540063_Inspection_20220209

;j Fadlih Number
• Division of Water Resources
0 Disision of Soil and Water Conservation
Q Other Agenes
f 5 pe of Visit; • Compliance Inspection
Reason for Visit; Routine Q Complaint
Date of Visit:
Operation Res kw Q Structure Esaluxrian Q Technical .Assistance
0 Follow -up
0 Referral 0 Emergency 0 Other
ArrnalTime: l •o. titi� Departure Time:
Farm Name:
1a l+V S*1
Owner Lame: saw cs Phone:
Owner Email:
0 Denied Access
Counts: ��•
Region:- qtl
Mailing Address: ti L-4 -I n + nl t LA } n } IQ C ) Si,5
Physical Address:
Facility Contact:
�ttillj-- . Title:
0u51te Representative:
Certified Operator:
Back-up Operator:
1-ot•ation of Farm:
Phone;
Latitude:
Integrator:
Certification Number:
Certification Lumber:
Longitude:
Swine
Design Current
Capacity Pop.
Wean to finish
Wean Feeder
Feeder to Finish
I7 o
farrow to Wean
farrow to Feeder
Farrow to Finish
(lilts
Roar.,
Other
Design Current
Vt et Poultr; Capacity Pop.
Nun-L:rsti
Design Current
Cattle
Design Current
Capacity Pop.
tar. Cow
L7;Eir Calf
Dail- Helfer
I)rs Cow
Non-Durs
Beef Stodr
Beef Feeder
h
heel Brood C nw,
Dischar_es and Stream lit -marts
I. Is any discharge observed from any part of the operation"
Discharge originated at: ❑ Structure ❑ Application Field
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 Dues the discharge bypass the waste management system'' (If yes, notify DWR;
2, is there evidence of u past discharge fmm any pan ut the operation''
3. Were there any ubsrn'ahie adverse impacts or potential adverse imparts to the waters
rEfihe State oilier than from a discharge?
❑ 4'�,
❑ Other:
❑ NA ❑ Z;
El Yes ❑No ❑NA El NE
❑ Yes El No El NA NE
ID Yes ❑
❑ Yes
❑ Yes
❑ NA 0 NE
❑ NA ❑ NE
❑ NA ❑ NE
Yuge 1 of
5f121?020 Continued

Facility Number;
-
Date of Inspection:).
Waste Collection & Treatment
4, is storage capacity (structural plus storm storage plus heavy rainfall) Icss than adequate''
a. if yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any oldie 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
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 pail 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?
1 1. Is there evidence of incorrect land application? If yes. check the appropriate box below. ❑ Yes
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zr, etc.)
❑ PAN ❑ PAN 10% or I D Ihs. ❑ Total Phosphorus ❑ Failure to incorporate Manure!Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
❑ Yes
❑ Yes
Structure 5
ENo El NA ❑NE
No ❑ NA ❑ NE
Structure 6
❑ Yes
❑ Yes
health or environment threat, notify' DWR
❑ Yes ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
1 2. Crop Type(s):
13. Soil Type{s):
144. 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?
jteuuired Records & Documents
19. Did the facility fail to ha). c the Certificate of C'o► erage & Permit readily available?
20, Does the facility fail to have all components of the CAWMP readily available'? !f yes, check
the appruprial: hox.
❑ . t'i. ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
.'.1. Does record keeping need improvement? If yes, check the appropriate
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 121) Minute Inspectiona
Did the facility fail to install and maintain a rain gauge?
21 ll'selected. did the facility fail to install and maintain mutbreakers on
Page l of 3
irrigation equipment?
❑ Yes al,04. ❑ NA ❑ NE
❑ Yes
126Io ❑ NA ❑ NE
[jiNo ❑NA ❑NE
❑ Yes Effio
❑ Yes ❑'lo
[] Yes
❑ Yes 6
❑ Yes II No
❑ Yes
❑Yes No
['Other'
❑ NA ONE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑
❑ NA ONE
❑ NA ❑ NE
❑NA ❑NE
box below. ❑ Yes []�N
❑ Soil Analysis ❑ Waste Transfers
['Monthly and 1" Rainfall Inspections
❑ Yes
[] Yes
❑ NA ❑ NE
❑ Weather Code
['Sludge Surrey
DMA ONE
❑NA ONE
51121020 ('onrinued

t- Did pate of ins
the Facility fail to calibrate wastefacility application equipment as required by the permit?
the a out or compliance bel with permit conditions Mated to sludge? if yes. check
�relmate box(es) below
❑ Failure to complete annual sludge survey
❑ Failure to develop a POA for sludge levels
25. Did the facility fats to provide indicating non�omPbJutce
27. Did the facility documentation of actively certified operator in charge?
ty fail to secure a phosphorus loss assessments (PLAT) certification?
Other
28. Did the facility fail to properly dispose of dead
and report mortality rates that were highernorm is with 24 hours andfor document
29. At the than normal?.
time of the inspection did the facility pos an odor or air quality concern?
If yes, contact a regional Air Quality represanative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems. aver -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 pennit or CAWMP?
❑ YYcs
ljaces
Erlo
datto
❑ NA
❑ NA
❑ NE
❑ NE
Nan-cnntpliant sludge levels in any lagoon q
List structures) and date of first survey ind'
ID Yes
El Yes
D Yes
❑ Yes
❑ Yes
❑ Yes
Nn
�No
o
▪ NA
❑ NA
❑ NA
ID NA
❑ NA
❑ NA
❑ Yes EIsio ❑ NA
33. Did the Reviewedlnspector fail to discuss review/inspection with an on -site representative? ❑ Yes El -No ❑ NA
34. flocs the facility require a follow-up visit by the same agency? ❑ Yes ❑ NA
Comments (refer to question #): Explain any YES ansners andinr any additional recommendations or an!, other comments.
Use drawings of facility to better explain situations (use additional pages as necessary}.
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12-17 Z!
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Reviewer/Inspector Name:
Reviewer/Inspector Signature=
Page3of3
❑ NE
❑ NE
❑ NE
Q NE
❑ NE
O NE
❑ NE
❑ NE
Q NE
hna
Date:
21 011