250029_Inspection_20220614

Facility Number
Division or Water Resources
D Division of Soil and Water Conseniation
Q Other Agency
Type of Visit; • Compliance Inspection 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 A€easy
Date of Visit:
Farm Name:
Owner Name:
Arri► al Time:".0 — Departure Time:
c.-- aiJC
�rlk�
0) aCJCL5 - (-' irt]
Mailing Address: 3
Physical Address:
Owner Email:
Phone:
County:C(0-`-c' Region: L.____
Facility Contact: Dn.:,
Onsite Representative: 7 [ k,.ac�
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator: I no.c t--�
Certification Number:
Certification Number:
Longitude:
Swine
Design Current
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
CO
Farrow- to Feeder
Farrow to Finish
[lilts
Boars
Other
Design Current
Wet Poultry Capacity Pop. Cattle
Layer
Non -Later
Design Current
Dr►Ponitry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey "'oohs
Other
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
I)ry Coo
Nun -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cost
DischarL=es and Streaut Impacts
1. Is any discharge observed from any pan of the operation?
Discharge originated at: © Structure ❑ Application Field Q 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 I;)W R )
2. is there evidence of a past discharge from any pan of the operation?
3. Were there any observable atIv rse impacts or potential adverse Impacts to the waters
of the Slate other than from a discharge?
Page !cif 3
❑ Yes 'o ❑ NA ❑ NE
El Yes []No ID NA El NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑
❑ Yes
❑ Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
5/f2i2020 Cominued

Facility Number: 2
Date of Inspection: 6. P- -2,Z
Waste Collection & Treatment
4. Is storage capacity (structural plus stoma storage plus hea►y rainfall) Tess than adequate? ❑ Yes
a. If yes, is waste Level into the structural Freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
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.)
6. Are there structures on site which are not properly addressed andlor managed through a
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
❑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 part 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
maintenance or improvement?
1 I. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10%0 or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into I3are Soi]
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ Application Outside of Approved Area
I2. Crop Type(s):
l3. Soi! 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 andlor operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
1tt_ Is there a lack ot`properiy 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 oftbe CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑chock]ists ❑ Design ❑ Maps ❑ Lease Agreements
2I, Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes 9"No 0 NA ❑ NE
❑ Yes E(No 0 NA ❑ NE
❑ Yes fo ❑ NA ❑ NE
▪ Yes ❑d<o ❑ NA ❑ NE
❑ Yes [No ❑ NA Q NE
❑ Yes ['No ❑ NA ❑ NE
❑NA ❑NE
0 Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
ElYe o
El Yes NNo
d4
L� No
['Na
o
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ONE
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ONE
❑Other:
❑ Yes Elio ❑ 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 [ No ❑ NA ❑ NP.
23. If selected, did the facility fail to instal] and maintain rainbreakers on irrigation equipment? ❑ Yes ❑'10 ❑ NA ❑ NE
Page 2 of 5/12r2020 Continued

1
Facility Number: ,, c D - cl I Dateof Ins ection • it -_Z.
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check
❑ Yes
the appropriate box(es) below.
['Failure to complete annual sludge survey
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
❑ NA 0 NE
26. Did the facility fail to provide documentation of an actively certified operator in charge? El Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
ZS_ Did the facility fail to properly dispose of dead animals with 24 hours andfor document ❑Yes ID/No ❑ NA 0 NE
and report mortality rates that were higher than normal?
29. At the timEli e of the inspection did the facility pose an odor or air quality concern?Yes No NA El NE
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 [ No ❑ NA D NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? ]f yes, check the appropriate box below.
❑ Yes Ei No ❑ NA 0 NE
❑ Application Field D tagoorilStorage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes EPIO ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ NA ❑ NE
34, Does the facility require a follow-up visit by the same agency? 0 Yes No ❑ NA ❑ NE
Comments (refer to question if): Explain any YES answers author any additional recommendations or any other comments.
t rca dIrattinQs of facility to better explain situations (use additional pages as necessary) -
E{No ❑NA ❑NE
'No ❑ NA 0 NE
❑Failure to develop a POA for sludge levels
❑ Yes El/No ❑ NA a NE
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Reviewer/Inspector Name:
Reviewer/inspector Signature: --/45/
Page3of3
472.
Date:
214i2011