790003_Inspection_20190926

Type of Visit: I Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 74 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: V
Arrival Time: Departure Time: County: �t"�tegion:0'S� 0
Farm Name: I o p Imo, Owner Email:
Owner Name: '�Q,���( y�ij�.Q , Phone:
Mailing Address:
Physical Address:
Facility Contact: ���( Title:
Onsite Representative:
Certified Operator: A�lQ,�
Back-up Operator: I � 1 L12 / � , (I I S
Location of Farm:
Latitude:
LUMUls1A
Phone: -
Integrator:
Certification Number:
Certification Number:
Longitude:
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Wean to Fimsh
['� Layer
Dairy Cow
Wean to Feeder
Non -La er
Dairy CalfI
Feeder to Finish
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
I
i Gilts
Non -La ers jj`'
Beef Feeder
1, Boars
Pullets
Beef Brood Cow
���!l1il�'n�()
TurkeysWI
TurkeyPoults
Other
Other �t�
[SI IIE4Ii s. !1 i
i B 94 ItB 7571t 4d M= 914b
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes N No ❑ NA ❑ NE
[—]Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
C5No
❑ NA
❑ NE
❑ Yes
IN No
❑ NA
❑ NE
Page I of 3 21412015 Continued

Facility Number:--ICA Q jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 1!� No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: �ltex/ems
Spillway?: �� y
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
U (20'^d'`'`_n
❑ Yes No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.) c�< Gvv��(ZoeIS
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes Q� No ❑ NA
❑ NE
waste management or closure plan?
dYW
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
Yes ❑ No ❑ NA
❑ NE
8. Do *any of the structures lack adequate markers as required by the permit?
Yes ❑ No ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
El Yes � No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes No ❑ NA
❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window Evidence of Wind Drift ❑ Application Outside of Approved Area
`Ao-' c v�
12. Crop Type(s): � A"A , JSW oL+
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �] No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
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
r No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
" No
❑ NA
❑ NE
Reguired 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 El Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If-yF grGk@Q _"_e_appropriate ber hdow ❑ Yes No ❑ NA ❑ NE
] Waste Application Weekly Freeboard Waste Analysis �] Soil Analysis E3-wft�rsfers ItWeather Code
Rainfall Stocking' Crop Yield API 120 Minute Inspections [Monthly and 1" Rainfall Inspections Sludge Survey'�uf,
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 4 No ❑ NA ❑ 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

Facility Number: -
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
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.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
N No
❑ NA
❑ NE
❑ Yes
v No
❑ NA
❑ NE
❑ Yes
V No
❑ NA
❑ NE
❑ Yes �p No ❑ NA ❑ NE
❑ Yes ANo ❑ NA ❑ NE
❑ Yes No
❑ Yes [ANo
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
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Reviewer/Inspector
Reviewer/Inspector
Page 3 of 3
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Date: C1 1
21412015