260013_routine_20230324

0 Division of Water Reso T
urces
0 Division of Soil and Water'Copservation
U Other Agency
of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
in for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: CUMP4/0%egion:
g)' rn r
Farm Name: jR::7jJ C16 �)M (th rl.L �j Owner Email:
Owner Name: F-1 CM C_ Phone:
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Mailing Address:
Physical Address:
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Facility Contact: Title: n—,Lg-,,O— Phone:
Onsite Representative: Integrator:SM1tf1M
Certified Operator: ,,,w MPG C)ffl Certification Number: LM;5-4—
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Design'
Current
Design,
Current
me Capaclty�
Pip.
0
Wet Poultry Capacity
P op
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
F-7—
I I Layer I I I
I INon-Layer I
Design Current
Dry Poultry CaDacitv, POD.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Longitude:
Design,
Cattle 'Capacity",
P.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Dischar2es and Stream Impacts
1. Is any discharge observed from any part of the operation?
E] Yes
No
0 NA
F] NE
Discharge originated at: 0 Structure E] Application Field F� Other:
a. Was the conveyance man-made?
Ej Yes
No
E] NA
E] NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
E] Yes
[R No
Ej NA
E] NE
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)
Yes
R No
E] NA
Ej NE
2. Is there evidence of a past discharge from any part of the operation?
E] Yes
R] No
E] NA
[:] NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
0 Yes
[0 No
Ej NA
E] NE
of the State other than from a discharge?
Page I of 3 511212020 Condnued

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lFacility Number: FDate of InspeEtion:
24. Did the facility fail to calibrate waste application equipment as required by the permit? E] Yes No E] NA E] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Ej Yes No E] NA 0 NE
the appropriate box(es) below.
F_� Failure to complete annual sludge survey E] Failure to develop a POA for sludge levels
F_j 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?
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)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
F-1 Application Field E] 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?
E] Yes
12sf No
Ej NA
NE
[:] Yes
0 No
[:] NA
NE
[—] Yes �(No [:] NA E] NE
[:] Yes �f No Ej NA Ej NE
E] Yes 0(�o Ej NA Ej NE
E] Yes No Ej NA [:] NE
[:]Yes
b4 No
E] NA
[:] NE
[:]Yes
M No
NA
E] NE
[:] Yes
�0 No
NA
[:] NE
4-t V CW-14"4LC 40 U, 6
VI/ Oki Z--_V
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
(;1'Vd0C -- 13-11
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�00: L/ du-e 2025
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Phone:
Date:
511212020