820090_Routine_20210820

Dtuision of Soil
I,Other Agency
Type of Visit: ®'Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (,j'Itoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
1917
Arrival Time:
Departure Time:
Owner Name: &aster T
Mailing Address:
Physical Address:
Facility Contact:
Owner Email:
Phone:
County: 5r Region: - C
�v ,Var-de.t
Onsite Representative: s�
Certified Operator: �;G�iary_ I IC: •"-7.-
Back-up Operator: Vert y,Frr
Location of Farm:
Title: ,otvnrC Phone:
Latitude:
Integrator: �jr5 -c
Certification Number: snag q
Certification Number:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field El 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 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [AIo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Page 1 of 3
2/4/2015 Continued

Facility Number:a_-
Waste Collection & Treatment
Date of Inspection: er-2-0/
12. Crop Type(s):
13. Soil Type(s):
k 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 Io ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
/`1 /9'
#2r
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 la< ❑ NA
❑ Yes ❑ No 0 NA
❑ NE
❑ 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?s ❑ No ❑ NA
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA
(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 El< ❑ NA
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Q N ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Er< ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN 0 PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable CropWindowindow ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
&ttfra k /ocdt r3 r-t j, 9tnf rrrer iffiezek/ i; 4 ,— ,4'-nn r
❑ NE
❑ NE
❑ NE
❑ NE
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [aio ❑ NA 0 NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes �No 0 NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable 0 Yes Io ❑ NA 0 NE
acres determination?
17. Does the facility lack adequate acreage for land application? 0 Yes Er< ❑ NA 0 NE
18. Is there a lack of properly operating waste application equipment? 0 Yes Io ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes p< 0 NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes la< ❑ NA 0 NE
the appropriate box.
❑ WUP ❑Checklists 0 Design ❑ Maps ❑ Lease Agreements ['Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes o ❑ NA 0 NE
0 Waste Application ❑ Weekly Freeboard ❑ Waste Analysis 0 Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall 0 Stocking ❑ Crop Yield ❑ 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Io ❑ 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: nj ---
Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes la< ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check la<s Milt ❑ NA ❑ NE
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:
frt /
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes
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
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
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
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
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?
❑ Yes
❑ Yes
❑ Yes
21 ❑NA ❑NE
E t o ❑ NA ❑ NE
No ❑ NA ❑ NE
o ❑NA ❑NE
No ❑ NA ❑ NE
❑NA ❑NE
lEl< ❑ NA
R< ❑ NA
Io ❑ NA
❑ NE
❑ NE
❑ 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)."
l�/i1sP2i - 77 r en ins;` e..L� ac- 1-7 Ds9
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: »jp 3 3—D(
Date: (}—.O
5/12/2020