820657_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quality
DateofVisit:la·G3C1 ... ('!1 ArrivaiTime:lf~'to A I DepartureTime:l/1!£tJ ·Q I County: SfltA Region:~
Farm Name: p o~b r k "tH""M.Jf E~ Owner ~':mail :
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
/. . _lc_;_o~£..:....;J;....:;':..:....·~....:;.,(,_V'5..:....(....:;;l~_J_rJ/ ___ Title: Phone:
lnteg.alo<' P tl<?'~ V .
Certification Number: ..... T_?~..---3...::8~'1....;...._/ ___ _
Onsite Representative: t(
Certified Operator: I (
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stre am Impacts
I . ls any discharge observed from any part o f the operation? DYes [d-N<> DNA ONE
Discharge originated at : 0 Structure 0 Appli cation Field 0 Other :
a. Was the conveyance man-made?
b. Did th e discharge reach waters of the State? (If yes, notify DWR)
DYes 0No @NA ONE
0 Yes 0No ~ ONE
c . What is the estimated vol ume that reached waters of the State (gallons)?
d. Does the di scharge bypass the waste man agement system? (If yes, notiiJ DWR) DYes 0No ~A ONE
2. Is there evidence of a past di scha rge 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 I of3
DYes
0 Yes
~0 D NA ONE
~0 DNA ONE
21411015 Continued
!Facility Number: lfJ--ts 1 I Date of Inspection: tli S_.-t (%
W.aste Collection & Treatment
4."s storage capacity (strucwral 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
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): flpt
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-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~DNA ONE
DYes DNo ~ ONE
Structure 5 Structure 6
DYes ~o DNA ONE
DYes~ DNA ONE
If any of questions 4-6 were answered yes, and tbe situation poses ao immediate public bealtb or environmental threat. notify DWR
7. Do any of the structures need maintenance or improvement? DYes ~o 0 NA 0 NE
8. Do any of the structures lack adequate markers as required by the permit? 0 Yes ~ DNA D 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
maintenance or improvement?
Waste Application
10. Aie there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes~ DNA ONE
DYes ONE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes
~DNA
~DNA ONE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > IOo/oor 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): geW',~~~~... s 0 0
13. Soil Type(s): Ay_ . AI o
I
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?
I 6. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
Page2of3
DYes
DYes
DYes
DYes
DYes
DYes
0 Yes
Oother:
DYes
0No DNA ONE
~0 DNA ONE
~0 DNA ONE
~0 DNA ONE
ITNo DNA ONE
~0 DNA ONE
~0 DNA ONE
~0
21412015 Continued
IFacili~ Number: t'h . b".S ;ff I Date of Inspection: "Nl -::}t c I f:
24. Did the fa c ility fail to calibrate waste application equipment as required by the pennit? 0 Yes ~~o 0 NA ,.
25. Is the facility out of compliance with pennit conditions related to s ludge? If yes, check 0 Yes o 0 NA
th e appropriate box(es) below.
0 Failure to complete annual sludge survey D Failure to deve lop a POA for sludge levels
0 Non-compliant sludge level s in any lagoon
List s tructure( s) and date of first survey indi cating non-complianc e :
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?
Otber Issues
28 . Did the facility fail to pr operly 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 ins pection d id the facil ity 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 e me rgency 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 Appl ication Field D Lagoon/Storage Pond D Other:
DYes
DYes
DYes
DYes
DYes
DYes
~0 DNA ~ DNA
~ DNA
~ DNA
p-No DNA
o;: DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33 . Did the Reviewer/Inspector fail to discuss revi e w/ins pection with an on-s ite representative?
DYes
DYes
DYes
DNA ONE
DNA ONE
34. Does the facility require a follow·up visit by the same agency? DNA ONE
CofunleotS (referlto 'gllestioo #):1:Ejplafu·anyYES allSWers.andlor an~·'additional recommendations or any other:,commeots.i U5el~ra ~-ihg5 ·6ir~·~'ilii)J~i~~~~ue~'eif;iii~;5ituatiJo.s~(O:·aaditi~~~.~,~~~is~'ri~ijk .. ! .~,,J·i · ;·,·: · -~,.. ,. '·''111":', ·,l·:~~:'l1~~',~:~~~~~,
~,l.._b lv r~ ----?"~t '7 -(7
sur-s.,-""1-vt -lr-r1
Revie we r/Inspector Name:
Re vi ewer/In s pector Signature :
Pt~geJ of3
Phone10'-{ 3J-3J3f
Da te : d-b~"'-{ [
V4/2015
0 Denied Access
Region:
Owner Email:
Phone:
Mailing Address:
Physical Address: -------------------------------------------
Title: Phone: Facility Contact: ~ JJ n£,_t.H \uQ ------------
Onsite Representative:
r1{
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 0 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)?
Integrator: f r« ~ 0
Certification Number: ~ r Sr rl
Certification Number:
Longitude:
DYes ~ DNA
DYes 0No gt
DYes 0No NA
d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No ~A
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?
DYes ·§t DNA
0 Yes No DNA
ONE
ONE
ONE
ONE
ONE
ONE
Page I ofJ 2/4!1014 Continued
8'2-bS7 I I Date of lnsp..,tion: s$J/fz J Facility Number:
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 I Structure 2 Structure) Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): '2. 5
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 ffNo 0 NA 0 NE
DYes 0No &cA ONE
StructureS Structure 6
D Yes GJ..H8 0 NA 0 NE
DYes [).HO 0 NA 0 NE
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? DYes ~o 0 NA D NE
8. Do any of the structures lack adequate markers as required by the permit? D Yes ~o D NA 0 NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes 0'No DNA ONE
DYes ~o DNA ONE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~o 0 NA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D 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 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?
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?
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 & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box .
owuP Dchccklists D Design 0 Maps D Lease Agreements
0 Yes ~0 DNA
0 Yes [jJ4fo DNA
0 Yes ~0 DNA
0 Yes ffNo DNA
DYes ~0 DNA
DYes [l'No DNA
DYes I;J No DNA
Oother:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes liJ No DNA 0 NE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes Q No 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes Q No 0 NA 0 NE
Page2of3 11411014 Continued
~. + _ !411 I Q lh.~ -11/ I F.acility Number: .0...,. 1"\ fl._~ I _ IL:D~a:..:.te_of_I_n_s..._pec_t_io_n_: _,~ ........ ~'¥L,.;...-____,;:...O _ ___.
24. Did the facility fail t~ calibrate waste application equipment as required by the permit? D Yes ~
25 . Is the fac ility o ut ~f compliance with permit conditions related to sludge? If yes, check D Yes ~o
the appropriate box(es) below .
