630001_Routine Inspection_20220801

Type of Visit: .Q Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Qitoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
r'z
Arrival Time:
tibb
Owner Name: / v jZ1 f -C ano
Mailing Address:
Physical Address:
Facility Contact:
Departure Time:
Owner Email:
Phone:
County: /1'(dac..
Region:
Title:
Phone:
Onsite Representative: ?f )' f1f/?JZ-C.. Integrator: j�'C�2c�vJ
Certified Operator:
Back-up Operator:
Location of Farm:
//
//
Latitude:
Certification Number:
Certification Number:
Longitude:
d'
Wean to Finish
+r...
Layer
Dairy Cow
'
Wean to Feeder --
Non -La er
--
Da Calf
Feeder to Finish
c
t
{{' Dairy Heifer
@
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I Dry Cow
Farrow to Wean 3a9 P.- 169
: , ..
' c
,
Non -Dairy
Farrow to Feeder III 9;
t
II
Farrow to Finish �
ayers j#;�'
Beef Stocker
Gilts
on -Layers
Beef Feeder
Boars
• ullets
Beef Brood Cow C'
urkes
TurkeyPoults
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i !n
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Other's
9 4
Other
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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) ❑ 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 No ❑ NA ❑ NE
❑ Yes
❑ Yes
No ❑ NA ❑ NE
No ❑ NA ❑ NE
Page 1 of 3
2/4/2015 Continued

(Facility Number: - Q
Waste Collection & Treatment
'Date of Inspection: d / %)-
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
N /D�
t� Ilqi
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? ❑ 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 have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ['Checklists El Design ❑Maps Lease Agreements El Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ' No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tran rs ❑ Weather Code
0 Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspecti s ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes o ❑ NA 0 NE
Page 2 of 3 2/4/2015 Continued
No ❑ NA ❑ NE
No ❑ NA ❑ NE
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes /9 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 m 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 environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(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 ❑Yes No El NA El NE
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 No ❑ NA ❑ NE
❑ Excessive Ponding 0 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`El Application Outside of Approved Area
12. Crop Type(s): 6 r&r�op�6.2tw (av �izyi 7 (i17 ,,
13. Soil Type(s): r � � �Y/r�a.--
14. Do the receiving crops differ from those desinated in the
❑ Yes No ❑ NA ElNE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
El Yes No El NA ❑NE

Facility Number: - (7/
1
Date of Inspection: g4 79—al
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
❑ Yes
['Failure to develop a POA for sludge levels
❑ NA ❑ NE
❑ 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
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:
h 24 hours and/or document
❑ Yes
❑ Yes
E 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?
❑ Yes
❑ Yes
❑ Yes
No
No
4 No
No
No
No
No
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other
Use drawings of facility to better explain situations (use additional pages as necessary).
❑ NA
❑ NA
❑ NA
❑ NA ❑NE
❑ NA ❑ NE
❑ NE
❑ NE
❑ NA
❑ NA
❑ NA
❑ NA
comment
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
Reviewer/Inspector Name: take/e/i5Okt)
Reviewer/Inspector Signature:
Page 3 of 3
Phone: /</G- SP9 z9'2t�
Date: b /C / a.
5/12/2020