820385_Routine_20220820

Facility Number
tJ�
0 Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
LE `IN)I22
Type of Visit: 9 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:
q .aa
mill rvn
Arrival Time:
Departure Time:
Owner Name:
►1�C
Mailing Address:
Physical Address:
Facility Contact:
Owner Email:
Phone:
county:SQ)7)Iqfl Region: Fr°
C E3ai-I,' i C-K
Title: -rem G r Phone:
Onsite Representative: ;c MQ Integrator: ,3rn i riei4
Certified Operator: A-Q hd bh 1 v D 1 Certification Number: I QQ 13 Si
Back-up Operator:
Location of Farm:
Certification Number:
Latitude:
Longitude:
Swine
Design Current
Capacity Pop.
Wean to Finish
Wean to Feeder
X
Feeder to Finish
MS-1B
j9JOO
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Design Current
Wet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Cattle
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
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
❑ 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 b\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?
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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):
Structure 2 Structure 3 Structure 4
2
y 3C3 LoO f (l?0
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?
❑ Yes No
❑ Yes o
Structure 5
❑NA ❑NE
❑NA ❑NE
Structure 6
❑ Yes IkNo
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
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? E Yes ❑\No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes \J 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 hi No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑,No ❑ NA ❑ NE
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 f ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): ()e r r u d alr o V€ rGoe d
13. Soil Type(s): c U t V (l t o
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. • ❑ Yes
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections
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
Itt No
0 No
13\No
lE No
N
No
LJ No
❑ NA
❑ NA
❑ NA
❑ NA
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
No
❑ Waste Transfers
❑ Monthly and 1" Rainfall Inspections
it No
No
❑ Yes
❑ Yes
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ 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?
❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check •Yes ❑ No ❑ NA ❑ NE
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:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes allo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes '❑ No ❑ NA ❑ 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 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 El Lagoon/Storage Pond El 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 El NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? El Yes �R\To ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
remove trees f'om lagoon is
faun R worKi rrg on bore cufac
Reviewer/Inspector Name: KQt. f n-Qn 0 I- sue 9kNitvii
Reviewer/Inspector Signature:
Page 3 of 3
KKratie fo nentt g
Phone:
Date: • c9.?
5/12/2020