260071_routine_20230331

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Qjmivi�i6 ofm son s
ervatio'n,,''
''W"'ater CoAs 'z
"FA Divisi n of Soil and,,
uln� z1b
7'', 0 Oth&'AgenCy
rype of visit: (D-Co`rnpliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Q-Ko-uitine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region: F�&
Owner Email:
Farm Name: gl��f zfj-Y 5;�
Owner Name: zq Phone:
11:7
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number: A/
Certification Number:
Longitude:
'Desig n- urren
X
Desi n,% Current
9
C11
n ap4cit 0
W, e�"_Ie�,' y
t",
we Poultry
apa y
cit Pop;i
C ty
4pac, P
Wean to Finish
Layer
Dairy Cow
Tean to Feeder
�-j
INon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design, Cu TINO,
Dry Cow
lFarrow
to Feeder
Dry, Poultry,,
Calioc"I Pop
iry
Non-Dai
a arrow to Finish
ow t'
ILayers
Beef Stocker
J
Gilts
Non -Layers
Beef Feeder
I
Bo
BoarEi
ss
E
1,
Pullets
Beef Brood Cow
Turkeys
er,
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DVvR)
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?
E] Yes B-1115 DNA D NE
D Yes D No
D Yes D No
Ej NA D NE
Ej NA D NE
F-1 Yes
Ej No
Ej NA
D NE
0 Yes
Eall�o
D NA
D NE
D Yes
[2-1�o
Ej NA
Ej NE
Page I of 3 511212020 Continued

IFacility Number: �7 CR - 74! jDate of Inspection:
Waste Collection & Treatment
100'
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
0 Yes
Eno
Ej NA
0 NE
a. If yes, is waste level into the structural freeboard?
E] Yes
0 No
F-1 NA
0 NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
0 Yes
F__.�44o
0 NA
Ej 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
[2-<o
Ej 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 DVM
7. Do any of the structures need maintenance or improvement?
[:]Yes
�o
E] NA
Ej NE
8. Do any of the structures lack adequate markers as required by the permit?
Ej Yes
D-11<6
Ej 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
Yes
ETT�'o
0 NA
ONE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
Ej Yes
E314o
Ej NA
0 NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes E�<o [] NA Ej NE
F-1 Excessive Ponding Ej Hydraulic Overload 0 Frozen Ground [:] Heavy Metals (Cu, Zn, etc.)
F-1 PAN F� PAN > 10% or 10 lbs. Ej Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
F-1 Outside of Acceptable Crop Window [:] Evidence of Wind Drift Ej Application Outside of Approved Area
12. Crop Type(s): S�2�� Z�nn5 r-4
13. Soil Type(s): Ahlr . / /- /
14. Do the receiving crops differ from those designated in the CAWMP?
Yes
E3-<o
0 NA
[:] NE
15. Does the receiving crop and/or land application site need improvement?
Ej Yes
[D-fl;o
[:] NA
0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
Yes
ETN'_o
E] NA
Ej NE
acres determination?
17. Does the facility lack adequate acreage for land application?
0 Yes
[2r<o
0 NA
0 NE
18. Is there a lack of properly operating waste application equipment?
E] Yes
F__-�N o
If —
Ej NA
NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes
[2-No
Ej NA
NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Ej Yes
�o
E] NA
Ej NE
the appropriate box.
Ej WP [:]Checklists [:]Design Ej Maps Ej Lease Agreements
Other:
2 1. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes
E2"&o
0 NA
ONE
F-1 Waste Application 0 Weekly Freeboard Ej Waste Analysis 0 Soil Analysis
0 Waste Transfers
0 Weather Code
F-1 Rainfall OStocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1 " Rainfall Inspections
Ej Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
OYes
[alNo
0 NA
0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
0 Yes
F_�/No
0 NA
Ej NE
Page 2 of 3
511212020 Continued

lFacility Number: a - 4, - Zj I Date of Inspection: 13_j1_2Q"31_3
24. Did the facility fail to calibrate waste application equipment as required by the permit?
Yes
�o
D NA ONE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
D Yes
[a4o
D NA F-1 NE
the appropriate box(es) below.
F-1 Failure to complete annual sludge survey 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?
D Yes
E�'<o
D NA 0 NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Yes
�o
F-1 NA E] NE
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 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?
E] Yes En-N-0 E] NA ONE
[:]Yes [E]�No D NA Ej NE
[:] Yes Z"No D NA [:] NE
D Yes ff<o E] NA [:] NE
0 Yes
[a<o
DNA
E] NE
D Yes
F,;Ko
D NA
D NE
D Yes
[3<o
D NA
D NE
Comments (refer to question#): Explain any YES answers and/or any additional recommendations or any other.comments.
Use draw-inas of facilitv to better exDlain situations (use additional oa2es as necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 1151
D 3—j/_
ate:
511212020