820274_Routine nspection_20230328

i ype oi visit. -izzj t-ompiance inspection �,j "peration Keview u Ntructure Evaluation U I ecnnical Assistance
Reason for Visit: )a -Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: S�4�_d"
—L-At I
Farm Name: Owner Email:
Owner Name: Phone:
C/
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: x
Back-up Operator:
Location of Farm:
Latitude:
Region:97,0-Z
Phone:
Integrator:
Certification Number: 7
Certification Number:
Longitude:
DeMgn Current,.,,:
Peslen
Men
CU t
D esign:
Swine
p
Capacity op.
Wet Poultry
Capacitv
Po p-
Ca le
tt
C apac!
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -Laye
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dry Poll ltry
Capaci
Pop.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gi ts
Non -Layers
Beef Feeder
113oars
Pullets
Beef Brood Cow
Turkeys
.................
Other
Turkey Poults
F7
Other
Dischar2es and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: E] Structure E] 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)?
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 ZNo F-] NA [:] NE
F-1 Yes [—]No
0 Yes Ej No
F-1 NA NE
F-1 NA NE
E] Yes ZNo F-1 NA E] NE
0 Yes 0 No F-] NA NE
E] Yes dNo F-1 NA NE
Page I of 3 511212020 Continued

9 1
Facility Number: jDate of lnspection:13/11� ldo�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? F-1 Yes 0 No E] NA E] NE
a. If yes, is waste level into the structural freeboard? M Yes �allo F-1 NA ONE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? 0 Yes-,E!fNo F-1 NA ONE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a Yes _E�No F-] NA ONE
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 improvement? D Yes ETN o F-1 NA D NE
8. Do any of the structures lack adequate markers as required by the permit? Ej Yes ff:�No [__j NA E] 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 goes _[�f No DNA E] NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need Yes4ETNo F-1 NA ONE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. E] Yes ffrNo F-1 NA Ej NE
F-1 Excessive Ponding F� Hydraulic Overload [:] Frozen Ground [:] Heavy Metals (Cu, Zn, etc.)
FI PAN r-1 PAN > 10% or 10 lbs. Total Phosphorus [:] Failure to Incorporate Manure/Sludge into Bare Soil
r-1 Outside of Acceptable Crop Window [:] Evidence of Wind Drift [:] Application Outside of Approved Area
12. Crop Type(s):
tj /
13. Soil Type(s): 6 VIV If
4 44!:(� 40dMima
14. Do the receiving crops differ from those designated in the CAWMP? Yes -EfrNo DNA NE
15. Does the receiving crop and/or land application site need improvement? J�TYes fKI*No [:] NA NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable D Yes 0 No D NA E] NE
acres determination?
17. Does the facility lack adequate acreage for land application?
D Yes -[�]rNo
E] NA
0 NE
18. Is there a lack of properly operating waste application equipment?
Yes E]"'No
0 NA
0 NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Pen -nit readily available?
[E::] Yes ff 1*1(0
N A
[-] N E
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
F] Yes WNo
D NA
0 NE
the appropriate box.
DWUP [:]Checklists [:j Design D Maps Ej Lease Agreements
00ther:
2 1. Does record keeping need improvement? If yes, check the appropriate box below.
n Yes—EfrNo
NA
[-] NE
Waste Application [:] Weekly Freeboard D Waste Analysis Ej Soil Analysis
[:] Waste Transfers
Weather Code
Rainfall 0 StockingO Crop Yield D 120 Minute Inspections Monthly and I " Rainfall Inspections Ej Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[:] Yes _Ef� No
0 NA
ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Yes __�] No
0 NA
0 NE
Page 2 of 3
21412015 Continued

__Rr3 - ;��7 Y -1 .0 4 4
lFacility Number: jDate of 1nspection:,,5/,,9-8/,-�'?
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes -f5-No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes JETNo
the appropriate box(es) below.
F-1 Failure to complete annual sludge survey [__j Failure to develop a POA for sludge levels
F-1 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? E] Yes [�rNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? 0 Yes Ef No
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-appli cation)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
F-1 Application Field 0 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:
le /7�� /^ /" / 6.-6 d
E] NA F] NE
0 NA F] NE
E] NA F] NE
F-1 NA F] NE
E] Yes ZNo F-1 NA F] NE
0 Yes _0No F] NA F] NE
F� Yes E�fNo F� NA F] NE
[:] Yes._ZNo r-1 NA F] NE
0 Yes 6No E] NA E] NE
E] Yes E�No [:] NA Ej NE
0 Yes _0 No Ej NA 0 NE
Phone: 6110 1
Reviewer/Inspector Signature: Date:
Page 3 of 3
511212020

FAC I LITY FARM NAME: LAGOON LEVEL
PERMIT (tig)
- DUE EVERY 5 YEARS
- B(PERIATION DATE NUMBER OF ANIMALS
- CURRENT NUMBER OF ANIMAL
- OIC CARD YES OR NO
WASTE UTILIZATION PLAN (WUP) (#20)
SOILTYPES
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 NITROGEN LEVEL
DATE
NITROGEN LEVEL
DATE—
NITROGEN LEVEL —A
SOIL REPORT (#21)
- EVERY 3 YEARS: DATE 1113
- P-1 (N - 0 MORE THEN 400)
- PH (Note if 4 or less) c2Zt�
- Cu/ZN (NO MORE THEN 8000) CU ZN
(IF PEANUTS NO MORE THEN 300)
IRR2 (#21)
Not over PAN CROP TYPES
FLOW RATES N ITROG EN (N)
Not over PAN CROP TYPES
FLOW RATES NITROC4 (N)
Not over PAN
FLOW RATES
Not over PAN
FLOW RATES
CROP TYPES
NITROGEN (N)
CROP TYPES
NITROGEN (N)

CALBRIATION (#24)
EACH REEL SHOULD BE CAL)BRATED EVERY OTHER YEAR
DATE OF CALIBRATION
FLOW RATES
RAIN FALL (#21)
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED POA NEEDED.
-DUE EVERY YEAR: DATE 16.,,;�/`_L) SLUDGE (#-21 &25)
o: 3, a 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 301h
Small Grain Over seed: Opens October Ist- Ends March 31st
Corn: Opens February I Sth - Ends June 30th
Cotton: Opens March I 5th - Ends August 1 zt
Rye: Opens September I st- Ends March 31 ��t
Oats: -Opens September IA- Ends April 15th
Wheat: Opens September 1 �,t - Ends April 30th
Soybeans: Opens April 13t- Ends September 15th
Fescue: Opens August 13t- Ends July 31st
Sorghum Hay� Opens March I 5th - Ends August 31 st