740038_Inpsection 2021_20211109

Facility Number ` t t - ! }
rPe
of Visit: • Compliance Inspection Operation Re►ie►v 0 Structure Evaluation O Technical Assistance
asgn for Visit: Routine 0 Complaint 0 Follow-u r 0 Referral 0 Emergenev 0 Other O Denied Access
County:
Division of Water Resources
O Division of Sail and IN &ter Conservation
O Other Agency
Date of Visit:
i4-9-,1 I
Arrival Time:
c.
Departure Time:
Farm 'Name:j r (A +{ JAY A+. L Owner Email:
Owner Name: No' m s r%t4"9 ctne , Phone:
��± l
Mailing Address: �- VIDp y�(d Gt } 4ocii NC
Physical Address:
Facility Contact: CYi010 t 1 Pk
i (A ay Title: Phone:�y ' `U Integrator: Ss 11+ Etc .
Onsite Representatirc: CY',0,1) ti rtiG { )n
Certified Operator: ❑ M71 t
Back-up Operator:
Loca 1vn of Farm:
Latitude:
Certification [Number:
Certification Number:
Longitude:
L
Swipe
Design Current
Capacity Pop.
Wean to Finish
3--, 7q
a` t;
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Design Current
Dairy Coss
Dairy Calf
Dairy Heifer
Dry Cow
Ron -Dairy
Beet Stacker
Beet Fecder
Beef Brood Cow
Design Current
Wet Poultry Capacity Pop. Cattle Capacity Pop.
La3Lr
Non -Layer
Design Current
D Paull Ca aci Pc
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? (lfyes, 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?
Page 1 of 3
❑ Yes
▪ Yes
El Yes U"o ❑NA NE
Q No ❑ NA ❑ NE
El NO ❑NA ❑NE
Yes
[] Yes
❑ Yes
❑ No ❑ NA ❑ NE
P❑NA ❑NE
Lfna ❑NA El NE
5/12/2020 Continued

ti1'aste ('ttllectiott & 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?
Structure 1 Structure 2 Structure 3
Identifier:
Spillway:':
[Date of Inspection: i� — `A
❑ Yes
❑ Yes
Structure 4 Structure 5
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(Le., large trees. severe erasion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
i NR
E
LI "o
Structure 6
❑ Yes
❑ Yes
DNA ❑ NE
NA ❑ NE
I'No ❑ NA ❑ NE
❑ NA ❑ NE
1f any of questions 4-f were answered yes. and the situation poses an immediate public health or environmen3l 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 pan 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?
l ! _ Is there evidence of incorrect land application? Um,. check the appropriate box below.
❑ Yes
❑ Yes
❑ Yes
❑N.A ❑NE
Nn El NA El NE
�fVR
❑ NA ❑ NE
❑ Yes Itho ❑ NA ❑ NE
❑ Yes [o ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate lvtanure1S1udge into Bare Soil
© Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
I6, 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
14. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility ['ail to have all components of the CAWMP readi13, available? If yes, cheek
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
21. Does record keeping need improvement? if yes, check the appropriate box below,
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis El Soil Analysis
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute [nspections ❑ Monthly and I" Rai
22. Did the facility fail to instal) and maintain a rain gauge?
23. lfsclecttad, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Page 2 of 3
❑ Yes [No
Yes ❑No
❑ Yes
❑ 1'es
❑ �'es ❑ No
UN0
dNo
❑ Yes EliNp
CI es
❑ i }Sher:
❑ NA
❑ NA
❑ NA
NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ Yes No ❑
❑Waste Transfers ❑NAWeather❑ CadeNE
nfall inspection__s,,// 0 Sludge Survey
❑ e
Yes N ❑\1 ❑NE
❑ Yes ❑ 0 NA ❑ NE
Sf1212420 Continued

Reviewer. inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
ariht. Number:
'Date of Inspect inn: I f I
4. Did the facility fail to calibrate waste application equipment as required by the permit''
.5_ Is the facility out of compliance with permit conditions related to sludge? lfycs, check
the appropriate box(es) below.
0 Failure to complete annual sludge survey
El Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
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 ("ail 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:
32. were any additional problems noted which cause non-compliance of the permit or CAWM P?
33. Did the Reviewer/Inspector fail to discuss rcviewiinspection with an on -site representative''
34. Does the facility require a follow-up visit by the sank agency?
Yes
❑ Yes
❑ Failure to develop a POA for sludge levels
El Yes
El Yes Q No
Yes
Yes
❑ Yes
❑ Yes
❑ Yes
O Yes
❑ yes
o
❑ NA El NE
13NA El NE
❑ NA El NE
❑ NA ❑ NE
DNA ❑NE
• NA ❑ NE
❑ NA ❑ NE
❑ NA ONE
❑ NA ❑ NE
© NA ❑ NE
❑ NA ONE
Comments (refer to question #): Explain any V'ES answers andlar any additional recommendations ur any other comments.
Use drawings of facility to better explain situations (use additional pares as ncccssan-)-
acm
5 A . St,'-,. et- % - Z.3
7-2Q-21
1-2o-21
LEI Z. — Sq .' .
vow ,.,1 -�- 7 t
Cl : +1A Lam.
IS)el nkiA.4
Date:
VVV 5/12/2020
„c.v.
NA ri".er0