470012_Inspection_20191120

tiko U 1 `C < %l',
i DIV1S1011of Water Resources__
- I+ac lity Number �-7� '0`D�vision of Sod and Water Conservatton �
3 l� LJ _
n0 Other Agency _
type of Visit: QXompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Zeason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: VW Arrival Time: 4 Departure Time: County: d( Region:Fr,
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: �-f �e Title:
Onsite Representative: A
Certified Operator: 1 (
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: e
Certification Number
Certification Number:
Longitude:
a
D"esign Current
Design
Current .s -
Design Current,
Swine'Capaetty
Pop
Wet i'oult ry
Capacity
,' Pop
Cattle Capacity
-
_r
Wean to Finish
Layer
Wean to Feeder
_
Non -La er
Feeder to Finish
Farrow to Wean
Design
Curreef
Farrow to Feeder
" Dr. Poult
Ca aei
PoP.
Farrow to Finish
Layers
Discharges and Stream Imuacts
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
1. Is any discharge observed from any part of the operation? ❑ Yes [cam--❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No [�Id'� ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No �A ❑ 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 �No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2015 Continued
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 �No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2015 Continued

Facility Number: Date of Inspection:NOV 1:7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [g'No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 2-15A� ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 7i
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �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 �io ❑ 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 [g-Ko ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes E� o ❑ 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 F_LNo ❑ 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 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): C R) 0 � c��w •S'('�
A 1
13. Soil Type(s): W ^- rn
Ir
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E3'1<lo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ff J' o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
ED-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
®`go
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
B o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Eg-156_
❑ 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 ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [dNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E:rNo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: jDate of Inspection: u
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
BTo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
L`J 1VO
❑ NA ❑ NE
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
E�J
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[]-No
❑ NA ❑ 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 E7rNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes LKo ❑ NA ❑ NE
❑ Yes Io ❑ NA ❑ NE
[]Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes rNo ❑ NA ❑ NE
Comments (refer.,to question #) Explain any YES answers and/or any additional recommendations 'or any other comments. _ Use drawings of facilitylo lietter explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phoned✓
Date: VV f ,
21412015