620004_Routine_20220928

Facility Number
Division of Water Resources
Division of Soil and Water Conservation
Q Other Agency
PD1 ffiC
�f
Type of Visit:
Reason for Visit:
Compliance Inspection 0 Operation Review Q Structure Evaluation
Routine Q Complaint 0 Fo11ow-u
p
0 Referral 0 Emergency
4111.111.11111116
Q Technical Assistance
O Other
Date of !Visit: CI �0c, -22 Arrival Time: ' 3Q 1 Departure Time: 40) ;30 Conn
Farm Name: )O Qf R 't t "itf ( V `j Nuilice 1 ? 2
Owner Name: dftt ftfl<INJ c
Mailing Address:
Physical Address:
Facility Contact: clek P It
Onsite Representative: (.
Certified Operator: 1
Back-up Operator:
Location of Farm:
Owner Email:
Phone:
0 Denied Access
On G
Region: ft)
1I `" J Title: It ) eo
Latitude:
Phone:
Integrator: gfn I 6((
Certification Number: 991)1"
Certification Number:
Longitude:
Swine
Design Current
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
101
Farrow to Finish
Gilts
Boars
Other
Layer
Non -Layer
Dry Poultry
Layers
Design Current
Capacity Pop.
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
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: [J Structure fl Application Field 1 I Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (I f yes.. notify DWR )
c. What is the estimated volume that reached waters of the State (2:allons)?
d. Does the discharge bypass the waste management system`? (If yes, notify DWR)
Yes [ No [l NA NE
LJ Yes[] No
Yes
[l NA n N• E
No pi NA fl NE
Li Yes
2. Is there evidence of a past discharge from any part of the operation'? Yes Ki
No
3. Were there any observable adverse impacts or potential adverse impacts to the waters Yes VI No
of the State other than from a discharge?
No fl NA NE
NA N• E
NA [] N• E
Page 1 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?
a. If yes, is waste level into the structural freeboard?
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 1 Structure 2
O
Structure 3 Structure 4
n Yes
Yes
Structure 5
No NA 7 NE
No El NA [11 NE
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed'? Yes No 7 NA n 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
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
Yes yiNo NA NE
7. Do any of the structures need maintenance or improvement? [1 Y• es
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?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
Excessive Ponding —] Hydraulic Overload
I1 No I ] NA 7 NE
Yes VI No ILI NA E NE
Yes INo Li NA NE
E Yes
(T NA ®N E
Yes VINo 0NA NE
Frozen Ground (J Heavy Metals (Cu, Zn, etc.)
PAN I PAN > 10% or 10 lbs. n Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
17 Outside of Acceptable Crop Window
12. Crop Type(s):
13. Soil Type(s):
C Evidence of Wind Drift 17 Application Outside of Approved Area
ft,(1,tve
cJcDlQvi'V
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.
WUP Checklists Design [1 Maps r Lease Agreements Other:
21. Does record keeping need improvement'? If yes, check the appropriate box below.
P1 Waste Application
—I Rainfall 1 I Stocking
[7 Weekly Freeboard
Waste Analysis
r1Soil Analysis
7Y• es VINO 7N• A ONE
Yes No 7 N• A ❑ N• E
7 Yes No I I NA ENE
I;w
7Yes No [ NA flNE
Yes ENo ENA 7N• E
7 Y• es 7INo flNA 7NE
Yes g! No ri N• A NE
I—IYesNo E1N• A NE
[� Waste Transfers
Weather Code
Crop Yield 120 Minute Inspections ri Monthly and 1" Rainfall Inspections ri Sludge Survey
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
[-] Y • e s
No
Yes No
NA SIN• E
7N• A [7N• E
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 El NE
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 n Failure to develop a POA for sludge levels
pi Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
❑ Yes
No []NA ENE
26. Did the facility fail to provide documentation of an actively certified operator in charge? Yes FANo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification'? E] Yes No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document n Yes No
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? El Yes 11' No
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 c
No
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. Ei Yes No
n Application Field n Lagoon/Storage Pond fl 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?
J Yes
n Yes
Ei Yes
NA
NA
❑ NE
E NE
El NA El NE
EjNA El NE
❑ NA El NE
EjNA fNE
No El NA
No El NA
No nNA
El NE
Li NE
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).
watch weedy IN C6 f'(Qld
Reviewer/Inspector Name:
frenot
Phone:
Reviewer/Inspector Signature:
Page 3 of 3
fo-wool
Date:
5/12/2020