0 Failure to complete annual sludge survey 0Failure to develop a POA for s ludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
2 6 . 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 fa c ility 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 repres entative immediately.
30 . Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i .e ., di s charge, freeboard problems, over-application)
31 . Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
DYes ~o
DYes ~
D Y es c;rNo
0 Yes [?No
DYes ~o
DYes ~o
0 Application Field D Lagoon/Storage Pond 0 Other: ------------------------
32 . Were any additional problems noted which cause non-compliance of the permit or C A WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-s ite representative?
34. Does the facility require a fo llow-up visit by the same agency?
DYes l2rNo
DYes (]'No
DYes ~No
CAtW~
J~&u~-6 -J . ~ p -t{._ c,
Jv aN>~.& ~·" {1.1/
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
Reviewer/Inspector Name: Phone: f31-3 J .sf
J
Page 3 of3
Date f ~_._,( fb
2 '412014
R e viewer/Insp ector Signature:
Com~ance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: G'Routine 0 Complaint 0 Follow-u 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1/1 ~t.4.\ ~ Arrival Time:Ltft 00 tf Departure Time: I L(:Jvt/ I County: S';f-YY( Region:~
Fann Name'?! • b~~ J-T. J J Vlkz-~ft Owner EmaU'
OwnerNam~ Bl?'''? vt&M Phone:
Mailing Address:
Physical Address: -----------------------------------------
Tide: Phone: Facility Contact: 1'6 Jf.. yUQ_..'1L.d/ ---------------
Onsite Representative: ____ t.......:(:__ _____________ _
Certified Operator: t
Back-up Operator:
Location ofFarm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Di scharge originated at: 0 Structure 0 Application Field 0 Other:
a. Was the conveyance man-made ?
b . Did the discharge reach waters ofthe State? (If yes, notify DWR)
c . What is the estimated volume that reached waters of the State (gallons)?
Integrator: f ~ ~s-'-<
Certification Number: f'l J ftj /
Certification Number:
Longitude:
DYes ~NA ONE
DYes 0No Ef'N"A 0 NE
QYes 0No []NA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWR ) DYes 0No 0i~A 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
DYes
DYes
[]-'No DNA ONE
lQ'No DNA ONE
114/2014 Continued
I Facilitf'Number: fA -(S] I
Waste Collection & Treatment
4.1s 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 Structure3 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 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 ~NA ONE
DYes DNo ~ONE
StructureS Structure 6
DYes ~DNA ONE
DYes~ 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
maint~nance or improvement?
Waste Application ' -10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~DNA ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes DNA ONE
11 . Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes
[31io
~0 DNA ONE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN > 10% or 10 lbs . D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12 . Crop Type(s): Cvu
13 . Soil Type(s): !I-{.,A-
I
14. Do the receiving crops differ from tho se designated.in the CAWMP?
15 . Does th e recei ving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation de s ign 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 & Permit readily available?
20. Does the fa cility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box.
DWUP Dchecklis ts 0Design 0 Maps D Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes 0No DNA ONE
DYes 0No DNA ONE
0 Yes 0No DNA ONE
DYes DNo DNA ONE
DYes DNo DNA ONE
0 Yes 0No DNA ONE
0 Yes DNo DNA ONE
DOther:
DYes 0No DNA ONE
0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers D Weather Code
0 Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fai l to install and maintain rain breakers on irrigation equipment?
Page2of3
0 Yes 0 No 0 NA 0 NE
0 Yes 0 No DNA D NE
2/4/2014 Continued
IFicility Number: I Date of Inspection: fi(;r '4 15
24. Did the facility fail to calibrate waste application equipment as required by the pennit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes EJ No
DYes DNo
0 Failure to c omplete annual sludge survey DFailure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date offrrst 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.
DYes DNo
DYes DNo
DYes 0No
D Yes DNo
DYes DNo
0 Yes DNo
0 Application Field D Lagoon/Storage Pond D Other: ----------------------
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes DNo
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes 0No
34. Does the facility require a follow-up visit by the same agency? DYes 0No
Reviewer/Inspector Name: Phone:
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
yt3-:?331
Reviewer/Inspector Signature:
Page3of3
Date: _J/L.....j.L..~::::a..z::. ... ~~/$=--
1/412014
ComJ.liance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: <3"Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: LS' :1'4t I r I Arrival Time:l c PD Departure Time:ID'ro Q I County:.£~ Region:Fl_Z..:V
FarmName: '66hbyJ(oJ~·~~~/ ~~'!.) Owner Email:
Jot~)-'((4~'-vdlf-B~ •••• .,
Mailing Address:
Owner Name:
Physical Address:
==~:{=b=p=J=~O{=:~~~~~~-----~T-it-le-:~~~~~~~~~~~~~--P-ho-ne_: ____________ __
{ Integrator: Erf'( r~-, =<.
Facility Contact:
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 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)?
Certification Number: q'f3?Y{
Certification Number:
Longitude:
DYes~ DNA ONE
DYes DNo ~ ONE
DYes 0No ~ ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No lZ(N': 0 NE
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes ~0
DYes ~0
DNA ONE
DNA ONE
V4/2011 Continued
I Facility Number: 1);: I nate oflnspection: S" ::t.~
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
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): :J\
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~ DNA ONE
DYes 0No ~ONE
Structure 5 Structure 6
DYes ~DNA ONE
DYes~ 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 require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~ DNA ONE
DYes ~DNA ONE
DYes~ DNA ONE
DYes ~DNA ONE
11. 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 D PAN> 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Typc(s): Sc,o
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 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 & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
DWUP 0Checklists 0 Design 0 Maps 0 Lease Agreements
DYes DNA
DYes ~DNA
DYes ~DNA
DYes ~DNA
DYes ~DNA
DYes ~DNA
DYes ~DNA
Oother:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
D Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? O Yes E::Jr'No 0 NA 0 NE
23.lfselected, did the facility fail to install and maintain rainbrcakers on irrigation equipment? DYes ~o 0 NA 0 NE
Page 2 of3 2/4!20II Continued
I F
1
aem; Numbe" f);;-[511 I Date oflnspeetio"' .$'-:r;j7
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.
111 f] I
0 Yes I2J'1ifO D NA · D NE
DYes ~DNA 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
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 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)
DYes
DYes
DYes
DYes
DYes
DYes
g.NO DNA ONE
~DNA ONE
0'"No DNA ONE
~ DNA ONE
~ DNA ONE
~ DNA ONE 31. 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 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?
