820655_Routine Inspection_20230328

Type of Visit: ,0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: A5-Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Arrival Time: Departure Time: 1/�L
Date of Visit: County4y �_
L
Farm Name: Owner Email:
Owner Name: Le, �111) Phone:
Mailing Address:
Physical Address:
Facility Contact: "Q-44. 11 Title:
i7
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
47
V_r
Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field F-1 Other:
a. Was the conveyance man-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)?
Phone:
_'7 f
Region: OrWo�
Integrator:
Certification Number: 2 Y 7
Certification Number:
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?
Longitude:
E] Yes R�No E] NA Ej NE
E] Yes E] No F-1 NA E] NE
E] Yes Ej No F-1 NA E] NE
E] Yes E] No F-1 NA Ej NE
Ej Yes E�J'No F-1 NA 0 NE
0 Yes 2 No F-1 NA E] NE
Page I of 3 511212020 Continued

[—Facility Number: jDate of Inspection: Vgw& j
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? F-1 Yes -Ef- "N� o F-1 NA F] NE
a. If yes, is waste level into the structural freeboard? F-1 Yes E] No F-1 NA E] NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 6
Observed Freeboard (in): V
5. Are there any immediate threats to the integrity of any of the structures observed? E] Yes EErNo F-1 NA 0 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 0 Yes E!fNo F1 NA 0 NE
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
7. Do any of the structures need maintenance or improvement9 F-1 Yes No F-] NA NE
_f:�]
8. Do any of the structures lack adequate markers as required by the permit? F-1 Yes _eNo F__j NA NE
(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 E] Yes E�No F-] NA NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need Yes,_[D/No F-] NA [—] NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:] Yes &No F-1 NA F-1 NE
Fj Excessive Ponding E] Hydraulic Overload 0 Frozen Ground E] Heavy Metals (Cu, Zn, etc.)
F-1 PAN F-1 PAN > 10% or 10 lbs. Ej Total Phosphorus Ej Failure to Incorporate Manure/Sludge into Bare Soil
F_� Outside of Acceptable Crop Window Evidence of Wind Drift Ej Application Outside of Approved Area
12. Crop Type(s): Zy
13. Soil Type(s): A-,)6
14. Do the receiving crops differ from those designated in the CAWMP? F] Yes ,ZNo F-1 NA F] NE
15. Does the receiving crop and/or land application site need improvement? 01yes F-1 No F-] NA E] NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable E] Yes E2-No F-1 NA E] NE
acres determination?
17. Does the facility lack adequate acreage for land application?
Ej Yes 13'No
F_� NA
F-1 NE
18. Is there a lack of properly operating waste application equipment?
Ej Yes La"No
F� NA
E]NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes L2,/No
F-1 NA
0 NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Yes Pl�o
F-1 NA
[:] NE
the appropriate box.
F�WUP E]Checklists Design F� maps 0 Lease Agreements
E]Other:
2 1. Does record keeping need improvement? If yes, check the appropriate box below.
F_� Yes 12-No
F-1 NA
Ej NE
F-1 Waste Application E] Weekly Freeboard F-1 Waste Analysis E] Soil Analysis
F-1 Waste Transfers
Ej Weather
Code
F-1 Rainfall F-1 Stocking F-1 Crop Yield 0 120 Minute Inspections E] Monthly and I" Rainfall Inspections
E]Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
Ej Yes -4allo
F-1 NA
Ej NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Ej Yes J�rNo
F-1 NA
E] NE
Page 2 of 3
511212020 Continued

lFacility Number: 1,S-5_
_j Date of Inspection: 3
24. Did the facility fail to calibrate waste application equipment as required by the permit? E] Yes _E��rNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes ETNo
the appropriate box(es) below.
F-1 Failure to complete annual sludge survey F-1 Failure to develop a POA for sludge levels
F_� Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? F_� Yes E] No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? E] Yes F-1 No
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)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
r_1 Application Field F-1 Lagoon/Storage Pond F-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?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
[—] NA E] NE
F__j NA F] NE
NA NE
NA NE
E] Yes _[;]-No F] NA F-1 NE
E] Yes [��rNo F] NA 0 NE
0 Yes 2rNo F] NA E] NE
F] Yes �o F] NA F-] NE
E] Yes CfNo F-1 NA NE
Yes J��rNo [:] NA NE
Yes J2�No Ej NA NE
Phone: r1l"li 5�2es—
Date:
511212020

FACILITY#:q,� FARM NAME: Q&P� 4��o LAGOON LEVEL
PERMIT (#ig)
- DUE EVERY 5 YEARS
- B(PERIATION DATE NUMBER OF ANIMALS
CURRENT NUMBER OF ANIMAL
OIC CARD YES OR NO
WASTE UTILIZATION PLAN (WUP) (#20)
SOIL TYPES
CROP TYPES
- ODOR CONTROL CHECK LIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (#21)
-GOOD FOR 60 DAYS BEFORE OR AFTER
DATE_\ N �3 NITROGEN LEVEL
DATE IVI b'-1
DATE
NITROGEN LEVELJ,
NITROGEN LEVEL /I
- EVERY 3 YEARS:
SOIL REPORT (#2i�
DATE
- P-1 (N.0 MORE THEN 400)
- P H (Note if 4 or less)
- CuIZN (NO MORE THEN k00) CU
(IF PEANUTS NO MORE THEN 300)
Not over PAN CROP TYPES
FLOW RATES
Not over PAN
FLOW RATES
I RR2 (#21)
NITROGEN (N)
CROP TYPES
NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN
FLOW RATES
CROP TYPES
NITROGEN (N)
ZN

CALBRIATION (#24)
EACH REEL SHOULD BE CALIPRAT�D EVERY OTHER YEAR
DATE OF CALIBRATION
FLOW RATES
RAIN FALL (#21)
-INITIAL AFTER I" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED POA NEEDED.
-DUE EVERY YEAR: DATE SLUDGE (#21 &26)
0: 3, P: % RATIO OF SLUDGE
0: P: % RATIO OF SLUDGE
0: P: % RATIO OF SLUDGE
0: P -. % RATIO OF SLUDGE
OTHER FORMS (#22 AND #21)
RAIN BREAKER FORM CROP YEILDS MORTALITY
*If fields are grazed there will be no crop yields
VISUAL CHECK
FOUNDATION OR PIT LEAKS PIPE LEAKS LAGOON SEEPAGE LAGOON BARE
AREAS TREES OR GRASS NEED TO BE REMOVED EROSION - DITCHES -
WINTER CROP(OVERSEEDED) HARVESTED FIELDS GOOD HEALTHY CORPS- CORRECT
CROPS NO PONDING REELS FEED BINS LAGOON GARBAGE
Bermuda grass: Opens March I st - Ends September 30t"
Small Grain Over seed-. Opens October Ist- Ends March 31st
Corn: Opens February I 5th - Ends June 30th
Cotton: Opens March I 5th - Ends August 1 �,t
Rye: Opens September I -,t - Ends March 3 1 3t
Oats: -Opens September 13t- Ends April 15th
Wheat: Opens September 1-3t - Ends April 30th
Soybeans: Opens April 13t - Ends September I Sth
Fescue: Opens August I �,t - Ends July 31 st
Sorghum Hay: Opens March I 5th - Ends August 31 st