820678_Compliance Inspection Routine_20210416

vision of Water;Resource
Divisiorrof ....
#Tther:Agoncy�.�
Type of Visit: .Stompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: .b xoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 9.9fa!
Farm Name:
Arrival Time:
/ig`' CU F:OW5 .rrc..
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
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Departure Time:
Owner Email:
Phone:
County: frir Region: //CO
FNTERED TO
LASERFICHE
APR 19 2021
DEQ/DWR WQROS
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Onsite Representative: J/
Title: �gEy-n� o!
FAYE TEVILLE REGIONAL OFFICE
Phone:
Integrator: Pit" 77
Certified Operator: /7 Certification Number: /, 33%tr'
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
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?
Longitude:
❑ Yes / No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [2o ❑ NA ❑ NE
❑ Yes ❑10 El NA ❑NE
Page 1 of 3
2/4/2015 Continued

Facility Number: rf' 4_) 7f
Date of Inspection: t--11,L T
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
❑ Yes [ do ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
/" rt.t'Y
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ago ❑ 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 0 Yes 'No ❑ 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? lEres ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes EriNo ❑ 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 ['11 o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 24 ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ago ❑ 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 ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
%w; �,-' rre
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ago ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 1i Io ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 124 ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? 0 Yes ErNo 0 NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ago ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes 12110 0 NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes L21 o 0 NA 0 NE
the appropriate box.
❑WUP ❑Checklists ❑Design 0 Maps 9 Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes "No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis 0 Soil Analysis 0 Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield 0 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes 124 ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 13/No ❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: -
IDate of Inspection: .41-/L-; (
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.
El Yes QNo ❑NA ❑NE
❑ Yes I21No ❑ NA ❑ NE
❑ 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 0 Lagoon/Storage Pond ❑ Other:
❑ Yes Ergo ❑ NA ❑ NE
❑ Yes ago ❑ NA ❑ NE
❑Yes []No ❑NA ❑NE
❑ Yes 21/..o ❑ NA ❑ NE
D Yes No ❑ 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?
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❑ Yes QNo 0 NA ❑NE
O Yes 20 0 NA ❑ NE
�es l�1VO ❑ NA ❑ NE
Cat, �• " ram// l J & i7 fiuh 2rpt r />' Ace Qt.. ltYY tftPnp -,�/'laI to
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Alen?: fld os
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
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Phone:
Date:
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2/4/2015