630006_Inspection_20200206

Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [Z�"" ❑ 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):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
IJw u ❑ 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
�lo ❑ 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
❑-Nv -❑ 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 E T'90 ❑ 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):.C'b�t
13. Soil Type(s): (�� V61-
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes EE-Na ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ©Tlo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes to ❑ 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
❑ Yes D-N-570 NA ❑ NE
❑ Yes 0-'N—o ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes l,J 1VO 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 Ea-N_o❑ 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 P1Co❑ 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: 7.
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�1Vo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
Q-N-b-_❑ 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
[(]_Few ❑ 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
❑ Yes
U-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?
❑ Yes
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
Et No ❑ 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 ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [g�o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes or ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes Q1Vo ❑ NA ❑ NE
Comnieuts (refer.to quirshau) ExOf- a_n anYES'answers. and/ox aa�y additional irecoinenendations ar any ather comments
Used' aw ngs of;facility to"Better explam_situations (use addatia�al;
Reviewer/Inspector Name: t
Reviewer/Inspector Signature:
Page 3 of 3
0
Phone: t0 I `A 3_i 's 5
Date: F-4
015

0 Diviion of Water Resources mot"
Facility Number ®� 0 Division of Soil and Water Conservation. - \
0 Other. Agency
Pype of Visit: 0-eompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
teason for Visit: FdRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ��� Departure Time: County: (LOCH Region: t_zl�
Farm Name: Owner Email:
Owner Name: /��L CSC mot' ytG� Phone:
Mailing Address:
Physical Address:
Facility Contact: � i(� '1 / a Title:
Onsite Representative:
i�
Certified Operator: IJ
Back-up Operator: Cj;, Cry t 115 e GA.
Location of Farm: Latitude:
Phone:
Integrator: &_,ri-,L5
Certification Number:: �-7
Certification Number: J� �'f J U C 1
Longitude:
,, Design Current
Design
Current '
a
s Design Current'
Swine
;-CapacityPop.
..
Wet Poultry
Capacity
Pop.
"
Cattle , _ Capacity Eop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I
INon-La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
�"Design
Current :
Dry Cow
Farrow to Feeder
1 5 G
113 1
D.ry=Poultry, .-Capacity
Po
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
_
Turkeys
Other'
Turkey Poults
Other
FlOther
'
Discharges and Stream Impacts
1. Is any discharge observed from the
any part of operation?
❑ Yes
a? 1o❑
NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
E5-'g/A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
B-INA
❑ 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
U'NO
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
E] No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued