820657_Compliance Inspection Routine_20210418

Type of Visit:`G.ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit:outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
'1115'al
gobbj E. mQrchaII fiho
V.DO
Arrival Time:
Owner Name:Row 3 -rod d ma rl-m!
Mailing Address:
Physical Address:
Facility Contact: mcli rnllt,hoif Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Game
Gclipe
Departure Ti County: / i e IN V Region: fro
ELATEED TO
LASERFICHE
Owner Email:
Phone:
APR 19 2021
a ,U ne_r
Latitude:
DEQ/DWR WORDS
FAYETTEVILLEREGIONAI nFFifF
Integrator:
Phone:
preWl9-e
Certification Number: I q 3fS1 1
Certification Number:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure El Application Field El 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) ❑ Yes "No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 'RNo ❑ 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?
Longitude:
❑ Yes Q No ❑ NA ❑ NE
❑ Yes siScNo ❑ NA ❑ NE
❑ Yes '&No ❑ NA ❑ NE
Page 1 of 3
2/4/2015 Continued

❑ Yes
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 azio ❑ NA 0 NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 'EkNo ❑ 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 '19 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑Yes �No ❑ NA El 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 /❑ Ap lication Outside of Approved Area
12. Crop Type(s): Crprl 41/1)-a 7s hrn l 72z-'o'iptf.y((0�/ 69f/rri, /
13. Soil Type(s): )(JpL / A- w Ad
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 9 Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
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
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Date of Inspection: Ai! 161ai
ND
❑ Yes
❑ Yes
Structure 4 Structure 5
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?
No ❑ NA ❑ NE
No ❑ NA ❑ NE
Structure 6
❑ Yes No
❑ Yes'RNo
❑ Yes N No
❑ Yes iq No
❑ Yes No
❑ YeskNo
❑ Yes IS1,No
❑NA ❑NE
❑NA El NE
❑ NA ❑ NE
El NA ❑NE
❑ NA ❑NE
❑ NA ❑ NE
❑ NA
❑ NA
❑ NE.
❑ NE
❑ Yes NNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis
y El Soil Analysis ❑Waste Transfers ❑Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections 0 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 ❑ NA ❑ NE
Page 2 of 3
2/4/2015 Continued

(Facility Number: flak - 067
Date of Inspection: 11511
24. Did the facility fail to calibrate waste application equipment as required by the permit?? ❑ Yes tiNNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check El Yes 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?
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 ❑NA ❑NE
❑ Yeso ❑ NA ❑ NE
D Yes "RNo ❑ NA ❑ NE
❑ Yes'lNo ❑NA ❑NE
❑ Yes RNo ❑ NA ❑ NE
❑ Yes
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?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
No ❑ NA ❑ NE
D Yes tNo ❑ NA ❑ NE
❑ Yes ti,No ❑ NA ❑ NE
❑ Yes '51,No ❑NA ❑NE
Phone:
Date: