330006_Compliance Evaluation Inspection_20200921

. L9 —
Q."Division of Water Resources
Facility Number - ! 0 Division of Soil and Water Conservation
0 Other Agency
)e of Visit: Com ce Inspection Opera
tion Review 0 Structure Evaluation 0 Technical Assistance
ison for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: : OG Departure Time: E I ! 27 County: Region:
Farm Name: SO PI Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: J Integrator:
Certified Operator: 4, <I 4 o Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Pullets
Poults
Design Current
Longitude:
Design Current
Cattle Capacity Pop.
IDairyCow
Dairy Calf
Dairy Heifer
D Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
I. 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
❑ NA
❑ 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
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ NA
rN
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
0 Yes
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 511212020 Continued

Facility Number: - Date of lns ection: - 2
Waste Collection & Treatment LV t Scv%-
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? []Yes No ❑ NA ❑ NE
a. If yes, is waste Ievel into the structural freeboard? ❑ Yes P14
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 5
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Z[No 0 NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which arc 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 environmenta rent, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ YesrNo
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ 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 ❑ Ycs ONo ❑ NA ❑ NE
maintenance or improvement?
Waste APDIiC2tl0n
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E5No ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
eNo ❑ 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): '3C7 r M fin r t n
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
No 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 Iack adequate acreage for land application?
❑ Yes
❑ 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
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
b No ❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ SoiI Analysis
❑ Waste Transfers
' ❑ Wcathcr
Codc
❑ Rainfall ❑ Stocking ❑ Crop Yield El120 Minute Inspections [3Monthly and V Rainfall Inspections
Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes�NoEo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbrcakers on irrigation equipment?
❑ Yes
.. NA
❑ NE
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21412015 Continued

Facility Number: W -M - Date of Inspection: -L/ —
0�7-0
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes No NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, 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 to 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 ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes o ❑ 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)
31. Do subsurface the 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
❑ NE
33. Did the Reviewerl Inspector fail to discuss reviewiinspection 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
RevieweriInspector Name: Phone: Z
Rev ieweri7nspector Signature: r2 et -5� (, e— j Date: y
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