430013_Inspection_20190913

"
.. ivisibn of Water Resources
Facility Number , 0 Division of Soil and Water —Cons,
®" -� "
0 Other Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
treason for Visit: Oliomp�utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: y d Departure Time: County:
Farm Name: �al/ rO� ((5 `� Db Z Owner Email:
Owner Name: -T-1 —A ty "4,tb lG CD✓` Phone:
Mailing Address:
Physical Address:
Facility Contact: ( A brie IjLJ �� Title:
Onsite Representative: ((
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
fA Wot 61i�:(�F z :�f oo&, 66e rccnk
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
�� KC Regionf��__
Phone:
Integrator: S
Certification Number:
Certification Number:
Longitude:
sign" Current Design Current "' Design . Current,
deity Pop. "' WetPoultry :: 'Capacity' Pop.''-,-, `_: .,,Cattle Capacity w Pop
.. Layer
Non -Layer
Design Current } .,
Dry Poultry Capacity a. = Pop'.'
Farrow to Finish
Gilts
Boars
-Other
Other
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)?
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 210 ❑ NA ❑ NE
❑ Yes
❑ No
�NA
❑ NE
❑ Yes
❑ No
-&A
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
[—]No
Y NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[�rNo
❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes ff�No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

n
Facility Number: jDate of Inspection:
2,4. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[q.Wl'
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
to
❑ 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
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
En- o
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
E117-o
❑ NA ❑ NE
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?
❑ Yes
ETNU-
❑ NA ❑ NE
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
❑ Yes
ET l�o
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EJ-No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑Yes
[N0
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
FJONo
❑ NA ❑ NE
(T4
Reviewer/Inspector Name: 1 \ CA Eof ® Phone:
Reviewer/Inspector Signature: � � Date:
/ l
Page 3 of 3 2/4/201

1 lM5' 101-
ivision of Water Resources
Facility Number 0 Division of Soil and Water Conservation '
`L/ 0 Other Agency
Type of Visit: Com ance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ff. I UY ILIArrival Time: `7 Departure Time: County:
Farm Name: % {,1 0�j Owner Email:
Owner Name: c.'/"' 0,6
® Phone:
Mailing Address:
Physical Address:
C
Facility Contact: K1 Title:
Onsite Representative:
Certified Operator: 1t V �4
Back-up Operator:
Location of Farm:
Latitude:
S� Region:7�
Phone:
Integrator: vA
Certification Number: / 04 C
Certification Number:
Longitude:
Design Current Design Current y ,Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle -,Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish op a
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Layer
Non -Layer
Design Current
Dry Poultry Canaeity 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)?
Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
I
Beef
Beef Brood Cow
❑Yes ❑N—oo ❑NA ❑NE
❑ Yes ❑ No
[:]Yes ❑ No
E'NA ❑ NE
Z-NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No [K NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [5No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes g�rNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued