820706_Routine_20220929

Facility Number
100
Division of Water Resources 6t. t IS
Division of Soil and Water Conservation
0 Other Agency I C "✓/i--`6,
pe of Visit: '9 Compliance Inspection
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency. 0 Other 0 Denied Access
Date of Visit:
Farm Name:
Owner Name:
Z912
Mailing Address:
Physical Address:
0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Arrival Time:r;. 10
ODq f(A
Jhr11l g?-ei(
JDeparttire Timc:
i' 10
Owner Email:
Phone:
County: 10MP Region:
.0/110
Facility Contact: Rfl f ( (11 ) (, r 001 Title:
Onsite Representative: cfl
Certified Operator: J C� r fl
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: P
Certification Number: l 7 1 go)
Certification Number:
Longitude:
Swine
Design Current
Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish
Wean to Feeder
00 ' C)
0 7 p
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Layer
Non -Layer
Dry Poultry
Design Current
Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey POUIts
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the
Discharge originated at: j Structure
Cattle
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
operation'?
F-1 Application Field
Other:
Ei Yes
No NA ❑ NE
a. Was the conveyance elan -made`)
b. Did the discharge reach waters of the State? (If 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`?
11
r---1 Y e s
Yes
No NA ❑NE
No flNA El NE
Li Yes `] No fl NA [ NE
Yes JNo fl NA fl NE
7 Yes [7o fl NA fl NE
Page 1 (/3
5/12/2020 Continued

Facility Number: e (p
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): 1
Structure 1 Structure 2
Structure 3 Structure 4
n Yes
[1Y• es
Structure 5
�No 7NA 7NE
No 0 NA ONE
Structure 6
5. Are there any immediate threats to the integrity of any (tithe structures observed? 0 Yes No 0 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 n Yes [ No n NA n NE
waste management or closure plan?
It' 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'?
n Yes
n Y• es
No [JNA 1NE
No []NA ❑NE
n Yes No 0 NA ❑ NE
Yes 17 No n NA NE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. Yes
Excessive Ponding
Hydraulic Overload Ti Frozen Ground LI Heavy Metals (Cu, Zn, etc.)
PAN E PAN = 10% or 10 lbs.
No n NA i NE
Total Phosphorus [I Failure to Incorporate Manure/Sludge into Bare Soil
Outside of Acceptable Crop Window n Evidence of Wind Drift [_ j Application Outside of Approved Arca
12. Crop Type(s):
13. Soil Type(s):
GP), (ID
of oid�, 10g1010
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.
r�WUP
0 Y• es \ No n NA NE
n Yes No NA n NE
n Yes No n NA NE
1 I Yes No n NA ri NE
1_1 Yes No n NA n NE
n Yes [ No n NA n NE
Yes No n NA n NE
Checklists Design Maps Lease Agreements Other:
21. Does record 'Keeping need improvement'? If yes, check the appropriate box below.
LI Waste Application
LI Rainfall
Stocking
Weekly Freeboard Li Waste Analysis
Crop Yield
120 Nlinute Inspections
22. Did the facility fail to install and maintain a rain gauge'?
23. 11-selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Page 2 of 3
Yes NNo
Soil Analysis Waste Transfers
n Monthly and 1" Rainfall Inspections
n Yes
P
n
NA Li NE
Weather Code
Sludge Survey
No 7NA Li NE
• Yes 7 No NA 1 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.
nFailure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
7 Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
7Yes No El NA ❑NE
7Yes No El NA ❑NE
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 [1 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?
Fl YesNo ❑NA ❑NE
7Yes El No Li NA ❑NE
❑ Yes No ❑ NA ❑ NE
❑ Yes n No (l NA ❑ NE
❑ Yes 1,E No ❑ NA ❑ NE
❑Yes No El NA ❑NE
El Yes
❑ Yes
❑ Yes
No
No
No
❑ NA
7 NA
❑ NA
n NE
❑ 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).
-RIM\ ono KC
Reviewer/Inspector Name:
Ofie, ±)fl�
Phone:
Reviewer/Inspector Signature:
Date:
Page 3 of 3 5/12/2020