\?.. -J () ,.-(3 -
Reviewerflnspector Name:
Reviewerflnspector Signature :
PageJ of3
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
Pho=j--S-/L(
Datei'J:: <t.?-3&}(
11411011
Technical Assistance
0 Denied Access
Date of Visit: asAWI] Arrival Time:ll[{]o . T-IL-A Reg~ on: /_ · v
Farm Name; ~ r}tf: ~~ ~clti
owner Name-: -=--..__H-~+-'G -{, lf----""--a...__"Tc_;_o___;,.JL..-~~-Jh-J&-/t.--_I_LJ_(-r-Owner Email:
Phone:
Mailing Address:
Physical Address:
-------~---------~-------------------------------------------------------------
__ --+-· r ....::.....;(} J:;..;;..JJ~oC.........~-r'n~t~V.+ILI\~L..Lf(..%f-t(_Title: -----Phone: Facility Contact:
Onsite Representative: l ( Integrator: I}-:) f -l.-j...(
Certification Number: ff f f'L(( Certified Operator: tf -------------------------------------
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 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)?
Certification Number:
Longitude:
0 Yes 0"No
DYes 0No
DYes 0No
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No
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 ~0
DYes ~0
DNA ONE
(];}NA ONE
[!j'NA ONE
(?&A ONE
DNA ONE
DNA ONE
214/2011 Co ntinued
[FacilityNumber: ··?2. -G37 [ [Date of Inspection; &J IJvD / l [
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 I Structure2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in): j 7
J t' 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 ~o DNA ONE
D Yes (2}1<1o 0 NA 0 NE
StructureS Structure6
0 Yes (ZYNo 0 NA 0 NE
DYes []J'No 0 NA 0 NE
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 require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes []}No 0 NA 0 NE
D Yes Q.-Mo D NA D NE
DYes~ DNA ONE
DYes~ DNA ONE
11. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. DYes 0 No DNA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy M~tals (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): &~~ se:.o csil
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CA 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?
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 & Permit readily available?
20. Does the facility fail to have all components ofthe CAWMP readily available? If yes, check
the appropriate box.
OWUP 0Checklists 0Design 0 Maps 0 Lease Agreements
DYes @-Hn DNA ONE
DYes []JXo DNA ONE
DYes 8-*o DNA ONE
DYes [Ll..No DNA O ·NE
DYes I{J-No DNA ONE
DYes liJ.-No DNA ONE
DYes []-No DNA ONE
Ootber:
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 NA 0 NE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections D Monthly and I" Rainfall Inspections 0 Sludge Survey
DYes ~
22. Did the facility fail to install and maintain a rain gauge? 0 Yes [JxO 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~o DNA 0 NE
Page 2 of3 214/2011 Continued
(Facili; Number: i7-6?7 I I nate oflospection:rfSJl)O 1flfl
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 llJ>ro
DYes (J>Io
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge le vels
D Non-compliant sludge leve ls in any lagoon
List structure(s) and date of fJISt survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified o p erator in charge?
27. Did the facility fail to secure a phosphorus lo ss 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 inspec tion did the facility pose an odor or air quali ty concern?
If yes, contact a regional Air Quality representative im mediately.
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)
DYes~
DYes I]J..Mo
DNA ONE
DNA ONE
DYes ~DNA ONE
DYes~ DNA ONE
DYes ~o DNA ONE
~-0No DNA ONE 31. Do subsurface tile drains exist at the facility? If yes , check the appropriate box below.
[B'Application Field 0 Lagoon/Storage Pond 0 Other: ---------------------
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?
I~ -I q-I(
Reviewer/Inspector Name :
Re vi ewer/Inspector Signature:
Pllge 3 o/3
()-
1-
0 Yes @Ht> 0 NA 0 NE
D Yes 1]1.-No
0 Yes QJ..No
DNA ONE
DNA ONE
Phonff/lJ ~ '133-33~{
DateJ5. f{}vV JJ
21412011
Compliance Inspection Operation Review 0 Structure Evaluation
Reason for Visit: ~tine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency
Date of Visit: Region: IIJ-1F/~rrival Time:! r:3 0 I DepartureTime:1io:3V I County:~~
Rol L'f' rf: Tbofo( /i1ac<S/,d£ Owner Email:------------
(
Farm Name:
13o bh Y £:-/Jfav--da,Lf Phone:
I
Owner Name:
Mailing Address:
PhysicaiAddress: ------------------------------------------------------------------------------------
Facility Contact:
Onsite Representative:
Certified Operator: a.• .
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: 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)?
Phone:
Integrator: J7lrj 7-~
Certification Number: £9'.5 %"~ /
Certification Number:
Longitude:
DYes J8-.No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, not ify 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 discharge?
Page I of3
DYes
DYes
ISa, No DNA ONE
~No DNA ONE
21411011 Continued
·!Facility Number: I Date of Inspedioo: /;? -j r I ;z._l
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] Structure2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): I?
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 f:&No DNA 0 NE
0 Yes 0 No DNA ONE
Structure 5 Structure 6
DYes [gNo DNA ONE
0 Yes ~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 require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes L81No 0 NA 0 NE
DYes ~No 0NA ONE
DYes ~No QNA ONE
0 Yes 123lNo 0 NA 0 NE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes £81 No DNA 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
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): ,&r-m M~a.. I /?V r-r 5~/ I t!DI'l'l I w/,.ef:fsoy k.--.r
13. Soil Type(s): ~~h \ (\\).-
14 . Do the receiving crops differ from tho se designated in the CA WMP?
15 . Does the receiving crop and/or land application site need improve ment?
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
DYes
DYes
DYes
DYes
DYes
~No DNA
~No DNA
l&J No DNA
~No DNA
IEJ No DNA
ONE
ONE
ONE
ONE
ONE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 0 Yes E29. No 0 NA 0 NE
20. Does the facility fail to have all components ofthe CAWMP readily available? Ifyes, check 0 Yes ~No 0 NA 0 NE
the appropriate box.
owuP 0Checklists D Design D Maps 0 Lease Agreements Oother: _________ _
21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes [B. No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
D 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? D Yes l2J No 0 NA 0 NE
23 . If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
Page 1 ofJ
DYes [&No DNA ONE
11411011 Continued
-!Facility Number: I Date oflnspection: ) .;L-I!!J?D I)-
•
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 [3.No D NA D NE
0 Yes [3 No D NA 0 NE
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of flfSt 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)
D Yes ~No D NA 0 NE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes ~No DNA ONE
DYes gj No DNA ONE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond D Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
DYes ~No
D Yes .li2.J No
DYes IBJ No
DNA ONE
DNA ONE
DNA ONE
Phone: 9z'o-~.33-:~'00
Date: /c9 -{ g-?of ;1-
•
Z/411011
\
Date ofVisit: l/.2-9:1/ I Arrival Timed to'« J!L I Departure Timedl/! /\31 County:~ Region: ~
Farm Name: &/Jr rT'!ffl/ L!/P0b a./f
Owner Name: PJ)Jy F /)1ocs AJI
Mailing Address:
Owner Email:
Phone:
Physical Address: -------------------------------------------
Facility Contact:
Onsite Representative: ..a.So::;..;;.-""!:..;;.~.==-----------------
Certified Operator: ~-z-:/?r~d,..../L
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part ofthe 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 Stale (gallons)?
Phone:
Integrator: ~~
Certification Number: 'f-9-3Yq'j
Certification Number:
Longitude:
DYes Q9 No DNA ONE
DYes DNo DNA ONE
DYes DNo DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notifY DWQ) DYes DNo DNA ONE
2. Is there evidence of a past discharge rrom 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 I of3
DYes
DYes
~No DNA ONE
~No DNA ONE
114/2011 Continued
!Facility Number: ?'?=-G £/ I
Waste CoUection & Treatment
I nate oflnspection: p-<f=lt
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
Identifier:
Spillway?:
Designed Freeboard (in): 19=
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 [8LNo 0 NA 0 NE
DYes 0No DNA ONE
StructureS Structure 6
D Yes jg.No D NA D NE
0 Yes (}iNo DNA D NE
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 ofthe 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
1 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
D Yes I2J.No D NA 0 NE
DYes ~No DNA ONE
DYes mNo DNA ONE
DYes ~No DNA ONE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes RNo DNA 0 NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): JJ.-cmz/a. /orrc~«tt"// L"o /n /#//...e~ b pt{r-e-:2
13. Soil Type(s): !Jod,l th< /!JJdl:>
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 selecte d, did the fa c ility fail to install and maintain rainbreakers on irri gation equipment?
Page2of3
DYes !B-No
DYes [BNo
DYes ~No
DYes ~No
DYes ~No
0 Yes [29 No
DYes ~No
00ther:
,Pa. Yes 0No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DYes ~No DNA ONE
2/4/2011 Continued
!Facility Number: ~ -{,671 !Date oflns~ction: /?--9 I L
24. Did the facility fail to calibrate waste application equipment as required by the permit? D Yes ~No DNA ONE
~ 25. Is the facility out of compl iance with permit conditions related to sludge? If yes, check DYes 0 No DNA ONE
the appropriate box(es) below.
0 Failure to comp lete annual sludge survey D Failure 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 provide documentation of an actively certified operator in charge? DYes ~No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes (g"No D NA ONE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes g) No DNA ONE
and report mortality rates that were hi gher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? D Yes 5"a No DNA ONE
If yes, contact a regional Air Quality representative immediatel y.
30. Did the facility fail to notify the Region a l Office of emergency situations as required by the DYes ~No DNA ONE
permit? (i.e., discharge, freeboard problems , over-application)
31. Do subsurface tile drains ex ist at the facility? If yes, check the appropriate box below. [g. Yes 0No DNA ONE
~Application Field 0 Lagoon/Storage Pond 0 Other:
32 . Were any additional problem s noted which cause non -compliance of the permi t orCA WMP? DYes U?J.No DNA ONE
33 . Did the Reviewer/Inspector fail to discuss review/i nspecti on with an on-site representative? DYes OQ No DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes [Sa No DNA ONE
Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature: Date: -------------------
Page 3 of3 114/2011
Type of Visit G-CO'mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Vislt ()-ROutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
DateofVisit: I ,~,01 ArrivaiTime:l d-', J a I OepartureTime: I3.,_JO I County: -.::5~~ Region: {:j<...fJ
Farm Name: bekky g--='TO,JJ (V/ar..S~ OwnerEmail: ------------
Owner-Name: b>;:>hj7 ft..._, IZ1.ar5hrwLL Phone:
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: Phone No:---------
Onsite Representative: _....;;S;;;......:.r'-·<-----=-::....-4'-==-------------Integrat~r: ,P~
Certified Operator: ____ 5....r..=.~----'--------------Operator Certification Number:
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharees & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes 12J.,N o 0 NA 0 NE
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, notify DWQ)
c. What is the estimat ed 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 pait of the ope ration?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
ot he r than from a di scharge?
Page I of 3
DYes 0No DNA ONE
DYes DNo DNA ONE
DYes DNo DNA ONE
DYes ~0 DNA ONE
D Yes f,i?lNo DNA ONE
11118104 Continued
!Facility Number: @=-?57J Date of Inspection I /r:;:;;?'t:vo
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 ~o DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:----------------------------------------
Spillway?:
Dcsi1,'11ed Freeboard (in): ---L(_C'J_:__ _________ -------·---------------------
Observed Freeboard (in): ---'tZ'=~"'-tfL-_ ------------------------------
5. Are there any immediate threats to the integrity of any ofthe structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
0 Yes 81-No DNA D NE
6. Are there structures on-site which arc not properly addressed and/or managed DYes SNo 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 en\ironmental 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?
D Yes l:&l.No 0 NA ONE
0 Yes G(No DNA ONE
DYes ~o DNA ONE
DYes ~o DNA ONE
I I. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes DJ,No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs D Total Phosphorus D Faiiure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Ev id ence of Wind Drift 0 Application Outside of Area
12. Croptype(s) LP'il buLMuz~J b;i.-,..-~ ~-r--rd
13. Soil type(s) tJ12t/-I AlA. I t<Jaf
14 . Do the rece iving crops differ from those designated in theCA WMP? DYes ~No DNA ONE
15 . Does the receiving crop and/or land application site ne ed improvement? DYes ISJ'No DNA ONE
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes ~NoD NA 0 NE
17. Does the facility lack adequate acreage for land application? DYes .81 No DNA ONE
18. Is there a lac k of properly operating waste application equipment? DYes .Kl.No DNA ONE
12128104 Continued
• I Facility Number: @--@ Date of Inspection 112:~ D
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 D Checklists D Design D Maps D Other
DYes 18-No DNA ONE
DYes BJ._No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes [8..No DNA 0 NE
D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers D Annual Certification
0 Rainfall D Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes fllNo DNA ONE
-23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes fi2(No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes R}No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes 6?J.No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes ~0 DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes it 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? DYes ~0 DNA ONE
lfyes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes ~0 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 Ui.No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes ~0 DNA ONE
• • ~~ ' l "' ' • "• • • .L • •• .,. --.!•4. ... " ., '
<r ' •• • """. • ";
12118/04
ompliance Inspection 0 Operation Review
Reason for Visit ~ne 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 19-/Z.: =tf" I Arrival Timed ?".'.JQ I Departure Time: 19.',) Q Region: ,==K 'D
Farm Name: Jje;bbt d: ICJJj mar:sha /( Owner Email: --------------
Owner Name: J::. r:;), lz v £ ma r:;d, a fJ
I Phone:
Mailing Address: ----------------------------------------------
Physical Address:----------------------------------------------
Facility Contact: TO)) n1(rl!/;:; )a.b_ Title: -----------
PhoneNo: ________________ _
Onsite Representative: __ __...5.::....::::~__::......;.;::=--------------Integrator: 9('~,1> ~~ 7 ,
Certified Operator: ____ -D_77-=·~:::;;.....k"7'rc:...,__ ---=~....:....:..a:~;;;.~·Y""--~;;;~~A~n.:::.~:::;.o,::io=----/ Operator Certification Number: --------
Back-up Operator: --------------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discha rges & Stream Impacts
1. Is any di sc harge obse rved from any part of the operation? D Yes ~No DNA ONE
Di sc harge ori gi nated at : D Structure D Appl ication Field 0 Other
a . Wa s th e c onveyan ce man-made?
