820011_Structure Evaluation Inspection_20180925

Structure Evaluation Inspection
Facility Number: tr� -- // Date:
Time in: //fl - Time out: 77
Farm Name: Farm 911 address:
Owner Name: Phone
Facility Contact: ,�T � � � --
Onsite Representative: Integrator:
Certified Operator: Cert. Number
Is storage capacity less than adequate? Yes No -
If yes is waste level into the structural freeboard? Yes �o
Was non-compliant level reported to.DWR POA receivety
Structure: 1 2 3 4 5 6
Identifier: /52- ,%/-- /53-
Spillway? ' /2 ' '• . _3() 7 /D
Designed Freeboard (in.): .
Observed Freeboard (in.):
Are there any immediate threats to the integrity of any of to structures
• observed? Yes No
Do any structures lack adequate markers as required by the permit? Yes_ No
Does any part of the waste.management system need repair Yes No
Condition of field's 1u1
Condition of receiving crop d..
• Comments: b
U s
GL-- rev s -