440011_Inspection_20201112

^', 0 Division of Water Resources
Facility Number �� - O Division of Soil and Water Conservation
O Other Auenev
II J ./jfisv ILA.
Dale of Visit: I lj a�Arrival Time: �t. Departure Time: j�4_ County: fy�r�(a )U>C1 Region:/
Farm Name: 11 u�) 17A4 �� Owner Email: 60'SS ls'N Ii31—Cd�% /aC&au.C'�
Owner Name: '{- I�X>A.N 'C.�$S Phone: '232-9-
Mailing Address: J I I L�c�pn S l�cLv he J u t f [� JG a—e7 ,'� 9
Physical Address:
Facility Contact: PewiiAlc_ )&5TS Title:
Onsite Representative: �,,wt� GU
Certified Operator: •'E'�rdP:� ,D , IIz-,,-S
Phone:
Integrator:
Certification Number: 5_ {
Back-up Operator: ��"" 1� '' 11 Certification Number: }y
PD
Location of Farm: C; - fWya /y — Latitude: �, 35. 065- Longitude: ?9 , O 1,19
Swine
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
!Layer
Non -Laver
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Dry Poultry Capacity Pop.
Layers
Non -La ere
Pullets
Turke s
Turke Polets
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify D WR)
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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Cattle Capacity Pop.
Dairy Cow
3e, o
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stacker
Beef Feeder
Beef Brood Cow
❑ Yes RNo ❑ NA ❑ NE
❑ Yes
[-]No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[]Yes U No ❑ NA []NE
❑ Yes 1�fNo ❑ NA ❑ NE
Page I of 21412015 Cautioned

FaciliC Number: IDate of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
K No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes
❑ No
❑ NA
❑ NE
Structure 1n Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifies
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
[R' 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 closrure 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 Cg No ❑ NA ❑ NE
S. Do any of the structures lack adequate markers as required by the permit? ❑ Yes allo ❑ 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 [�No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [� No ❑ NA
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [�No ❑ NA
❑ Excessive Pointing ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN> 10%or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Dare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Types): h) �i �1'FGt_ LJ �p� � Ae' u f-
13. Soil Type(s): l I L(c-A A� ( I . IJ vG dl� zlc , /I luaa7L
14, Do the receiving craps differ from those designated in the CAWMP? rls U i`l {
15. Does the receiving crop and/or land application site need improvemem?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
❑ NE
❑ NE
(s h02-iD
❑ Yes
EA No
❑ NA
❑ NE
[:]Yes
allo
❑ NA
❑ NE
❑ Yes
[A No
❑ NA
❑ NE
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
Wo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
EA No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
5bm
❑ 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
KLNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard []Waste Analysis ❑Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
12� No
❑ NA
❑ NE
23, If selected, did the facility fail to install and maintain raird reakers on irrigation equipment?
❑ Yes
[yNo
❑ NA
❑ NE
Page 2 of
21412015 Continued

Facifity Number: jDate of Inspection: 1111L
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[ONo
25. Is the Facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[0 No
the appropriate basics) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structures) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
[tNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
allo
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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 tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
AltWeRAloer, 1 -5- j�klaY 'S;u,U 'Clow
dJo
Reviewer/InspectorName: _ /IV
Reviewer/Inspector Signature: >6
Page 3 of
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
EXNo
❑ NA
❑ NE
❑ Yes
[JNo
❑ NA
❑ NE
❑ Yes
'7 N
❑ NA
❑ NE
❑ Yes
E�Nc
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
LyKA No
NA
❑ NE
❑ Yes
MNo
❑ NA
❑ NE
A(oT- r)e7uivedL-
Phone:
Date: Z 7A
21412015