820689_Inspection_20210427 (2)

FACILITY #: eq,)
FREEBOARD "7L%
FARM NAME: c'66
ACTUAL LAGOON LEVEL CI 1
PERMIT (#19)
- DUE EVERY 5 YEARS
- EXPERIATIO� ATE � 3-50-Y
- OIC CAR 'YES /0R NO
NUMBER OF ANIMALS � 5 -L�
WASTE UTILIZATION PLAN (WUP) (#20)
SOIL TYPES } c pe
-�°
CROP TYPES (' .� ( ) 9117
THE UTLIZATION PLAN SHOULD HAVE A (-) NEGATIVE NUMBER
ODOR CONTROL CHECK LISTOR NO
Irrigation Plan Maps
WASTE REPORT (#21)
-GOOD FOR/60 DAYS BEFORE OR AFTER
DATE ,/, f ( NITROGEN LEVEL
</1-�
SOIL RPORT(#21)
EVERY 3 YEARS: DATE i.
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
IRR2 (#21)
ZONEACRES a7,2PANp/-%5- CROP TYPE /3-14/714-e-i-elti
FLOW RATES NITROGEN (N) ,2 (
120 Min inspection initialed Weather Codes
Commercial Fertilizer Chicken Litter

CALBRIATION (#24)
- EACH REEL SHOULD BE CALIBRATED
- DATE DUE EVERY TWO YEARS
- FLOW RATES
RAIN FALL (#21)
-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
-DUE EVERY YEAR: DATE
0: P:
SLUDGE (#21 & 25)
1-
% RATIO OF SLUDGE
RAIN BREAKER FORM
OTHER FORMS (#22 AND #21)
v7 CROP YEILDS rl� MORTALITY/
VISUAL CHECK
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

Facility Nu
-1/440 Division of Water Resources
0 Division of Soil and Water Co
0 Other Agency
6,474 e`//2/,),
Type of Visit: 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:
Owner Name:
Arrival Time:
IN1/igN21
Departure Time: L 2 ; 3 rp 'ounty:
Owner Email:
Phone:
Mailing Address:
Physical Address:
Facility Contact:
Region:
Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
iti/de/f
dz�
Latitude:
Integrator:
Phone:
Certification Number:
Certification Number:
Longitude:
Swt e
Design Current
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
asNci)
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Design Current
et Poultry Capacity Pop.
Layer
Non -Layer
Other
D Pout
Desigi
Ca aci
Curren
Po
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Cattle
Design ` Curren
Capacity Pop.
Beef Brood Cow
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)
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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Page 1 of 3
2/4/2015 Continued

Facility Number: - 6, F
Date of Inspection: /-7 42/
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?
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 1 Structure 2 Structure 3 Structure 4
l
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 ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes „,❑. No ❑ NA ❑ NE
❑ Yes f No ❑ 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?
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 e' No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes j' No ❑ NA ❑ NE
❑ Yes ❑'No ❑ NA ❑ NE
❑ Yes Jallo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs.
12. Crop Type(s):
13. Soil Type(s):
❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
Y]& d4%
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
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.
❑ Waste Application ,Weekly Freeboard ❑ Waste Analysis 'oil Analysis
❑ Application Outside of Approved Area
J
iffj:r0tAf rirk144e7 91.WK
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
l:
cizz,c66,7; (12},64-4-eict,
❑ Yes ❑"` No
❑ Yes a, ` No
❑ Yes No
q
❑ NA
O NA
❑ NA
1-61-91-)
❑ NE 61
❑ NE
❑ NE
❑ Yes _❑,.No ❑ NA ❑ NE
❑ Yes Q`'No ❑ NA ❑ NE
❑ Yes ❑.No ❑ NA ❑ NE
❑ Yes ,121'No 0 NA ❑ NE
n Other:
r Yes ❑ No 0 NA 0 NE
❑ 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? 0 Yes 71"No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes 'No 0 NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: < - S/�'j
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.
n Failure to complete annual sludge survey
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
n Failure to develop a POA for sludge
'Date of Inspection: C7 /1`
❑ Yes _O4To
❑ Yes .12N0
levels
❑ NA
❑ NA
❑ NE
❑ NE
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:
❑ Yes No 0 NA ❑ NE
❑ Yes Ef No 0 NA ❑ NE
❑ Yes .EliNo 0 NA ❑ NE
O Yes ,„No ❑ NA ❑ NE
O Yes ErNo 0 NA ❑ NE
❑ Yes '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 fa -No ❑ NA ❑ NE
❑ Yes ❑` No ❑ NA ❑ NE
n Yes 2No ❑ NA ❑ NE
befrte.
(c? daye....4--h,Y- A/0440-6. -5-0--a.770-c/
%. ;2c?-6) 6640 76 Cm.ed
a4,97_
Reviewer/Inspector Name:
`lv/14z,/2454,A„,
Phone:
1'&) 3Sf%75 "
Reviewer/Inspector Signature:
Page 3 of 3
Date:
2/4/2015