charge? D Yes fZl.No D NA O NE
27. Did t he fac ilit y fai l to secure a phosphorus loss assessme nt (PLA D certificatio n? D Yes ~No DNA O NE
O the r Iss ues
2 8. Were any additional problems noted wh ich cause non-compli ance of th e permit o r CA WMP? D Yes ~No D NA O NE
29. Did the tac il ity fai l to properl y d ispose of dead anima ls within 24 hours and/or document D Yes ~No DNA O NE
a nd report the mortali ty rates that were higher th an nonna l?
30. At t he t ime of the inspection did the fa c ili ty pose an odor or a ir quality concern ? D Yes ~No DNA O NE
If yes , conta ct a regiona l Ai r Q ua li ty re presentat ive immediate ly
31. Did the facil ity fail to notify the re gional office of em ergency situations as req ui red by DYes ~No D NA O NE
Genera l Perm it ? (ie/ discharge . fr e eboard problems, over application)
32 . Did Rev ie wer/In spector fai l to discuss review/inspection wi th an on-s ite representative? D Yes IZJ No DNA O NE
33 . Does fa c ilit y requi re a follow-u p visit by same agency? D Y es 12J.No D NA O NE
Pa ge3 of 3 12128104
ompliance Inspection 0 Operation Review 0 Structure Evaluation
Reason for Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: 1?-flf/0 ] Arrival Timed///t['S: I Departure Time: I
I
fOt,'JOj County:~~ Region: EJZ-'0
Farm Name: Ti2 m7 PI~&; rA... 6""1*'1--~ Owner Email: ---------------
Phone:
Mailing Address:
Physical Address:-----------------------------------------
Facility Contact: /)B!n 't:',r-Phone No: ---------
Integrator: /Yt ~ 7')1
Operator Certification Number: 2:3? l-fr'
Onsite Repmentat;ve';t:!;::; .,,""""""
Certified Operator: "
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stre am Impacts
I . Is a ny d isc harge o bs erved fro m any part of th e operati on? D Yes ~o D NA O NE
Disc harge orig in ated at: 0 S tru ctu re 0 App licati on Fi eld 0 Oth er
a. Was the conveyance man-made?
b. Did th e disc harge reac h wate rs ofthe Sta te? (If yes, no ti fy DW Q)
c. What is th e es tim a ted vo lum e th at reached wate rs of th e State (gallon s)?
d. Does di sc harge by pass the waste manage me nt sys tem? (I f yes , noti fy DWQ)
2. Is the re ev id ence of a pas t disc harge from an y part of the o peration ?
3 . Were th ere any adverse impac ts o r po tenti a l adverse im pacts to th e Wa ters of the State
othe r than from a disc harge?
Page I of 3
DYes 0 No DNA ONE
D Yes 0 No DNA ONE
D Yes 0 No DNA ONE
D Yes ~N o D N A O NE
D Yes 12iNo DNA O NE
12128104 Continue d
I Facility Number: f'l--L3A-Date of Inspection I ?--JJI-Iti
~Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes ~o DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier: ______________________________________ _
Spillway?:
Designed Freeboard (in): __ .:...I_,Cf'-----------------------------------
Observed Freeboard (in): --"cJ=:...._...17 ___ -----------------------------------
5 . Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes 172J.No DNA 0 NE
6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE
through a 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 DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste managemen t system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks , or compliance alternative s that need
maintenance/improvement?
~Yes 0No DNA ONE
DYes ~o DNA ONE
DYes &No DNA ON E
DYes ~o DNA ONE
II . Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~o 0 NA 0 NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metal s (Cu, Zn , etc.)
D PAN 0 PAN > 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D O utside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12 . C roptype(s) ~ io-v-rOSr-J/f~~ JwjY"~
13. Soil type(s) ____:!::J3~oJ3:::::~...~, ____________________________ _
14 . Do the receiving crop s differ from those designated in th e CAWMP? DYes S No DNA ONE
15. Does the receiving crop and/or land app li cation site need improvement? DYes ~No DNA ONE
16 . Did the facility fail to secure and/or operate per th e irrigation desi&rn or wettable acre determination? DYes ~No 0 NA 0 NE
17. Does the fac ility la ck adequate acreage for land app li cation? D Yes ~No DNA O NE
18. Is there a lack of properl y operating waste application equipment? DYes ~0 DNA ONE
Comments (refer to question#): Explain any YES answers and/or any recommendations or any other comments.
Use drawings offacility to better explain situations. (use additional pages as necessary): ·
-·-
l@r).X b~ert/t?r-~~_5 ~~$-~; ...
~
1-...
Reviewer/Inspector Name I :5h;-~ {b-u:;/;r:..-A .. 1 Phone: :tzp-~-YJco
Reviewer/Inspector Sign:.t turc:
.,., ';/'_/ Date: 7-/~ -??J/1,) ~-
Page 2 of 3
, 12118/04 Contmued
I Facility Number: Q-b:JJ.-Date of Inspection 1?-)tf-Jb .
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available ? l f yes , chec k
the appropriate box. 0 WUP D Checklists D Design 0 Maps D Other
2!. Does record keeping need improvement? If yes, check the appropriate box below .
