640021_Compliance Evaluation Inspection_20200622

?3 -
$dTlvision of Water Resources
Facility Number I - O Division of Soil and Water Conservation
O Other Agency
Type of Visit: 0 Com ce Inspection Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: n rye �1�� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Phone:
Title: Phone:
Onsite Representative: p Integrator:
Certified Operator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Design Currei
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean S7
Farrow to Feeder
Farrow to Finish
Boars
Other
Other
Latitude:
Longitude:
Design Current
Wet Poultry Capacity Pop. Cattle
Pullets
Other
Poulis
Design Current
Region:
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
PNo ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[] Yes
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
[3 Yes❑
VN NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (Ifycs, notify DWR)
E] Yes
LfrNo ❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
' ❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
El Yes
No ❑ NA
❑ NE
of the Slate other than from a discharge?
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Facility Number: - Date of Inspection: &z 7 r
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes [2 N '
❑ 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: 3O 6 —i 30 S' -J.;
3.7. a
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ��� 31; 34���
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes JZNo
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 hreat, 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 o
❑ 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 o
❑ 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 ❑ 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): "64 e1'1" J'
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes VNo,'
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 'Co ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes ZN ❑ 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 ' ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0 No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? 1 f 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 udge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE
Page 2 of 21412015 Continued

Facili Number: - Date of Inspection: - ZZ — t?
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes VN
NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑Yes ❑ 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 VJ ❑ 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 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
❑ No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
3I . 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
❑ No
❑ NA
0 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).
5 IH ��e Survey ha-j- 4ue Dec 31 J-oJ�
Col fib(r)''s' rx�y-(9
Reviewer+ Inspector Name:
Reviewer/Inspector Signature:
Phone: ��l crZDv
Date: 2 2 - 7-d
21412015
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