310475_Structure Evaluation_20210223

O'Division of Water Resources 13
Facility Number O Division of Soil and Water Conservation
O Other Agency
Visit: O Compliance Inspection 0 Operation Review Cr9tructure Evaluation 0 Technical Assistance
for Visit: O Routine O Complaint r ollow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:l Arrival Time: Departure Time: ��j�� County:
Farm Name: RE.Ey4 Iy ev IoWS t-AR MSS � d o2a Owner —EmraiL'
Owner Name: R �ift� �bUS� Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Title:
Latitude:
Phone:
Region: W 0 RD
Integrator: � ryl , ili rl E L D S
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
nry Pnultry Canacitv Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
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 DWR)
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [ /"No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ 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 o ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes go ❑ 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?
0
Page 1 of 3 21412015 Continued

Facility Number: 11 - 4 5 jDate of Inspection: L �'-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? dY s
a. If yes, is waste level into the structural freeboard? WYees
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: i
❑No ❑NA ❑NE
❑No ❑NA ❑NE
Structure 6
Spillway?:
Designed Freeboard (in):_� q 5
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [. ] 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 �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 [3No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes Q o
❑ 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 [3"No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
�,/
❑ Yes I3 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 ❑ 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): S &O
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA ET�NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA dE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA NNE
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
Z] E
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA
D E
the appropriate box.
❑ WUP ❑Checklists ❑Design ❑Maps ❑Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
E2"'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
❑ No
❑ NA
[�NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
D<
Page 2 of 3
21412015 Continued

Facility Number: jDate of Inspection: da -oZ3"
0
24. Did the facility fail to calibrate waste application equipment as required by the permit?.
❑ Yes
❑ No
❑ NA [�KE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ No
❑ NA E3"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
❑ No
❑ NA �iE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
❑ No
❑ NA
[ E
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
❑ No
❑ NA
E VE
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
En -'Yes
[:]No
❑ NAE
permit? (i.e., discharge, freeboard problems, over -application)
1, '
co, Cyc'q
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ 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?
ER-�es
[:]No
❑ NA
aJ
1
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑ No
❑ NAtNE
Comments (refer to question ft 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 necessarv).
due io' "\AWS non-co-pl,"Ce ;ssues
No 954-48
RuFus (ZouSe'S 1"s ?1A expired 01-3o-a\ ar� u.y�,S nafi C'e-t`� c� a,nd
were nc Ceeor�ed.
Cl � � not
'the j%.c� I,`i1� a � d« �ofl �� � S�.;-�1�QId�•
(��Do�� �farV� "ii�e /1@Qr by
-j"�ne �oG� �►�'}� cthucQo./SGo Nss �(? W'Cks C l + -the
.. �e CceeK. �jC� lia..S do ev, Aer\ee. 'I 1.�—i ay°`� Po"^Q""ry
�,e1ds h� OGGur��+
err-;VV o1 Cori 8 11 CA . n ir Ve IPo C-t h'b
'Fj12 1� �' `+� '"1e I-t�abel- itiSP r�S wef C +1r+al2S` Way . I nQ CeSI� Q�
®� W i1 �011 bld
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone: o vo71 i� - 544
Date:
21412015