310242_Compliance Evaluation Inspection_20210719

41111 Division of Water Resources
Facility Numberm -FTTT__1 O Division of Soil and Water Conservation
O Other Agency
Reason for Visit 0 Routine O Complaint O Follow-on O Referral
Date of Visit:
Arrival �Time:
Departure Time
FarmName: OaAnnDTi—)Facn
Owner Email:
Owner Name: l �S`M�i1V1.1v�S Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Other
Other
Title:
Assismncc
l,n Region: jt� Igo
Phone: T'`q-'I
)0-!/D-1G�)
Integrator: f,( ](( (1 U 3A
Tf
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Laver
non -Laver
Discharees and Stream Immcts
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 yea, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (Ifyes, 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
ofthe State other than from a discharge?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes (A No ❑ NA ❑ NE
❑ Yes
K No
[:]NA
❑ NE
❑ Yes
% No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
[:]Yes
xWNo
❑ NA
❑ NE
❑ Yes
{ No
Ial
❑ NA
❑ NE
Page I of 214120IS Continued

Facili Number: Date of Inspection:
Waste Collection & Treatment .�1
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Z No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes '® No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):Q
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ 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 ❑ Yes gNo ❑ 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? 0 Yes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ® No ❑ 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 ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes N No ❑ NA ❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 14 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 Hare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
/� /� yt
I ts, V C 1"j 1;,n A
14. Do the receiving crops differ from those designated in the CAW MP?
❑ Yes
❑ No
® NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
® Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
❑ NA
U[NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
K No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Recruited Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
® Yes
❑ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
® Yes
❑ No
❑ NA
❑ NE
the appropriate box.
OWUP ®Checklists 0Design ®Maps ❑ Lease Agreements
❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
✓N Yes
❑ No
❑ NA
❑ NE
®Waste Application g Weekly Freeboard WWaste Analysis ISSoil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall 'A Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections Vg 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
CR No
❑ NA
❑ NE
Page 2 of
21412015 Continued

Facili Number: Date of inspection: 07"
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes ❑ No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
® Failure to complete annual sludge survey ❑ Failure to develop a PDA 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?
Ifyes, 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? Ifyes, check the appropriate box below.
❑ Application Field ❑ LagooNStomge Pond ❑ Other:
® Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
® NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
® NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
®No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑ No
❑ NA
❑ NE
to question #): Explain any YES answers
or any
Jae drawings of facility to better explain situations (use additional pages as necessary).
1\8. Sly T `z�)"C j 1 t Anal�55 , C61'6 )lo-1')�Ccr0l5'
Cpc. �wni , gpll 1_10y e I He bard ,Shock+ ) mot �81+� I
C'rap(de►d . (Aa-Iq�, Nod 'Z&%AG 1 records. t�-
'' q)n-lan.a Reviewer/Inspector Name: f '�1y Phone: n—t (7�
Reviewer/Inspector Signature: -/f �(�,(�( `� /k(7111.= Date: fyf')-I—ZI
Page 3 of T U 21412015