820621_routine_20220617

Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Type of Visit: .ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 04t<tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
67`'02. Arrival Time:
4t4tuLt ("I -0
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
JUtL Cze),771-4.
Departure Time:
Owner Email:
Phone:
County:Region; re"- D
L
Onsite Representative:
Title:
r?:414,4Certified Operator: e¢ e.a
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Phone:
Certification Number:
Certification Number:
Longitude:
Layer
Non -Layer
Design Current
Capacity Pon,
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?
❑ Yes io ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) 0 Yes 0 No ❑ NA ❑ NE
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) ❑ Yes 0 No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes U < ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3
2/4/2015 Continued

Facility Number: $ '- - to;'21
Date of Inspection:
42-i7- , -
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ To ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
J5
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes E No ❑ NA ❑ NE
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
7. Do any of the structures need maintenance or improvement? ❑ Yes [ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes u 1V o ❑ NA ❑ NE
(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 ❑ Yes ❑°No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ENo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
F
12. Crop Type(s): (ryy r /� t 4 /rf72ftttJ,- ib ' °;4� .
6_7 13. Soil Type(s): 0/ . 1, L.
14. Do the receiving crops differ from those desi nated 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? ❑ Yes allo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ©''1Vo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
❑ Yes Ergo ❑ NA ❑ NE
❑ Yes U 110 ❑ NA ❑ NE
❑ Yes I o ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
El Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [ "feather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield El 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? El Yes JNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes CNo ❑ NA ❑ NE
Page 2 of 3 5/12/2020 Continued

Facility Number: - 69 -i
Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes [ To ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ©moo ❑ NA ❑ NE
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 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.
❑ 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 L'"J 1`' o ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes [-] No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes rfiVNo ❑ NA ❑ NE
[ENo ❑NA ❑NE
'No ❑ NA ❑ NE
'No ❑ NA ❑ NE
❑ Yes
❑ Yes
n Yes
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or
Use drawings of facility to better explain situations (use additional pages as necessary).
other
'&71)41 11.-)
;:t Fp/iv-
Reviewer/Inspector Name:
Phone: jO3-0 15 e(
Reviewer/Inspector Signature:
Date:
Page 3 of 3 5/12/2020