820448_Routine_20211022

Type of Visit: ()g Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (PJ Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
Owner Name:
03aa
Arrival Time:
Jones Farm_
IV. OD
Departure Time:
rnithaet Nth Junes
Mailing Address:
Physical Address:
Facility Contact:
l23O
Owner Email:
Phone:
County: 90m'SDI1 Region:' 19-0
e-€nr Michel
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:f€`>f gpe .
Latitude:
Integrator:
Phone:
Certification Number:
Certification Number:
Longitude:
*I ki r
ine
D0, n
Capacity
.Y. ,.$C
wpyQtpept E „ Design
i K' op � 1, „ Wet=Raaltty' 'Capaafy
ry �jxit p ., , T�v „.r ... r f„�rxx
Current
Pop t
r.
,w.
RS �..
w Design
Cattle Capacity
•
l orrent
�,..
Wean to Finish
°'
Layer
Dairy Cow
* *:
Wean to Feeder
a
Non -Layer
Dairy Calf
Feeder to Finish
µ��
';
K ,�
� „ �
D ; Poultr , ^
esi
pes�
('a, a cr,
Dairy Heifer
�*
p*I
Farrow to Wean
'n
`
3i
p�i'�tnt
;aP,o' .. a M„
Dry Cow
Farrow to Feeder
,
Non -Dairy
Farrow to Finish
'�--."
Beef Stocker
Gilts
•Non
-Layers
--
,i
Beef Feeder
4`
Boars
•
Pullets
_-:
'
Beef Brood Cow
x '
�5Other nt., cx r4., rr.
�i' 3 �•���
„y *> : �Turke
Poalts
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tI
Other
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
v of the State other than from a discharge?
❑ Yes 'J No ❑ NA ❑ NE
❑Yes 'LINo ❑NA ❑NE
El Yes No ❑NA ❑NE
❑Yes c] No ❑NA al NE
❑ Yes ij No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3
5/12/2020 Continued

PSQ - 119
Treatment
ructural plus storm storage plus heavy rainfall) Less than adequate?
if yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Date of Inspection:
Identifier:
Spillway?:
'Designed Freeboard (in):
Observed Freeboard (in): Re
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
❑ Yes
Structure 5
No ❑ NA ❑ NE
No ❑ NA ❑ NE
Structure 6
❑ Yes ' No ❑ NA ❑ NE
❑ Yes IXNo ❑ NA ❑ 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? Yes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? Q Yes ISR 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 to ❑ NA ❑ NE
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 �No ❑ NA 0 NE
0 Excessive Ponding ❑ Hydraulic Overload 0 Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
0 PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable
e Crop 1Windo�w ❑ Evidence of {Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): C 0 t 11, �/v P t�l/I , J09 hi', t9 1 9
13. Soil Type(s): «Q t h S D) 4 g b ro
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA 0 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.
❑WUP ❑Checklists ❑Design 0 Maps Lease Agreements ['Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA 0 NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tr sfers ❑ Weather Code
0 Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes No 0 NA ❑ NE
Page 2 of 3
❑Yes tRNo ❑NA ❑NE
❑Yes No ❑NA ❑NE
"`SYes ❑ No ❑ NA ❑ NE
Yes 'J No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑Yes No ❑NA ❑NE
5/12/2020 Continued

AilityNumber: f)Q - 49%
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.
❑ 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
❑ Yes
No 0 NA ❑ NE
o ❑NA ❑NE
26. Did the facility fail to 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
❑ Yes
�No
No
❑ Yes No
❑ Yes -N No
❑ Yes No
❑ Yes IN,No
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
MNo
TN No
sicl No
❑ NA
❑ NA
❑ NE
❑ NE
❑ NA ONE
❑ NA ❑ NE
❑NA ❑NE
❑ NA
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
Comments (refer to question #): Explain any YES answers' and/or any additional recommendations
Use drawings of facility to better explain situations (use additional pages as necessary).
�. mom R.0 im�ll�v lfi,
iG . Mt ov-or C 4 Kra O. c
ooci Hof
or any other comments..
Reviewer/Inspector Name:
Otie forrcnof
Reviewer/Inspector Signature: at JD � tfl(J
Phone: I I I f (�(,&' 9 715
Date:
Page 3 of 3
5/12/2020