D Yes Rl.No DNA O NE
D Yes ~No DNA ONE
D Ye s ~No DNA O N E
0 Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Anal ysis D Waste Transfers D Annual Certifica tion
0 Rainfall D Stocking D Crop Yield 0 120 Minute Inspections D Mon thl y and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes S-No DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes SNo DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA O N E
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ®-No DNA O N E
26. Did the facility fail to have an actively certified operator in charge? D Yes ~0 D NA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes liWo DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or doc ument DYes IS-No DNA ONE
and report the mortality rates that were higher than normal?
30. At the time ofthe inspection did the facility pose an odor or air quality concern? D Yes 13-No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes ~No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application}
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representati ve? DYes gNo DNA O N E
33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE
Additional Comments and/or Dra"·ings:
....
I-
I-.....
Page 3 of 3 12128104
' \
\
~
Type of Visit
Reason for Visit @1foutine
0 Structure Evaluation 0 Technical Assistance
0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Region: Efi?_() , DateofVisit: I ~-tfo2'J ArrivaiTime;j//.'OD I DepartureTime: I1£1D0 I County:..Z~
Farm Name: 1Ph17 /RI'n/0~~ ~h'h .t:;;Z OwnerEmail: -------------
Owner Name: Zi?ht7 mz:--Lv> ~ Pbone:
Mailing Address:
Physical Address:------:~-------=-------------------------------....,,"""'~~""':"-=~'::JiiL-----L//&t~oQ...-~:::...<-=---Title: ---------Facility Contact: PhoneNo: ________ ___
Onsite Representative: '>k#hlf~ :z;;,.H' ~~ Integrator: ~~
Certified Operator: ~ ~ ....... ~""""""'""~-6.-/-"S....:·::.~------Operator Certific:zmbe~:-lb 7C.. 7
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? DYes ~No DNA ONE
Discharge originated at: D Structure 0 Application Field D Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2_ Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes [&No DNA ONE
DYes !&No DNA ONE
12128104 Continued
' l • l Facility Number: &;?--Q?J Dllte of Inspection I §'#?p91
\\'nste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a . lfyes, is waste level into the structural freeboard?
S tn1cture I StOIClUI'C 2 S tructure 3 Structun.-4
DYes ~No DNA ONE
DYes 0No DNA ONE
S tructur..: 5 Stru ctur,; 6
ldentifh:r: ------------------------------------
S pillway?:
Desi!,.rn ed Freeboard (in): J CZ"
Observed Freeboard (in): ====/).:• ==?=====
5 . Are there any immediate threats to the integrity of any of the structures observed?
(ie/large trees, severe erosion, seepage, etc.)
0 Yes _t){No 0 NA 0 NE
6. Are there structures on-site which are not properly addressed and/or managed DYes ®No DNA ONE
through a 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 DWQ
7. Do any of the structures need maintenance or improvement?
8 . Do any of the stuctures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
DYes 1?.l.No DNA ONE
DYes ~No DNA ONE
DYes R!No DNA ONE
10. Are there any required buffers, setbacks, or compliance alternatives that need DYes t)lNo 0 NA 0 NE
maintenance/improvement?
11 . Is there evidence of incorrect application? If yes, cbeck the appropriate box below. D Yes .lil.No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 100/o or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
12. Croptypo(s) dk:.......Ja (o~...,.j l.z,_l= jul..,/
13. Soil type{s) ~'B~D.~(B"""----------------------------
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application s ite need improvement?
DYes
DYes
~0 DNA ONE
l)a,No DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'i O Yes ff4.No DNA ONE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
D Yes
DYes
~0
~0
DNA ONE
DNA O NE
."Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
·U~ drawings offacility to better explain situations. (use additional paees as necessary):
... -
1-..
Reviewer/Inspector Name -<~vv (' __.-i rtrn-. Phone: ~/ ()-1/3:3-~()1::)
Reviewerllospector Signature: c::LF; . .}.../ _/L-Date: k'-if-,9-oe g..
'/ 12128104 Continued
. . • l Facility Number: g;2.-b,t4-Date of Inspection I~ J
ncquire-d Records & Document~
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box . 0 WUP 0 Checklists 0 Design 0 Maps D Other
DYes ~o DNA ONE
DYes IE..No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes £R..No DNA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and l" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes
26. Did the facility fail to have an actively certified operator in charge? DYes
27. Did the facility fail to secure a phosphorus loss assessment (PLAn certification? DYes
Oth{'r Iss ues
28 . Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewernnspector fail to discuss review/inspection with an on-site representative? DYes
33. Does facility require a follow-up visit by same agency? D Yes
Additional Comments and/or Drawings:
12/28/04
L)lNo
~No
~No
~No
fiCNo
ij{No
liWo
~No
®No
gNo
~0
~0
DNA" ONE
DNA
DNA
DNA
DNA
DNA
DNA
DNA
DNA
DNA
DNA
DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
..
