820015_Inspection_20181211

Type of Visit:m fiance Inspection Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: / rG Arrival Time: CI U Departure Time: County:
Farm Name: '►�4 /y Owner Email:
Owner Name: j/ Phone:
Mailing Address:
Physical Address:
Facility Contact: � I Title:
Onsite Representative: kt j ,I"
Certified Operator:
T
Back-up Operator:
Location of Farm:
Latitude:
Regional
Phone:
Integrator: -i,--� i e�d
Certification Number: Ff s%� 0 '
Certification Number:
Longitude:
Desi`QQn Current
+"e
Design Current
r
Swine Capacity P,o
�Curre�bDesign
s
.,>r .�L +h. AS 1-+...a-c'h• k t! -i
Wet#Poultry `apacity; P Cattle ;��}`apacity Pop r
p _
y _
Layer
Dairy Cow t 'f
`'
Non Layer
n Dairy Calf
Dairy Heifer
?�
De`slgni ,Cur> ent D Cow '
"
_Diyou_lt_ry'-;Ca
: acity��P`o Non -Dairy '
Layers;
—� {
Beef Stocker
i
Non -Layers..
j ; - Beef Feeder
-
Pullets
�- ` Beef Brood Cow
r
Turkeys:
�: s
Other
Turkey Puuets
Y
Other
Other
1 -
-
• Wean
Finish
WFeeder B D t
Feeder to Finish
Farrow to Wean ,
Farrow to Feeder
a Farrow to Finish �
Gilts
� Boars '
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[Pd� NA
❑ NE
Discharge originated at, ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
EJ-NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
[]Yes
❑ No
CNA
❑ 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
Q No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
E�N-
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: - Date of Inspection: y�
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
Structure 1 Structure 2 Structure 3
Identifier:
Q-N,D-- ❑ NA ❑ NE
❑ No [d ❑ NE
Structure 4 Structure 5 Structure 6
Spillway?:
Designed Freeboard (in): PT
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 �o ❑ NA ❑ NE
❑ Yes ®11fo ❑ 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 QNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes to [�] 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 &10---,-❑ 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 To ❑ 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): �� �
/
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
DIN-0❑
NA
❑ NE
IS. Does the receiving crop and/or land application site need improvement?
❑ Yes
To
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
0 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
eNo
❑ 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
E2rNc
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
�Z No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
N
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
VNo
❑ 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
EI�No
❑ 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: - Date of Inspection: ' QrG
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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?
D-No ❑ NA ❑ NE
(]' tgo ❑ NA ❑ NE
❑ Yes
g-N—o
❑ NA
❑ NE
❑ Yes
® to
❑ NA
❑ NE
❑ Yes
Q'110 ❑ NA
❑ NE
❑ Yes
®'No
❑ NA
❑ NE
❑ Yes EjNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
[—]Yes
[I�No
❑ NA
❑ NE
❑ Yes
❑/No
❑ NA
❑ NE
Comments (refer to question #) 'Explam¢anytYES answers�and/o`r any additionalrrecommendahons or and other, comments r
�Tse drawngsloirfacihty,.toJ.fbetter explain situahonsA(use addltionalipages;,as�t_rieeessary) �,_�,�,h=.� '4 � ,�*�N�. �-...�;
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone: 3YEN
Date:
21412015