310353_Compliance Evaluation Inspection_20200819

f
- ion of Water R eDivissources
Tacility Number,' • '-° _0 Division of Soil and Water Conservatfon
:O' Other° Agency °
type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
2eason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1 12,o I Arrival Time: Departure Time: 070 County:
Farm Name: 10 r, �-'3,n; j� Owner Email:
0
Owner Name: j Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
D­t
Onsite Representative: h t'\ Integrator:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Design Current
Swine "Capacity. Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish 74.14Y 2
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Phone:
Certification Number:
Certification Number:
Longitude:
Region:
` s Design Current ° llesign ".Current.
Wet Poultry Capaci(y 'Pop. Cattle .'Capacity`p° ¢'Pop..'
Layer
Non -Layer
',Design Current
° Div Poultry Canacitv .•Pon, °.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
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
❑'f1A;
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ 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
EErNA
❑ 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 _
❑ Yes
ENo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 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
E'No
❑ NA/
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
0'NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: l
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3�
T
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Q'Ilo
❑ 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
Fl-&o
❑ 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
❑i No.
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Q'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
Q'No
❑ NA
❑ NE
maintenance or improvement?
1
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Q No
❑ NA
❑ NE
maintenance or improvement?
/ /
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑i ffi o
❑ 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
E2-,N;p
❑ 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
l
Q'No
❑ 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
❑'I�o
❑ 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
% 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. Q"des ❑ No ❑ NA ❑ NE
❑ Waste Applicati6 ❑ 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 Q No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA [El NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection: LC�
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes r o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Q'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 Q No ❑ NA; � ] NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No O�NA ❑ NE
Other Issues
28..Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 0 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?
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 0'No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑,N'
❑ Yes
❑ Yes
❑ Yes
[]"No ❑ NA ❑ NE
❑ NA ❑ NE
[3_No ❑ NA ❑ NE
Reviewer/Inspector Signature: ���� Date:
Page 3 of 3 21412015