630004_Routine_20220922

Facility Number W-1,- I 9 1
Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
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Type of Visit:
Reason for Visit:
Compliance Inspection 0 Operation Reiiew Q Structure EN aluation O 'Technical Assistance
Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: [4;2'0,2 J Arrival Time:I <<
Farm Name: kl,1 fOM
1
Owner Name: WO fi tql
Departure Time:
Ow net' Email:
Phone:
Mailing Address:
County:
Region:
Physical Address:
Facility Contact: t7\ \ It 1 Witte: owN 1t Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
NIH
Certification Number:
Certification Number:
Longitude:
Swine
Design Current
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish%
Farrow to Wean
Farrow to Feeder -
Farrow to Finish
Gilts
Boars
Other
Design Current
Wet Poultry Capacity Pop.
Layer
jNon -Layer
Design Current
Layers
Non -Layers
Pullets
Turkeys
Turkey Points
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure
a. Was the conveyance man-made?
Application Field Il Other:
Cattle
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
fl Yes fl No NA NE
b. Did the discharge reach waters of the State'? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the St -ate (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 No F-1NA 7NE
r1 Yes `No [1 NA NE
El Yes I No
Yes LJ No Li
Li Yes I�� No
I1
NA flNE
NA 7NE
NA NE
Page i 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?
Yes
a. If yes, is waste level into the structural freeboard? n Yes
Identifier:
Spillway'?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 1 Structure 2
Structure 3
Structure 4 Stricture 5
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?
No
Structure 6
n Y• es E No f NA
nY• es
n
NA
No NA n NE
nNA nNE
NE
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?
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?
1 1. Is there evidence of incorrect land application? If yes, check the appropriate box below.
Excessive Ponding n Hydraulic Overload ri Frozen Ground
PAN LI PAN > 10% or 10 lbs. T Total Phosphorus
Outside of Acceptable Crop Window I I Evidence of Wind
12. Crop Type(s):
13. Soil Type(s):
fl Y• es �') No nNA I-1 NE
U Yes n No E NA ❑ NE
n Y• es
nYes
No n NA NE
nNA nNE
n Y• es n, No n NA n NE
U Heavy Metals (Cu, Zn, etc.)
Failure to Incorporate Manure/Sludge into Bare Soil
Drift n Application Outside of Approved Area
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.
W'UP
Checklists n Design Maps Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
Li Waste Application I I Weekly Freeboard l Waste Analysis f I Soil Analysis
nY• es No nNA 1 INE
n Y• es n No nNA nNE
Yes No [ I NA n] NE
Yes fi No NA NE
n Yes f No Li NA pi NE
nY• es No nNA nNE
Yes No nNA NE
Other:
Yes [T No
Waste Transfers
I Rainfall [ Stocking Crop Yield n 120 Minute Inspections n Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes n No
23. 1 f selected. did the facility fail to install and maintain rainbreakers on irrigation equipment? n Y• es n No
Page 2 of 3
pi NA
NE
Weather Code
Sludge Survey
NA nNE
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?
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 7 Failure to develop a POA for sludge levels
n Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
Yes I;, I No
Yes 7 No
NA ❑ NE
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 fl.No ❑ NA n NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 7 Y• es 7 No ❑ NA n 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 n NA Li 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 n Yes f No fl 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. n Yes❑ No ❑ NA ❑ NE
❑ Application Field 7 Lagoon/Storage Pond ❑ Other:
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?
❑ Y• es ❑No El NA ❑NE
❑ Yes ❑ No ❑ NA 7 NE
n Y• es n No ❑ 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).
Reviewer/Inspector Name:
Phone:
Reviewer/Inspector Signature:
Page 3 of 3
Date:
5/12/2020