310310_Inspection_20191031

Division of Water Resources
Facility Number E3_1 - 1 9 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: (ID Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: C Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival
Time: Departure Time: County:
Farm Name: COIJ4_ P"t+, Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: a i glul hf /6 CA C I - Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to
to
Other
Other
Latitude:
Phone:
Certification Number:
Certification Number:
Design Current
Wet Poultry Capacity Pop.
La er
Non -La er
Design Current
Longitude:
Region:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
DairyHeifer
D Cow
Non -Dairy
Beef Stocker
Beef Feeder
Bcc eRrooa C(m
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[—]Yes
No
NA
NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[:]Yes
No
A
NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
[:]No
L3 rvA
NE
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)
[:]Yes
❑ No
CIONA
NE
2. Is there evidence of a past discharge from any part of the operation? Yes [21No NA NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes �o NA NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: -310 Date of Inspection: i
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
No ❑ NE
❑ NoVNA ❑ NE
Structure 3 Structure 4 Structure 5 Structure 6
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?
❑ Yes No ❑ 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 hrea4 notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes Lff 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 ❑ Yes U 1V o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes o ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes C240 ❑ 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?
❑ Ye o ❑ 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 FEK0 ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes to ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes [ Io ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑Yes o ❑ NA
L�'�
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check th propriate box below. es ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard aste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Q N ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA
Page 2 of 21412015 Continued

Facility Number: Date of Inspection: t77 1
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes D-Ko ❑ NA ❑ N,$
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 Q-No ❑ NA E] NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No D-N-A ❑ NE
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 [�<o ❑ NA ❑ NE
❑ Yes E3<0 ❑ NA ❑ NE
[—]Yes
Io
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA Di
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
,�No
[,—
❑ NA
❑ NE
❑ Yes
U"°
❑ NA
❑ NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional pages as necessary).
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Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ci\O%cib?'l
Date: 10 31 I � q
21412015