670035_Compliance Evaluation Inspection_20201001

° Division of Water Resources
FacYlity^Number 3�' © Division of Soff9and Water, Conservation
%° .O'OtherAgency
Type of Visit: ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ®Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Q ! Arrival Time: Departure Time: [ t1 County: Region:
Farm Name: 4-Cy ce,Y-, Owner Email:
Owner Name: Phone: i
Mailing Address:
Physical Address: 70 2 �C,
Facility Contact:
Title: Phone:
Onsite Representative: 4,A Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Design' Current
.Capacity ° Pop.,
Certification Number:
Certification Number:
Latitude:
.Design Current'. °
° Wet Poultry Capacity' Pop.
La er
Non -Layer
Design Current
-Dry Pnitltrv, C'anaeity "Pon.
Layers
Non -Layers
El
Pullets
Turkeys
Turkey Poults
Other
Longitude:
Design Curreat°-
Cattie ° Capacity�� Pop.
y Cow
y Calf
y Heifer
Cow
Beef Stocker
Beef Feeder
Beef Brood Cow
Other A
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? 0 Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No NA
❑ NE
W
b. Did the discharge reach waters of the State? (If yes, notify DR)
❑ Yes
❑ No 51f A
❑ 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
El NA
No
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
E-, ❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
EJ N' o ❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: jDate of Inspection: Jcj i `Z,U
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes ❑'No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No DINA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: �a_ _
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes []lo ❑ 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 t reat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes To ❑ 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 E14 ❑ 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 0 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? 0 Yes E� o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑lKO ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes Ealo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ YesF3-f4o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes 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 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ 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: - Date of Inspection: ID
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
es
[:]No
❑ NA
0 NE
the appropriate box(es) below.
❑ Fail re to complete annual sludge survey ❑ Failure to develop a POA for sludge
levels
011�on-cornpliant sludge levels in any lagoon
��7o q
�� I
�—
List structure(s) and date of first survey indicating non-compliance: i
QL
26. Did the facility fail 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
❑'NA
❑ NE
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:
❑ Yes [/] No
❑ Yes ZNNo
❑ Yes [�No
❑ NA ❑ NE
❑NA ONE
❑ NA ❑ NE
❑ Yes ❑ No ❑ NA 2T/NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
E2'<o
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
E�r o
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Flo
❑ NA
❑ NE
Comments (refer to question ft 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).
lo 2,0 , S U 4' (Uij) v\td WA
1� \'eqO r'A /I
Reviewer/Inspector Name:
Reviewer/Inspector Signature: f:?
Page 3 of 3
40, \') �P_C;-
Phone: % () 5-2x� 3 S- I (7
Date: 1-0 z I / zc�
21412015