820529_Routine Inspection_20210930

Facility Number
ivision of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 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:
Facility Contact:
Arrival Time:
Departure Time: q.'j'64County:
Owner Email:
Phone:
Region:
Onsite Representative:
Certified Operator: /&72Leeldi
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
Capacity Pop.
Wean to Finish
vW
can to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Wet Poultry
Layer
Non -Layer
Design Current
Capacity Pop.
DryPoultry Capacity, Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Cattle
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
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?
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
j2-i'(o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes jago ❑ NA ❑ NE
❑ Yes ,No ❑ NA 0 NE
Page 1 of 3
5/12/2020 Continued

Waste Collection & Treatment
Date of Inspection:�;:�
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):
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? 7 Yes ❑-No 0 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
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?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA 7 NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 0 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 , 0 No 0 NA ❑ NE
maintenance or improvement?
Waste Application
1 0. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [1 Heavy Metals (Cu, Zn, etc.)
[1 PAN [1 PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift 7 Application Outside of Approved Area
f,r
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes `"❑ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yesa= "No 0 NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes _-❑lNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? 0 Yes ..,❑-No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ❑-No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes 0-No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check n Yes _4 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. 0 Yes ❑ No ❑ NA ❑ NE
7 Waste Application ❑ Weekly Freeboard ❑ Waste Analysis n Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking 7 Crop Yield ❑ 120 Minute Inspections n Monthly and 1" Rainfall Inspections 7 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge'? ❑ Yes `No ❑ NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ,❑ No ❑ NA ❑ NE
Page 2 of 3 5/12/2020 Continued

,Jliant sludge levels in any lagoon
. ture(s) and date of first survey indicating non-compliance:
lity fail to provide documentation of an actively certified operator
facility fail to secure a phosphorus loss assessments (PLAT)p for f charge?
ce
suescertification'?
the facility fail to properly dispose of dead animals with 24 hours
i report mortality rates that were higher than normal? and/or document
❑ Yes
.At the time of the inspection did the facility pose an odor or air c ua
If yes, contact a regional Air Quality representative immediately.1 l�ty concern?
O. Did the facility fail to notify the Regional Office of emergency
permit? (i.e. discharge, freeboard problems, over -application) situations as required by the
❑ Yes LJ ��o ❑ NA ❑ NE
31. Do subsurface the drains exist at the facility? If yes, check the
EI Application Field appropriate box below.
❑ Lagoon/Storage Pond Other: ❑ Yes NEl ❑ 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 w' ❑ Yes Eric() El NA
with an on -site representative? ❑ NE
34. Does the facility require a follow-up visit by the same agency'?
��
❑ Yes 0-No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES ans
Use drawings ffacility to betterwers and/or any additionalmendations or any other comments.
El Yes No ❑ NA El NE
explain situations (use additional pages as necessary)
❑ Yes
❑ Yes
No
❑ NA ❑ NE
No ❑ NA ❑ NE
calibrate waste application equipment as required by the permit?
f compliance with permit conditions related to sludge? If es, ch
ox(es) below. Y ecl<
implete annual sludge survey
Failure to develop a POA for sludge levels
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
0'* J� 1/U�-rr rniqU,-61 'D G—digawoo
d� (17#1,/
z_poic6 G-ped
/fewer/Inspector Name:
fewer/Inspector Signature:
age 3 o1'3
Phone:
Date:
5/12/2020

FACILITY #: "
FARM NAME:
I / i
FREEBOARD ACTUAL LAGOON LEVEL
PERMIT (#19)
- DUE EVERY 5 YEARS
- EXPERIATION DATE NUMBER OF ANIMALS
- OIC CARD YES OR NO
WASTE UTILIZATION PLAN (WUP) (#20)
SOIL TYPES
CROP TYPES
THE UTLIZATION PLAN SHOULD HAVE A (-) NEGATIVE NUMBER
ODOR CONTROL CHECK LIST 1 ES'0R NO
Irrigation Plan Maps
WASTE REPORT (#21)
-GOOD FOR 60 DAYS BEFORE OR AFTER
DATE h/r'/ NITROGEN LEVEL
SOIL REPORT (#21)
EVERY 3 YEARS: DATE /6 t/42- 6
P-I (NO MORE THEN 400)
Cu/ZN (NO MORE THEN 3000) CU ZN
(IF PEANUTS NO MORE THEN 300)
MENTAL CHECK OF CROP AND FIELD NUMBERS
ZONE ACRES PAN
FLOW RATES
120 Min inspection initialed
Commercial Fertilizer
IRR2 (#21)
CR P TYPE
ITROGEN (N)
r�
Weather Codes
PH (Note if 4 or Tess)
Chicken Litter

CALBRIATION (#24)
- EACH REEL SHOULD BE CALIBRATED =�
- DATE DUE EVERY TWO YEARS (1 /`7 /-1--/
- 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
/SLUDGE (#21 & 25)
-DUE EVERY YEAR: DATE - 67/ )-
O: r4, P: % RATIO OF SLUDGE
OTHER FORMS (#22 AND #21)
RAIN BREAKER FORM 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