510034_Compliance Evaluation Inspection_20200731

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Facility-
Number �
V Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Aeencv
Visit: O Compliance Ins
for Visit: 0 Routine 0
Operation Review 0 Structure Evaluation 0 Technical Assistance
0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: ha Rcgion:QRD
Farm Name: Owner Email:
Owner Name: Phone: !!�3 y— O I bfd 9 3 V - $03
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
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
Title: Phone:
Integrator:
Certification Number: Aw&LY 2 Q=
Certification Number:
Latitude:
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Pullets
Other
Poults
Dischar es 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?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c, What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (It"yes, notify DWR.)
_ 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 diharge?
Page 1 of 3
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
_Dairy
Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes to No ❑ NA ❑ NE
❑ Yes
Gj' No
❑ NA
❑ NE
❑ Yes
%rJ�'No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
21412015 Continued

Facility Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes P?rNo ❑ NA ❑ NE
a. If yes 's waste lcvcl into the structural frccbnard? ❑ Yes En No ❑ NA ❑ NE
Siv�[urZ 3 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): -f
5. Arc 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 and/or managed through a
❑ Yes WNo
❑ 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 yj No
❑ 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, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes �] No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes 21 No
❑ NA ❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? Ifyes, check the appropriate box below. ❑ Yes Z] No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 101bs. ❑ 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 ZNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes JZ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 'VNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes ❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Repuired Records & Documents
19. Did the facility fail to have the Certificate Coverage
of & Permit readily available?
❑ Yes Ef No
❑ 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 Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minutc Inspections [:]Monthly and I" Rainfall Inspection. ❑ 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

Facility Number: IDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with ermit conditions related t sludge? Ifyes, check ❑ Yes No
the appropriate box(cs) below. S �r y e red 0 c+s'e Iti PC A P
❑ Failure to complete annual sludge survey ❑ FaiIure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any Iagoon
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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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 tilc drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes [� No
❑ Yes No
❑ Yes No
❑ Yes [� No
[] Yes No
❑ Yes No
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No
33. Did the Reviewer/Inspector fail to discuss review.1nspection with an on -site representative? ❑ Yes rf j No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [�] No
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any othr
Use drawings of fac!Uq to better a lain situations (use additional a es as necessary).
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Rcviewcr.'Inspector Name:
Reviewed Inspector Signatur
Page 3 of 3
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❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
[DNA ❑ NE
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❑ NA ❑ NE
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Date: _2Zp�
21412015