820243_Routine Inspection_20220719

Type of Visit: 0 Compliance Inspection 0 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 Access
Date of Visit:
Farm Name:
1-19'n
Arrival Time:
qt Ob
edile form kb�
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
To rM edge
Departure Time:
Owner Email:
Phone:
County: Sump Region: Fro
ENTERED TO
LASERF!CHE
JUL 2 d 2022
Cvrtl S Faro) I cic
cA ►I
DE.itDWR:WOROS
FAYEJ EVILLE REGIONAL OFFICE
Title:RU1 j. Phone:
Tanner 9QN
Latitude:
Integrator:
Certification Number c",/plc
Certification Number:
Longitude:
>urren sLe= am'
w ON x;+4—raa
tP+'"aa a:. asx;
a' ts4
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?
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 DWR)
2. Is there evidence of a past discharge from any part 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?
❑ Yes I\ I No ❑ NA ❑ NE
❑ Yes ILINo ❑NA ❑NE
❑ Yes No ❑NA ❑NE
❑ Yes V No ❑ NA ❑ NE
❑ Yes n No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Page 1 of 3
5/12/2020 Continued

Facility Number:
Date of Inspection:
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?
Structure 1
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
No
tat rr
Structure 2
Structure 3 Structure 4
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
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public
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
❑ Yes
Structure 5
No ❑ NA ❑ NE
No ❑ NA ❑ NE
Structure 6
❑Yes iklNo ❑NA ❑NE
❑Yes tNo ❑NA ❑NE
health or environmental threat, notify DWR
XIYes ❑No ❑NA ❑NE
❑ Yes iCl No ❑ NA ❑ NE
❑ Yes tc,No ❑ NA ❑ NE
❑ Yes fi 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
um
off Wind DDrift ❑ Application Outside of Approved Area
12.Crop Type(s): Cbc1St�\►nmiAcl/ WI!
g k1e
i/
13. Soil Type(s): QUkt I Ile
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
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 1'
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
El Yes
❑ Yes
No
No
No
❑ NA
❑ NA
❑ NA
❑ Yes 'INo ❑NA
❑ Yes Nip No ❑ NA
❑ Yes
❑ Yes
No ❑ NA
No ❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑Other:
❑ Yes i No ❑ NA ❑ NE
❑ Waste Transfers ❑ Weather Code
' Rainfall Inspections E Sludge Survey
❑ Yes j No ❑ NA ❑ NE
? ❑ Yes Cl1/4No ❑ NA 0 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
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
❑ Yes No ❑ NA ❑ NE
❑ Yes NNo ❑NA ❑NE
❑Failure to develop a POA for sludge levels
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 ❑ No ❑ NA ❑ NE
❑ Yes ES-41No El NA ❑NE
❑Yes ES7]No ❑NA ❑NE
❑ Yes IS] No ❑ NA ❑ NE
❑Yes 1E1No El NA ❑NE
❑ Yes No ❑NA ❑NE
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 t No ❑ NA ❑ NE
❑ Yes k] No ❑ NA ❑ NE
❑ Yes k] No ❑ NA ❑ NE
�- wonc on bare areas on tagoon spray
Moon for weets.
t00K eta( gods ,
Inside
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
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Phone: 6qt1 iJq@ lest
Date: 1 .022
5/12/2020