400004_Inspection_20200916

Division of Water Resources
` Facility Number O Division of Soil and Water Conservation
O Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: • Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: :3 S Departure Time: 3; 020 County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address: 19-3 /y /���,,,� � � PL 2 % 7,2"F—
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: L4e_
rl
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wcan to Finish
Wean to Feeder
Feeder to Finish 3 4
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Title:
Latitude:
Phone: 0'W9 - V ) ',(O(� A—
Integrator: % G D_r�
Certification Number: /e)Q,-9,9-,3 7
Certification Number:
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non-Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
J
1. Is any discharge observed from any part of the operation?
❑ 1"es
1 No
❑ NA
❑ NIE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ N n
❑ N L
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ N A
❑ N E
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
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes M/No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ 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 environment l threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑Yes [ o ❑ NA ONE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [.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 [fNo ❑ 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 N o ❑ 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): G-�:111 —SW-_ 4? % ON
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
© o
❑ NA
0 NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Xo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
fNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
dNo
❑ NA
❑ NV
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ff No
❑ NA
❑ N I?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
o
❑ NA
❑ N E
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
ftNoN
❑ NA
❑ N F,
the appropriate box.
❑ WUP [:]Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 16 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 Inspecho ❑ 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

Facili Number: AAQ JDate of Inspection:-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes dNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes dNo ❑ 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 o ❑ N A ❑ N E
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [j/N o ❑ N A ❑ N E
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?
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 file drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes [21'No ❑ NA ❑ NE
❑ Yes [dNo ❑ NA ❑ NE
❑ Yes [dNo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
E�'No
V0
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ N1
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: ��.p �� /� PA""-
Reviewer/Inspector Signature:
Page 3 of 3
�ro �o•ny
Phone:
Date:
21412015