820487_Routine_20211013

Facility Number
5K Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: t,25 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
�4-i321
Owner Name:
Mailing Address:
Physical Address:
Arrival Time:
tEhhy cm\-011
Kerr{ ca jroil
Departure Time:
Owner Email:
Phone:
County: SQmp4oN Region: -fp
Facility Contact: Ci\ \i c eQ NJ I CK, Title: real
Onsite Representative: q rii2
Certified Operator: Ken fl C-Q rrD 1
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
Capacity Pop.
Design Current
Wet Poultry Capacity Pop.
Design Curren
Poultr Ca ' aci Po .
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?
Design Current
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes cZ1 No ❑ NA ❑ NE
O Yes j34 No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes XI No ❑ NA 0 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) 0 Yes V] No El NA 0 NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes fp No 0 NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 0 No 0 NA 0 NE
of the State other than from a discharge?
Page 1 of 3
5/12/2020 Continued

Facility Number: $0.,- i ^1
Date of Inspection: j 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
a. If yes, is waste level into the structural freeboard?
Identifier:
Spillway?:
No ❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
Designed Freeboard (in): 1
Observed Freeboard (in):
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 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
pyre Yes ❑ No ❑ NA ❑
7. Do any of the structures need maintenance or improvement? ] NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes rgl 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 Q No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes El No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs.
❑ Outside of Acceptable Crop Window
12. Crop Type(s): gaD r
13. Soil Type(s): CC1\N ho'j ) ()L(i hDtD
❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
cow, u,iwtOi€Qfls
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes qNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Q No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 1Z1 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ 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 n No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E] No ❑ NA ❑ 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 n No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes tsj No ❑ NA ❑ 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

Facility Number: tg. -
Date of Inspection: G j3 2
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 ❑ 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 gl No ❑ NA ❑ NE
❑ Yes II No 0 NA ❑ 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?
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?
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
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No ❑ NA 0 NE
❑ Yes in No ❑ NA ❑ NE
❑ Yes fJ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes Et No ❑ 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 with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
Comments (refer to questiolt0 Explain a
Usedrawings of facility to better explain s
ny additional reco
pages as necessa!
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
endations or any othe
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remove tree vwng on baud of- v?qc)or\).
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Reviewer/Inspector Name:
KQtfe ftotenet
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
Thi 7i1'
ial3 ZI
2/4/2015

FACILITY #:%' ='F ,� FARM NAME:
FREEBOARD ACTUAL LAGOON LEVEL
PERMIT (#19)
- DUE EVERY 5 YEARS
- EXPERIATIDN_DATE
NUMBER OF ANIMALS "j
- OIC CARD/YES/OR NO $ „_./V(..7/4
WASTE UTILIZATION PLAN (WUP) (#20)
SOIL TYPES
CROP TYPES
- THE UTLIZATION PLAN SHOULD AVE A (-) NEGATIVE NUMBER
R NO
- ODOR CONTROL CHECK LI YES
_.
- Irrigation Plan Maps IY�
WASTE REPORT (#21)
-GOOD FOR 60 DAYS BEFORE OR AFTER
NITROGEN LEVEL
EVERY 3 YEARS:
P-I (NO MORE THEN 400)
Cu/ZN (NO MORE THEN 3000
(IF PEANUTS NO MORE THEN 300)
MENTAL CHECK OF CROP AND FIELD
SOIL REPORTf(#21)
DATE
PH (Not? if 4 or Tess)
ZN
UMBERS
IRR2 (#21)
ZONE ACRES PAN CROP TYPE
FLOW RATES ` / NITROGEN (N)
120 Min inspection initialed Weather Codes
Commercial Fertilizer Chicken Litter