2020

sion of:t: esour5► qivFacility Number Z - O 0 Divon of nd Water Conser anon 1
0 Other Agency
Type of Visit: Co�m Hance 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: 9\et SH,(1y "Arrival Time: ( ;CJ/ Departure Time: I SO g County: glq-10 pcv Q11Region: 01_
Farm Name: tqll l(/ /®C (& [—a IAA Owner Email:
Owner Name: 6 L c i C• 0L1<eA.A4 Phone:
Mailing Address:
Physical Address:
FacilityContact: �` r�
C�. l .S l�tLe-tv� Title: Phone:
Onsite Representative: t Integrator: L I e
n
Certified Operator: i�� �I y Lea G Certification Number: I ? q7
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish Layer Dairy Cow
_ Wean to Feeder Non-Layer Dairy Calf
Feeder to Finish Z vio Dairy Heifer
Farrow to Wean Design Current Dry Cow
Farrow to Feeder Dry Poultry Capacity Pop. Non-Dairy
Farrow to Finish Layers Beef Stocker
Gilts Non-Layers Beef Feeder _
Boars Pullets Beef Brood Cow
Turkeys
Other Turkey Poults
Other Other
Discharges and Stream Impacts
1.Is any discharge observed from any part of the operation? • ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure El Application Field ❑ Other:
a. Was the conveyance man-made? El Yes ❑ No n NE
b. Did the discharge reach waters of the State?(If yes,notify DWR) ❑ Yes ❑ No :INA ❑ 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 El NA ❑ NE
2.Is there evidence of a past discharge from any part of the operation? ❑ Yes E'4lo ❑ NA ❑ NE
3.Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes DNo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2015 Continued

Facility Number: p Z.--j ' 0 Date of Inspection:
Waste Collection&Treatment
4.Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑ Yes 0' ❑ NA ❑ NE
a.If yes,is waste level into the structural freeboard? ❑ Yes ❑ No ❑—Ni❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard(in):
Observed Freeboard(in): 3 0
5.Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E 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 E Yes ErNo ❑ 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? ❑ Yeso ❑ NA ❑ NE
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 ❑ Yeso ❑ NA ❑ NE
maintenance or improvement? 1
Waste Application
10.Are there any required buffers,setbacks,or compliance alternatives that need ❑ Yes Q o ❑ NA ❑ NE
maintenance or improvement?
11.Is there evidence of incorrect land application?If yes,check the appropriate box below. ❑ Yes dNo ❑ 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): C ( `S G e4 y
13. Soil Type(s): 1\1 u
14.Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 'No ❑ NA ❑ NE
15.Does the receiving crop and/or land application site need improvement? ❑ Yes IEINo ❑ NA ❑ NE
16.Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [( lo ❑ NA ❑ NE
acres determination?
17.Does the facility lack adequate acreage for land application? ❑ Yes [�No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 'o ❑ NA ❑ NE
Required Records&Documents
19.Did the facility fail to have the Certificate of Coverage&Permit readily available? ❑ Yes 'o ❑ NA ❑ NE
20.Does the facility fail to have all components of the CAWMP readily available? If yes,check ❑ Yes ❑' o ❑ 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 1 'No ❑ NA ❑ NE
❑Waste Application ❑Weekly Freeboard ❑Waste Analysis ❑Soil Analysis ❑Waste Transfers ❑Weather Code
E Rainfall ❑Stocking ❑Crop Yield ❑120 Minute Inspections E 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 4No ❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: (�� - Date of Inspection: 27.E ZeD°0
24.Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes aNO.
❑ NA ❑ NE
25.Is the facility out of compliance with permit conditions related to sludge? If yes,check ❑ Yes © No ❑ 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 [No ❑ NA ❑ NE
27.Did the facility fail to secure a phosphorus loss assessments(PLAT)certification? ❑ Yes El4 ❑ NA ❑ NE
Other Issues ��
28.Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes L�'1V0 ❑ 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 to ❑ 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 []No ❑ 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 �to ❑ 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 ❑ NE
33.Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes N ❑ NA ❑ NE
34.Does the facility require a follow-up visit by the same agency? ❑ Yes ffNo ❑ 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).
C w( (b +lam /C( C(u /Or .5'-161 i 1 - ,C- 1 C/ 0 -13- L(
Cfit`✓ e �(� i vL nro.� 1' cke-7-C��G1- L G� '-1 64-e-cl-fT .
G `'I
'Cs a `t10-(30d • ts(
Reviewer/Inspector Name: �?)j `1 1 i)►/\,, 2 Phone:9, G-q 33 '3?j it
Reviewer/Inspector Signature: ,A�� Date: Z ei 3.Jy 2-0 2
Page 3 of 3 ✓ 2/4/2015