b. Di d th e di sc harge re ach wate rs of the State ? (If yes, noti fy DWQ)
c . Wh at is the es ti mated volum e that reached wate rs of th e State (gallons)?
d. Does d isc harge bypass th e waste man age ment syst em ? (If yes , notify DWQ)
2. Is th ere evi dence of a past di sc ha rge fr om an y part of the ope ra tion ?
3. Were the re any adv ers e im pac ts or pote ntia l adverse impac ts to the Wate rs of the State
o th er th an fro m a disc harge?
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes 0 No DNA ONE
DYes laNo DNA ONE
D Yes ~No D NA O NE
12128104 Continued
'f
j Facility Number: fl;l-k?71
(
Date of Inspection l'f-1 t.-ot
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 ~o DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:------------------------------------------
Spillway?:
Designed Freeboard (in): I <]
Observed Freeboard (in): t..-J D
5. Are there any immediate threats to the integrity of any of the structures observed? DYes !&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 ~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)
DYes QlNo 0 NA 0 NE
DYes !Bl..No DNA ONE
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/improvement?
DYes i:StNo 0 NA 0 NE
DYes ~No DNA ONE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. D Yes (g. No D NA 0 NE
D Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN D 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 Area
12. Croptype(s) fln:nuJa. /~v..-$~~//cocn lwhc£/s~t
13 . Soil type(s) No A I .!tu J IA.Ia !5 r »
14. Do the receiv ing crops differ from those designated in the CA WMP? DYes
15. Does the receiving crop and/or land application site need improvement? DYes
16. Did the facility fail to secure and/or operate per the irrigation desi gn or wettable acre determination ?
1 7. Docs the facility lack adequate acreage for land application?
DYes
DYes
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
DYes
Phone:
Date:
P'J No DNA ONE
181No DNA ONE
jgJ No D NA 0 NE
~No DNA ONE
[2"gNo DNA ONE
Continued
f I Facility Number: 1':?-:-k,z;i Date of Inspection II ,-/1;,-~'t
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Pennit 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
DYes ~o DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes ~No 0 NA 0 NE
D Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge?
· 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than nonnal?
30. 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
31. Did the facility fail to notify the regional office of emergency situations as required by
General Pennit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
DYes ~No
DYes 1:&1 No
DYes ~No
DYes j&JNo
DYes ~No
DYes ~No
DYes [8No
DYes rg{_No
DYes [i.No
D Yes ~No
DYes [81No
DYes ~No
]2/18/04
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
I
~
ompliance Inspection 0 Operation Review 0 Structure Evaluation
Reason for Visit ~ne 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
i
Ei(o DateofVisit: ~Arrival Time: I jt1;oo I DepartureTime: I //.!~0 I CountyL:,.~~ Region:
Farm Name: $nlzby m~ltSha I I {;,,r ~ Owner Email:-------------
1 I
Owner Name: J3n h b '7' rrJa C.-5 /,a. / ( Phone:
I
Mailing Address: -----------------------------------------
Physical Address:-----:--------------------------------------
_....---~/ a~J:.a..IJ:L!....-----L..Irn""'""a.:.r..c .... 5~k..ti..«...Lfl(_ Title: ___J6on~....!..!....I..___JI?t~~;;;;..;:r.t-· __ Facility Contact: Phone No: ________ ___
Onsite Representative: _..:.5:::...~~~::::::.:;...::;..;:==-------------­
Certified Operator: ---...t.•.J.f~~=..:=~<......_ -----------
Integrator: -,.r8--l-/"t!"'--=-~L.¥+=~L.:..:=--------­
Operator Certification Number: ~~~.~7.~/ti::L.o~ ... ~(,.e:....--
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation? D Yes I54.No D NA
Discharge originated at: 0 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 vo lume that reached waters of the State (gallons)?
d . Does discharge bypass the waste management syste m? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3 . Were there any advers e impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
DYes 0No DNA
DYes 0No DNA
I
DYes CINo DNA
DYes l)l.No DNA
DYes ~N o DNA
ONE
ONE
ONE
ONE
ONE
ONE
,
,·~ Page 1 of 3 12/28104 Co ntinued .. , w ti ..
I
'
I Facility Number:& -G5"j Date of Inspection I B:"-/3-iJr"'
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 I Structure 2 Structure 3 Structure 4
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:----------------------------------------
Spillway?: ----------------------------------------
Designed Freeboard (in): ---4{~.-Cf_,_ __ ----------------------------------
Observed Freeboard (in): _ _...__y....,..r.-;;. __ ----------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes
(ie/ large trees, severe erosion , seepage, etc.)
[ij'No DNA ONE
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 pennit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
l2tves 0 No DNA 0 NE
DYes -~No DNA ONE
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
DYes ~No DNA ONE
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/i mprovement?
