960006_Inpsection 2021_20211119

Facility Number
Division of Water Resources
D Division of Soil and Water Conservation
a Other Agency
Type of Visit: Compliance inspection i Operation Review 0 Structure F.valuutiun Technical Assistance
Reason for Visit: Routine Q Complaint ❑ Follow-u Q Referral 0 Emergent. 0 Other Q Denied Access
County:
Date of Visit:
Farm Name:
Arri'al Time:
C
Owner Name: Q ti5 (6 \4 Phone:
Mailing Address: Wit t 0 lGA t- 1
Physical Address:
Departure Time:
Owner Email:
Region:
Facility Contact: '\011.\. �
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Titlrr
Latitude:
Integrator:
Phone:
Certification ti u mbcr:
Certification u mber:
Longitude:
Swine
Wean to Finish.
Design Current
Capacity Pop.
Wean to Feeder
Feeder to Finish
Iarrow to Wean
I - arrow to Feeder
'Farrow to Finish
Gilts
Boars
Other
I
Design Current
Wet Poultry Capacity Pop.
I.3ticr
Nun -Layer
Design Current
Dry Poultr ('a.aci Pi)
IM
IIIIEMEMI
• Pullets
•i1
•
•
Turkey Poults
liher
Design Current
Cattle Capacity Pop-
I):Lir, t ,
Lain Calf
Dairy Heifer
1)r,. Cow
Non -[)airy
lied' Stocker
licef Feeder
Beef Brood i•,'u
Discharges and Stream Impacts
I . 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 Suite other than from a discharge''
Awe lr►f3
D \ e1 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
D r es ❑ No ❑ NA ❑ NE
El Yes ❑No
❑ Yes o
❑ Yes &No
❑ NA ❑ NE
❑ NA ❑ NE
ID NA El NE
5/l2/2020 Conrinrred

Fac]iit Number_ "1c - 1 1fate of Inspection: Sl -
Waste Collection & Treatment
4_ is storage capacity {.structural plus storm storage plus hcas . rainfall', less than adequate?
a_ If yes, is waste 1e%el into the structural treehoard?
Structure I Struenire 2 Structure 3 5tntcture 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
(� f PD5? -
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?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
❑ Yes
❑ Yes
Structure 4
❑No ❑NA ONE
D° ❑ NA ❑ NE
Structure 6
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?
i l . Is there evidence of incorrect land application? if yes, check the appropriate box below.
0 Yes
• Excessive Fanding ❑ Hydraulic Overload ❑ Frozen Ground ❑
Heavy Metals (Cu, Zn, etc.)
❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
Yes 0 No El NA 0 NE
❑ ''es No ❑ NA
❑ PAN ❑ PAN IQ% or 10lbs.
❑ Outside of Acceptable Crop Window
❑Yes Enplo ❑NA ❑NE
❑ Yes Elf No ❑ NA ❑ NE
❑ Yes EiNo
❑ Yes [' No
CYNo
0 NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
12. Crop Type(s): _
]3. Snit Type(s); ❑
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA
NI
❑ Yes IA No ❑ NA ❑ \ l-:
15. Does the receiving crop and/or land application site need improvement? ❑ Yes u{ No 0 NA ❑ I-
16. Did the facility fail to secure and/or operate per the irrigation design or wettable a�
E
acres determination?
17, Does the facility lack adequate acreage for land application?
IS. is there a lack of properly operating waste application equipment?
Rewired Records & Documents
l9. Did the facility fail to have the Certificate of Coverage & Permit readily available.?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements Other:
❑Yes No El NA ❑NE
0 Waste Application Areal
21. Does record keeping need improvement? If yes. check the appropriate box below. l is Waste Transfers ❑ Weather Code
❑ Weekly Freeboard ❑ Waste Analysis ❑ ❑ 0 Rainfall ❑Stocking❑ivlontht and 1" Rainfall Inspections ['Sludge Survey
El yield DIl2Q Minute Inspections Y
❑Yes [✓]H ❑NA El NE
22, Did the facility fail to insist/ and maintain a rain gauge? 0Yes to ❑ N❑ NE
0
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?12F2A NA ContinuedprrgeZof3
0 YesNo ❑ NA ❑ NE
❑ Yes d No ❑ NA ❑ NE
❑ Yes Il No ❑ NA ❑ NE
❑ Yes [No ❑ NA ❑ NE

!Facility Number:
[Date of Inspection: 1.1— .Z
❑ Yes IJ No
❑ Y �No
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 boxes) below.
0 Failure to complete annual sludge survey
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
Failure to develop a POA for sludge levels
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
2g. 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, cheek the appropriate box below.
❑ Application Field ❑ LagoordStorage Pond ❑ Other:
❑ Yes
❑ Yes
❑ Yes
❑ Yes
[] Yes
❑ Yes
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewerrinspector fail to discuss ret iewrinspection with an on -site representative?
34. Does the facility require a follow-up visit b1 the sante agency?
E1 Yes
❑ Yes
❑ Yrs
❑ NA ❑ NE
NA ❑ NE
gbio ❑ NA ❑ NE
No ONA ❑ NE
No ❑ NA ❑ NE
[J1 No
1 N0 ❑ NA ❑ NE
No ❑ NA ❑ NE
❑ NA
❑ NE
No ❑ NA ❑ NE
No ❑ NA El NE
\u ❑ NA 0 NE
Comments (refer to question 4): Explain any YES answers and/or arts additional recommendations or any other comments.
Use draKings of facility to bertirr explain situations (use additional pages as necessary).
- }�, ti rC 1 v�441 o .d CA C. \c". ASTIZa,.4 +~�
k5 Ca.4 6 r-I Q 2or
Rev iewer'lnspcctor Name:
Reviewer/Inspector Signature:
Page 3of3
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Phone: •Ct'{�~►
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