770012_Inspection_20190226

Type of Visit: 0 Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ; op& Departure Time: :; p County: ktIeS*j Region:
Farm Name: �w'` I1 �'� fz r�M Owner Email:
Owner Name: ) 'T tc C'Si t 5 Phone:
Mailing Address:
Physical Address:
Facility Contact: �1 "i Q •ua- Title:
Onsite Representative: l
Certified Operator: 1(
Back-up Operator:
Location of Farm:
Latitude:
Phone: J
Integrator: Al cy, l c-1 u s
Certification Number:
Certification Number:
Longitude:
Design ,Current
:Design ` `Current . • •- Design, • Current ,
Swme Capacity ',Pop,"' s
Wet Poultry," .°$.
Capacity :1'gp. ' ' Cattle � Capacity ` .Pop...
Wean to Finish
_
Layer-;�;
Dairy Cow"
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish
d
Dairy Heifer
Farrow to Wean
, -„ _
j I-ed
Design .Current �'
D Cow
Farrow to Feeder
Dry Poultry,
' .; ,Ca acity . Po
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
r
eef Brood Cow
Turkeys
Other:
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[r 6 ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[],-NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
Q'1 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
ff NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
E]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 21412015 Continued

Date of Visit: Arrival Time: Departure Time: i County:
Farm Name: ✓ � � Owner Email:
r �� �
Owner Name: w uJ Phone:
Mailing Address:
Physical Address:
Facility Contact: GCS Title:
Onsite Representative: i.
Certified Operator: 'r`t'/'e`z-,
Back-up Operator:
Location of Farm:
�I
Swine
�,
Latitude:
Current „p
y P;op met Poultry'
Wean to Finish _
F
Wean to Feeder
Feeder to Finish
V
x
Farrow to Wean
Farrow to Feeder
lit
Farrow to Finish
Gilts
Boars
Other _
Phone:
Region:
Integrator: &o0V-e'W Number: /t/)t' � L53
Certification Number:
Curis;"ent
Pop {
Non -Layer
. �Des�gn�' Cur,�ent
Dry Poultryf ;Ca ac ly PO ,,,-
Layers
Non -Layers
1
Pullets
Turkeys
Turkey Poults
Other
k
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)
Longitude:
Dairy Cow
Dairy Calf
s
Dairy Heifer
i
Dry Cow
Non -Dairy
Beef Stocker
;
`
Beef Feeder
Beef Brood Cow
❑ Yes Quo ❑ NA ❑ NE
❑ Yes
❑ No
❑"NA
❑ NE
❑ Yes
❑ No
El"NA
❑ 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 [2"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 21412015 Continued

DkWk7 'L: D r_V'
Division of Water Resources
Facility Number � - L� 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: ,0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other ``0 Denied Access
,
Date of Visit: , Arrival Time: /y ; Departure Time: s C, County: ,6 7tJ Region: !`
Farm Name: ' l �v`' /1 t' I� Yoh Owner Email:
Owner Name: �j G �[� C"a t q Phone:
Mailing Address:
Physical Address:
Facility Contact:�� {. Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Latitude:
Phone:
Integrator: Al 6_ PC'y%U tS
Certification Number: ! / /-, r
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Dry Poultry Capacity POD.
Layers
Non -Layers
Pullets
Turkeys
Turkey Pouets
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?
Longitude:
Design Current
Cattle . Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes �o ❑ NA ❑ NE
❑ Yes ❑ No D-NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
LTNA
❑ 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
dNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[D No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[—]Yes
[:I No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued