820354_Inspection_20201105

Facility Number
22
Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Krf
(-1• t0
Type of Visit: %Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 6ARoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
Owner Name:
ro•20
Arrival Time:
--R-+pl-e H Fp -rnc
Jatrzc Mttcle( HQf@
Departure Time:ITCounty: CartfG0h Region: 11:su
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: CUM 7 BQr W I L( Title: [ Q,C . QC Phone:
Onsite Representative:
Certified Operator: NI' C\ 3 Q I N 0 ?.e
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
crrictinKeici)
Certification Number: I V)J O 98
Certification Number:
Longitude:
Swine
��. Design Current
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Nil
arrow to Wean
/100 J
aGoo
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Wet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Cattle
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
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 DWR)
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
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No i NA ❑ NE
❑ Yes ❑ No IX1 NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes kiJ No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes f4 No ❑ NA ❑ NE
of the State other than from a discharge? "`TTTGGG
Page 1 of 3
2/4/2015 Continued

Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 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):
;Lj
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
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
❑ Yes [I No ❑ NA ❑ NE
D Yes vi No ❑ NA ❑ NE
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 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 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance altematives 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 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload D Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
El PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Cropo1Window* 9 ❑ Evidence of Wind Drifty ❑ Application Outside of A provedArea
12. CropType(s): BQrmt clO, over ,€ed: T`t iI Fe✓cl>�C LoI It1"i,e gr42e
13. Soil Type(s): 1) O1 Fb K 3 V) Gig r Jfl) 3 L 4) I
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ViNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes K No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes — l' No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes al No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes KI No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 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 NI No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard El Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield El 120 Minute Inspections El 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 '/No ❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: e - :j"911
Date of Inspection: Ill C 1,1/O
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
❑ Failure to complete annual sludge survey
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
❑ Yes '[/ No ❑ NA ❑ NE
❑ Yes No E NA ❑ NE
0 Failure to develop a POA for sludge levels
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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 facilitypose 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?
Yes El No
Yes No
Yes 01 No
Yes ,7 No
Yes
N
Yes y No
Yes Kti No
Yes No
Yes M No
❑ NE
❑ NE
❑ NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑NE
❑ NA ❑NE
❑ NA ❑ NE
❑ NA ❑NE
❑ NA
❑NA
Comments (refer to question=#):'Explain any YES answers'. and/or any additionahrecominendations
Use drawings of facility, to better explain situations (use additional pages as necessary)=
or any othercomments:E
JfFq-. v,voK on kIT 0 Iglopieb
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
04R famoT
Phone: Cr 1D 3V
Date:
015'
2/4/2015