430001_Inspection_20190903 (3)

• 1vision of Water"Resources .
Facility Number 3 0 Division of Soil and Water Conner`vahoxt
�`. n
0 Other'Agency
Type of Visit: (.enmpliance 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: " Arrival Time: /Qt.15 Departure Time: I //I,flg ounty:
Farm Name: K� •��.�''�. Owner Email:
Owner Name:Phone:
Mailing Address:
Physical Address:
Facility Contact: K"� Y-C," Title:
Onsite Representative:
Certified Operator:
Back-up Operator: .
Location of Farm:
Latitude:
Awle- f� Region: 5%
Phone:
Integrator: %&tsee,.p
Certification Number: pL , L 3
Certification Number:
Longitude:
.Design
Current,
Design Current' ';
Design • Current`
Swine ., Capacity
, Pop.
Wet Poultry Capacity_,' Pop. '
Cattle,-,,, rapacity • Pap.
Wean to Finish
Wean to Feeder
(S
I4(4v
Feeder to Finish
Z Q
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
-''Other
Other
Layer Dairy Cow
Non -Layer DairyCalf
Dairy Heifer
,Design ;'Cur'tentDry Cow
'06 PoultryCa ac ty.' : Po .. Non -Dairy
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:
Beef Stocker
Beef Feeder
Beef Brood Cow.
❑ Yes ®-N@-- ] NA ❑ NE
a. Was the conveyance man-made?
❑ Yes
❑ No
�
❑ NE
b.. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
[r
❑ 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
[ AA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
2--No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
o
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facilrity Number: - Date of Inspection je-
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 Ejj�
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E?LNc— ❑ 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 cJ > ❑ 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
[]-No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
FL-4-5-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
p No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
� ❑ 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 r3 sc— G Q
13. Soil Type(s): & No
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ®'<o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [ N' o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [TNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�No
❑ NA
❑ NE
Reciuired Records & Documents
19. Did the facility fail have Certificate Coverage &
�No
to the of Permit readily available?
❑ Yes
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
u lvo
❑ 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 ❑moo
❑ 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes E3 No
[—]Yes F-K0
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412015 Continued

FaciY,ty Number: 49 - Date of Inspection: St:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No ❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[] c ❑ 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
E5< ❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
D<O ❑ 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 No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes 2<o ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes �fNNo
❑ NA ❑ NE
Comments (refer to question #): E:rplain any YES answers and/or any additional recommendations of any other comments.
Use drawings of facility`to better explain situations (use additional pages as necessary).
C"a gf0-30g'6$5(
'
Reviewer/Inspector Name: �I ``
Reviewer/Inspector Signature:
Page 3 of 3
Phone:[phone]
Date: 3 SC I q
21412015