820009_Inspection_20190812

FaciilityNumher ,9 ? - dg
7Division of Water Resources
Division of Soil and Water Conservation'
-ther Agency = -
of Visit: Compl�pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
in for Visit: G-f outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: G� /z-:. ('! uu.o, �t,, r"i rl2 �tOwner Email:
Owner Name: r'y �.5 rj,y�,- ,�yyty ��e, Phone:
Mailing Address:
Physical Address:
Facility Contact:Title: �4/5z�.
Onsite Representative: s�
Certified Operator: J.�x; p�,�,'�
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean p
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator:
Certification Number: `;Z/_7Gj,If
Certification Number:
Design Current
Wet Poultry Capacity `'Pop.
Layer
Non -Layer
Design Current
Dry Poultry Capacity Po
Layers
Non -Layer;
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 ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑NA ❑NE
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 N ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes Q'No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: - Date of Inspection:
—
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): _3 b
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
RrNo
❑ 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
E 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
�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
Q No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
EfrNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
ffNo
❑ 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
f
12. Crop TYpe(s):
13. Soil Type(s): lKae'
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
2�/No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
ENo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�o
❑ NA
❑ NE
18. Is there a lack"of properly operating waste application equipment?
❑ Yes
Q-lo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
2<0
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
21�0
❑ 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 E No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard. ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [a No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - ® Date of Inspection:
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 [] 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 LQ 1V o
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [j] N
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?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes �o ❑ NA ❑ NE
❑ Yes ❑moo ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes [3'No
❑ Yes PNo
❑ Yes e'No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
lComm6nts. (refer to question # ): Explain any YES answers.and/or any additional recommendations or any other comments.,
Use,drawings of facil ty`to better ;explain situations (use additional paces as necessarv). "
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Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
Phone: �/0
Date: 9—/�z
21412015