310547_Compliance Evaluation Inspection_20200319

P Q Division of Water Resources
FacilitytNumber' " - 0 0 Division of Soil and Water Conservation' `;"` • .
0 Other Agency
Type of Visit: ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Zeason for Visit: V Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: r Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: �/✓ Title:
Onsite Representative: 1�Gwv1
Certified Operator:
Back-up Operator:
Location of Farm:
Design • Current
Swine. ° ° ° ° Capacity L Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Design' Current
°'Viet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry: Capacity Pop..
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Longitude:
_Design ;° Current
Cattle:: Capacity; ° ,PoA.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
2005o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
D<
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
F XA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
loll
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
2<
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
�N/o
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued'

Facility Number: - Date of Inspection: 7 �.
i
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?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): _
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
[�No ❑ N ❑ NE
❑ No NA ❑ NE
Structure 5 Structure 6
❑ Yes ZNo WNA ❑ NE
❑ Yes /No 0 NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmenta hreat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes y
❑ NA ❑ N�
8. Do any of the structures lack adequate markers as required by the permit? El 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 E2 XNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes D-4o ❑ 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
L� lq
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
VNo
❑ 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
N
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
VNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
N
❑ 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 ❑ No ❑ NA ❑ NE
❑ Waste Applica ' n ❑ 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 [2"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: "I A.
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes D4 ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes To ❑ 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 No ZNA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
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
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
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
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
ZNo ❑ NA ❑ NE
;Nc ❑ NA ❑ NE
No ❑ NA ❑ NE
❑ No DJIC�A ZfNE
o ❑ NA ❑ NE
o ❑ NA ❑ NE
No ❑ NA ❑ NE
Reviewer/Inspector Signature:
Page 3 of 3
Date: j
21412015