1--
I-•
'
IFacility Number! t9--.H ~:s~ 9'1>ivisioo of Water Quality 7-,;?-v7 0 Division of Soil and Water Conservation SHG· ~ 0 Other Agency
Type of Vis it eJCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I 2:/n ~ op Arri\•al Time: I /[)[37:> I Departure Time : I j/ ,' 3 ~I County: ¥8--\..-Regjon : el:O.
Fum Na me' T0au>~ IJ1 c.t V ;,._{-,. ~ IJ<t ~ Owner Email'
Owner Name: ~ /Jt:.J. U ' ;oL. Pho ne: ---------------
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: JQ n1 h~l!:/.:.cL 1/ I "t. Title: -----------Phone No: ---------
Onsite Representath·e: _ ......... _3~::--=;;....;;...:;..______________ Integrator : Ofur";e"~
Certified Operator: -----~2£..:;;..~~;-=:oo------------Operator Certification Number: -------
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD 'D " Longitude: D OD 'D"
Design Current Des ign Current Design Current
Swine Capacity Population Wet Poultry C apacity Population Cattle Capacity Population
r.:ID:::::--w-e_a_n-to_F_i_n-ish-rl -----,~..------.1 10 Layer I I I
D Non-Layer _ _ _ D Wean to F e edcr diPt>O ld-S~o
D Feeder to Finish
D Dairy Cow
D Dairy Calf :
D Dairy He ife t :
D Farrow to Wean
D Farrow to Feeder
D Farrow to Finish
0 Gilts
D Boars
OorvCow
0 Non-Dairy
0 Beef Stocket
0 Beef Feeder i 0 Beef Brood Cow
Dry Poultry
D Layers
0 Non-Layers
0 Pullets
0 T urkeys
Other D Turkey Poults
D Oth er ID Other Number of Structures: [lJ
Disch arges & Stream Impacts
I . Is any discharge observed from any part of th e operation? 0 Yes IS'[ No 0 NA 0 NE
Discharge originat ed at : 0 Structure 0 Application F ield D Other
a . Was the conveyance man-made? DYes 0 No DNA ONE
b. Did the dis c harge rea c h waters of the State? (If yes. not ify DWQ) D Yes 0No D NA O NE
c . What is the estimated volume that reached waters of the State (ga llon s )?
d. Do cs discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there ev idence of a past di sc harge from a ny part of the operation?
3. Were the re any adverse impact s or pot entia l adverse impacts to the Waters of the State
other than from a di sc ha rge?
D Yes 0No
D Yes Kl No
D Yes ~0
12128104
DNA O NE
D NA O NE
D NA ONE
Contin u ed
\
' ..
I Facility Number: p-C? ~~ Date of Inspection I Z-1 D-P7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
D Yes (Z] No D NA D NE
DYes 0 No DNA ONE
Structure 5 Structure 6
Identifier:--------------------------------------
Spillway?:
Designed Freeboard (in): __ /,__9'----,---+------------------------------
Observed Freeboard (in): --->"'-=D":;,_ __ ------------------------------
5. Are there any immediate threats to the integrity of any ofthe structures observed?
(ie/ large trees. severe erosion, seepage, etc .)
6 . Are there structures on-site which arc not properly addressed and/or managed
through a waste management or closure plan ?
DYes ~No DNA ONE
DYes §?l.No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental th!~ notify DWQ
7. Do any of the structures need maintenance or improvement? Jd Yes (ifm-D NA D NE
8. Do any of the stuctures lack adequate markers as required by the permit? DYes j2g No DNA D NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) .f
9. Does any part of the waste management system other than the waste s truc tures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
DYes ~No DNA ONE
I I. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes JE,No DNA 0 NE
0 Excessive Ponding 0 Hydraulic 0Yerload 0 Frozen Ground 0 Heavy Metal s (Cu, Zn, etc .)
0 PAN D PAN > 10% or 10 lbs 0 Total Phosphorus 0 Fa ilure to Incorporat e Manure/Sludge into Bare Soil
0 Outsi de of A ccepta ble Crop Window D Evidence of Wind Drift D Applica tion Outside of Area
12 . Croptype(s) 'f5~:?"!11U.J£ /&v~Witti/5'..~
13. Soil type(s) _ .... ~~12~$!:::::.... ______________ / _________________ _
14 . Do th e recei ving crop s differ from those designated in theCA WMP? DYes 0No DNA ONE
15. Does the receiving crop and/or land application site need improvement? DYes 0No DNA ONE
16. Did the facility fail to sec ure and/or operate per the irrigation des ign or wettable acre determination?D Yes 0No DNA ONE
17 . Does the fac ilit y la ck adequate ac reage for land app lication?
18 . Is there a lack of properly operating waste application equipment?
DYes 0No DNA 0 NE
DYes 0 No DNA ONE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use dra\\ings of facility to better explain situations. (use additional pages as necessary):
~ 1. 8fj ,_ qJ1 .:C KK? ~..5
7r ~~~\(~ vJvrK'-(7 ~ i.ar-~~·
Reviewer/Inspector Name ______ .....,Lt-....z.~u::-._~;:::!:~"4'-?--!:::::.=..= ____ Phone:
Reviewer/Inspector S ignature: Date:
12128104
J• I Facilit y Nu mber: !!fi?-~j._ Date o flns p ection I 2:to-t>F
Re quir ed Records & Doc uments
I 9 . Did the faci lity fai l to have Certificate of Coverage & Permit readi ly avail abl e?
20. Does the fac ili ty fai l to have a ll com ponent s of theCA WM P rea dil y avai la ble? I f yes, check
the approp iratc box . D WU P 0 C hecldists 0 Design 0 Maps 0 Other
D Yes !ZNo D NA O NE
D Yes ~No D NA O NE
2 1. Doe s record keeping need improvemen t? Ifyes, check the appropriate box be low_ [2J..Yes 0 No D NA D NE
jiZl Waste App li catio n D Weekly Freeb oard 0 Waste Analysis D So il Analysis 0 Waste Transfers 0 Annual C ert ifi cation
0 Rainfall D Stock in g D Crop Yie ld 0 120 Mi n ute Inspec tions 0 Mon thl y and I " Rain In specti ons D Weather Code
22. Did the facility fai l to in stall and m aintai n a rain gauge? D Yes ~No DNA O NE
23. If se lected, did the faci li ty fa il to ins ta ll and mai ntai n rai n breakers o n irrigat ion equipment? D Yes ~No DNA O NE
24 . Did the faci lity fail to calibra te w a ste application equipment as re qu ired by the pennit? D Yes Q11 No D NA O NE
25 . Did the faci lity fai l to conduct a sludge s urvey as requi red by the permit? D Yes la.No D NA O NE
26. Did the faci li ty fai l to have an actively certified operator in charge? D Yes Iii No D NA ONE
27 . Did th e faci li ty fail to sec ure a phosphorus loss asses sment (P LAT ) certification ? D Ye s .[i.No DNA ONE
O ther Issu es
28. Were any additional p roblem s noted which cause non-compliance of the permit orCA W MP? D Yes ~N o DNA O NE
29 . Did the fa cility fai l to properl y dispose of dead anima ls within 24 ho urs and/or document
and report the morta lity rat es that w ere hi g he r than normal?
D Yes !&No DNA O NE
30. At the time of the inspection did the faci lity pose an odor or air qua lity conce rn? D Yes J3 No DNA O NE
If yes, contact a regiona l Ai r Q ua lity rep resentative immediately
3 L Did the fac ili ty fail to noti fy the region a l office of e mergency situations a s required by D Yes ~No D NA O N E
General Permit? (ie/ discharge, freeboard proble ms, ove r app lic ation)
32 . Did Rev iewer/Inspector fail to disc uss re vi ew/inspection with an on-site representative? D Yes DQ No DNA O NE
33 . Does fac il ity re quire a fo llow-up visit by same agency? D Ye s ~No D NA O NE
Addition al Comm en ts a nd/or Drawings:
..._
1--
1--
~
/Z/28104
J •
Type of Visit ~mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: I~ Arrival Time: I /J/1.-J 0 I Departure Time : l /£ !JO I County: '~"v----Region:CE l)
Farm Name: 7/inr--7 IJ1-eL.tl h.-Fa.-.rm.. ~ OwnerEmail: ---·----------
Owner Name: ffm 7 /J1r L,; •' t"\...-Phone:
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: zP?.r, '"f L?Jt: Lui ~ Title: ----------PhoneNo: ________ _
Onsite Representative: ___ f:.:;,...c~=;...=~-----------Integrator: ~"A'~
Certified Operator: _:5 A-·
7/
Operator Certification Number: 2"3 ZJ/r
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD 'D " Longitude:
Discharges & Stream Impa cts
I . Is any discharge observed from any part of the operation? D Yes ~:&No D NA O NE
Discharge ori g inated at: D Structure D Application Fi eld D Other
a. Wa s the conveyance man-made?
b. Did the di sc ha rge reach waters of the State? (If yes, notify DWQ)
c. Wh at is the estimated volume that reac hed waters of the State (g all ons)?
d. Does di sc harge bypass t he waste management system? {If yes, notify DWQ)
2. Is there evidence of a past discharge fro m any part of the operation?
3. Were there any adverse imp ac ts or potentia l adver se impacts to th e Wate rs of the State
other than from a di sc harge?
Page I of3
DYes 18 No DNA O NE
DYes ~0 DNA O NE ·
D Yes [RNo D NA O NE
D Yes ~N o DNA O NE
D Yes ,3-No D NA ONE
12128/04 Continued
. I Facility Number: If~ G; 3~ Date of Inspection I~ o--tp~
r -.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard ?
Structure 1 Structure 2 Structure 3 Structure 4
DYes t21No DNA 0 NE
DYes [SNo DNA ONE
Structure 5 Structure 6
Identifier:---------------------------------------
Spillway?:
Designed Freeboard (in): I r
Observed Freeboard (in): Jfi
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ la rge trees, severe erosion, se epage, etc .)
DYes ~No DNA ONE
6. Are there structures on-site which are not properl y addressed and/or managed
through a waste management or closure plan ?
