820692_Inspection_20181211

sioof Wate aReso ees
"��Fac�tyNumlier a � �"� �� a4 ®ivis'on o SoiI and Water Conservatio
Cype of Visit: (D-C-Ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
2eason for Visit: . tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: r4,Sj 9 17County: 'L Region:%
Farm Name: R 1 Q Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Title:
Onsite Representative:
Certified Operator: 0 k9 ' �1
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number: �O
Certification Number:
Longitude:
',A
.;, ..
�. -. e ! >• __..T.441 Y.4*r
' Curzent�
Design. Current
Design; oFurxentDesign
�e `e
Swine Capacity Pop
t h a th, r r ''
Wet Eoultt� capacity," Pop t. Cattle y apacity 'Pop
�p
r ; t
Layer
il ;`;
t
Non -Layer
:-?._
F t
:,Desigm tCurzent
'
Diy Poltryr °Ca achy �Po
i;
Layers
Non -Layers;
Pullets
�+ A_ 1 .F
( ,f r' �. �"MC` Y :"%eSWat+ 1t ➢ .rj!' q A. b4
Turkeys s , u=� •s ,.= -�.d s ,
Turkey Poults
Other
Other,
Wean to Finish
Wean to Feeder
pd
�10
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
�
r
Dairy Cow
Dairy Calf
[
1
Dairy Heifer
Dry Cow
f
Non airy
Beef Stocker
Beef Feeder
`
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
�,_��
Lam° ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[? A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
U N* 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
[3-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 2/4/2015 Continued

Facility Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Z X6—❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? _ ❑ Yes ❑ No ®-N:Oc ❑ 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 to the integrity of any of the structures observed? ❑ Yes EINfo ❑ 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 �o ❑ 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 �g o ❑ NA ❑ NE
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 ❑'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
12. Crop Type(s): v G�
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes E] l o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes E` No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ® o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�o
❑ 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 of Coverage & Permit readily available?
❑ Yes
[!:�No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[—]Yes
[No
❑ 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
E]No
❑ 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
d o
❑ 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: - Date of Inspection: A
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑'l�7o
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Q No
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
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Q o
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?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes 0 ❑ NA ❑ NE
❑ Yes ffNo ❑ NA ❑ NE
El Yes
QNo
❑NA
❑NE
❑ Yes
2-No
❑ NA
❑ NE
❑ Yes
❑/ &
❑ NA
❑ NE
Comments (refer'to 'question'#):i Explain any YES answers aria/or any additionali recommendations or' any other' comments
Use drawings.offacihty,fo better ex _lain ituations;additiogaT,-a es.as.necessar
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone: (� -I0 ` [�
Date:(i .0
21412015