820088_Structure Evaluation Inspection_20210120

Structure evaluation nspection
Facility Number: f�� --
Time in: /:=/, ' �
) Time out:
Farm Name: cu;.�-
Owner Name:
Date:
Facility Contact:
Farm 911 address:
Phone
Onsite Representative: ;y °~ Integrator:
Certified Operator: Cert. Number
Is storage capacity less than adequate? Yes No
If yes is waste level into the structural freeboard? Yes No
Was non -compliant level reported to DWR POA received
Structure: 1 2 3 4 5
Identifier:
Spillway?
Designed Freeboard (in.):
Observed Freeboard (in.):�--
Are there any immediate threats to the integrity of any of tie structures
observed? Yes No _ ~'
Do any structures lack adequate markers as required by the permit? Yes No
Does any part of the waste management system need repair Yes No
Condition of field's
Condition of receiving crop
Comments: