040034_Routine_20220620

Facility Number
ic.„9
0 Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
ns
001,bdo
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
(tY)
Arrival Time:
O
Departure Time:
Ite irrn
wner Name: vJhlt2 RocJ< ffIlYY1S
Mailing Address:
Physical Address:
Owner Email:
Phone:
County:
Region: frO
ENTERED 10
I ASERFICHE
J U N 21 2022
�0� �
DEQ/DWR WQROS
Facility Contact: FL)tQ Title: FAY�tLLE REGIONAL OFFICE
Onsite Representative: C (1 fli.9.'
Certified Operator:
Back-up Operator:
Location of Farm:
roily Uel
Latitude:
Integrator:
Certification Number: 9(177Y1S
Certification Number:
Longitude:
Design Current
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Layer
Non -Layer
Dry Poultry
Design Current
Capacity Pop.
Design Current
Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
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?
El Yes No ❑ NA ❑ NE
❑ Yes kl No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
❑ No
No ❑ NA ❑ NE
No ❑ NA ❑ NE
❑ NA ❑ NE
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5/12/2020 Continued