820002_Compliance Inspection Routine_20210504

Division of Water Resources
Division „of Soil and Water Conse
Other Agency
Type of Visit: 1Y(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:
Owner Name:
Mailing Address:
Physical Address:
Arrival Time:
5
—�i J /� ( /� (�� Departure Time: [' , 9Q 1 County: ✓tAJ Region:
o y�y� r ndc!J/ 3oN tirr� Owner Email:
Jo 111l Phone:
Fru
Facility Contact: ION NA l N C
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
(1
Title:
fl
Latitude:
Integrator:
Phone
smithfiell
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 ❑ 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
107&2@
No ❑ NA ❑ NE
❑ Yes
❑ Yes
No ❑NA ❑NE
No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3
5/12/2020 Continued

Facility Number: eR - �S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA 0 NE
❑ Yes�fls4o ❑NA ❑NE
Date of Inspection:
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: l
Spillway?: q
Designed Freeboard (in):
Observed Freeboard (in): 30
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 0 Yes 0 NA 0 NE
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. 0 Yes No 0 NA 0 NE
❑ Excessive Ponding ❑ Hydraulic Overload 0 Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crops Window 0 Evidenceidof Wind Driifft� (❑}^(Applic t'iio`/n, Outside
oofApproved
(,AArea�y //�//
12. Crop Type(s): C' Il ft W h2 a,�l Gr `� bl OrbjC 3eA 1 1 I udc ., Simi I J ra✓I + "
13. SoilType(s): 1�90 l oiK, mac, 3ofrig
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? ❑ Yes ISI No ❑ NA 0 NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check 0 Yes .\J No ❑ NA 0 NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application 0 Weekly Freeboard ❑ Waste Analysis 0 Soil Analysis ❑ Waste Tran ers 0 Weather Code
0 Rainfall ❑ Stocking 0 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 © o 0 NA 0 NE
Page 2 of 3 2/4/2015 Continued
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yeso ❑ NA 0 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? ❑ Y s� ❑ No 0 NA ❑ NE
O Yes
to ❑NA ❑NE
❑ Yes ❑so ❑ NA 0 NE
❑ Yes No ❑ NA ❑ NE
Et Yes o ❑NA ❑NE
O Yes�0 NA 0 NE
O Yea ",No 0 NA
❑ Yes No ❑ NA
❑ NE
❑ NE

Facility Number: Vr'1 -
Date of Inspection:
0
24. Did the facility fail to calibrate waste application equipment as required by the permi/
❑ Yes fNo ❑NA ❑NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check D,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:
ialls120
sot
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Y s �No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes Io ❑ NA ❑ NE
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 ❑ Yes No ❑ NA ❑ NE
permit? (Le., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Ye o ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
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 No ❑ NA ❑ NE
❑ Yes
❑NA ❑NE
❑NA ❑NE
o ❑NA ❑NE
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Reviewer/Inspector Name: R
Reviewer/Inspector Signature: -�t�. rit JJPJ °
Phone:'7J9 Sq(770
Date:
Page 3 of 3
2/4/2015