310249_Compliance Evaluation Inspection_20191120

(Type of Visit: aC��ompliance Inspection O Operation Review O Structure Evaluation U Technical Assistance
Reason for Visit: Q),,/Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: (1- 11 Arrival Time: 0 Departure Time: dfl County: Region:
(< Farm Name: r 7 Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design
Current
Desig' 'n Current
Design Current
Swine
Capacity
. Pop,
Wet Poultry .
Opacity I'op
Caftle Capacity Pop.
Wean to Finish
ILa er
Dairy Cow
Wean to Feeder
Non -Layer
Dai Calf
Feeder to Finish
C1
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dr Poultr
Ca acif
Pp
Non-Dai ry
Farrow to Finish
Layers
;.
Beef Stocker
HBoars
Gilts
Non -Layers
Beef Feeder
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
01
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ 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
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
� No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
4 No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412014 Continued

Facility Number: - jDate of inspection: 8 -gyp ( '
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
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
T
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes
No
❑ 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
[� 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 strictures 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
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes
[21 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
[d No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
M No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[4 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
Zf No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
rV No
❑ NA
❑ 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 rulMonthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[0 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
[:]No
❑ NA
P NE
Page 2 of 3
21412014 Continued

Facili Number: - Date of Inspection: - 2'� -(
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes rV No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 10 No
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 to provide documentation of an actively certified operator in charge? ❑ Yes z 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?
jUse drawings of facility to better explain situations (use additional pages as necessary).
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Z,INA ❑ NE
❑ Yes [Z No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes [) No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA /0 NE
❑ Yes
Lid No
❑ NA
❑ NE
❑ Yes
LB No
❑ NA
❑ NE
❑ Yes
�9 No
❑ NA
❑ NE
ins or
lV 50o s << C0 4&'+ 4v co/lst-/�
�oj fUL / C" PLC v�
L r-�prav �� s s �vUr ov,\ Wf\Wail I
Reviewer/Inspector Name: / ' f
Reviewer/Inspector Signature: _!�%✓� �/ L
Page 3 of 3
Phone: llo -GO -g577
Date: H —eh "/ �
21412014