250029_Inspection 2021_20210720

Facility Number
Division of Water Resources
4 Division of Sail and Water Conservation
0 Other Agency
!.y pe of Visit: 0 ['umpliance Inspection Z.,} {? cratirrn lie► it+�
P D Structure Evaluation 0 Technical Assistance
Reason Fur Visit: • Routine 0 Complaints -up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
1
Arrival Time:
OMner Name: 0017 \ c
D cht rc. Q
Mailing Address:
Physical Address:
Facility. Contact:
Departure Time:
_ ODp
County: C(•— Region: tO
{1►tner Email:
Phone:
NC P15,11
1 "� Title: Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
(»..) OnVI
Latitude:
Integrator: OCC k
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
I.ceder to Finish
Farrow to Wan
Farrow to Feeder
arrow to Finish
[jilts
Boars
Other
C}thcr
Wet Poultry
Layer
Non -Layer
Capacity Pop.
Design Current Design Currant
Cattle
rDairy Coo
Design Current
Dry Poultry Caoacitr•
Luycrs
Non -Layers
Pullets
Turkeys
Turkey Puults
O
Other
Capacity Pop,
Dairy Gill
Dairy Ileifer
Dry Cow
Nun -Dairy
Beef `}Tucker
Beef Feeder
13ee1' Broad Cow
Discharges and Stream Impacts
I. Is any discharge observed from any part oi'the operation?
Discharge originated at: IJ Structure ❑ Application Field ❑ Other:
a. Was the conveyance roan -made?
b. Did the discharge reach waters of the Stater (If yes, notify DWR).
c. What! is the estimated volume that reached waters ofthc State (gatl❑ns)?
d. Does the discharge bypass the waste management system'? {1f yes, notify DWR)
2. 1s 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
the State other than from a discharge?
Page 1 of 3
Yes
[]NA NJ
El Yes No NA NE
EI Yes 0 No ❑ NA El NE
▪ Yes N
❑ Yes Nu
El Yes
NA 0 NE
NA ❑ NE
11 NA Q NE
2/4/2015 Cr,nrrnued

15cilit Number; a 5
[)ate of Ins lion: - 2'71 .- hi 1
Waste Collection & 'Treatment
4. is storage capacity (structural plus storm storage phis heavy raint:tll) less than adequate?
a. if yes, is waste level into the structural freeboard'?
Identifier:
❑ Yes E o ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Stnututr S Structure 6
Spillway?•
Designed Freeboard (in):
Observed Freeboard (in):]
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?
Ef any oil -questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify D VR
7. Do any of the structures need maintenance or improvement? ❑ Ycs ❑ NA ❑ N 1:
S_ Do any of the structures lack adequate markers as require{ by the pennil? ❑ Yew JJ ° ❑ NA ❑ N
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Docs any part of the waste management system other than the waste structures require ❑ Yes El/No ❑ NA ❑ NE
maintenance or improvement'?
Waste Application
l0. Are: there any required buffers, setbacks, or compliance alternatives that need ❑ Ycs Na ❑ NA ❑ NE:
maintenance or improvement?
11. Is there evidence of incorrect land application'? If yes, check the appropriate box below. ❑ Ycs fl Nu ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ I'Leavy Metals (Cu, Zn, ctc.)
❑ PAN ❑ PAN > 10%or 10 Ibs. D Total Phosphonts ❑ I nilurc to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ Application Outside of Approved Arca
12. Crop Type(s): C ,
❑ Ycs DiNo ❑ NA ❑ NE
❑ Yes 04 ❑ NA ❑ NI':
13. Soil Typc(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yea , , f laiNo ❑ NA D NI:
15. Docs the receiving crop and/or land application site need improvement? ❑ Yen I yblo El NA ❑ NE
16. Did the facility fail to seeurc and/or operate per the irrigation design or wettable El Yes ❑ jiu ❑ NA ❑ NE
acres .determination?
!7. Does the facility lack adequate acreage for land application.?
8. Is there a lack of properly operating waste application equipment:'
Required Records & Documents
19. Did the tacility Jail 10 have the Certificate of Coverage & Permit readily available? ❑ Yes 10 ❑ NA ❑ NI
20. Docs the facility fail to have all components of the CAWMP readily available? 1t yes, cheek ❑ Yes No D NA ❑ NI,
the appropriate box.
❑WL11' El Checklists ❑ Design ❑ Maps ❑ Lease Agreements El Other:
❑ Ycs 'N ❑NA ❑NE
No NA
NE❑ Yes ❑ ❑
21. Docs record keeping need improvement? If yes, check the appropriate hnx below. ❑ Ycs ❑/hlu ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste 'fransters ❑ Weather Code
❑ Rainfall ['Stocking ❑ Crop Yicid ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall tnspeciinns [ Sludge Survey
22. Did the facility fait to install and maintain a rain gauge?
23. ]fst;lcctcd, did the facility 1;6i1 to install and maintain rainbrcakers on irrigation equipment?
Page 2 of 3
❑Ycs 1r N . ❑NA ❑NE
❑ Yes No ❑NA El NE
2/4i20!5 Continued

1
aw Cry 4'
[Facility Number: �j - ti,c I Date of Inspection: " _. 20-•2 1
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
the appropriate box(es) below.
❑ Failure to complete annual sludge survey
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance;
o
No▪ Yes
❑ Failure to develop a POA for sludge levels
❑ NA
❑ NA
❑ NE
❑ NE
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus toss assessments (PLAT) ccniftcation?
Other Issues
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 concern?
Ifycs, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency siniations as required by the
permit'? (i.e., discharge, freeboard problems. over -application)
31. Do subsurface tile drains exist at the facility? ]f yes, check the appropriate box below.
D Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes o ❑ NA ❑ NE
❑Yes [YNo ❑NA NE
[i Ycs 0/No ❑ NA ❑ NE
[] Yes I No ❑ NA ❑ NE
❑ Ycs fo Q NA ❑ NE
❑ Ycs 04 ❑ NA ❑ NE
Li Ycs
❑Ycs
D yes
• NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
Comments (refer to question #): Explain any YF.S answers and/or am additional recommendations or any other comments.
Use drawings of facility to better expiain situations (use additional pages as necessary).
f Y"lf \- 1 -2 0 Sal L17th
5')- cc_ 1etJ
56 Cv 'r S .04'. R r t ;1.L Gam- t, c4
c_Lt( [A
Revicwcr/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
0-C3c1
R,L)
oi?np—'— :39
Date: • 2 0-
2/4/2015