310259_Inspection_20191105

QF Division of Water Resources
Facility Number � -� 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: • Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Timee� Departure Time: County:
Ferro Name: �O P1 j `(�aY tM S Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative:" CDS r^ Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to
to
I I Farrow to Feeder I I I
n Farrow to Finish
Other
Other
Latitude:
Region:
Phone: 110 7_016-72 ( 0
Certification Number:
Certification Number:
Design Current
Wet Poultry Capacity Pop.
!Mayer
Non -La er
Design Current
Dischar¢es and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Stmcture ❑ 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)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[—]Yes lQ `o d NA ❑ NE
❑ Yes [—]No N ❑ NE
❑Yes ❑No+r ❑NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ N M NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters []Yes I �J 1Vo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2015 Continued

Facili Number: Date of inspection: l
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 Q NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: J 2
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
1AIS
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?
Structure 5 Structure 6
❑ Yes [2 o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ 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? ❑ Yes 0 o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes NO ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes I_ 1"No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes ONo
❑ 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 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 c
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes j I N
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes V
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes [TI o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes [%o
❑ 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 E NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑Stocking []Crop Yield ❑ 120 Minute Inspections El Monthly and V Rainfall Inspections
El Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[] No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA 3 N
Page 2 of 3
21412015 Continued

Facili Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ®No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [:]Yes No ❑ ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [:]No ICJ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes &No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
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 2'h'Io ❑ NA ❑ NE
❑ Yes EKo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA D NE
[:]Yes
ff No
❑ NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facilitv to better explain situations (use additional pages as necessary).
1 doj
W'C,V - ru l C�' I A-6 11 M e �.
ar-c_
Reviewer/InspectorName: W p Phone: Gill 1
Reviewer/Inspector Signature: Date: ` I
Page 3 of 3 2141 015