090088_Inspection_20200331

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pe of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
ason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
to of Visit:13j Ativ-c-LaP Arrival Time: -2, is P Departure Time: V;jc> /-' County: 13(cede-1 1_ Region: y
3 $t jv a(- 3 ?3 Owner Email: (4 vls Xf '�`( Z0� 1)�
rm Name: �a-� 3 515', 7 IJ
vner Name: 010,,,p lty— 6�tork LL Phone:
''ling Address: l
ysical Address:
cility Contact: 01 , Kr, ( tMC $ Title: Phone:
'site Representative:
l( Integrator: ,Sour Ill Ti\r(t
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�rtified Operator: Certification Number: 6, . 713
ick-up Operator: n'11 C-t-riL( Certification Number: Z-
'cation of Farm: Latitude: Longitude: 1'
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)ischarees and Stream Impacts
-Is any discharge observed from any part of the operation? ❑ Yes UN:1,-0 NA ❑ NE
Discharge originated at: ❑ Structure E Application Field ❑ Other:
a. Was the conveyance man-made? Yes ❑ No [9'NA ❑ NE
b. Did the discharge reach waters of the State?(If yes,notify DWR) n 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 Q'lGA ❑ NE
a.Is there evidence of a past discharge from any part of the operation? ri Yes 0'l 1�o n NA n NE
3.Were there any observable adverse impacts or potential adverse impacts to the waters [ 1 Yes ( 0 0 NA ❑ NE
of the State other than from a discharge?
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'Facility Number: `°j - rJ Date of Inspection: ?( '6t.e. £ D
Waste Collection&Treatment
4.Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑ Yes ❑ ❑ _NA ❑ NE
a. If yes,is waste level into the structural freeboard? ❑ Yes ❑ No El-fir-A—
iB ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 S ' V ( C
Spillway?:
Designed Freeboard(in):
Observed Freeboard(in): 2_.1 Z q
5.Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Fo ❑ 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 El- . ❑ 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? ip Yes [lo ❑ NA n NE
8.Do any of the structures lack adequate markers as required by the permit? ❑ Yes Et< ❑ NA n 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 n Yes o ❑ NA n NE
maintenance or improvement?
Waste Application
10.Are there any required buffers,setbacks,or compliance alternatives that need n Yes ra'Go n NA n NE
maintenance or improvement?
11.Is there evidence of incorrect land application?If yes,check the appropriate box below. ❑ Yes ❑N o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground 0 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 [2 Application Outside of Approved Area
12.Crop Type(s): C✓ ( P ac t )-e / -`t
13.Soil Type(s): 4A G o 111
14.Do the receiving crops differ from those designated in the CAWMP? n Yes E N ❑ NA ❑ NE
15.Does the receiving crop and/or land application site need improvement? n Yes El< ❑ NA ❑ NE
16.Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yeso n NA ❑ NE
acres determination?
17.Does the facility lack adequate acreage for land application? n Yes lalClo ❑ NA ❑ NE
18.Is there a lack of properly operating waste application equipment? n Yes No ❑ NA ❑ NE
Required Records&Documents
19.Did the facility fail to have the Certificate of Coverage&Permit readily available? ❑ Yes No ❑ NA n NE
20.Does the facility fail to have all components of the CAWMP readily available?If yes,check ❑ Yes E No ❑ NA ❑ NE
the appropriate box.
❑WUP n Checklists ❑Design ❑Maps ❑ Lease Agreements ['Other:
21.Does record keeping need improvement?If yes,check the appropriate box below. ❑ Yes ©'g-o- ❑ NA ❑ NE
n Waste Application ❑Weekly Freeboard ❑Waste Analysis ❑Soil Analysis ❑Waste Transfers ❑Weather Code
n 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 n NE
23.If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 16-No ❑ NA n NE
Page 2 of 3 2/4/2015 Continued

Facility Number: ft - t Date of Inspection: $l Rbr.-cQ w
24.Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑- ❑ NA ❑ NE
25.Is the facility out of compliance with permit conditions related to sludge? If yes,check ❑ Yes [ F No ❑ N A ❑ 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 -N ❑ NA ❑ NE
27.Did the facility fail to secure a phosphorus loss assessments(PLAT)certification? ❑ Yes ❑'N ❑ NA ❑ NE
Other Issues
28.Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes Q-No f] 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 FM-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 1=4-44 r ❑ NA ❑ NE
permit?(i.e.,discharge,freeboard problems,over-application)
31.Do subsurface tile drains exist at the facility?If yes,check the appropriate box below. ❑ Yes tr ❑ NA ❑ NE
El Application Field ❑ Lagoon/Storage Pond ❑ Other:
32.Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes C3-No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes 0-316 ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yesa ❑ 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: 3t�' L `a Phone ( f�3 J 1
Reviewer/Inspector Signature: r0 1 Date: 3\ titit" i zo Z b
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