820132_Routine Inspection_20220719

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ti6 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
Owner Name:
q99-
Arrival Time:
Sam hope firms
€arnvei J. hove
Mailing Address:
Physical Address:
FacilityContact: C tic, bOlthILK
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Departure Time:
County: Same Region: f f O
Owner Email: ENTERED TO
Phone:
LASERI-IONE
JUL 2 1 2022
sQm�
Sgrnuei Nape
DEQ/DWR WQROS
FAYETTEVILLE REGIONAL OFF -ICE
:�� Titleth 4j . Phone:
Latitude:
Integrator: smft1 i IeJ4
Certification Number:
Certification Number:
Longitude:
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 No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes 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 No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ 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?
❑ Yes l No ❑ NA ❑ NE
Page 1 of 3
5/12/2020 Continued

Facility Number:
Waste Collection & Treatment
Date of Inspection:
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):
❑ Yes ' No ❑ NA ❑ NE
❑ Yes NI No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
NC)
ICI
Observed Freeboard (in): ;I%
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ER 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 [NNo ❑ 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?
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?
❑ Yes 'N No ❑ NA ❑ NE
❑ Yes t No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑Yes No ❑NA ❑NE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ 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 Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): GB to K1 G
13. Soil Type(s): G\) `' IVI I l v1 g B Li n O y
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?
18. Is 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 ['Other:
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 ❑ Monthly and I"
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Page 2 of 3
❑ Yes No ❑NA ❑NE
❑ Yes [�No ❑NA ❑NE
❑ Yes 4 No ❑ NA ❑ NE
❑ Yes NINo ❑NA ❑NE
❑ Yes j] No ❑ NA ❑ NE
❑Yes ICJNo ❑NA ❑NE
❑ Yes is;]
No ❑ NA ❑ NE
❑ Yes j No ❑ NA ❑ NE
❑ Waste Tran fers ❑ Weather Code
Rainfall Inspections ❑ Sludge Survey
❑ Yes
❑ Yes
No ❑ NA ❑ NE
No ❑ NA ❑ NE
5/12/2020 Continued

Facility Number:
Date of Inspection:
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 structure(s) and date of first survey indicating non-compliance:
❑ Yes
❑ Yes
No ❑ NA ❑ NE
No ❑ NA ❑ NE
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:
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ 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 visit by the same agency?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes
❑ Yes
❑ Yes
No ❑ NA
No ❑ NA
❑ NE
❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
5/12/2020