040009_Inspection_20191014

v
Date of Visit: Arrival Time: Departure Time: 7 ounty: �a
Farm Name: a, C-t 9V Z Owner Email:
Owner Name: �/�„ c Z_ 0,0 ` ` �.6 c� � Phone:
Mailing Address:
Physical Address:
Facility Contact: Y"tV(C Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Region:
Phone:
Integrator:
Certification Number: �� S 67
Certification Number:
Longitude:
mov-2,220 'A
NONE n € ire gn
Current - D,,,esign
Curren
E,� Design Cu rent `_
Swans_Capacaty
Pop W_et Poultry Capacity
Pop':
Cattle Capacrty Pop —
Wean to Finish
_
Layer
Wean to Feeder S3
Sbd
Non -Layer
Feeder to Finish
=
_ ,4
Farrow to Wean
=
,esa n
Current:
Farrow to Feeder
'I? 1'ouitaryCa aci
"
POy
Farrow to Finishin
'
Gilts
Boars
R Other
Vm
La ers
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
�NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
ff NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑-lA
❑ 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
eNo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3
21412015 Continued

Facility Number: 44- Date of Inspection: 6
`.Haste Collection & Treatment �
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Q'IVo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No FLKA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): I--5
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
2-T o
❑ 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
Q'�o
❑ 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
t-Ko
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
EiKo
❑ 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
Eil-53
❑ 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 To ❑ 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): c IS P ,5-% 0
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
g�
❑ 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
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[t]'1(1O
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
©-TTo
❑ 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
❑ YesF3-_N__o
❑ 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 �o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste 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 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ONo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection: DL
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Rgo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [ o
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 <o
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [.M-
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?
q (C'J' Sw� - �--ZO
y
O A 5® -2-2.
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ Yes to ❑ NA ❑ NE
[:]Yes C N ❑ NA ❑ NE
❑ Yes g-503 ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
[:]Yes 1V U
❑ Yes �lo
❑ Yes LJ ' o
m°ns oraniy other
F-. 3.6 8
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Name: t `1 r� .T Phone2� �1,3�-' M 3
Reviewer/Inspector Signature: _ Date: I q D
Page 3 of 3 21412015