820491_Routine Inspection_20210624

& •7 /o3/a-i
obivision of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: kr
Reason for 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
Date of Visit:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Arrival Time:
rer
A/6(.44
Departure Time: [J, 14f1 County: c y�Wii Region: l d
Owner Email:
Phone:
f fi
Facility Contact:Title: Phone:
f(
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
ge..442,1‘-e
Latitude:
Integrator: Z-9
Certification Number: j %3dS
Certification Number:
Longitude:
Design Curren
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
Layer
Non -Layer
Non -La ers
Pullets
Turke Poults
Other
ign Cu
fty Poi
Dairy Cow
Dairy Calf
Dairy Heifer
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
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?
❑ Yes
❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
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 ®'1lo ❑ 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?
Page 1 of 3
2/4/2015 Continued

Facility Number: O a2 - Y c9
Date of Inspection: ‘7,;(//4
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
l
.73
Structure 2
Structure 3 Structure 4
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?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
❑ Yes c_f_;1,-10 ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
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.
❑ Yes 210 ❑ NA ❑ NE
❑ Yeso ❑ NA ❑ NE
❑ Yes ..EF'No ❑ NA ❑ NE
❑ Yes_I o ❑ NA ❑ NE
❑ Yes .21-No ❑ NA El NE
❑ Yes No ❑ NA ❑ NE
❑ 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 ❑ Application Outside of Approved Area
12. Crop Type(s): Pe64-&-ij,,pL&rii47L�z-u�2�
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ,a -No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes J'No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes jallo ® NA 0 NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ..2111\To ❑ NA 0 NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 0 Yes ® NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes rilco [] NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design El Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
El Waste Application El Weekly Freeboard El Waste Analysis ❑ Soil Analysis
❑ Yes j=1,.No ❑ NA ❑ NE
❑ Waste Transfers El Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield El 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ..e—No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes - STo ❑ NA ❑ NE
2/4/2015 Continued
Page 2 of 3

Facility Number:
Date of Inspection:
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 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:
Yes,,ENo ❑ NA 0 NE
❑Yes 0No EjNA El 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?
Yes Q No Ej NA 0 NE
0Yes ..ONo 0NA EINE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document Yes ..El -No 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 �Q No ❑ NA 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 0 Yes- fl No 0 NA 0 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 No Ej NA ❑ NE
Application Field P1 Lagoon/Storage Pond P] Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 0 Yes NA El NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? 0 Yes Q No NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? 0 Yes ±„Q No NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature: Date:
Page 3 (4.3 2/4/2015

FACILITY #:
FREEBOARD
'71 FARM NAME:
(.1
0
(
ACTUAL LAGOON LEVEL r1_3
PERMIT (#19)
- DUE EVERY 5 YEARS
- EXPERIATION DATE NUMBER OF ANIMALS
- ACTUAL NUMBER OF ANIMAL
- OIC CARD YES OR NO
WASTE UTILIZATION PLAN (WUP) (#20)
SOIL TYPES
CROP TYPES f ��. r1,t: ,,L t' ///.._.. ) -e-eie . ;
- THE UTLIZATION PLAN SHOULD .HAVE A (-) NEGATIVE NUMBER 4`_; ,• d-1 r'G .b:.f
ODOR CONTROL CHECK LIST YES,6R NO
t
Maps Irrigation Plan
9 p ,
WASTE REPORT (#21)
-GOOD FOR 60/DAYS BEFORE OR AFTER
DATE -�� NITROGEN LEVEL
EVERY 3 YEARS:
P-I (NO MORE THEN 400)
PH (Note if 4 or less)
SOIL REPORT (#21)
DATE
ii
Cu/ZN (NO MORE THEN 3000) CU ZN
(IF PEANUTS NO MORE THEN 300)
MENTAL CHECK OF CROP AND FIELD NUMBERS
IRR2 (#21)
ZONE ACRES PAN 'CROP TYPE
FLOW RATES l Via,; NITROGEN (N)
120 Min inspection initialed / Weather Codes
Commercial Fertilizer Chicken Litter
CALBRIATION (#24)

- EACH REEL SHOULD BE CALIBRATED
- DATE DUE EVERY TWO YEARS
- FLOW RATES#
RAIN FALL (#21)
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED
-LOOK FOR BIG NUMBER DIFFERENCES SEE THAT THEY MATCH THE IRR2
FORM
LU GE (#21 & 25)
-DUE EVERY YEAR: DATE, - C'
RAIN BREAKER FORM
% RATIO OF SLUDGE
OTHER FORMS (#22 AND #21)
CROP YEILDS MORTALITY
VISUAL CHECK
FOUNDATION OR PIT LEAKS PIPE LEAKS LAGOON
SEEPAGE LAGOON BARE AREAS TREES OR GRASS NEED TO
BE REMOVED EROSION DITCHES
WINTER CROP(OVERSEEDED) ALIVE CROP HARVESTED
FIELDS GOOD HEALTHY CORPS CORRECT
CROPS NO PONDING REELS FEED
BINS LAGOON GARBAGE