710002_Compliance Evaluation Inspection_20180531

Facility Number H-0 -
(0 Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency/
Type of V ISn: .Q'Compliance Inspection U Operation Review Q Structure E nation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral Emergency 0 Other 0 Denied Access
Date of Visit: 3 / Arrival Time: I} Departure Time:O County:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
OnsiteRepresentative: C"tn9 /�{p�C/"� ('14rA5C]
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
feeder to Finish
7 S
Z4p
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Owner Email:
Phone:
Phone:
Integrator
Region:
z r7 Certification Number: ify2,7?_
f
Certification Number: `l 5'j7 i
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er I I—]
INon-Layer I I�
Design Current
Discharges and Stream Impacts
I. 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 DW R)
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 DW R)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than front a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes aKo '❑ NA ❑ NE
❑ Yes ❑ No
[]Yes ❑ No
❑ NA ❑ NE
❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
[—]Yes ❑ NA ❑ NE
❑ Yes ❑�NNo ❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facili Number: Date of Inspection: 3 /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? es ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: L
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): H J1
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ONo
❑ 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
❑ No
❑ NA
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
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA O'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 El 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?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
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.
❑ Yes ❑ No ❑ NA N
❑ Yes ❑ No ❑ NA N] N
❑ Yes ❑ No ❑ NA ONE
❑ Yes ❑ No ❑ NA NE
❑ Yes ❑ No ❑ NA — NNEE
❑ Yes ❑ No ❑ NA I XNE
❑ Yes ❑ No ❑ NA ��7"`��"' NE
❑ 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 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA EINE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA �E
Page 2 of 3 21412015 Continued

Facili Number: - Date of inspection:b-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No
❑ NA kE]" FIE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No
❑ NA qt�
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
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No
❑ NA 1d
Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ � Yes �
❑ 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? ❑ Yes 'E]-lq�o
❑ NA ❑ NE
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 ❑ Yes ❑ No
❑ NA
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ NA AJ E
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? Yes ❑ No
❑ 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).
PO tl, 3�da� nee �C cY�.sn�
S
4_ p to
P �
� Ivy � tv . `'✓ � %i-h 0,D o C I-Ce
`, k
/� /D "/
L
(y
/C N UV- Ia e, C (L— ✓✓. r � (ca G 0 r CA
S�wc iY„-c_ r<N�.%t�. N� �=fy jJ t�R
pass, Lly kc (o
s y
APO or
-Fr4'j 4�r. J 40 a� g �l v �a�^90 A a /So,
�9 ,�, on-5 'C &0 k" �ti�
'� kC2P Qo �- i� recoils
MG VA TO 77.0 a/G �
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
-qto -796 730y
T�?//
2141201 S

llFacility Number I! 1_J - O Division of Soil and Water Conservation
O Other Agency
Type of Visit: �mpliance Inspection O Operation Review Q ructure Evaluation O Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral mergency O Other O Denied Access
Date of Visit: B / Arrival Time: Departure Time: County: Region
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact:
Title:
Onsite Representative:
y O
9f/
Certified Operator:
Back -tip Operator:
Location of Farm:
Swine
Wean to Finish
Wen to Feeder
eeder to Finish
Z (�
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Ij Lay
er
Non-Layer
Poults
Design Current
Discharges and Stream Impacts
I. 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 DW R)
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 DW R)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[—]Yes n 1yo� ❑ NA []NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
a
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page I of 3 21412015 Comiinued

