740041_Inspection 2021_20210819

Facility Number
l Ype or Visit: GO Compliance Inspection Operation Rcvie►% 0 Structure Evaluation 0 'fechnical Assistance
Reason for isit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
vidi
t1
Division of Water Resources
❑ Division of Soil and Water Conservation
Q Other Agency
Date of Visit: It- IR-.dt,i / Arrival Time:I\!'.)- ._, I Departure Time:
Farm Name: Va i t („..0 1 A 5
Owner Name:
r4�
Owner Email:
Phone;
Mailing Address: 9) rG (IA.
Physical Address:
Facilit3 Contact: , A }-\\„„
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
County:
Region:
Title; Phone:
Latitude:
Integrator: is 1 t ! t
if
Certification Number:
Certification Number;
Longitude:
Swine
Design Current
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
)CFarro
to Wean
i • 15
ite.k.
Farrow to Feeder
v, to Finish
LS11ts
Gilts
Roars
Other
Other
Design Current Design Current
Wet Poultry Capacity Pop. Cattle Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry Capacity Po
Layers
Non -layers
Pullets
Turkeys
Turkey Poults
Other
Dairy Cow
Dairy Calf
Dairy Heifer
Dry ['ow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream impacts
I. Is any discharge observed from any pan of the operation?
Discharge originated at: Elstructure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (Iryes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? Of 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 State other than from a discharge?
❑ Yes 1=2/No ❑ NA ❑ NE
❑ Yes No ❑NA ❑NE
❑ Yes No ❑NA ❑NE.
DYcs ❑No ❑NA ❑NE:
❑ Yes I o ❑ NA ❑ N1',
❑ Yes No ❑ NA ❑ NI
Page 1 of 3 214/2015 Continued

7. Do any of the structures need maintenance or improvement?
S. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits. dry slacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
tnainicnance or improvement?
Waste Application
W. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
11. Is there evidence of incorrect land application?lfyes, check the appropriate box below.
❑ Excessive Ponding
❑ PAN ❑ PAN > 10% to I 0 lbs.
❑ Outside of Acceptable Crop Window
12. Crop'l'ype(s): Y ,
13. Soil Typc(s):
}
Il acElity Dumber; l l 1 ( Date of limped ion:
Waste Collection & 'I'reatruent
4. is storage capacity (structural plus storm storage plus heavy rainfall) Tess than adequate?
a. If yes. is waste level into the structural freeboard?
Structure l 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 of the structures observed?
lark 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?
! d t_
ErYcs ❑ No ❑ NA ❑ NE
❑ Yeti ENo ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes No 0 NA 0 NE
0 Yes Er/No ❑ NA ❑ NI:
If any of questions 4-6 sere answered yes, and the situation poses an immediate public health or ensironmentai threat, notify DWR
QNo ❑ NA
O Ycs Ito ❑ NA
❑ Yes Eat ❑ NA
❑ Yes
❑ NE
❑ NE
❑ NE
Yes 0"10 ❑NA El NE
❑ Yes
❑ Hydraulic Overload ❑ Frozen Ground 0 I [navy Metals (Cu, in, etc)
❑ Total Phosphorus ❑ failure to Incorporate Manure/Sludge into Bare Soil
❑ Evidence of Wind Drill ❑ Application Outside of Approved Arca
14. Do the receiving crops differ from those designated in the CA W MP?
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?
[7, Does the facility lack adequate acreage for land application?
18. Is there a lack ofproperly 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? ]f yes. eJieck
the appropriate hox.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements El Other:
21. Does record keeping need improvement? If yes, cheek the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑Soil Analysis ❑ Waste Transfers
Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and ]" Rainfall lnspectiuns
22. Did the facility fail to install and maintain a rain gauger ❑ Yes, 04
23. If selected, did the facility fail to install and maintain rainbreakcrs on irrigation equipment? [l Yes [llo
Page 2 of 3
IZl No 0 NA ❑ NE
❑ Yes E o ❑ NA ❑ N>
❑ Yes '[No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ 1'cs L.f! o El NA ❑ NE
❑ Yes [ No ❑ NA 0 NE
O Yes "No ❑ NA ❑ NE
❑ Yes 'Nu ❑NA ❑NE
❑ NA ❑ NE
❑ Weather Code
0 Sludge Survey
❑ NA ❑ NE
❑ NA 0 NE
2/412015 Continued

Facility Number:
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? Ifyes, check
the appropriate box(es) below.
❑ Failure to complete annual sludge survey
❑ Non -compliant sludge levels in any lagoon
List sttvcturc(s) and date of first survey indicating non-compliance! _
26. Did the facility fail provide documentation of an actively certified operator in charge?
Date of inspection: 6 - iq—�l 1
❑ YcsNo
❑ yes 12( No
El Failure to develop a POA for sludge levels
❑ NA
❑ NA
❑ NE
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
2R, Did the facility fail to properly dispose of dead animals with 24 hours andlor 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.c., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the t'acility? 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 CAWMP?
31 Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow -tip visit by the same agency?
Comments (refer to question 0): Explain any YES answers and/or any additional recommendations or any other comments.
Ilse drawings of facility to better explain situations (use additional pages as necessary).
r
i s -e-- InlvkailLy5 S- 5 -
0
t`� C
C.4 o ILAISc-sittee_CC)
0.9. JCL)-\r\c6 t ie d5
l 15
(00
El Yes
❑ Yes
❑ Ycs
Li Yes
❑ Yes
O Yes
Qivo
❑' °
❑ Ycs El/No
❑ Yes by
❑ Ycs IniNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA El NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE.
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
,f
Phone:9'T 1 —0a3/
Date
2/4/2015