820246_Routine Inspection_20210727

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Type of Visit: 9 Compliance Inspection 0 Operation
Reason for Visit: 0 Routine 0 Complaint 0 Follow -
Review 0 Structure Evaluation 0 Technical Assistance
up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
Owner Name:
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Arrival Time:
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Mailing Address:
Physical Address:
Facility Contact: CU rrl (
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Departure Time:
q 3 0
Owner Email:
Phone:
County: sOMecOn Region: I rb
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Title: T H l sf.
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
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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.
b.
c.
d.
Was the conveyance man-made?
Did the discharge reach waters of the State? (If yes, notify DWR)
What is the estimated voltune that reached waters of the State (gallons)?
Does the discharge bypass the waste management system? (If yes, notify DWR)
anoaO
❑ Yes 11 No ❑ NA ❑ NE
❑ Yes
❑ Yes
No ❑ NA ❑ NE
No ❑ NA ❑ NE
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?
El Yes
❑ Yes
❑ Yes
No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
Page 1 of 3
5/12/2020 Continued

Facility Number: W. -
Date of Inspection: 7•
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 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?: NO
Designed Freeboard (in):
Observed Freeboard (in):
aV a
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 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
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 ❑ 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
❑ Yes
❑ Yes
Structure 5
No ❑ NA ❑ NE
No ❑ NA ❑ NE
Structure 6
12. Crop Type(s): Co () ro w d q-e
13.SoilType(s): (�UFHVdl� VAig1Qn1
14. Do the receiving crops differ from those des'gnated 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.
❑ Yes tI No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes It4 No ❑ NA ❑ NE
❑ Yes
Yes
❑ Yes
❑ Yes
O Yes
❑ Yes
O Yes
['Other:
No ❑NA ❑NE
❑ No ❑ NA ❑ NE
tgNo ❑NA ❑NE
7 No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
El Yes ti]No ❑NA ❑NE
O 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? 141 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 04 No
Page 2 of 3 5/12/2020 Continued
❑ Yes
❑ Yes
❑NA ❑NE
❑ NA ❑ NE

Facility Number: - otto
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? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑Yes No ❑ NA El 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 ly No ❑ NA ❑ 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 ❑ 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 No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
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Reviewer/Inspector Name:
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Reviewer/Inspector Signature: \V 3a}-te(f V 1
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Phone:
Date
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Page 3 of 3
5/12/2020