820401_Inspection_20191210

'-W, 174 f '7
Division of Water Resources
Facility plumber � - L��� 0 Division of Soil and Water Conservation
0 0ther Agency
Type of Visit: ® 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: /® Arrival Time: i Departure Time: County: cSqkt�,! jt Region:
`3 � A$ Owner Email:
Farm Name: G45 —�
Owner Name: 131 a �- K° �, Ltc Phone:
Mailing Address:
Physical Address:
Facility Contact: cc,1 l 0®Y'i° Title:
Onsite Representative: 6y'rtet- ,A?w.ne ®o
Certified Operator: V c _4 �!Al Moo r'lle-
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
2 4CD
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator: 5M;- i't a qz
Certification Number: ayDO
Certification Number:
Design Current
Wet Poultry Capacity Pop.
l
ayeron-Layer I I :::]
'Design' Current
Dry Pnultry C'anacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
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)?
Longitude:
Design Current
Cattle Capacity , Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes
No
r
❑ NA
❑ NE
❑ Yes
❑ No
Ep NA
❑ NE
❑ Yes
❑ No
[� NA
❑ NE
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 ❑ No NA ❑ NE
❑ Yes o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facility Number: p - iI Date of Inspection: O
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
P NA
0 NE
Structure 1 Structur 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
N
Designed Freeboard (in):
Q
Observed Freeboard (in): / ti 2 q "
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
FA No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
M 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
M No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
EP 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
E4No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
V9 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Y I 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 CropWindow❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): i !A/h d 1 San, m s
13. Soil Type(s): Lll il
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
V] No
❑ NA
❑ NE
❑ Yes
�p No
❑ NA
❑ NE
❑ Yes
� No
❑ NA
❑ NE
❑Yes
MNo
❑NA
❑NE
❑ Yes
M No
❑ NA
❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes ER No ❑ NA ❑ NE
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes `r No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes � No,
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: -X - Date of Inspection: p
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 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 J� 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?
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ Yes `� No ❑ NA ❑ NE
❑ Yes FltA
C No ❑ NA ❑ NE
❑ Yes N No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes No
❑ Yes [� No
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Name: Ma-Y-101-P Phone: Clio - - 33vo
Reviewer/Inspector Signature: e le Date: I /D i 9
Page 3 of 3 21412015