670080_Compliance Evaluation Inspection_20210128

V Division of Water Resources
Facility Number -0 Division of Soil and Water Conservation
0 Other Agency
Type of visit: ©' Compliance 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: 7,Q� Arrival Time: I Departure Time: cJ� County: Region:
Farm Name: —P�� y-ti ,1Sf,..� �G�r-� Owner Email:
Owner Name: Phone: 3
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative:1^ Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
l; D
0L?
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Certification Number:
Certification Number:
Design Current
Wet Poultry Capacity Pop.
Layer
Non -Layer
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
Discharses and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑N-o ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑Z
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No / ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)? O
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 No 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 I of 3
21412015 Continued

Facility Number: Ej - jDate of inspection: l t.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
�
L ^❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑- No ©-N-A
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: NQA"j J_
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Q ,6,
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑'1Qo ❑ 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
o ❑ 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? [:]Yes [_1X0 ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [a'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 QNo ❑ 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 to ❑ 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):
13. Soil Type(s):
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
EXXI'l ❑ NA
❑ NE
Did the facility fail to secure and/or operate per the irrigation design or wettable
16 ty P p g g
❑ Yes
❑ 'No
❑ 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
❑/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
Q-Ko_�
❑ 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 E3 o ❑ 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 Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E N ❑ N ❑ 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

Facility Number: jDate of Inspect -ion: 2 L /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑f N ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Q o ❑ 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: i
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [3'<o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No E?N-/A ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 0 o ❑ 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 o ❑ 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 ❑ /oo 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 [:]No ❑ NA ❑ NiE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes N9f ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes O No ❑ 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).
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Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
cola --7 _? 0 -_�-i L- B
Phone:
Date: Er
112 S