820442_Inspection_20190304

W%1.\j✓ I "-- 1`
;'Facility Nu�u
Type of Visit:
ompliance Inspection 7
Operation Review 0 Structure Evaluation
0 Technical Assistance
(Reason for Visit:
outine 0 Complaint
0 Follow-up 0 Referral 0 Emergency
0 Other 0 Denied Access
Date of Visit: Arrival Time: —Departure Time: County:
Farm Name:—pt,,t vo1 /o L> Owner Email:
Owner Name: wk-yr W yl - Phone:
Mailing Address:
Physical Address:
Facility Contact: i �D r f U Title:
Onsite Representative: a(
Lf�
Certified Operator: c' GZ� 1'�� `� FV- Z
Back-up Operator:
Location of Farm:
Latitude:
Region:
Phone:
Integrator: grg•+4 6,6�9
Certification Number: /coz- t `y
Certification Number:
Longitude:
Design Current Desi n Current �; R DesignCurrent
Swine
Capacity= Pop
Wet Poultry
w
Capacity Pop
Cattle Capacity Popp
-.
Layer
Non -Layer
i`
?Design ;Current
`DzY$Ptoultry'Ca
achy 1'oLL`
z
O�th`ex
`
y
Other
4
s
Wean to Finish_
Wean to Feeder
#
Feeder to Finish
i
Farrow to Wean
Farrow to Feeder
�
Farrow to Finish
4
Gilts
Boars
i
Layers
Non -Layers
Pullets
�
Turlceys
�
Turkey Pouets
i
Other
f
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)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Dairy Cow
�
Dairy Calf
�
Dairy Heifer
Dry Cow
4
Non -Dairy
�
Beef Stocker
Beef Feeder
Beef Brood Cow
�
❑ Yes ❑�❑ NA ❑ NE
❑ Yes
❑ No
❑�NA
❑ NE
❑ Yes
[]No
" NA
❑ NE
❑ Yes ❑ No Qk� ❑ NE
❑ Yes 4—Nb ❑ NA ❑ NE
❑ Yes 1�rNo ❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facility Number: - Date of Inspection: t
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Identifier:
LSJ-�'QO ❑ NA ❑ NE
❑ No M-NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes ED>M ❑ NA ❑ NE
❑ Yes E No ❑ NA ❑ NE
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
1�3�o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
D c
❑ 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
❑�vo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
0 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes © No ❑ NA
❑ 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 Yk� T e(s):��
13. Soil Type(s):
14. Do the receiving crops differ
&Q PC
those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reouired Records & Documents
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ,No ❑ NA ❑ NE
❑ Yes [ N ❑ NA ❑ NE
❑ Yes Ei-No ❑ NA ❑ NE
❑ Yes [1No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Q o
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Q N
❑ 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
®�lo
❑ 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
eNo
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes eNo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ®moo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑moo ❑ 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 'No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [31No ❑ 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 U�No
[:]Yes L No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ©4o_ ❑ NA ❑ NE
❑Yes [ENo ❑NA ❑NE
❑ Yes Er�o ❑ NA ❑ NE
❑ Yes BNo ❑ NA ❑ NE
❑ Yes ]�No ❑ NA ❑ NE
Comments`(refer,'to gp:est�on #)clExpiain'tanyYnadditinalcentther.commens omons or'an o
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Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
Phone:10 49 3 - M I
Date: '144
21412015