820485_Routine_20211016

/sit:
Arm Name:
empliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
tZ5 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
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Arrival Time: Ij : 00 Departure Time:
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Owner Name: LIhdCu VM Cki1'IfI Ie1(/
Mailing Address:
Physical Address: /�{ I'
Facility Contact: j e n 1 m I I} On Q j
Onsite Representative:
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Owner Email:
Phone:
County:JQ IIIr oYs/ Region:
Title: ie ct
Certified Operator: en — Jon"); COvcr
MOJ Lai L
Back-up Operator:
Location of Farm:
Latitude:
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? 0 Yes \No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) 0 Yes rS„No ❑ NA ❑ 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) ❑ Yes 'No 0 NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? 0 Yes No Ei NA 0 NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ❑ No ❑ NA ❑ NE
of the State other than from a discharge?
Integrator:
Phone:
Certification Number:
Certification Number:
Longitude:
❑Yes RNo ❑NA ❑NE
Page 1 of 3
5/12/2020 Continued

Facility Number: Ra - sc
Date of Inspection:
Waste Collection & Treatment
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 T� 1TT No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 "�' Structure 6
ta
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 IN 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
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
gYes ❑ No ❑ NA ❑ NE
❑Yes No ❑NA ❑NE
❑ Yes NI No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
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 ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12.CropType(s): W\t ter annU�t summer annvo
13. Soil Type(s): g rw l 11, orange burg
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes NI No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? 4 Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes y 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 C No ❑ NA ❑ NE
Required 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 ,p 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.
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections
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?
Page 2 of 3
❑ Yes J No ❑ NA ❑ NE
❑ Waste Tran fers ❑ Weather Code
❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
❑ Yes jj No ❑ NA ❑ NE
❑ Yes Q No ❑ NA ❑ NE
5/12/2020 Continued

'Facility Number: `7, - 4-1C
Date of Inspection: (0'
co
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 kl No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes IV No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes C No ❑ NA ❑ NE
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 Fly No ❑ NA ❑ NE
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 Ecl No ❑ NA ❑ NE
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 IV No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
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 T No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 4 No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any addifonal recommendations or any other commeni
Use drawings of facility to better explain situations (use additional pages as necessary).
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Reviewer/Inspector Name:
Reviewer/Inspector Signature
Page 3 of 3
Ka tleftr}tQ fl0t
Phone:
Date:
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5/12/2020