400061_Inspection_20221207

{
• 0 »itislo]n O Water R2eNou.i:eees
Division of Soil gnd Water Conserpat o)t. •
r4itY Number ,t= -
O Other Agency
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: 5(-7-- rrivalTimee: /. :'O v Departure Time:
Farm Name: ,9 rired--, 3ot', I — C7t-`/B [-by
Owner Name: 1 f �u /7 Phone:
Mailing Address:
Physical Address:
Facility Contact:
Owner Email:
County: 6.-rk i-r• Region: geit_ O
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title: QGP>Viz^c-
7ilGrc�
Latitude:
Integrator:
Phone:
Certification Number: /4.' 09
Certification Number:
Longitude:
l sign . Cui renn : DQ lga Cur t
a l'op� • Wet poultry Capacity Eel. • game
Wean to Finish
Wean to Feeder
} y_ Feeder to Finish
Farrow to Wean
(%S7 -•o
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Layer
Non -Layer
• Design *Current '
Dry'Poudtry Capacl ERp•
-
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
S.
• In,
Capacity l'op.
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 o
Discharge originated at: ❑ Structu
a. Was the conveyance man -mad
b. Did the discharge reach waters
c. What is the estimated volume
d. Does the discharge bypass the
2. Is there evidence of a past discharge from
3. Were there any observable adverse impact
of the State other than from a discharge?
the operation?
e ❑ Application Field ❑ Other:
❑ Yes Ello ❑ NA ❑ NE
f the State? (If yes, notify DWR)
t reached waters of the State (gallons)?
aste management system? (If yes, notify DWR)
ay part of the operation?
or potential adverse impacts to the waters
❑ Yes ❑No ❑NA ❑NE
❑ Yes No ❑NA NE
❑ Yes
❑ Yes
❑ Yes
❑No ❑NA ❑NE
EiNo ❑ NA ❑ NE
F.2'No ❑NA El NE
Page 1 of 3
5/12/2020 Continued

Facility Number: 110 - (1 /.
Date of
Waste Collection & Treatment
4. Is storage capacity (structural plus storm .rage plus heavy rainfall) less than adequate?
a. If yes, is waste lev.1 into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
33
5. Are there any immediate threats to the inte
(i.e., large trees, severe erosion, seepage, e
6. Are there structures on -site which are not
waste management or closure plan?
If any of questions 4-6 were answered yes,
7. Do any of the structures need maintenance
8. Do any of the structures lack adequate
(not applicable to roofed pits, dry stacks,
9. Does any part of the waste management
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks,
maintenance or improvement?
11. Is there evidence of incorrect land applic
❑ Excessive Ponding ❑ Hydraulic
❑ PAN ❑ PAN > 10% or 10lbs.
❑ Outside of Acceptable Crop Window
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those
15. Does the receiving crop and/or land appli
16. Did the facility fail to secure and/or op
acres determination?
17. Does the facility lack adequate acreage fo
18. Is there a lack of properly operating w
Required Records & Documents
19. Did the facility fail to have the Certifica
20. Does the facility fail to have all compone
the appropriate box.
❑ WUP ❑ Checklists
21. Does record keeping need improvement?
❑ Waste Application ❑ Weekly Free
❑ Rainfall ❑ Stocking ❑ Crop Yield
22. Did the facility fail to install and mainta i a rain gauge?
23. If selected, did the facility fail to install : d maintain rainbreakers on irrigation equipment?
Page 2 of 3
'ty of any of the structures observed?
c.)
operly addressed and/or managed through a
❑ Yes
❑ Yes
Structure 5
to ❑NA ❑NE
El No ❑NA ❑NE
Structure 6
❑ Yes 'ago ❑ NA ❑ NE
❑ Yes []'.o ❑ NA El NE
nd the situation poses an immediate public health or environmental threat, notify DWR
r improvement?
ers as required by the permit?
d/or wet stacks)
tem other than the waste structures require
r compliance alternatives that need
❑ Yes
El Yes
El Yes
❑ Yes a o ❑ NA
tion? If yes, check the appropriate box below. ❑ Yes E— ❑ NA
erload El Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ Total Phosphorus El Failure to Incorporate Manure/Sludge into Bare Soil
❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
esignated in the CAWMP?
tion site need improvement?
per the irrigation design or wettable
•
land application?
application equipment?
of Coverage & Permit readily available?
is of the CAWMP readily available? If yes, check
El Design ❑ Maps ❑ T .esisP Agreements
yes, check the appropriate box below.
and El Waste Analysis ❑ Soil Analysis
11
No ❑ NA ❑ NE
0- ❑NA ❑NE
❑ Yes E'N'o
❑ Yes [ago
❑ Yes Q10
❑ Yes I o
❑ Yes o
❑ NA
❑ NA
❑ NA
❑ NA
❑ NA
❑ NA
❑ Yes Q1 To ❑ NA
❑ Yes Io ❑ NA
['Other:
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑NE
❑ NE
❑ Yeso ❑ NA
❑ NE
El Waste Transfers El Weather Code
120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections El Sludge Survey
❑ Yes
❑ Yes
[l% ❑NA ❑NE
No ❑NA ❑NE
5/12/2020 Continued

Facility Number: ‘719 - (Q /
24. Did the facility fail to calibrate waste app
25. Is the facility out of compliance with pe
the appropriate box(es) below.
❑ Failure to complete annual sludge sury
❑ Non -compliant sludge levels in any la:
List structure(s) and date of fast surve
26. Did the facility fail to provide documents
27. Did the facility fail to secure a phosphoru
Other Issues
28. Did the facility fail to properly dispose o
and report mortality rates that were highe
29. At the time of the inspection did the facili
If yes, contact a regional Air Quality repr
30. Did the facility fail to notify the Regional
permit? (i.e., discharge, freeboard proble
31. Do subsurface tile drains exist at the facil
❑ Application Field ❑ Lagoon/Sts
32. Were any additional problems noted whic
33. Did the Reviewer/Inspector fail to discus'
34. Does the facility require a follow-up visit
Date of Inspection:
cation equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
t conditions related to sludge? If yes, check ❑ Yes ErSTo ❑ NA ❑ NE
❑ Failure to develop a POA for sludge levels
oon
indicating non-compliance:
on of an actively certified operator in charge?
loss assessments (PLAT) certification?
dead animals with 24 hours and/or document
than normal?
pose an odor or air quality concern?
entative immediately.
ffice of emergency situations as required by the
, over -application)
? If yes, check the appropriate box below.
rage Pond ❑ Other:
•
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
cause non-compliance of the permit or CAWMP?
review/inspection with an on -site representative?
y the same agency?
❑ Yes
❑ Yes
❑ Yes
❑NA
DICIo ❑NA
[-lo
g-icfo
13'To
ErNo
[No
ErNo
❑ NA
❑ NA
❑ NA
❑ NA
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
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i
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
—367—t915-1
5/12/2020