820146_Inspection_20181211

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Type of Visit: o ance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: p Departure Time: L' County: Region: i
Farm Name: 2+ Lr� V`L ti'Lt Owner Email:
Owner Name: ( Ceti' ��ea�'C/ Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
P ✓I Title:
Certified Operator:
n
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: �'���-�.�%
Certification Number: � a ,� 73
Certification Number:
Longitude:
Y Design Current .Design Current Design C�urreni 5
_
Capacity
VS'et�Poul'try �apaciy Pop
Cattle ;dap aci op
ty
Swine Popes
>
_
Layer
Non Layer
r
;
=Design tCurnent%
Dry Poultry___. -,_,<Ca achy P'o
E
q
�y
x
`
Other
r ,
e
Wean to Finish
Wean to Feeder
Feeder to Finish
r
Farrow to Wean
L� �
� ;
Farrow to Feeder
`
Farrow to Finish
Gilts
Boars
Discharges and Stream Impacts
Layers
`
Non -Layers
Pullets
'
Turkeys
�
Turkey Poults
'
Other
�
Dairy Cow
Dairy Calf
�
Dairy Heifer
�
D Cow
Non -Dairy
t
Beef Stocker
i
Beef Feeder
�
Beef Brood Cow
E
1. Is any discharge observed from any part of the operation?
❑Yes
®�._ ❑ NA
❑ NE
Discharge originated at: ❑Structure ❑Application Field ❑Other:
a. Was the conveyance man-made?
❑Yes
❑ No
[c�A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑Yes
❑ No
�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
�A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑Yes
�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• - Date of Inspection: t
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [Z],Fu- ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [�-1 AA D NE
Structure 1 Structure 2 Structure 3
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [j�o ❑ 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 No ❑ 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 El"go- ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [-1� ❑ 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 g-IN ❑ 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 [j'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
��gqWindow ,Qom❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
AM
12. Crop Type(s): N
13. Soil Type(s): (��� �' 1L)al
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes to ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes FZ
N ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack, of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑ Checldists ❑ Design ❑ Maps ❑ Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below
❑ Yes No ❑ NA ❑ NE
❑ Yes E]"No ® NA ❑ NE
❑ Yes 2'1�o ❑ NA ❑ NE
❑ Yes 10 ❑ NA ❑ NE
❑ Other:
❑ 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 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E�FNo
�(o ❑ NA ❑ NE
23. If selected, did the facilityfail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: -14 k7 jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes .Eg-T�to ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [.No ❑ 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 �o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes E2-?16­ ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
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?
c�(-3�g-Gesl
Reviewer/Inspector Name: "
b
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes No ❑ NA 0 NE
❑ Yes To ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑-5o
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
Phone
Date:
21412015