820075_Complianec Inspection Routine_20210422

Division of -Water Resources
Division of Soiland Water Conservation'
Other Agency:.
Type of Visit:
Reason for Visit:
Date of Visit:
Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Arrival Time:
8' 1
Departure Time:
FarmName:11t'i+P9 \i\)011Il ntinCJ, NC
Owner Name:6iflOOiiN J61:edttlh
Owner Email:
Phone:
County: _____ O_ Region: fil
Mailing Address:
Physical Address:
n� (���
Facility Contact: P\ tiO ti YAV D Title: Phone:
Onsite Representative: Integrator: MillC,
Certified Operator: <
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Certification Number:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field D 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 tl No ❑ NA ❑ NE
❑ Yes',No ❑ NA ❑ NE
❑ Yes "No ❑NA ❑NE
❑ Yes ❑ NA ❑ NE
❑ Yes -- NNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3
5/12/2020 Continued

Facility Number: IW -
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?
Date of Inspection: 9I i2 f zl
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
❑ Yes
❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
19 1�-
No ❑ NA ❑ NE
o ❑NA ❑NE
Structure 6
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 .-a-No 0 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?
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.
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground 0 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 ❑ Ap lication Outside of Approved Area
❑ Yes�No 0 NA ❑ NE
❑ YeZ-ONTo ❑NA El NE
❑ Yes'No 0 NA ❑ NE
❑ Yes To ❑NA El NE
0
12. Crop Type(s): plc-AU-1 1 Berm tl U'l� CDi WORM (J tv 1
13. Soil Type(s): �Dtf n N. a lg tarn
❑ Ye;sinstl
❑ NA ❑ NE
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Ye No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Y s o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable 0 Yes ❑ NA ❑ NE
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.
0 Waste Application 0 Weekly Freeboard ❑ Waste Analysis
0 Rainfall ❑ Stocking 0 Crop Yield ❑ 120 Minute Inspections
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?
Page2of3
O Yes No ❑NA ❑NE
❑ Yes No ❑ NA 0 NE
❑ Yes NNo ❑ NA 0 NE
❑ Yes 0 NA 0 NE
❑ Other:
O Yes No ❑ NA
❑ Soil Analysis 0 Waste Transfers ❑ Weather Code
0 Monthly and 1" Rainfall Inspections ❑ Sludge Survey
❑ Ye
O Yes
❑ NE
No ❑ NA ❑ NE
No ❑NA ❑NE
2/4/2015 Continued

Facility Number: ?Q -1
Date of Inspection: ilia l J-1
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
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
❑ Yes
❑ Yes
❑ Failure to develop a POA for sludge levels
No ❑ NA ❑ NE
❑ NA ❑ 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.
D Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No ❑ NA ❑ NE
❑ Yes Is o ❑NA ❑NE
❑ Yes nNo ❑ NA ❑ NE
❑ Yes 1V No ❑ NA
❑ Yes ` .44o ❑ NA ❑ NE
❑ YesbNo ❑ 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?
tttie dire -it C1v6i fQUY v'jOj INV‘ftLtt 2P0
Note cat c. ofl due bi dec j, o2I
❑ Yes flN
❑ Yes
❑ Yes�No
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
a tri--ea(
Phone: i( IJ I(V 11IS
Date: 1 l 21
2/4/2015