820601_Inspection_20190514

V S 1 0 1 V� 5
Division of Water Resources
Facility Number -] O Division of Soil and Water Conservation
`'. O Other Agency
Type of Visit: ompl ance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: CYRoutine O Complaint O Follow-up O Referral O. Emergency O Other O Denied Access
Date of Visit: %' Arrival Time: (. Departure Time: County: Region:C
Farm Name: .2
h l �� C Owner Email:
1
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Q__t" Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
8
�(
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Discharees and Stream Impacts
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Design Current
Wet Poultry . Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Longitude:
Design Current
Cattle Capacity Pop.
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 0,,6qO ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No E] NA ❑ 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 ETNo ❑ 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

Facility tNumber: Lo, c jDate of Inspection: /Lf1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
E N� NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No 23-N"�
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats totheintegrity of any of the structures observed?
❑ Yes
d]-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
D ND—❑ 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
ONE
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
No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
to ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
Q'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):
13. Soil Type(s): Me
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Ej-lvo-^ ❑ NA
q_
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ o ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[&-NV_'M NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
moo' D NA
�
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate Coverage & Permit
of readily available?
❑ Yes
No DNA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
['5'�^ ❑ 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 D-Nlo— ❑ 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
❑/ ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: M, - 3i>I Date of inspection:,-c:
JI
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes rEj-N'P ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ 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 Q o ❑ 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 [ —D NA ❑ NE
❑ Yes L]go ❑ NA ❑ NE
❑ Yes ❑ I o ❑ NA ❑ NE
[—]Yes Q Imo ^ ❑ NA ❑ NE
[—]Yes
�N o
❑ NA
❑ NE
❑ Yes
To
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Comments"(refer to question ft Explaui any•YES answers and/or any additional reeommendations or any other comments.
Use drawings' of facility -to better explain situations (use additionaLpages as necessary):
-V s
Reviewer/Inspector Name:
Reviewer/Inspector Signatw
Page 3 of 3
Phone: ', •- j 3 ,3
Date: k & I y
21412015