960113_Inspection_20220216

Division o Water R e0+3
0 Divisfoh ° Soil au0 Wolur COPie} v ii, '
O'Other Agency
Type of Visit: ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: -%6- Arrival Time: / Q : 710 Departure Time:
Farm Name:�W*4 > .42--
Owner Name: ���,, Phone: ?1FY
Mailing Address: (((7 4t ‘0, 4 i/ i4-, o'er)
fd; 3a
County:
Region: (/U
Physical Address: it
Facility Contact:
ILA.
Onsite Representative: n42.,,,(:[
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Owner Email:
4,104,2ea
Latitude:
Integrator:
Phone:
Certification Number: addp d
Certification Number:
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
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. Does the discharge bypass the waste management system? (If 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?
Longitude:
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes dNo ❑ NA ❑ NE
❑ Yes ❑No ❑NA ❑NE
❑Yes ❑No ❑NA El NE
❑ Yes ❑
❑ Yes
❑ Yes
❑ NA ❑NE
❑ NA ❑NE
No ❑NA ❑NE
Page I of 3
5/12/2020 Continued

,Nnmbor •
, •
•
© Divisioia otWater Resources• " . •.. _
• 0 btviston of Soil a W*ter Conservufiou'
.d Oder Agency •
.,
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ®Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
Arrival Time:
Departure Time:
Owner Name:
Mailing Address:
Physical Address: f �— /3 s41
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
4f4/e-1-(f ci,f(
Owner Email:
County:
on: GUcs /i.CJ
Phone: 9// —0 72—c3/,.3
Q-f,,z7e,47
Title:
Latitude:
Integrator:
Phone:
Certification Number:
Certification Number:
Longitude:
I- oil --g-egd
n..
:De ..c t
c rop..
Wean to Finish
x
Wean to Feeder
Feeder to Finish
5-6 Dd
a
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
.�,` • rr• .,-
Wet'oaltri . Capaeit • 19p.
Layer
Non -Layer
..De gn Gt Trent
:DrpVou1t CA • Eo7i. •
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow '
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
4.4
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
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. Does the discharge bypass the waste management system? (If 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 [No ❑ NA ❑ NE
El Yes No El NA ❑NE
❑ Yes No El NA ❑NE
❑ Yes ❑ o ❑NA ❑NE
❑ Yes [ No ❑ NA ❑ NE
❑ Yes NNo ❑ NA ❑ NE
Page 1 of 3
5/12/2020 Continued

Facility Number: 76f -
Date of Inspection: 3 - i
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? If yes, check
the appropriate box(es) below.
E Failure to complete annual sludge survey
❑ 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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?
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.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
❑ Yes
❑ Failure to develop a POA for sludge levels
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Application Field El 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
❑ Yes
❑ Yes
di-sTo ❑ NA ❑ NE
No ❑ NA ❑ NE
No
No
IR(No
[ 'No
dNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
No ❑NA ❑NE
*Attett 404, )a# ally YES 'answer's aind]or evladdiiiiusatftoolinbltaiktioniaf
'. t ,beta situations (useftd4Hm n1 ages''a nerssa.'y). " ...•
i-/e-0-1 - •/a
c)l--mdte
l
764/-ti-z4ige. _ dam- 9 - 1-
÷ -41-a447---Wg/
Reviewe
r/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
✓f tav14c 5 10. ✓
��tlt
Phone:
Date:
A5V da*
/4) 9 92-
5/12/2020