DYes ~No DNA ONE
II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes [i No D NA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground D 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 Area
12 . Croptype(s)~ /arMc.>crJ /CtJc"'= Lsbr),An-S ,/uk/:
13 . Soiltype(s) .4,,fJr /p.fozf /LAia'B
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
DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?D Yes
17. Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Pagel of 3
DYes
DYes
Ji'lNo DNA
[21No DNA
~No DNA
&lNo DNA
BJ.No DNA
ONE
ONE
ONE
ONE
ONE
I Facility Number: :t;l:-?;S"j7 Date of Inspection I ~13-QS"'
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 ofthe CA WMP readily available? If yes, check
the appropirate box. 0 WUP D Checklists 0 Design 0 Maps D Other
DYes ~o DNA ONE
0 Yes 129-No 0 NA 0 NE
21. Does record keeping need improvement? Ifyes, check the appropriate box below. 0 Yes ~o 0 NA D NE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
D Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes {lJ.No DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes [gi.No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes fgNo DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes ~0 DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the pennit orCA WMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes taNo 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? DYes ~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 representative? DYes ~No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes til No DNA ONE
Page3 of 3 12/28104
! [Facility Number I_{?--_H h__s-?11 Qnivision of Water Quality .$"~-~
0 Division of Soil and Water Conservation ?-?t;-iJ/
0 Other Agency
Type of Visit ~ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason f or V isit ~e 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
DateofVisit: 15'-~-o71 ArrivaiTimed 7.00 I Departure Time: I /t>15D I County: ~~ Region: EJ?U
Farm Name: $ob}y rJ: JOJJ 'Mt(i!= r:-tlut .d , Owner Email: -----------
Owner Name: '8e £j,v {?. /Yta.r-_34atL Phone:
I
Mailing Address: ----------------------------------------
Phys ical Address:----:--------.--~-----------------------------~L-1/ P"--"J.:..ud"'-'---"""'!ll.....,.A.=-r'---;5"-L)..:.:.::IZ::.;_:;,-t/....;;....__ Title: _____ _ Facility Contact: PhoneNo: ____________ _
Onsite Representative: ---'.J;~~....;;.:;.~=--------------Integrator: ~~~
Certified Operator: __ ,5.""'---'-~------------------Operator Certification Number: ~11---f<'?.....:;.Jr.._,-;51>::;_.;__ __
Back-up Operato r : --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD 'D " Longitude: D OD'D"
Design Current Design Current Design Current
Swine Capacity Population Wet PouJtry Capacity Population Cattle Capacity Population
ID Wean to Finish I I
0 Wean to Feeder
0 Dairy Cow
0 Dairy Calf
JD Layer
Qa Feeder to Finish ~lf/0 ~ITO 0 Dairy Heife1
0 Farrow to Wean
0 Farrow to Feeder
0 Farrow to Finish
0 Gilts
0 Boars
~· .•.. -------
0 Dry Cow
0 Non-Dairy ' ·,
D Beef Stockel .'
0 BeefFeeder
' 0 Beef Brood Cow i
·--···---·--·-4 "
Dry Poultry
0 Layers
0 Non-Layers
0 Pullets
0 Turkeys
Other 0 Turkey Poult s
0 Othe r ID Other Number of Structures: W
Discharges & Stream Impacts
I . Is a ny discharge observed from a ny part of the operation ? 0 Yes IX! No DNA 0 NE
Discharge originated at : 0 Structure 0 App lication Field 0 Other
a. Was the conveyance m an-made? D Yes 0No DNA ONE
b. Did the discharge reach waters of th e State? (If yes, notify DWQ) DYes 0No DNA ONE
c. What is the estimated vo lume that reached waters of the State (gallons)?
d . Does di scharge 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 a ny adverse impacts or potentia l adverse impacts to the Waters ofthe State
othe r than from a discharge?
D Yes 0No
DYes ~No
D Yes ~No
12128104
DNA ONE
DNA ONE
DNA ONE
Continued
. I Facility Number: a-~sj Date of Inspection IACf="ld:io 7
~ Waste Collection & 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 I Structurc2 Structure 3 Structure4
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:------------------------------------
Spillway?:
Designed Freeboard (in): IT
Observed Freeboard (in): tf3
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/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 DNA ONE
DYes 18_No 0 NA D NE
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
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
0 Yes OlNo DNA 0 NE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes 181No DNA ONE
II . Is there evidence of incorrect application ? If yes, check the appropriate box below . 0 Yes ~No 0 NA D NE
0 Excessive Ponding 0 Hydrauli c Overload 0 Frozen Ground 0 Heavy Metals (Cu , Zn, etc.)
0 PAN 0 PAN > I 0% or I 0 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
12. Croptypc(s) :&:rm...b__ &f!d2e~, 27/,Am-2 /a;r,./ wJ.~J T I
13. Soil type(s ) J.lpA: !WaB ,1/h<
14. Do the receiving crops differ from tho se de signated in theCA WMP?
I 5 . Does the receiving crop and/or land app li cation site need improvement?
DYes
DYes
16. Did the facility fail to secure and/or operate per the inigation design or wettable acre detennination?O Yes
17. Does the fac ility lack adequate acreage for land application?
18. Is there a lack of properly operating wa ste application equipment?
DYes
DYes
~No
lgNo
qwo
~No
!.&No
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):
DNA
DNA
DNA
DNA
DNA
cJ }, JJ~ So~L.f~lc 71:511-1'., /IA!-V~ -dis J..~ '~~ De~~r?:>7.
11/e ~~) r/.-r:: CVrft STP~r &.4 ~ rt~4,1. s-, ~ oFo?
J,lf-{,fi-e fA6.,-J. 76 rvr 71~ ~a... tiJ-he, S;'~~ ttr---ffe wi II 'fi'te 7J,~ 7P &te-"-~ CliFFir-TO nt4-/c~ aill5Tm,-,.:l-n-r J/i.5 J.~.d-erz;,IJ.
ONE
ONE
ONE
ONE
ONE
....
1-
...... ....
Reviewer/Inspector Name s~IH:-G-JqL_n~ Phone: CjjP-J/.:53-3 3'p0
Reviewer/1 nspector Signature_: ~~L Date: <;-
12118104 . Contmued
i
'
I Facility Number: 8;! -L,fl
Required Records & Documents
Date oflnspection 17:-a-o J7
19 . Did the facility fail to have Certificate ofCoverage & 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 D Design 0 Maps 0 Other
DYes ~No DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 1:8 Yes 0 No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard D Waste Analysis IE Soil Analysis D Waste Transfers 0 Annual Certification
0 Rainfall D Stocldng 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I " Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes lijNo DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes l)lNo DNA ONE
24. Did the facility fail to calibrate waste appl ication equipment as required by the pennit? DYes lXNo DNA ONE
25 . Did the facility fail to conduct a sludge survey as required by the pennit? DYes ~No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes ~No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE
Otber Issues
28. Were any additional problems noted which cause non-compliance of the pennit orCA WMP? DYes 1}4No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes 13No 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 ? DYes ~No DNA ONE
If yes, contact a regional Air Quality repre sentative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes SNo DNA ONE
General Permit? (i e/ discharge, freeboard pro blems, over application)
32. Did Reviewer/Inspector fail to discuss revie w/inspection with an on-site representative? DYes ~No DNA ONE
33 . Does facility require a follow-up visit by same agency? DYes ~·No DNA ONE
..
Drawings:
Page3 of3 12128104
\
I
I
'
II> .f ·l -':.·
Compliance Inspection 0 Operation Review
Reason for Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I G-::Jzr&!fJ Arrival Time: I $"! l){) I Departure Time: I 9 ! ..3l) I County:-S~ Region: r /?7)
FannName: J3'i>~ rf=/o~ ltleo~
Owner Name: E j; ~P )_ u /11ordLt/
Owner Email: --------------
Phone:
Mailing Address: .<)j Yi Chr /' r ~ /1.$ /1-z I
Physical Address:-----------------------------------------
Facility Contact: _.70'---o__,k!:.=..l...---~....m~a"-=':.....s~·h...ua:::.....;..ai( __ Title: _______ _ PhoneNo: ________ ___
Onsite Representative: __ .... S.:;..;;..~-.::....:::.~oo-------------Integrator: -~P~c~r_:~;;u..;ZP;;:;;..,~,__<-=---------
Certified Operator: ___ .... :?.::;.;~::;_;_~=--------------Operator Certification Number: _1_./~ff:.:;;....:::~~~::...._---
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I. Is any discharge observed from any part ofthe operation? DYes ~No DNA ONE
Discharge originated at: D Structure D 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 (g allons )?
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 S tate
other than from a discharge?
Page 1 of3
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes 00No DNA ONE
DYes ~0 DNA ONE
DYes l&INo DNA ONE
12/28104 Continued
. -·-~.-~~--<r:·---·
I Facility NumberyQ -bSZI Date of Inspection
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 Structure2 Structure 3 Structure 4
DYes ,3No DNA ONE
DYes ~No DNA ONE
Structure 5 Structure 6
Identifier:----------------------------------------
Spillway?: ---------------------------------------
Designed Freeboard (in): /9
Observed Freeboard (in): ~3
5. Are there any immediate threats to the integrity of any of the structures observed? DYes ~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 gjNo 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
10. Are there any required butTers, setbacks, or compliance alternatives that need
maintenance/improvement?
0 Yes l)fNo 0 NA D NE
0 Yes [81No DNA D NE
DYes ~No DNA ONE
0 Yes Da._No 0 NA D NE
II. Is there evidence of incorrect application? If yes, check the appropriate box below . 0 Yes ~No 0 NA 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 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s) ZrrtMwl.-c. /fa;! .b~r;'i?;,_ ()(!'<!! r.sz-cJ~J.,J/Col"'l1. />o;rl'l_-"~~-->
13. Soil type(s) ;1/ok ~:D /A:t<
14. Do the receiving crops differ from those designated in the CA WMP? DYes gjNo DNA
15. Does the receiving crop and/or land application site need improvement? ~Yes 0No DNA
ONE
ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes I& NoD NA 0 NE
17. Does the facility lack adequate acreage for land application? DYes ~No DNA ONE
18. Is there a lack of properly operating waste application equipment? DYes ~No DNA ONE
Reviewer/Inspector Name
Reviewer/Inspector Signature:
~~~~~~~~~~~~~~~~~~~~~~ Phone: 9-/o-¥3.3.-33 3;2-.
te ~ 3 tJ ;:i10 c:>G Date:
Page 2 of3 12128104 Continued
t [ Facility Number: ~-'-SJ
Required Records & Documents
Date of Inspection I G-3o-lf~
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. D WUP 0 Checklists 0 Design D Maps D Other
DYes l'&No 0 NA 0 NE
0 Yes gj No 0 NA 0 NE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes 3-No DNA D NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stoclcing 0 Crop Yield 0 120 Minute Inspections D Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes g) No 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 ~No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes IR1No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes ~No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes !»No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CA WMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes ~No DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspec tion did the fa c ility pose an odor or air quality concern? DYes ~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/ dis charge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes Ia No DNA ONE
33. Does facility require a follow -up visit by same agency? DYes a No DNA ONE
Page3of3 12128104
Type of Visit e Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit e Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access
L.J IDateofVisit: 1"1/:Jo/o¥ lrune : I I :,9o FacilityNumber I 1:2 r-1 ~57 I
""--------------------' lO Not Operational 0 Below Threshold
. .JI Permitted ~Certified [] Conditionally Certified [] Registered Date Last Operated or Above Threshold: ---·-·--·--·
Farm Name: ..... 6o..~.b...,...J ...... k.J~ ..... l?.1gr..S..b~l.L .. fit..~................. County: -·---~-P-.:Ul.t).. .... -----·-.J: ~.'!-.
Owner Name: __ ..Go.lt-~;--~---L~~---· .. tn..a.x.L':tsJL ......... -----·-····· Phone No: ..... 0..~'!.>-.... ::~--~~.:'. __ lj__!_~~----··-·····--·
Mailing Address: __ £1.l..'.f ...... .l:la..r:.r-'.L1""--Jd. ; 1 l ... , £_1-·-·--·· __ G~.J.a.n...Lr-l\L.C..._____________ -~ i ~'l:L
Facility Contact: -------···-· .. ·-···-·-------·-·-·--Title: ·--.. ---·--·-·-····-·-·-·-···-·---· Phone No: ------------
Onsite Representative: ____ l5?..t/d ___ m_"l..blJ.~L/_, __________ .. Integrator: ........ P,. Y J Q1-S::---E:_~~ ----
.,;
Certified Operator:·----~~!~...~ ............. _ .... _t::!J_~.:!l!_~---·---·-· .. ·-·-Operator Certification Number: ___ L7..8..£f ____ _
Location ofFann:
Ill Swine 0 Poultry 0 Cattle D Horse Latitude ..._ _ _,1•1._ _ __,j•l L.. _ ___,I " Longitude ...._____.!• ._I _ ..... I· ._I _ _.I "
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
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 th e State? (If yes, notify DWQ)
c . If discharge is observed, what is the estimated flow in gaVmin?
d. Does discharge bypass a lagoon system? (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 I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ............... !. ................. .
,.,, i,
Freeboard (inches): o/ __ .;;___..;.,. __
12112103
DYes lJNo
DYes ONo
DYes ONo
/JIA
DYes 0No
DYes ~No
DYes ~No
DYes WNo
Structure 6
Continwd
(Facijity Number: 8 .l -tf? I Date of Inspection 111-~-~ I
5 . ire there any immediate threats to the integrity of any of the structures observed? (iel 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 the situation poses an
immediate public health or environmentaJ threat, notify DWQ}
7. Do any of the structures need maintenance/improvement?
8. Does 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. Axe there any buffers that need maintenance/improvement?
11 . Is there evidence of over application? If yes, check the appropriate box below.
