820195_Routine_20220929

Facility Number
O Division of Water Resources
O Division of Soil and Water Conservation
Q Other Agency
61riJ
10M72.
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
Owner• Name:e)are Oar tQ!)
1_Ong_
Mailing Address:
3• 2 7 J Arrival Time: I _ � j Departure
feet7:Niter Email:
Phone:
1 County::?'
ffl NRegion:
Physical Address:
r,
Facility Contact: (Am 0\ .tDC)t Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Phone:
191,17,9g-2
Certification Number
Certification Number:
Longitude:
Fr-19(p
Design Current
Capacity Pop.
Wean to Finish
tR714
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Design Current Design Current
Wet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
Cattle Capacity Pop.
Dairy Cow
II Dairy Calf
IDairy Heifer
Dry Cow
Dry Poultry Capacity Pop. • Non -Dairy
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Beef Stocker
Beef' Feeder
Beef Brood Cow
Discharges and Stream Impacts
l . Is any discharge observed from any part of the operation'?
Discharge originated at:
Lil Structure
Application Field Other:
No n NA ❑ NE
a. Was the conveyance man-made`'
b. Did the discharge reach waters of the State? (11 yes, notify DWR)
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)
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
Yes
No n NA nNE
No I I NA I I NE
0 Yes
fYes
Yes
No ❑ NA 0 NE
No NA nNE
nNA nNE
No
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?
Structure 1
Identifier: 1�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ?)1
Structure 2 Structure 3
Structure 4
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?
n Yes No n NA 7 NE
Li Yes V No NA 1 NE
Structure 5 Structure 6
Yes \-1No ElNA nNE
n Y• es
No n NA nNE
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?
11. Is there evidence of incorrect land application? 1f yes, check the appropriate box below.
Yes {j No
Yes k-1 No
Yes
NA PI NE
NA LINE
No U NA LI NE
Y• es cl No n NA El NE
n Y• es In No ElNA nNE
Excessive Ponding n Hydraulic Overload Frozen Ground n Heavy Metals (Cu, Zn, etc.)
Li PAN PAN > 10% or 10 lbs.
Outside of Acceptable Crop Window
12. Crop Type(s): c90
13. Soil Type(s): )(U t tO
n Total Phosphorus n Failure to Incorporate Manure/Sludge into Bare Soil
Evidence of Wind 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?
n Yes No ❑ NA n NE
Yes No 1 NA nNE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable 0 Yes No 1 NA n N• E
acres determination'?
1 7. 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`? n Y• es \; No NA n NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check Yes �n No NA H NE
the appropriate box.
WUP [ Checklists n Design Maps Lease Agreements Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
L_i Waste Application
1
Weekly Freeboard [n Waste Analysis I Soil Analysis
7Yes No fNA Li NE
1nY• es [ ]No 1 INA nN• E
11
Yes [ No n NA NE
Waste Transfers
Li 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?
23. If selected, did the Facility fail to install and maintain rainbreakers on irrigation equipment?
P(ii,e 2 of 3
n Y• es
Yes
n Weather Code
Sludge Survey
No 1 1 NA -n N• E
No n 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.
ri Failure to complete annual sludge survey n Failure to develop a POA for sludge levels
1 Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
n Yes No n NA NE
❑ Yes [ No 7 NA ❑ NE
26. Did the facility fail to provide documentation of an actively certified operator in charge'?
LI Yes
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document n Yes No fl 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? 7 Yes
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
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
fl Application Field fl Lagoon/Storage Pond fl Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 0 Yes
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? n Yes
34. Does the facility require a follow-up visit by the same agency? 0 Yes
No
E-4 No
No
N
E] No
MI I
No
NA
❑ NA
❑NE
NE
No fNA El NE
ri NA ONE
11NA 0NE
111 NA
❑ NA
n NA
[]NE
NE
111 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).
GG jONC? ieec hui- (TM
IDOK (L;Dod
dnoK 9Dor!
Reviewer/Inspector Name:
Reviewer/Inspector Signature:CW_
-Ikterr-r
cv-e,ret
Phone:
Date: 2c/
22
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