310077_Structure Evaluation_20200604

(Division of Water Resources°=
Facility Number " 3 - I 7 7' J Division of Soil and Water .Conservation
0 Other Agency, °
Type of Visit: 0 Compliance Inspection 0 Operation Review Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint &Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: -opt-aaa Arrival Time: I'. V 5 Am o Departure Time: ( :3p County: E�UPLtf\l Region: W 120
Farm Name: (', 112C f Id- TL Owner Email:
Owner Name: Co H N k-000 cXC Phone:
Mailing Address:
Physical Address:
Facility Contact: rTQ EP— Mppa Title:
Onsite Representative: Lg6F_ f—,MMP_g
.o
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone: -
Integrator:
Certification Number:
Certification Number:
Longitude:
Design = Current . '
Design
Current
Swine Capacity Pop.,
Wet Poultry. °
Capacity
Pbp. a °
Wean to Finish
[Ion-Laye
ayer
Wean to Feeder
99'
N 6
r
Feeder to Finish
Farrow to Wean
Design
Current.
Farrow to Feeder
Dry Poultry
Capacity
Pop:
Farrow to Finish
Gilts
Boars
Other
Other
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Designs Cd'rrent
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
No
[:]'NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
Fa/No
❑ 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)
❑ Yes
No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
E]"No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
D No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: -?, jDate of Inspection-oy-ao� o
Waste Collection & Treatment �
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 'R Yes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [?fNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 14.5 19"
Observed Freeboard (in): 13 D is J (. S
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[dNo
❑ 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
[2/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
g✓ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
dNo
❑ 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 E/ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA [2"'NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA I rJ l
❑ 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?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
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
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
❑ No
❑ NA
ffNE
❑ Yes
❑ No
❑ NA
[�1E
❑ Yes
❑ No
❑ NA
Ep/�E
❑ Yes
❑ No
❑ NA
2r'�E
❑ Yes
❑ No
❑ NA
[D-I�E
❑ Yes ❑ No ❑ NA [3"�E
❑ Yes ❑ No ❑ NA ED NE
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA DINE
❑ Weather Code
❑ Sludge Survey
❑ NA [3'�[E
❑ NA F2 NE
Page 2 of 3 21412015 Continued

Facility Number: 3 I jDate of Inspection: o6-oy
S 4-f! ao
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
XNo ❑ NA
gdNE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
bl�No ❑ NA
03'NE
the appropriate box(es) below.
-F 6-11-ac
❑ 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:
3�y-1l-oie
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
o ❑ NA
NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
El Yes
ho ❑ NA
WNE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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
3 1V�
❑ Yes
[YNo
❑ NA
❑ NE
[:]Yes
[E�No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
► NE
❑ Yes ENo
❑ Yes [N
❑ Yes VNoNo
❑ 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).
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Reviewer/Inspector Name: --5.1ko '-w+z-2y' Phone: (q 10) 6/7-9S77
Reviewer/Inspector Signature: �--�^ Date: 136-O' -a(1o2O
Page 3 of 3 21412015