820644_Routine_20220729

C0ivisio11of Water Resources
Division of Soil; and. Water Co'nse
Other Agency
Type of Visit: ®'Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Ca'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 7-- Arrival Time:
Farm Name:
Owner Name:
gobnp-71--tucc
Mailing Address:
Physical Address:
Facility Contact: C
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Departure Time: /#6?:.3 0 I County:
Owner Email:
Phone:
Title:
Phone:
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
Wean to Finish
Wean to Feeder
ijc
Cfreti
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
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 la< ❑ NA ❑ NE
of the State other than from a discharge?
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [ No ❑ NA ❑ NE
Page 1 of 3
2/4/2015 Continued

Facility Number: f�' zqq
Date of Inspection: 79-
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?:
Designed Freeboard (in):
Observed Freeboard (in):
J
❑ Yes To ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a El Yes
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmen
7. Do any of the structures need maintenance or improvement? e] Yes
8. Do any of the structures lack adequate markers as required by the permit? El Yes
(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
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes21Cio ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes QTIo ❑ NA ❑ NE
❑ Excessive Ponding El Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
El 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):
13. Soil Type(s):
Di< ❑NA ❑NE
Eti:rJ ❑ NA ❑ NE
threat, notify DWR
❑NA ❑NE
❑"No El NA ❑NE
121<o ❑ NA ❑ NE
14. Do the receiving cropl 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 El Checklists ❑ Design El Maps ❑ Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ Yes
❑ Yes
lal< ❑ NA
io ❑ NA
2'sro ❑ NA
❑ NE
❑ NE
❑ NE
❑ Yes LJ 5o ❑ NA ❑ NE
❑ Yes ENO ❑ NA ❑ NE
❑ Yes
❑ Yes
El Other:
❑Yes 0 ❑NA ❑NE
❑- ❑ NA
D-N-6 ❑ NA
❑ NE
❑ NE
❑ Waste Application ❑ Weekly Freeboard El Waste Analysis ❑ Soil Analysis ❑ Waste Transfers El Weather Code
El Rainfall ❑ Stocking ❑ Crop Yield El 120 Minute Inspections El Monthly and 1" Rainfall Inspections El Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes L"1VO ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes u 1V o ❑ NA ❑ NE
Page 2 of 3 5/12/2020 Continued

Facility Number:
I,P
Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check g-ees
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
®-ldon-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
I -I D 2D
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:
No ❑ NA
❑ No ❑ NA
❑ Yes To ❑ NA
❑ Yes 1V o ❑ NA
El 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
OTIo ❑ NA
j 4o ❑ NA
fo ❑NA ❑NE
l N<D ❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
No
®No
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
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). •
comments. •
L ,iee,freh
rAfr ?1.5
kfferDC, Ape%v't•-
-
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
5/12/2020