960109_Inspection 2021_20211005

l~uelilly Number
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Division of Wtrlrr Resource"
Q Division of Soil and Water einsitteVoliun
Q Other Agency
I . ilt• fFi L Itilt; t omplirince Inspection Operation Review 0 Structure I. ainalk I rcbpieal Abelstru�r
Its anon tar ti kit: • Routine 0 Com I2inl 0 I - Mimi -up 0 Referral 0 Emergent-% Q Other Q Ueuied Acct"
Luunr►7.r, t+v ion: L~I
- Hrg
Dale of Visit:
Arrival Time:
Faun Name: r t n.-.
Departure lime:.
(r t - r eV'.
[twner Name: -. •� - � �' �' '}` [�
'*!ailing Address: f . ?,{ t 02 x G—x— , r..0 i5j )
Physical Address: I
Facility Contact: Title:
Onsite Represeotatire: Yj lMllrl
Certified Operator: 5C Wi
Back-up Operator:
Location of Farm:
i)n ner F:rnaiI:
Phone:
Latitude:
Phone:
integrator:
Certification ~umber:
Certification Number:
Longitude:
5 ine
Design Current
Capacity Pop.
14 can to Flrii,h
1t'can to Feeder
1 eoderto Finish
4LJ0
1- arrow to Wean
Farrow in Feeder
Farrow in Finish
(jilts
i oar,
Other
[lnccr
Design Current
Wet Poultry Capacity Pop.
L��tir 1
ti.�n-Latin
Design Current
Ca . xcit% Po . .
Cattle
Design Current
Opacity Pop.
I).il[l t ,+Lr
fair, t 3if
[lain Ileitir
llr, ('i7nr
\ ii-flair,
Berl Si ker
*
1t,•.1 ]t:.'.ai t .`u
Discharges and Stream Imoaclh
I. Is any discharge ohs r cd from any part of the operation''
[)ischargc originated ai: ❑ Siructtarc ❑ Application Ficld ❑ Other;
a. Was the conveyance man-made?
b. Did the discharge reach waters of[hc Statc? (If yeti. notify I)W111
c. What is the estimated volume that reached watcm of the Stale (gallons)?
d, Days the discharge hyplus the waste management system? (If yes. notify i)%VR}
2. is there evidence aid pa.Mt discharge from any part of the operation?
i, Were there any observable adverse impacts or potential advert tmpacis io Ihr NAtr. r.
of the State other Than from a discharge?
Page i of 3
❑ 1 �, Ef\ra ❑ i` 1 ❑ \I
❑ \,. El NO ❑}ti-' ❑\i
El Yes El No ID NA ❑NI:
❑ Yes Efl
► ❑ NA 0 NI;
❑ 1 ra O "`, 0 NA 0 NIL
2442111 i [ drtnonetif

Fatilit1riumber: Z
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?
Date of Inspection:)S
Identifier;
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
❑ Yes ° (o Q NA ❑ NE
❑Yes ❑No ❑NA NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
31
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 arty of questions 4-6 were answered yes, and the situation poses an immediate public health or envirunmentathreat, notify DWR
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)
4_ 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?
11. 1s there evidence of incorrect land application? If yes. check the appropriate box below.
7. Do any of the structures need maintenance or improvement? 0 Yes [� ❑ NA ❑ NE
Q Yes No 0 NA 0 NE
O Yes
❑ Yes
{NNo El NA DNE
124/:10 El NA ❑NE
❑ Excessive Ponding ElHydraulic Overload El Frozen Ground ❑ Heavy Metals (Cu, in, etc.)
❑ PAN ❑ PAN } 10% or 10 lbs. 0 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. Crop Type4s1:
13. Sail "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?
1.6. 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?
I8. 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?
20. Does the facility fail to have all components of the CAWMP readily available? If yes. check
the appropriate box.
❑WiJP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
21. Does record keeping need improvement? if yes, check the appropriate box below.
0 Yes
❑ } t;
❑ )(es
❑ Yes
❑ Ycs
❑ Yes
❑ Yes
❑Other
❑ No ❑ NA ❑ NE
E(No
LiNo
17No
1:2‘
❑NA ENE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[2 Yes No 0 NA ❑NE
❑ Waste Application 0 Weekly Freeboard Q Waste Analysis ❑Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ['Stocking 0 Crop Yield ❑ 120 Minute Inspections ❑Monthly and 1" Rainfall Inspections/ ❑ Sludge Sur -ey
❑ Yes
❑ Yes
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 2of3
No
❑ NA ❑ NE
❑\.1 DNE
5/1212020 Continued

Pa
Ca Jr \0—?-2i VA 1(755f
.b„„e cont
[Date of Inspection: [p -
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? 1 f yes, check
the appropriate box(es) below.
ID
Yes
Yes
NA
❑ NA
❑ NE
• NE
Failure to complete annual sludge survey 0 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:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 121No ❑ NA ❑ NE
27_ Did the facility fail to secure a phosphorus loss assessments (FLAT) certification? Yes []No ❑ NA ❑ NE
Other
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 concert?
If yes, contact a regional Air Quality representative immediately.
34. 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.
0 Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes 0/No ❑ NA ❑ NE
❑ Yes Efrikr. ❑ NA NE
❑ Yes [No [] NA ❑ NE
El Yes dNo ❑ 7 1 [] NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 12 o DNA ONE
33. Did the Reviewer/Inspector fail to discuss review inspection with an on -site representative?
❑ Yes Ui QNa ❑NE
34, Does the facility require a follow-up visit by the same agency'
❑ Yes No ❑ NA ❑ NE
Comments (refer to question ): Explain any YES answers and/or any additionalrecommendations or any other comments,
Use drawings of facility to better explain situations (use additional pages as necessary),
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53
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Rev iewer/Inspector Name:
Reviewer -Inspector Signature:
Page 3nj3
Phone: -AA 31
Date: /� ,
5/12/2020