DYes tiNo DNA ONE
If any of questions 4-6 were answered yes, and tbc si tuation poses an immediate public health or emironmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the s tuctures lack adequate markers as requi red by th e permit?
(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
ma intenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or comp liance alternatives that need
maintenance/improvement?
J2JYes 0No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes {2J-No 0 NA 0 NE
II . Is the re evide n ce of incorrect applic at ion? If yes, check the appropriate box below. 0 Yes ~No 0 NA D NE
0 E xcess iv e Pending 0 Hydraulic Over load 0 Frozen Ground 0 Hea vy Meta ls (Cu, Zn , etc.)
D PAN D PAN > 100/o or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/S ludge into Bare Soil
D Outside of Acceptabl e Crop Window D Evidence of Wind Drift 0 Application O utsid e of Area
12. Crop type(s) &rm~J4!. /Jmdl ~·; '-.hor6c~:z !Jvjtf.J--;
13 . Soi l type(s) .....;.Bi~O::...P>o~::::.-____________________________ _
14 . Do the receiving c rops differ from th ose designated in the CA WMP? D Yes ~N o DNA ONE
15 . Does the receiving crop a nd/or land appl ication site need improvement? DYes C3-No D NA ONE
16. Did the facility fail to secure and/or operate per the irri gation des ign or wettable acre det ermination ? DYes 18-NoD NA 0 NE
17. Does the faci lity lack adequate ac reag e for land appli cation? DYes ~N o DNA ONE
18. Is there a lack of properly operatin g waste application equipment? DYes [8No DNA ONE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
(ZJ 41"' tvPrf.::. ~ ~ ~r-,:L fY11._ ~~ YLr "~r ....
f--
fn-,_) ; n ~-+~;?t~~
f--...
. -· ---5/c-Yc -G t:~ ---------. --
9-t Q-1/E-3 31lt> Re\'iewer/lnspector Name ~ tr-Phone:
Re\'iewerllnspector Signature: ...... .-~ .r Date: q-~ ~0-~f)~ fa S?".A .,.
Page 1 oj3 11118/04 Continue d
I •
I Facility Number: 0---hJJ-.. Date oflnspectioo I lj /ij 0 I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes , check
the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps D Other
2l. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes ~No 0 NA 0 NE
DYes jZ?JNo DNA O NE
DYes ~No DNA ONE
0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soi l Analysis D Waste Transfers D Annual Certification
D Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~N o DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes f8No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes l2j No DNA O NE
27. Did the faci lity fail to secure a phosphorus loss assessment (P LAT) certification? DYes ~N o DNA O NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes 1:3-No DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? D Yes 1(1 No DNA ONE
If yes , contact a regional Air Quality representative immediately
31. Did th e faci li ty fail to notify the regional office of e me rgency situations as required by DYes B!No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32 . Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes IS No DNA ONE
33. Does fa c ility require a follow-up vi sit by same agency? DYes ~No DNA ONE
Additional Comments and/or Drawings: .
... -
-...
Poge3 of3 12128104
I • e Divi~ion of Water Quality . . . ~-· .. ·
0 Division of Soil aoc:i Water Cooservatio'i•-. ~,~_-·' ::~~ ~ ~
Q Otber Agency · · . . . '/ :;· }i .', .
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Ua tc of Visit: 17!': 'f~ I Arrival Time: I B:~C' I Dep arture Time : ._1 ___ -Jj County: ~~--Region : 17fo
7·tJ·or
Farm Name: Tt!1_/ __ L!1~L':ti.~ F-~~-=:•:....:::;::?~---Owner Email: --------------
Owner Name: 77?~ ltf~L~a.4·------Phone: '?JCJ-S::J'f· /.2 7'f
Mailing Address: _3__()t:; ft'eev.~ £L 6-ev·k_,r;/_,_tL_(., _:; 8'-l!i./--
Physic a l Address:-----------------------------------------
Facilit)' Contact: ---~-eJ)'___P-LeLvJ·~:.,,__ __ Title: -----------Phone No: ---------
Onsite Representative: __ ro~7 __ &/,-'1·--------Integrator:----------------
Certified Operator: TJJ~mttS --_/!f_e /.,./~~-------Operator Certification Number: :23 '7'-ftz
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D Oo ·o u Longitude: D li D'D "
Des ign Current D esign Current Design Current
Swine Cap a city Population Wet Poultry Capacity Population Cattle Capacity Population
I I r 10 Layer I I
0 Non-Lave1 _ _
ID Wea n to Fini sh
~ean to Feeder ..:2£()0
O DairvCow
0 Dairy Calf
D Fee de r to Finish 0 Dairy Heife1
D Farrow to Wean
D Farrow to Feeder
0 Farrow to Fin ish
0 G ilt s
0 Boars
0 DrvCow
0 Non -Da irv
0 Beef Stockel
0 BeefFcedcr
0 Beef Brood Cow
Dry Poultry
0 Lavers
0 Non-l ave rs
0 Pullets
0 Turk eys
0 Turkey Poults
0 Other
Other
ID Ot her Number of Structures: [L]
Di sc h an:cs & Stream Impac ts
I . Is any discharge observed fr o m an y part of the o perati on? D Yes~ D NA O NE
Di scharge o ri gina ted at: 0 Structure 0 Application Fie ld 0 Other
a . Was th e conveyan ce ma n-made? D Yes 0 No D NA ONE
b. Oid th e di scharge reach wa ters ofthc State ? (I f yes, n otif~' DWQ) D Yes 0 No D NA ON E
c. Wh at is the e s ti mated vo lume that reac hed waters of the S tat e (gall ons)?
