310740_Compliance Evaluation Inspection_20200402

Division of Water Resources
Facility:Numbei P Division of-,Soil°and Water Conservation
0 Other Agency
type of Visit: ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
leason for Visit: (D Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: C)Arrival Time: I (�� Departure Time: ounty:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: M V p I 4 � )�c l , , Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Design 'Current
Swine Capacity ,Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Certification Number:
Certification Number:
Design Current
Wetepoultry. ° Capacity Pop.
Layer
Non -Layer
Design Current °
nr'v Pnultry . Capacity ` Pon:
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Longitude:
Region:
Design° Cukrent
`Cattle Capacity ; Pop, °
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
2<o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
U NO A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
[Ej<
❑ 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
❑ NA
❑ NE
3. Were there an observable adverse impacts or potential adverse impacts to the waters
Y p
❑ Yes
Vo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: - ` 1 Date of Inspection: `L IAJ
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑Yes C3 No ❑ I�A ❑ 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: .'ti 3 rkw l : Ye
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ?—fD 2-1-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �NoD ❑ 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 ❑ 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 2�No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
Yes
No NA
❑ NE
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑
❑
maintenance or improvement?
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
EjNy ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes
No 0 NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
04o ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
EZ"No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ffNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ YesF3--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 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 ETNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NAEj-N"E
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
E�No ❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
2-Yes
❑ No ❑ NA
❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
Ton -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance: v -
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
- No
NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No PXA
❑ 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?
[:]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 EKo ❑ 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 IJ E
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes ErNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes I�1 ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes 910 ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other, comments.
Use drawines' of facility to better explain situations (use additional palies as necessary).
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Reviewer/Inspector Name: \% �" @f U Phone: 51('JS203 �
Reviewer/Inspector Signature: Date:
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