540042_Inspection (Annual)_20220510

Facility Number
NA
4 Division of Water Resources
O Division of Soil and Water Conservation
ID Other Agency
rT} pc of 4'isit: t� Compliance inspection 0 Operation Res ic►s 0 Structure Es aluation
0 Technical Assistance
Reason for Visit: • Routine 0 Complaint 0 Follow-up D Referral 0 Emergency 0 Other 0 Denied Access
Date of'Vjsit:
Farm Name:
Err].
❑wner Name:
Mailing Address:
Ph►sical Address:
Arris al Time:I l) . 3 rr., ,1 Departure Time:1 ] a 3 v— County:
"AIi Wet r �
Owner Email:
Phone:
t ,(
+--E.rt a Itegicrn:t )
Facility Contact: y) M 1 j Title: Phone:
Onsite Representative: A, r,l,s.J'C' I\\t + i
1 t`VLGt, hr c. Cr
Certified Operator:
Back-up Operator:
Location of Fairrll:
Latitude:
Integrator: c'M )—'
Certification Number: f ')
Certification Number:
Longitude:
Swine
Design Current
Capacity Pop.
Wean to Finish
Wean to Feeder
rI�,
XFeedcr
to Finish
.Yc`'ts--)
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boar.
Other
Design Current
Wet Poultry Capacity Pop.
4i e r
Non -Layer
Design Current
Dry Poultry Ca i acih• Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poulis
Oilier
Cattle
Design Current
Capacity Pop.
Dairy Cow
Dairy Call
Dairy Heifer
I)ry Cow
Non -lair}
Beef Stocker
Beet Feeder
Beef Brood Copt
Discharges and Stream Impacts
1. Is any discharge observed from any part oldie operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man -trade?
b. Did the discharge reach waters of the State? Of yes, notify DWR)
c. What is the estimated volume that reached waters at the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there rti idence ofa past discharge from any pan 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?
Page Iof3
❑ Yes
❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yrs ❑ No ❑ NA ❑ NE
17 Yes ❑ NO ❑ NA ❑ NE
❑ Yes 2FN ❑ NA ❑ NE
[J Yes OiNro ❑ NA ❑ NE
5112/2020 Continued

Facility Number: l( - 1L;)
'Date of Inspection: 10 ".. .
Waste Collection & Treatment
4. is storage capacity- (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
❑ Yes o D NA D NE
❑ Yes No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5
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 ❑ Yes 6/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 environmen l threat, notify DWR
pro
7. Do any of the structures need maintenance or improvement? E(Yes o ❑ NA ❑ NE
8. Do any of the structures Iack adequate markers as required by the permit? ❑ Yes ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
Structure 6
❑ Yes [j No ❑ NA ❑ NE
9. Does any part of the waste management system other than the waste structures require ❑ Yes
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
11. Is there evidence of incorrect land application'? if yes, check the appropriate box below. ❑ Yes INo ❑ NA ❑ NE
• Excessive Ponding ❑ Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
Ld�iO
�NA ❑NE
❑ Yes 121//No ❑ NA ❑ NE
❑ PAN ❑ PAN } 10%or l0 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
12. Crop Type(s):
13. Soil Type(s):
14, Do the receiving crops differ from those designated 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 far land application? ❑ Yes No ❑ 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 ha+e the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have atI components of the CAWMP readily available? if yes, check ❑ Yes 'Nn ❑ NA ❑ NE
the appropriate box.
WUP ['Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping necd improvement? lfyes, check the appropriate box below. ❑ Yes [ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ['Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall Stocking ❑ Crop Yield ❑ 120 Minute Inspections ['Monthly and 1" Rainfall inspections ['Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [ ❑ NA ❑ NE
23. if selected, did the facility Fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes i.� No ❑ NA ❑ NE
Page 2 of J 5/12/2020 Continued
❑ Yes ❑ o 0 NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE

IDate of Inspection: 5- la -
❑ Yes
E Ycs
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_
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
© Non -compliant sludge levels in any lagoon
List structures) 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?
lfycs, 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)
32. Do subsurface ti]e drains exist at the facility? Ifyes, check the appropriate box below,
❑ Application Field ❑ Lagoon/Storage Pond
❑ Other:
n ❑NA ❑NE
No ❑ NA ❑ NE
❑ Yes
▪ Yes
El Yes
Yes
O Yes
❑ Yes
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 vi'it by the same agency?
❑ Ycs
❑ Ycs
❑ Yes
[J] o ❑IAA
o ❑ NA
�N
ID/No
NE
❑ NE
QNA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any otter comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
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Reviewer/Inspector Name:
Reviewerllnspector Signature:
Page 3 of 3
Phone:k Lt f`
Date: - I O - 27_
21422911