d. Dc~cs discharge bypass the wast<? managemen t system? (If yes, notify DWQ)
2. Is there evidence of a past di scharge from a ny part of th e opaation'?
3. Were there a ny adv erse impacts or pot ential adverse impac ts to the Waters of the State
other th an from a discharge?
D '{es 0 No D NA O NE
DYes ~ DNA O NE
D Yes ~DNA O NE
12118/04 Co ntinued
[Fac~lity Number: $.2 -t 3 ;J.. J Date of Inspection 17 -J..J· orl
Waste Collection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) Jess than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Stru cture 4
DYes ~ DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier: ----''----------------------------------------
Spillway?: J?rO
Designed Freeboard (in): ! 'f
Observed Freeboard (in): ------------------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes Cd'No DNA ONE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed DYes ~0 DNA ONE
through a 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 DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~o DNA ONE
DYes (d1:jo DNA D NE
DYes 0"'No 0 NA 0 NE
0 Yes fa'No DNA ONE
II. Is there evidence of incorrect application? If yes. check the appropriate box below. 0 Yes ~o 0 NA 0 NE
0 Excessive Pending 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
t, ;. 3 s-o .:/~ s
12. Crop type(s) f<ye {Fovu c,~) (Jer"'"le &-,}
13. Soil type(s) 6 l} ~~~----------------------------------------------------------
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
DYes ~o DNA ONE
DYes~ ONA~E
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre deterrnination'i O Yes D No 0 NA ~
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
DYes 0No DNA ~
DYes ~ DNA ONE
.•
Comments (refer to question#): Explain any YES answers and/or ~y"~ecommeridation~ or any other comments. . ,
.·, ' (Jse drawings offacllity to better explain situations. (nse additional pages as necessary):"
~~ ..._ ;.· .. . .. ·
. .. , ...
"' ' . • ~·· ""' •· I>
,·. ..
IC
~
Reviewer/Inspector Name I Marlt /l,.a,.,.t/,..., 0 I Phone: fJJ.a , '1 S. t£.-I s::t.l P d 'l "J,
Reviewer/Inspector Signature: ffl_,. j, IL .. ~ Date: 7-z'J_-o} , 12128104 Conttnued
.. I Facility Number: 8;1 -t.J..21
Required Records & Docume nts
Date of lnsp~ct io n I i -JJ -0 <) I
19. Did th e facilit y fai l to have Ccrtilicatc of Coverage & Permit readily available?
20. Does the faci lity fail to have all components of theCA WMP readily available? If yes, check
the appropir ate box. 0 ~ 0 Ch~ D ~1 0 ~D ~
DYes ~DNA O NE
DYes .OxO' DNA O NE
21. Docs record keeping need improvement? If yes. check th e apprOl(f iate box below. 1 1 ~ D No DNA 0 NE
~ '1-f,-' I. 'f ?· '"~'> /. i ~-·:;)~-~-> ''f'
D '"ia::.tc Application 0 Wet?k!y ~·ruel"l:trd D ·Waste .\mtlprs D &eil Analysis 0 Waste T•an .lfi:ts 0 .Artmual Ccfiil1etttiou
0-RaiRfa.H D ~teekin~ QJ.efOp Yield D ~Minute inspections 0 MI?RtHiy aRcll" Rsit, lRspe-ctions D Weathct Gees-,.
22. Did the facility fail to install and maintain a rain gauge? DYes ~0 DNA ONE
23. If selected, did the facility fail to install and maintain rainbrl·akers on irrigation equipment? D Yes 0No DNA Q.NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? D Yes 0No DNA (l.Nr:
25. Did the fa c ility fail to conduct a s ludge survey as required by the permit ? DYes 0No DNA ~E
26. Did the facil ity fail to have an actively certilicd operator in charge? DYes ~0 DNA O NE
27. Did the facility fai l to secure a phosphorus loss assessment (PLAT) certification? DYes 0No DNA ~E
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP'! D Yes G3-'No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document D Yes ~0 DNA ONE
and report the mortality rates that were higher tha11 no rmal?
30. At the time of the inspection did the facility pose an odor or air quality concern'! DYes ~0 DNA ONE
If yes, contact a regional Air Quality rcpn:sentativc immediately
31. Did the facility fail to notify the region al officL~ of emergency s ituations as required by DYes 0'No DNA ONE
General Permit ? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Ins pector fail to discuss review/inspection with an on-site re presentative'! D Yes G"'No DNA ON E
33. Does facility require a follow-up v isit by same agency? D Yes ~0 DNA O NE
Additiooai 'Comments and/or Drawings:
~/. jDJe•Jt_ tl't'Jf'
;
Cr~ y,el/ /lee"'/.. Prt:~~vc,, ~ s jtt',r,· .. , !'lui .... ,/ .rtt~.,.A
Ovl , • .f-_, ~/"•wei ~""""'· /Jte,~ /(;~_,. ,.~.,..~.
