090203_Inspection_20200331

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pe of Visit: 6ommpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
ason for Visit: c Ltoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
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to of Visit: 31 Yu1�n.�l Arrival Time: g!�s n Departure Time: /��D,.5 County: 6 � ..��'l g
rm Name: 011.- u 1 40&$ 5 1 eY Owner Email: 6 1 T A S' 1 P-e 11_0 c O
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vner Name: Y l(34., W�1. L Phone:
ailing Address: i
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tysical Address: 1
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cility Contact:. i�(. i f . 4v�i. 1&$ Title: Phone: `� ,� i
�( Integrator: -j vti1`` T"L�c C"' i
isite Representative:
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rtified Operator: i j l vt� �c 0 Certification2-6 7 ick-up Operator: 1114 i !�
,.� 4�„ t `S Certification Number: G V 6 70
)cation of Farm: Latitude: Longitude:
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Discharges and Stream Impacts / ❑ ❑
.Is any discharge observed from any part of the operation? ❑ Yes Ly'1vo NA NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
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a. Was the conveyance man-made? ❑ Yes ❑ NO ' ©NA. El NE
b. Did the discharge reach waters of the State?(If yes,tnotify DWR) r- ❑ Yes 0 No ❑NA ❑ NE
c. What is the estimated volume that reached waters of the State(gallons)?
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d. Does the discharge bypass the waste management system?(If yes,notify DWR) ❑ Yes ❑ NolA ❑ NE
a.Is there evidence of a past discharge from any part of the operation? V ❑ Yes 'No ❑ NA ❑NE
3.Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ❑ No n NA ❑NE
of the State other than from a discharge?
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Page 1 of 3 2/4/2015 Continued

Facility Number: 9 - Zo_1 Date of Inspection: 3
Waste Collection&Treatment
4.Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑ Yes C -❑ NA ❑ NE
a.If yes,is waste level into the structural freeboard? ❑ Yes ❑ No [-N7t ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 240 G 30 l3 Iou 3O - 30 f 3O64 34-C 1-0-0S 3670 3orY s. Ciq), o4(
Spillway?: _
Designed Freeboard(in):
Observed Freeboard(in): 8 I Li( kg 9 S( 30 IN 36 1
5.Are there any immediate threats to the integrity of ariy of the structures observed? ❑ Yes Eliclo ❑ 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 9No ❑ 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 ❑ No ❑ NA ❑ NE
8.Do any of the structures lack adequate markers as required by the permit? ❑ Yes [l 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 ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10.Are there any required buffers,setbacks,or compliance alternatives that need ❑ Yes [ - co ❑ NA ❑ NE
maintenance or improvement?
11.Is there evidence of incorrect land application?If yes,check the appropriate box below. ❑ Yes n 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 0 Evidepcej of Wind Drift ❑ Application Outside of Approved Area
tick
12.Crop Type(s): 0 '" 56, 0 it�
col_ G�l3
13.Soil Type(s): o O24-wr Lam' t- cc�l l l`�t� I 0 v-ka
14.Do the receiving crops differ from those designated in the CAWMP? ❑ Yes D'No ❑ NA ❑ NE
15.Does the receiving crop and/or land application site need improvement? ❑ Yes E 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 lack adequate acreage for land application? ❑ Yes []N o ❑ NA ❑ NE
18.Is there a lack of properly operating waste application equipment? ❑ Yes O4Io ❑ NA ❑ NE
Required Records&Documents
19.Did the facility fail to have the Certificate of Coverage&Permit readily available? •- ❑ Yes Q'Rlo ❑ NA ❑ NE
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20.Does the facility fail to have all components of the CAWMP readily available?If yes,check ❑ Yes [r 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 Er so ❑ 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 [t1 o ' ❑ NA ❑ NE
23.If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes Dr No ❑ NA ;❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: ct - .- 3 Date of Inspection: 3I$1a ,'.rO
24.Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes El-No ❑ NA ❑ NE
25.Is the facility out of compliance with permit conditions related to sludge? If yes,check ❑-Yes alcio— ❑ 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 'o ❑ NA 0 NE
27.Did the facility fail to secure a phosphorus loss assessments(PLAT)certification? ❑ Yes [o ❑ NA ❑ NE
Other Issues
28.Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes []'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? ❑,Yes �No ❑ NA ❑ NE
If yes,contact a regional Air Quality representative immediately. -
30.'Did the facility fail to notify the Regional Officeof emergency situations as required by the ❑ Yes ErNo ❑ 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 Er-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 0 NE
33.Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes No D NA ❑ NE
34.Does the facility require a follow-up visit by the same agency? - ❑ Yes 1:1-No . ❑ NA ❑ NE
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Reviewer/Inspector Name: 4:3 e (:1D (-0 Phone:gib- L3 'J c]3
Reviewer/Inspector Signature: l War Date: 14ta•'L
Pa2e 3 of 3 2/4/2015