250038_Inspection_20180430

[1/4.1-- 1$
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Facilit `umber
5
6_1
Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: • Compliance Inspection 0 Operation Ret ion 0 Structure Evaluation 0 'I'cchnical Assistance
Reason for Visit: • Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency Q Other 0 Denied Access ]ite of Visit: Arrival Time: S'.45. I Departure Time: - County: CIS',- Region: 1, l2
°5 111 r-.1
I arm Name:
OwnerName: 5
Mailing Address: L71 o ] k r
Physical Address:
Owner Email:
Phone:
(I'd 11601CAM o✓oL
Facility Contact: t./5OYl Q S Title:
Cc try 1r� 5
Latitude:
Integrator:
Phone:
10(
Certification number:
Certification Number:
Longitude:
Swine
Design Current Design Current
Capacih Pap. Wet Poultry Capacity Pap.
Wean to Finish
)(Olean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gi Its
Roars
Other
Other
Layer
Non -Layer
Design Current
pry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
.
Turk9s
Turkey Poults
Other
Cattle
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy lfeifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharevi and Stream Impacts
1. Is ally 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 afthe 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 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 1 of 3
❑ Yes l__l :io ❑ NA ©NE
❑ Yes ❑ No ❑ NA ❑ NE
El Yes ❑No ❑NA NE
❑ Yes
❑ Yes
❑ Yes
Q o ❑ NA ❑ NE
[i ❑NA ❑ NE
❑NA NE
2/4A2015 Continued

Facil[ty amber: -
1Ya tc ('ullectiun Treatment
'Date of Inspection: E{— o--!`h I
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
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.)
b. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan')
If any of questions 4-6 mere answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
❑ Yes
❑ Yes
Structure 5
No ❑ NA ❑ NE
❑No ❑NA ❑NE
Structure 6
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any pan of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks. or compliance alternatives that need ❑ Yes Na © NA ❑ NE.
maintenance or improvement?
11, [s there evidence ufincorrect land application? If yes„ check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
Yes ❑ No ❑ NA [] NE
❑ Yes E'No ❑ NA ❑ NE
❑'Yes
❑ Yes
❑ No
ago
❑ NA
❑ NA
❑ NE
❑ NE
❑ Yes [No ❑ 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 Sail
O Outside of Acceptable Crop Window ❑ Evidence of Wind I]riri 0 Application Outside of Approved Area
12. Crop Type(s): b}
l3. 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 for land application''
L. ]s there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20, Does the facility fail to have all components of the CAWMP readily available? If yes. check
the appropriate box.
❑ WUP ['Checklists ❑ Design ❑ Maps ❑ Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below_
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Rainfall Stocking ❑ Crop Yield ❑ 120 Minute Inspections
22. Did the facility fail to install and maintain a ram gauge?
23. It selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Page 2 of .3
❑ Monthly and l"
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑Other:
El Yes El NA
❑ Waste Transfers ❑ Weather Code
Rainfall inspections ❑ Sludge Survey
n No
El NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
flNo ❑NA ❑NE
QNo ❑NA ❑NE
o
U No
❑ NA
❑ NA
❑ NE
O NE
❑ Yes ❑'1Go
❑ Yes ❑ No
❑ NE
❑ NA ❑ NE
ONA ❑NE
2/4/2015 Continued

Facility Number: o `J -
(late of inspection: 4 —4-43O ti
24. Qid the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes INo © NA ❑ NE
25, Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑Yes E<TO ❑ NA El NE
the appropriate box(es) below,
❑ Failure to complete annual sludge suneey ❑ Failure to develop a POA For sludge Ieveis
❑ Non -compliant sludge levels in any lagoon
List srructure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
2S. Did the facility fail to properly dispose of dead animals with 24 hours andlor document ❑ Yes iV4 ❑ NA ❑ NE
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? ❑ Yes ❑ No ❑ NA 1.1E
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 ❑ Yes El'o ❑ NA ❑ NE
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 O/No 0 NA ❑ NE
0 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.tinspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes lNo El NA ONE
❑ Yes ❑No D'1A ID NE
O Yes
❑ Yes
O Yes
7NA El NE
NA u NE
flNA ❑NE
Comments (refer to question #I: Explain any YES answers ancl/or any additional recommendations or any other comments
Use drawings of facilit• to better explain situations (use additional pages as necessary).
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Reviewer, Inspector Name: 1 _ L - Phone: �k I
Revicwerllnspectar Signature; - - -- Date: T
gV
Page 3 of 3 2/4/2015