260008_Compliance Routine Inspection_20210520

acility Number
ivision of Water Resou ces '3
0 Division of Sod ant
1' Other
Type of Visit: [Compliance 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:
111WII. 'I, "Hai lirA
Arrival Time:
?3- o0
Departure Time: I ! aO
Mailing Address:
Physical Address:
Facility Contact:
htede
Owner Email:
Phone:
County:
Region: PRO
/44-47
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title: QW►lz'/" Phone:
r1G�u
Latitude:
Integrator: 7f�s.1
Certification Number: o—C—/
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:
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes
2K ❑
NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
El Yes El No El NA ❑NE
❑ Yes []'510 ❑ NA ❑ NE
❑ Yes ErKo ❑ NA ❑ NE
Page 1 of 3
2/4/2015 Continued

Facility Number: [a -
Waste Collection & Treatment
Date of Inspection: j�e'D
f
12. Crop Type(s):
13. Soil Type(s):
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 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
L33 3r
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
❑ Yes
i No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 5 Structure 6
0 Yes laiNo ❑ NA ❑ NE
❑ Yes [ g.° ❑ 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.
9"fesNo ❑ NA ❑ NE
❑ Yes 2-No 0 NA [] NE
❑ Yes allo ❑ NA ❑ NE
❑ Yes Qua ❑ NA ❑ NE
❑ Yes ago 0 NA ❑ NE
❑ 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
6/ Pi, /wIY
emu.. //
❑ Application Outside of Approved Area
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 ❑ No ❑ NA ❑ NE
❑ Yes al' o ❑ NA ❑ NE
❑ Yes []'No ❑ NA ❑ NE
❑ Yes [r No 0 NA ❑ NE
❑ Yes DNo ❑NA ❑NE
❑ Yes ago ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [ J 1Go ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists 0 Design ❑ Maps ❑ Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Rainfall ❑ Stocking ❑ Crop Yield El 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?
Page 2 of 3
❑ Other:
❑ Yes 12-1‹:-; ❑ NA
❑ Waste Transfers ❑ Weather Code
❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
❑ Yes llo ❑NA ❑NE
❑ Yes E'No ❑ NA ❑ NE
2/4/2015 Continued
❑ NE

Facility Number: ) [o -
V
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 El 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:
(Date of Inspection: ApS 02.p.-Ap/
❑ Yes ' No
❑ Yes o
❑ NA
❑ NA
❑ NE
❑ NE
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes 13<o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? El Yes ❑i'&lo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes aislo ❑ 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? ❑ Yes ENo ❑ NA El NE
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 Ergo El NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes hTo ❑ NA ❑ NE
❑ Application Field 0 Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes allo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? El Yes Iff-No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? El Yes It 1V o El NA ❑ NE
T lam. ,C1n DTJ � j,
fP4-e- ; 4,Ifec.7j F-0 I- e'rere.ek_ kv-e- Ge_4-43,1a& 7n4..5
Reviewer/Inspector Name:
,e_
Phone:
`-/O-3Z3--A ,5 I
Reviewer/Inspector Signature:
Page 3 of 3
Date: ®,f`p�(
2/4/2015