620004_Inspection_20200218

QW
rvision ofWater Resources �� e �
jlu Z 4.0
� - U and WFcility Number ater Conservation
0. Other Ageacy,
Type of Visit: Q<ompliance Inspection 0 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: f' r- Arrival Time: t�1� Departure Time: county: ��G' Region:
Farm Name: '� Ot t� y�44 i`-5`' '�—k dj �j f %— Owner Email:
Owner Name: `� E' { �� f /� l�C Phone:
��( Mailing Address: S � �� � �,•ti-� (� 1: Y 12_�73 7
Physical Address:
Facility. Contact: Title: Phone:
Onsite Representative: Integrator _•9/� ( ����� `�
Certified Operator: ( / Certification Number: C(
Back-up Operator: ! Certification Number:
Location of Farm: Latitude: Longitude:
ti 0 Ld - r C, , tv,� Z,
Design
Currenf
Design
Current
:;,Design Current .
Swme -
_Capacity
t'op''
Wet Poultry
Capacity
_
Pop.: "
Cattle Capacttys Pop.
E
Wean to Finish
_
ayer
DairyCow
Wean to Feeder
;,z
E[NNon-Layer
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dry Poultry'- .
Capacity
Po I P.°
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
-
Turke Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of thb operation?
❑ Yes
0-No—
❑ 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
[3'T1A
❑ 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
❑-lo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
®'%10
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3
21412015 Continued

Facility Number: - Date of Inspection:
Zp
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
M-Na-
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard? _
❑ Yes
❑ No
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
d
Observed Freeboard (in): 2�i 1-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[ 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
�
❑ 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
�❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E9 1qo
❑ 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
Eq-a `o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
©,Xo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Q--N"o ❑ 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): r—tS /--L, s✓ / k
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ®No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes LS No ❑ 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 L No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes EDNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ©,N—o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [:]Yes © ❑ 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 U-i,4a ❑ 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 10 ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: 6 • - LT Date of Inspection: •1 O P�k: -2v 23
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes 0-No�
❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
t. 'es ❑ 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: , �c
A::CyY� (,t eG'
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 o
❑ 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 -tip visit by the same agency?
❑ Yes ❑"No ❑ NA ❑ NE
❑ Yes [Z/No ❑ NA ❑ NE
[:]Yes �No ❑ NA ❑ NE
❑ Yes ✓f No ❑ NA ❑ NE
❑ Yes [j No
❑ Yes 9No
❑ Yes No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
ate(( 3o, . � ss (
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: t10` U )—S.
} I Date:
t�
21412015