960074_Inspection_20210929

Facility Number
t
..__________.
TtyNisi':* Compliance Inspection 4 Operation Review-Z Structure Evaluation 0 Technical .1,. i' 'int•r
Reason fur 1 isit: 0 Routine 0 Complaint 0 Follow-up
of 1p 0 Referral 0 1{mcrgency 0 Odor 0 I1��nicti Access
p
Date of Visit:
Farm Name:
Owner Name:
Arrival Time:
Division of Water Resources.
Division of Sail and 11'seter ['onsers Ntilul
0 Other Agency
Departure Time:
(loner Email:
Phone:
County:
rlNt.Region: 1.0k1 '0
Mailing Address: _ Goy s OC i t ! , ) X)C' J 7 6
Physical Address:
Facility Contact: ti I"" L
Onsite Representative:
Certified Operator:
Rack -up Operator:
Location of Farm:
Fide:
Latitude:
Integrator:
Phone.
Certification Number:
Certification Number:
t.ongitude:
too 7
Swine
Design Current
Capacity Pop.
Wean to Finish
x
Wean to Feeder
Feeder to Finish
Farrow to Wean
DiSO
o0
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design i urrent
1%et Poultry C itpacirc Pop.
arer
Lai I :Ivcr
Discharges and Stream Impacts
I. is any discharge observed from any part of the operation?
Design Current
Poultr C'a l aci Po
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.
Cattle
Resign Current
Capacity Pop.
Dairy Coo,
Dairy Call'
Dairy Ileit'er
Dry Cow
Non -Dairy
Beef Stocker
B 0,1 r Feeder
Beef Brood Cow
❑ Ycs [No El NA ❑ NE
[Ycs No ❑NA []NE
❑ Ycs El No ❑NA ®NE
Does the discharge bypass the waste management system? (Ifyes. 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 ;t disc:har ,4?
Page 1 43
❑ Ycs ❑
❑ Yes
❑ Ycs
❑ NA ❑NE
❑ NA ❑N>
[]NA El NE
241i'1a/s Continued

Required Records lac Documents
❑ Yes ElN El NA ONE
❑ Yes No ❑ NA ❑ NE
[] Yes o [] NA ❑ NE
❑ Yes
❑ Yeti
El NA
d NA
(Jracility° Number: �7 -
\1 aste 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: -.k--- 2( 1
Identifier:
Spillway?:
Designed Freeboard tin):
Observed Freeboard (in):
❑ des
❑ Yes
Structure l Structure 2 Structure 3 Structure 4 Structure 5
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
❑ NA ❑ NE
❑ NA ❑NE
Structure 6
7. Do any of the structures need maintenance or improvement?
h. 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
lti. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below,
❑ Yes 7Nu ❑ `iA ❑ NE
O Yes laZ ❑ NA ❑ NE
es ❑ No a NA ❑ NE
❑ Yes o ❑NA ❑NE
❑ Yes No ❑ NA ❑ NE
❑Yes ❑NA ❑NE
❑ Yes No [] NA ❑ NE
❑ Excessive Fondling ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals lCu, 2n, etc.)
O 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 Type(s): # i- f
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?
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?
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 0 _ .es .--lr. ®NA 0 NE
❑ NE
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes. check ® Yes © No ❑ NA Q NE
the appropriate box,
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ['Soil Analysis [] Waste Transfers ❑ Weather Code
❑ Rainfall ®Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes []'N ❑ NA [ NE
23. J f selected. did the facility fail to install and maintain rainbreakers on irrigation equipment'' 0 Yes
Page 2 of 3
❑ NA ❑NE
5112/2020 Continued

Faci1ih (umber: -
IDate al Inspect ion :C1— _s) -
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25 Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
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 noncompliance: _
No No
❑ NA
❑ NA
❑ NE
❑ NE
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes 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 ❑ YesNo 0 NA ❑ NE
and report mortality rates that /were higher than normal?
29..4t the time of the inspection did the facility post an odor or air quality concern? ❑ Yes L-1 f 10 [] NA ❑ NE
/ryes. contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the 0 Yes [No ❑ NA ❑ NE
permit:' (i.e_, discharge, freeboard problems, over -application)
3I . I)o subsurface tilt drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ["No ❑ NA ❑ NE
El 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/im pcction with an on -site representative? ❑ Yes No ❑ NA ❑ NE
344_ Does the facility require a follow-up 4 isit by the same agency? ❑ Yes e+ ❑ NA ❑ NE
'Comments (refer to question #): Explain any YES answers andfor any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Li _. 9 —.z
r 5-2{
50 o )-20 s \,0f „ 0 -o)�5
Crl cam' "
LeAua
,1n
Revieweriilnspector Name:
Reviewer/Inspector Signal
Pag'3of3
Signature:
'honc, 00-0 39
Date:
1
2/4i29f 5