330002_Compliance Evaluation Inspection_20200622

23--70
Facility Number -1 ICJ
(0 Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Complia cc Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 2rRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: -a+ Arrival Time: ! 3 Departure Time: O0 County: Region:
Farm Name: t?� _ Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title:
Onsite Representative: ,Zx1-�sr✓
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Pullets
Other
Poults
Design Current
Dischmes 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?
Longitude:
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 EXO
❑ NA ❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWR) ❑ Yes No�,Fj NA ❑ 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)
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'?
❑ Yes VNo[]
NA FINE
❑ YesNA ❑ NE
❑ YesNA ❑ NE
Page 1 of 3 21412015 Continued

Facility Number: Date of Inspection: (r - Z Z —
Waste Collection & Treatment
XNNol
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: o Id b�
so I J S
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 7 1,7 ,2
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No{ ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed andior managed through a
❑ Yes n 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 environmenta rest, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes N ❑ 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, andior wet stacks)
9. Does any pan of the waste management system other than the waste structures require
❑ Yes ZINo ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes Z/No ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[:]Yes O(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): CZY A
13. Soil Type(s):}
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
V>6' ❑ 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
Z ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
o ❑ NA
jNo
❑ 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 eNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers L] Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspection D 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

Facili Number: 3 3 - O 2— jDate of Inspection: - 2Z x-d
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ZN9q,❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? I ryes, check ❑ Yes ��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:
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 ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes VINo ❑ 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?
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?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ 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).
5 [11 jj'e sit,, rrq- '( J1,e
Ctn�t�r��,��-, 12 S
Reviewer, -'Inspector Name:
Reviewer;7nspector Signature: r3Gt 54zil- -Fa✓e-/
Phone: Ci (q ?9 ( q Zee
Date: 7-2 - -7-0
Page 3 of 3
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