D Excessive Ponding D PAN 0 Hydraulic Overload 0 Frozen Ground 0 Copper and/or Zinc
12. Crop type /ic,., •• ua/~ .Soy b s•a, W J.-f~ Ct~,._n
13 . Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)?
14 . a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15 . Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17 . Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Axe there any dead animals not disposed of properly within 24 hours ?
19. Is there any evidence of wind drift during land application ? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. 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 .
DYes rlNo
DYes £1No
DYes IJJNo
DYes [).No
DYes ciNo
DYes [iNo
DYes ~No
DYes IIJNo
DYes dJNo
DYes [)No
DYes Iii No
DYes ONo
DYes 11!No
DYes "No
DYes J;S 'No
DYes ~No
DYes ~No
Reviewer/Inspector Name ;.j~~~~~=:j: ~~i~~~~~L§\f:·:~::·> ~~; .·:·~~~i~::.~~~;~_j._j~~&~~17~~~:;;: ~;~~J~~~:f~~~i~
Reviewer/Inspector Signature: Date: ~
12112/03 Continued
I Fa~ty Number: g J -t.r71 Dat4:' of Inspection I Df"' .lD~t .
f ·' RedUired Records & Documents
21 . Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
0 Waste Application 0 Freeboard 0 Waste Analysis ~oil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25 . Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss reviewfmspection with on-site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35 . Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
0 Stocking Form [J Crop Yield Form 0 Rainfall 0 Inspection After 1" Rain
0 120 Minute Inspections 0 Annual Certification Form
DYes
DYes
~Yes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
[J No violatioos or deficiencies were noted during this visit. You will receive no further c_orrespondence about this visit.
II! No
~No
0No
IJNo
~No
~No
~No
[JNo
[l!No
~No
IJNo
~No
(i4No
{)No
3)No
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c\A.~.,.<
12112103 . ' ....... · __ ., .. :
. . :J
Date of Inspection l/0-fCI.JfZI Facilit~· Number I "dz.
Time of Inspection I /I ~ Oo I 24 hr. (hh:mm)
C Registered "Certified C Applied for Permit J(Permitted (C Not Operational Date Last Operated: ......................... .
F.arm Name: .. 6..~.~~.~.::t:L;J!.. .. ~r..s.~t\ ................................. ~.................... County: ... 5~56.~ ............................................... ..
Owner Name: ..... Bo.b.h~ ........................... .fY.\o..t:s .. h~\\ ......................... :.... Phone No: .................. 5.J.:1. .. :: ... :J.).flj: ............................ .
Facility Contact: .. ~.o.h.~.~ ..... m.~.S .. ~~.\L ......... Title: ..... D.~~.f#:.C. ........................ :... Phone No: .... 5~ .......... : ......... .
Mailing Addre_ss: ....... S.J.~ ...... Jk~\h ..... ~.1" .............................................. G.~.r::J.~~-~ ... , ..... N..~ ............................... ~~-~.~.L ..
Oosite Representative: ... ~---&~................................. Integrator: ...... P..r.~d~.~ ........................ _, ............. ..
Certified Operator~ .. ---~-~~ ... ?~ ..... r.?1 .. ~.C.J.~.JJ.. ... _ .. ,.,............................ Operator Certification Nomber: .... J..7.r..~., ............... .
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Di scharge originateu at: 0 Lagoon 0 Spmy Field 0 Other
a. If di sc harge is observed, wa<> the conveyance man-made?
b. If di~chargc is observed. did it reach Surface Water? (If yes. notify DWQ)
c. If discharge is obserwd, what is the estimated flow in gnUmin?
·d . Does di scharge bypa ss a log oon system '! (If yes. notify DWQ)
3. Is there evidence of past disc harge from any ·part of the operation?
4 . Were there any adverse impacts to the waters of the State other than from a di scharge?
5. Does any part of the waste management system (other than lagoo ns/holding ponds) require
maintenanc e/improvement?
6. Is facility not in compliance with any applicab le setback criteria in effect at the time of design '!
7. Did the facilit y fail to hav e a certified operator in re sponsib le charge?
7/25/97
DYes p{No
DYes ~0
DYes 0No
DYes 0No
DYes 0No
DYes ~0
DYes ~0
DYes ~0
DYes~o
DYes ~
Continued on back
jFacility Number: 15'Z. -~?71
8 . Are there lagoons or storage ponds on.sitc which need to be properly closed?
Structures (Lagoons.Holding Pnnds, Flush J'its, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Identifier:
Structure l
s'
Structure 2 Structure 3 Structure 4 Structure 5
DYesXNo
DYes~o
Structure 6
Freeboard (ft): oou•u•••••••·••••••-•••••-••••••• '''"''''"'''' ••••• ooooooooo••••••••• ••••••••••·•••••....,.•• oooooooo0000,.., 0 ._00,,0000....,,,,,,,,,,,,,,, .. ,.,,,, •••-••••ouoouo•-•-••••••••••••• •••••n••••><•••••••••-••••'000000000
10. Is seepage observed from any of the structures?
II. Is erosion, or any other threats to the integrity of any of the structures observed?
12 . Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public heaHh or em·ironmental threat, notify DWQ)
13 . Do any of the structures lack adequate minimum or maximum liquid level markers?
DYes }(No
DYes ~o
DYesko
DYes ~o
Waste Application
14. Is there physical evidence of over application? 0 Yes ~o
ts. c::~;·"_~:.~&_::j_:~~:;.~~r:::=e.;;~:h~t-/5.Q,t_&-.-L .-··-----·· -·
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (A WMP)? 0 Yes~
17. Does· the facility have a lack of adequate acreage for land application? D Yes ~o
18. Does the receiving crop need improvement? DYes ~o
19. Is there a lack of available waste application equipment? DYes ~o
20. Does facility require a follow-up visit by same agency? DYes~
21. Did Reviewer/Inspector fail to discuss review/inspection wi~h on-site representative? DYe~ ~o
22. Does record keeping need improvement?
For Certified or Pennitted Facilities Only
23 . Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cau se noncompliance of the Certified A WMP?
25 . Were any additional problems noted which. cau se nonc ompliance of the Permit?
. : ~~ :~i~l.ations ~o~ .defiCiencies . ~·~re · noted·. dufin~ o~is : visit · You ·will ~e.i~e : ~o·fUrt~-:r :::
:->correspondence aboiltthis·. visit-:-:<·> . . . . . : · · · · : . : .....
DYes *o
DYes JaiNo
DYes *o
DYes ~o
7/25/97
Date: .j/J--./1{ 17