820316_Inspection_20190124

Date of Visit: Arrival Time: /7 ' •) Departure Time: /.< j fj County: Region: ��
Farm Name: �/jr jam; J�-�,tJp✓��j� �y 15�er Email:
Owner Name:�,�y19� �ry��� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: -&V17 Phone:
Onsite Representative: �a� Integrator•
Certified Operator: �� _ Certification Number: _J� )
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Current
Swine -Capacity Pop.
_
Wet Poultry
Capacity
P®p. ,
Cattle° ti Capacity Pop.`
_
Wean to Finish
Layer
Dairy Cow
W an to Feeder
I
INon-Layer
Dairy Calf
eeder to Finish
Dairy Heifer
Farrow to Wean
_ ` Design
Current _
Dry Cow
Farrow to Feeder
`Di PoultryCa
aci
Po :
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
_
Turkeys
Ot'b�er .
Turkey Poults
Other
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)?
❑ Yes ❑ No ❑ NA Q 1QE
[:]Yes [:]No
❑ Yes [:]No
❑NA ❑NE
❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NEB
2. Is there evidence of a past discharge from any part of the operation? [:]Yes [—]No ❑ NA 0-1E
3. Were there any observable adverse impacts or potential adverse impacts to the waters 0 Yes ❑ No ❑ NA NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: - {' Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
IE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
Ej<E
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 to the integrity of any of the structures observed?
❑ Yes
❑ No
❑ NA
©-Iq-E--
(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
❑ No
❑ NA
ETNE
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
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NA
EK
(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
0-NTE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ 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
f❑
12. Crop TYPe(s)��
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
0 Yes
Ea<o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑-'g0
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[allo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E3-T o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate Coverage & Permit
of readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E]-<
❑ 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 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Ej<o ❑ 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 io ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Ej<o ❑ 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 ErNo ❑ 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 1`'o ❑ NA ❑ NE
❑ Yes [3-Ko ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
0 Yes Q-l<o ❑ NA ❑ NE
❑ Yes
[] N
❑ NA
❑ NE
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
io
❑ NA
❑ NE
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77
Reviewer/Inspector Name:
Reviewer/Inspector Signatut
Page 3 of 3
Phone: j
Date: Z �21� �97
21412015