820175_inspection_20210317

fcCrr. 31 ( 7 / A I
Facility Number
Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 4 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
Arrival Time:
/40
Departure Time:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: ®._(''L ����"} Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Owner Email:
Phone:
County:
Region:
Phone:
0(17 s.iee-vz,,,
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
�e oZ�c""ro
/60 7ylo
Swine
Design Current
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
a'/
ci
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Wet Poultry
Design Current
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: n Structure ❑ Application Field n Other:
a. Was the conveyance man-made?
❑ Yes
F'
❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
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
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 1 of 3
2/4/201 S Continued

Facility Number: ?"d2. - .2V-- Date of Inspection: 3O/7 /a-/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? n Y• es No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard'? [] Y• es No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
19
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?
n Y• es rrS1 No ❑ NA ❑ NE
El Yes
No El NA ❑ NE
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? n Yes E3No ❑ N• A ❑ N• E
8. Do any of the structures lack adequate markers as required by the permit? [ Y• es f No NA ❑ N• E
(not applicable to roofed pits, dry stacks, and/or wet stacks) T"
9. Does any part of the waste management system other than the waste structures require [1 Y• es No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ri Yes No [1 NA ❑ N• E
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. Fl Yes Ez No El NA [] NE
Excessive Ponding El Hydraulic Overload Frozen Ground [1 H• eavy Metals (Cu, Zn, etc.)
PAN fl PAN > 10% or 10 lbs.
Outside of Acceptable Crop Window
12. Crop Type(s):
13. Soil Type(s):
Total Phosphorus Li Failure to Incorporate Manure/Sludge into Bare Soil
P
Evidence of Wind Drift [1 A• pplication Outside of Approved Area
LP-
4i �N ��. s�%G ' „_ 7 `i�' _ - /
14. Do the receiving crops differ from thos 'designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available'?
20. Does the facility fail to have all components of the CAWMP readily available'? If yes, check
the appropriate box. _
WUP L�iCliecklists Li Design [.J Maps Ci Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
[1 Waste Application Weekly Freeboard El Waste Analysis Li Soil Analysis
Rainfall 1- Stocking
Cop Yield C 1 1 20 Minute Inspections
ri Y• es f- No ®NA []N• E
L�I Yes No LI NA ❑ NE
[- Y• es J No ❑ NA ❑ NE
El Yes [0No ri NA []N• E
ri Y• es liX1 No ri NA fN• E
[1] Yes
Yes [ ] No
ri N• A flNE
NA [l N• E
[_] Other:
[] Yes l No r N• A NE
Waste Transfers f Weather Code
[1 Monthly and 1" Rainfall Innspections ri Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakcrs on irrigation equipment'?
Page 2 op
' J
El Y• es IN No fl N• A r1 N• E
Yes No NA p NE
2/4/2015 Continued

Facility Number: V„/` -
Date of Inspection:3 // 7/a/
24. Did the facility fail to calibrate waste application equipment as required by the permit?
Yes No ❑NA ❑NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes El No ❑ 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:
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 El No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ 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 El No ❑ 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 n No ❑ 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 41
No ❑ NA ❑ NE
1-1 Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes UI''No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 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).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
4 RR /s D Phone:
Date:
2/4/2015