820014_Inspection_20210426

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Facility Number
Type of Visit: E3 ompliance 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:
Farm Name:
Owner Name:
Arrival Time:112111irrpeparture Timeyf/` <i)i97/1 County:
1795erbelo-r#
Mailing Address:
Owner Email:
Phone:
Region: % i�
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: , f
Back-up Operator:
Location of Farm:
Lt.Li„)1774e-07,42,)-1
Title:
Phone:
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
Wet Poultry Cap
Layer
Non -Layer
D Poult
Beef Brood Cow
Turke Poults
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?
❑ Yes No ❑ 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 .E.-No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Ye No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3
2/4/2015 Continued

'Facility Number: al -
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
/
Date of Inspection:
VA26
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
14
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?
''Yes
Yes
Structure 5
❑NA ❑NE
❑ NA ❑ NE
Structure 6
❑ Yes _lo ❑ NA ❑ NE
❑ Yes _allo ❑ 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? Yes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes L No ❑ NA ❑ NE
❑ Yes _® No ❑ NA ❑ NE
❑ Yes ,,,Er No ❑ NA ❑ NE
❑ Yes JNo ❑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
12. Crop Type(s):
13. Soil Type(s): Jae
❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
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14. Do the receiving crops differ from those 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
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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 ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
ErWaste Application ❑ Weekly Freeboard ❑ Waste Analysis .E Soil Analysis
n Yes ErNo ❑ NA ❑ NE
❑ Yes 2l4o ❑ NA ❑ NE
❑ Yes „e''No ❑ NA ❑ NE
❑ Yes „ rNo ❑NA ❑NE
El Yes ,, 'No NA ❑NE
❑ Yes ,j' No ❑ NA ❑ NE
❑ Yes .0No ❑ NA ❑ NE
❑ Other:
„12Yes D No ❑ NA ❑ NE
❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ StockingCrop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ 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 rainbreakers on irrigation equipment?
Page 2 of 3
❑ Yes ONo
p Yes No
❑NA ❑NE
❑ NA ❑ NE
2/4/2015 Continued

Facility Number: 6,9 - /4/
(Date of Inspection:
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
ZNon-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
❑ Yes
0 Yes
n Failure to develop a POA for sludge levels
/VI 6-6
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 facility pose 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:
-D-No ❑ NA ❑ NE
to 0 NA ❑ NE
S-6 A-ZS Pd
❑ Yes ,®`No ❑ NA ❑ NE
n Yes .❑`filo ❑ NA ❑ NE
❑ Yes .. -No ❑ NA 0 NE
❑ Yes .12'No ❑ NA ❑ NE
❑ Yes ,❑ No ❑ NA ❑ NE
0 Yes 0 No ❑ NA ❑ NE
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 j2 No
❑ Yes ,.e'No
❑ Yes No
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
y YES answers and/or any additio ai �recommendatic ns ttr any of omme ts.
+ 11a a� t ettear a ain uations (use additional pages
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Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Date:
Phone:62::/e)
//94/ /
2/4/2015

FACILITY #: �'f �I
FREEBOARD I � ACTUAL LAGOON LEVEL
PERMIT (#19)
(f-orii go-4 fool) U
FARM NAME: fiq D d&414 ee"t-d
- DUE EVERY 5 YEARS
- EXPERIATION DATE 0Zla7 J`� � �7 NUMBER OF ANIMALS VIO
- OIC CARD6OR NO 9.6 1-zi
WASTE UTILIZATION PLAN (W JP) (#20) 6
SOIL TYPES 1416, div�.1: ., ... ,, i 1 �'
k _It( et- t .� i-w�
- THE UTLIZATION PLAN SH'OULD,HAVE Af (-) NEGATIV
,
- ODOR CONTROL CHECK LIST ES OR NO
- Irrigation Plan Maps`
WASTE REPORT (#21)
-GOOD FOR 60 DAYS BEFORE OR AFTER
DATE , 1 / NITROGEN LEVEL
SOIL REPORT (#21)
EVERY 3 YEARS: DATE % Oh (C)
P-I (NO MORE THEN 400) PH (Note if 4 or Tess)
Cu/ZN (NO MORE THEN 3000) CU ZN
(IF PEANUTS NO MORE THEN 300)
MENTAL CHECK OF CROP AND FIELD NUMBERS
qd v
IRR2 (#21)
ZONE ACRES PAN CROP TYPE
FLOW RATES NITROGEN (N) 3 3
120 Min inspection initialed .- ' Weather Codes
Commercial Fertilizer Chicken Litter 1"
Aucl
46/rmi ee
4,2

CALBRIATION (#24)
EACH REEL SHOULD BE CALIBRATED
DATE DUE EVERY TWO YEARS dl / 961 -7 Aged
FLOW RATES
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED
-LOOK FOR BIG NUMBER DIFFERENCES SEE THAT THEY MATCH THE IRR2
FORM
RAINFALL (#21)
di6e-(
SLUDGE (#21 & 25)
-DUE EVERY YEAR: DATE -% a 7 / 6
0: ql a P: 3, (, % RATIO OF SLUDGE
OTHER FORMS (#22 AND #21)
RAIN BREAKER FORM CROP YEILDS 1_ MORTALITY
arcia&
VISUAL CHECK
11,3-/31 /01
FOUNDATION OR PIT LEAKS PIPE LEAKS LAGOON
SEEPAGE LAGOON BARE AREAS TREES OR GRASS NEED TO
BE REMOVED EROSION DITCHES
WINTER CROP(OVERSEEDED) ALIVE CROP HARVESTED
FIELDS GOOD HEALTHY CORPS CORRECT
CROPS NO PONDING REELS FEED
BINS LAGOON GARBAGE