I:>#? ~~.JI''ofl<".( /;,,.,.,S,
fl'fr. ,.,~ /.,,•..., •S vs,r,, ~~~ c ~ /,,.., ,.e/ ..z:~~-1 Cot,/ .:r /?4-.) tv~rl~
.,._ r~ ...... ~ ~/"1" /,•CtJf/_.,.-'1 ~v~,.,/-4 ,
~
12128/04
Type of Visit e Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit • Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access
-I G H ?3 :' I I Date or Visit: I 9-.;v-t~y I Time: I 8': /L> I Facility Number aQl _ _ ..,._ ~ _ lo Not Operational 0 Below Threshold I
!(Permitted E( Certified C Conditionally Certified C Registered Date Last Operated or Above Threshold: -------------·-···· -~ Farm Name: ··--·---·-t.e~~-¥-···-.!?.l..~&~tY...._._&!:ft:!. .. _ ........ _d._________ County: ······-·S.f?:~.,e.~.£-~:l-..... -.. ·····-·-..... E.~.?.. ..
Owner Name: ···-·---·-···J;.b2.~:"(-···· ___ O:J.d~!~"1..---···································· Phone No: ···-·····1..!..9. .... : .... ;?.:~-~-~---···/..i!...?..:L .... ----
Mailing Address: ··-·-···--J._C::~-------B..~~-~<...§ .. ______ .(?.~-'-······-----····· _____ Ge..~_l.e.~--r ·hlC.._________________ .:Jf._1::f'J ...
Facility Contact: ··-·-·-···-···-····-·-····--·-···---····---·--···--·-Title: ··-······-·······-····-····-····-·-·-·-·--······· Phone No: -····-······-····-··--·-·------······
Onsite Representative: ·····-·--··J;_~L!!..f--·-·./J:!d'!...!."!:Y._____________________________ Integrator: ... L'?.?.(:l~o/.--::: ..... .dr.:c.A1t.M. ___________ _
Certified Operator: ········-·L.I:z.c.a:l .. a.~l----·· ___ .LJ::J..c...{JL .. !:.a ... -.................. Operator Certification Number: ____ d:_;!_:Z_~!.._ ___ _
Location ofF arm:
rs/ Swine 0 Poultry 0 Cattle D Horse Latitude ...__ _ _.!• L..l _ ___.I' L..l _ __.I " Longitude L....-____.1• ._I _ ..... ~ 1._ _ _,1"
swine c~;:-~~~~~: ::;_J.i~try ~~ty _;~=!n
00 Wean to Feeder ::2.~ t:>P f lO Layer I I I ~
eO=-=Feed_e_r_to---::Ft:-:". m..;.· s.;;..h-+----+-------1 ~10 Non-Layer I I J
· DesiP ·· · il ciJrlmi~:"" ·,
Cattle Capacity ·Po,pubtiol{ __ ;~ 8 ~~;Dmy I I ,,~
.. · ~.:.-.· .... :~--:-~;.._~
.Total Design Capacity :I >~ ~~
-·Total SSLW .::::::1 ======~~~
0 Farrow to W ean
0 Farrow to Feeder :(0 Other
0 Farrow to Finish
IQ Gilts
CJ Boars
II
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Lagoon 0 Spray Field 0 Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? ar yes , notify DWQ)
c. If discharge is observed, what is the estimated flow in gaJ/min?
d . D ocs discharge bypass a lagoon syslem? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4 . Is storage capacity (freeboard plus storm storage) less than adequate? 0 Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: _____________ /.. ............... .
Freeboard (inches): _ _:3=-~-1(---
12112103 ------
DYes [j!No
DYes DNo
DYes DNo
JUtp.
DYes 0No
DYes ~No
DYes ~No
DYes Jt]No
Structure 6
Continued
I Facility Number: tf ,2.. -t;Je<l Dat~ of Inspection
5. Aie there any immediate threats to the integrity of any of th e structures observed? ( ie/ trees, severe erosion,
seepage, etc .)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and tbe situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/i mprovement?
8 . Docs any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? D Excessive Ponding D PAN D Hydraulic Overload
12 . Croptype &rm•.u/A. /"i'.:~tT / .S~~/( rD~.t:.o'A.l
13 . Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)?
14 . a) Does the fa c ility la c k adequate acreage for land application?
b) Does the faci li ty need a wettable acre determination?
c) Thi s facility is pended for a wettable acre determination?
15. Docs the re ce ivin g crop need improvement?
16 . [s there a lack of adequate waste application equipment?
Required Records & Documents
1 7. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan r ea dily available ?
(ie/ WUP. checklists , design, maps, etc.)
19 . Does record keeping need improvement? (ie/ irrigation , freeboard , waste anal ysis & soil sample reports)
20. Is fa ci lity not in compliance with an y applicable setback criteria in effect at the time of design?
21. Did th e facili ty fai I to have a actively certified operator in charge?
22 . Fail to notify reg ional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems , over appli cati o n)
23 . Did Reviewer/Inspecto r fail to discuss review/inspection with on-site r epresentative?
24. Docs faci li ty require a follow-up visit by sam e agency?
25. Were any additiona l proble m s noted which cause noncompliance of th e Certified A WMP ?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
05103101
Date:
DYes [(!No
DYes lJ)No
DYes [i]No
DYes rnNo
DYes [ENo
DYes [XJ No
DYes llJNo
DYes III No
DYes ~No
DYes [$No
DYes (i]No
DYes [i]No
D Yes [kiJ No
DYes ~No
DYes IXJNo
DYes []lNo
DYes ~No
DYes IX] No
DYes [iJ No
DYes [lJNo
DYes ~No
DYes ~No
Continued
J ·--------· -. -~---. ·----.. _ _.... -------~------------------~----___________ __,__ -----------·-.... __ .. __ --------
Division of Environmental Management
Animal Feedlot Operations Site V"~ftadon Record
. Dale:~
Tuoe:~
::.-:::nni!IIQJ!; fl\c.\";..,__ t:;;), ~ /~""'""\'an (:oaaty; So.-,~~ •• ,.,
OwDer Name: TO co :""'a tN\eA \lr: &' Phone No: 9'J-I J-7?
On Site Representative: C/ht\ Ul~ IDtegrator:_(f}~"-,..rfh'-'-')T------
Mailiug Adcbas: g+. J. f3 9 x so cf
Q,r;..,{Vv'd . N c..-.:{fY'I(
Physical AddressiLoc:ation:.---'-O....:.if.F ................... 5=12-'I ..... Q=::.......o;)~.....--_______________ _
..
Latitude: I I Longitude: I I
Operation Desc:dption; (b~d on desip charac:teristics)
t)'p~ of SwiM No. of AniiNlls
CSow
t&-Nunay :z.~ o'il
CFceda'
OIAerTJ1U of Lili'Ut«J:.: Number D/ A.nimms:
Nllmber ofLagoons: _ __,__(iDelude i.e tbe Drawinc,s and Obserntions the ftccboard ofeacb ll&ocm) ·.
[acUity Inspection;
. ~ODn :
Is lagoon(s) freeboard Jess than 1 foot+ 2S yesr 24 ~our_ st~nn storage?:
Is seepage observed from the.lagocm?:
Is erosion observed?:
Is any discharge obServed?
0 MM~ 0 Not Mt~~~...U
OJver Crop
DOes the facility need more acrUge for spraybag?~
Does the cover ~rop need improv~t?:
( lisr rlv crops wlaicA_T!imp~J
Oop~: Loy~ .. 7 Aaage:. __ i_ __ _
Sttbtzclc Criterill
Is a dwelling located withiri 200 feet ofwa5te application?
·Is a ~n locatM within _1 00 feet of Waste application? · ..
Is ~irnal wa$te stockpOed wilhin 100 feet of USGS Blue Line Stream?
·1s aniinal waste land applied or spray inigaied within 2S feet ofBfue Line Stream?
A01-1anuary17.1JH ..:
Yes 0 Nb-0:::
YesC No-Q_
YesC No&-
YesC NoQ-
YesO Na:Q...
YesO . No9-
YesO Non-.
.YesO ~oQ-..
YesO NoO
YesO No''.
-· ·-~·' -. . ,. ;,.
r.'"
MtzinU~J~U~a
Does the facility maiDtenance aeed improvemat?
Is cbe:e evidence of past discharje from ay part of the openlion?
Does record keeping need improvement?
Diddle facility fail to have a copy of the Animal Waste Man&&ement PJaD OD lise?
YesC
YesC
YesC
YesQ
Nof No
No
No~
&plain any Yes &DSWeD'-" -----------------------
. ~---.. (2 ~ """' Dallo : ~ /l'l/1'6 S1~ U..Anocllmmai{N-wl ec: Flldliry Alsusmm~ Ullit
Drawfnes or Observations;
ft:~r.J :: lffl-
. .
-. ··-·-·
-.... -. -
. . ·-. . ·-. . .
.•. ' -~-.
·-.. --. _._. -.... -. -· -~·-·-·
~ \~::.:-~.:-;~_.;· ~· '-
..
Ill •••
. ·. -· -. . --. , !" ...... ...,... •• _,.,_ ...... 1 • ., .. In w. .. .l\&• ... ;,.,.,...,..__.......,_,:.,....,...a..,•..,.._..• '"''··• -·•·: .::~ ~--· ...... --···· ..... -· ·-. -· ........ _ -·~··-.. -~·-· ~..-··:--··
. ~·~~--... ;;..,..'!~ ~··.~-.. ':" ·-~~ .' ,~' ~~<~:-s: ~,-.:..::~~'"=' ...... ~. -.~ . ...... ('.·· . ....~. . .
-·· ..
AOI-JanUU'J 17,1fH . .
·--·-------------------