310536_Inspection_20190820

Division of Water Resources
Facility Number ®- ' (o 0 Division of Soil and Water Conservation
0 Other Agency
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
Date of Visit: l Arrival Time:
(D+eparture Time: County: Region:
Farm Name: We r7 j"1 mat YvtW O'O� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: t -� ,,, ,o ► t Title:
OnsiteRepresentative: -- y
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to I
Wean to I
Feederto
Farrow to
Farrow to
Farrow to
Gilts
Boars
Other
Other
Latitude:
Phone: �) 1 U ZSel 14 Z
Integrator:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
NNon--
La er
Design Current
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Co"
Dairy Calf
Dairy Heifer
Dry Caw
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 4 No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
[:]Yes ❑ No
❑ Yes No
❑ Yes No
NA ❑ NE
NA ❑ NE
NA ❑ NE
NA ❑ NE
NA ❑ NE
Page I of 3 21412015 Continued

Facility Number: 6- Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 5 NA ❑ NE
Structure 1 Structure 2
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 3 Structure 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Structure 5 Structure 6
❑ Yes V No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
9
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
�No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�10
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
�No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
❑ NA
4 NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
[;aNE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
'❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
YNE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
FYNE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
❑ NA
�NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ������"```�NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need ' oveme . If yes, eck the appropriate box below. 91Xes [:]No ❑ NA NE
❑ Waste Application 6Zekly Freebo ❑ Waste Analysis ❑ Soil Analysis EJWaste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking d ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Surve
22. Did the facility fail to install and maintain a rain gauge? [:]Yes [:]No ❑ NA Z NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA �NE
Page 2 of 3 21412015 Continued

FacW Number: Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [ No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA C)4NE
❑ NA '�LNE
❑ NA ❑ NE
❑ NA NE
❑ Yes ❑ No ❑ NA P NE
[:]Yes [:]No ❑ NA MNE
[:]Yes ❑ No ❑ NA rMNE
6r
❑ Yes ❑ No ❑ NA NE
❑ Yes ❑ No ❑ NA NE
❑ Yes ❑ No ❑ NA NE
❑ Yes ❑ No ❑ NA NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
r2�hcc.r� o"Q tl
G` h�j Nvc JGu C,�eck< 1 r (,,t-D
Reviewer/Inspector Name:
Reviewer/Inspector Signatm
Page 3 of 3
Phone: { 101 1b�2
Date:
21JI2015