Facility Number: Date of Inspection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? es ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? E2—Y-Cs ❑ No ❑ NA ❑ NE
Structure 1 Structure 2
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 3 Structure 4 Structure 5 Structure 6
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 4b.+ o ❑ 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 Ca No ❑ 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 nNE
maintenance or improvement?
Waste ApDlication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
❑ NA
[:]
maintenance or improvement?
7
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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA )2-9E
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
0-ME
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
❑ No
❑ NA
E31GC
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ""
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑-NL
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 PXE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA jD
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: -_j Date of inspection:
24, Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ 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 ❑ No
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 ETWE—
❑ NA ETI; E
❑ NA U_N -
❑-9A ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes �o ❑ NA ❑ NE
❑ Yes Z No ❑ NA 7KE
❑ Yes ❑ No ❑ NA
[-]Yes
❑ No
❑ NA
❑ NE
❑ Yes
lU "o
❑ NA
❑ NE
❑ Yes
[-]No
❑ NA
EKE
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).
(
U/ V & lru(�-jvo.j , �1uy �0 S✓V' 1/ �{ Se l owyy -
rvc, t I Fit C-1� /
. 0 R � 3 . Ar I-/A(i i 4, 15 ctiss'c+/
Op,,,-r' I� GIrerl '`j Z e,,ds-0T t!.-r / /y1oCam/` e-on_1 f-
Lit ` fG n.-Q rJ S C in a 1 /,q , p r_� .
/aco,s ti M- P-4 4e,-
' boo 4�K0348' i
cif 1u03eJ 1.40
I i I a�oor� ��i Iy 1341-e i¢vr a l ck-cc k
A14 V N- S4r~ Fa t„wdt r-,- _)-ft, 54-u4 ee
Reviewer/Inspector Name: wA b -0 / A lu `2 Phone: R h 73��
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412015

d Division of Water Resources
Facility Number -� 0 Division of Soil and Water Conservation
.� 0 Other Agency i I
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up OReferral 0 Emergency 0 Other
Date of Visit:U*R—
Arrival Time: O Departure Time: County: _
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: K _.' ��*- t " _R r --s r'0 ir Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedej
Farrow to Finish
Boars
Other
Other
Latitude:
Phone:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
NNon--
La er
Design Current
Dry Pnu try Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
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)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Denied Access
Region:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes �Ng ❑ NA ❑ NE
❑ Yes FffNo ❑ NA ❑ NE
Page 1 of 21412015 Continued

Facili Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No ❑ NA
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ 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 ❑ No ❑ NA Zf 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 ❑ LJ E NA
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 NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ IdE'
t applicable to roofed pits, dry stacks, and/or wet stacks)
9. D es any part of the waste management system other than the waste structures require
aintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA Nn
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA P
❑ 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?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
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.
❑ Yes
❑ No
❑ NA
❑ Yes
❑ No
❑ NA
❑-1VE
❑ Yes
❑ No
❑ NA
&NE
❑ Yes
❑ No
❑ NA
Ef NE
❑ Yes
❑ No
❑ NA
EfNE
❑ Yes
❑ No
❑ NA
E5 NE
❑ Yes
❑ No
❑ NA
ET<E
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA Z 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 ❑ No ❑ 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:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No
25..Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ 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 ❑ No
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
❑ NA P K5_
FNE
❑ NE
❑ Yes ❑ No ❑ NA „❑-Nr-
❑ Yes ❑ No ❑ NA NE _
❑ Yes ❑ No ❑ NA _Q-IVE—
❑ Yes ❑ No ❑ NA NE
❑ Yes 0 NA ❑ NE
❑ Yes No NA ❑ NE
❑ Yes No ❑ 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).
P t^5f /-C. J
n n � tic c •�• �.-� o�
c 'r/5 n Cf
f J 1
den , �tQ7 r. r�l l (bc �..7�oi�-cam( (ri // �,lc ass
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
IQ 7%6 73ok
21412015

VDivision of Water Resources
Facility Number ' J O Division of Soil and Water Conservation
O Other Agency Z
Type of Visit: O Compliance Inspection 0 Operation Review ructurree valuation O Technical Assistance
Reason for Visit: O-/R-ouutine O Complaint O Follow-up O Referral E Emergency O Other O Denied Access
Date of Visit: I 1p/D /(gl Arrival Time: Departure Time: Z County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Ih,,
Onsite Representative: 6 � �
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to
Wean to
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
Other
Owner Email:
Phone:
Title: _
(�'A K-O _S C cv
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non--
La er
Design Current
Dry Poultry Capacity Poo.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
I. 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)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 2rNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes❑
NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

-7/ z
Facili Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
Yes
[—]No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
N I eJ
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: `
Spillway?:
Designed Freeboard (in):
ti
Observed Freeboard (in):
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
to
❑ 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
❑ No
❑ 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
V� "E
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
❑ NA
OrNE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
❑ Excessive Pending ❑ 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
❑ No
❑ NA
E
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
❑ NA
VNE16.
acres determination?
17. Does
the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
Z NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
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
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑LeaseAgreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑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 I" Rainfall Inspections ❑ Sludge Surve
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA
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

Facili Number: Date of Inspection: /
24. Did the, facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA FJ ICE
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 ��NA
A NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NE
Other Issues ,__,1�
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes .LNo ❑ 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? ❑ Yes E No ❑ NA ❑ NE
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 ❑ Yes D_90�EI NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA 016
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes E3 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question ft 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).
V "I I I I '. L / ��) . {. e 4 c�"— -k -;7 1
v r l0 eck
�� Sp',^1
�
ya q
YS
4-1
QOA
�
Pwv R P�/ low 't p 4! rc C04
I 77o 2
�sfisk.nce
�l
�Hnrcc+
7z/ s �9��y
Reviewer/Inspector Name: O&VI 9 4j S 1 1 vktZ Phone: (1 0 7 'FG 7%o fi
Reviewer/Inspector Signature: Date:
Page 3 of 3 2/4 015

ivision of Water Resources
Facility Number - 0 Division of Soil and Water Conservation
0 Other Agency 7�
Type of Visit: 0 Compliance Inspection 0 Operation Review Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Ferollow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: 0 0 Departure Time:O County:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: IYWO,s6p 4U',yl; Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to I
Wean to I
Feederto
Farrow to
Farrow to
Other
Other
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
IN
Non--
Layer
Other
Design Current
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)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Region:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes I�No ❑ NA ❑ NE
[—]Yes
[—]No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes
[:]No
❑ NA
❑ NE
❑ Yes
21 No
❑ NA
❑ NE
❑ Yes
[2f No
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

Facility Number: 7 ( - 2 jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
EZ'No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I 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
ErNo
❑ 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
[EfNo
❑ 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
❑ No
❑ NA
(Ii NE
S. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NA
VNE
(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
[t]'CVE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
❑ NA
Dv NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
[v'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
❑ No
❑ NA
[!�NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
ED&
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
❑ NA
[j"NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
E[NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
P�'NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA
ZNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA
C3 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
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes [� No
❑ Yes [� No
❑ NA ONE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412015 Continued

Facility Number: '' / jDate of Inspection: /2-(
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ 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 ❑ No
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 the 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 [ErNE
❑ NA 127 NE
❑ NA EErNE
❑ NA [!(NE
❑ Yes ❑ No ❑ NA EffNE
[—]Yes ❑ No ❑ NA dNE
❑ Yes [VfNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA E2'NE
❑ Yes [ No
❑ Yes ["No
❑ Yes [D"No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to question ft 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).
Corr; �oMec'(ow 4--o 4&ke, , aAA con f<kae 4Vvo,, t\ eke rrs� o�
%he; wok .2 hoo-6&.r sty by die m& d ke&k. Na rt5fock,nq
w,id 6,ck ;n friulzv*A / Co✓1 (Vue. 4-�, subw POO
P`'P l ✓nCil t ( (Z°tJ; ows 1 e4; a !is.
CbV� �-tA k, �O e W li"\ c�dt y WA}e 0 �,U+
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 9/0- r no
Date: 4G-P2-- /g
21412015