820152_Routine_20230331

elDivision of Water Resources
Fad��'Nuwber 0 Division of'Soil and Water Conservation'
GOth6iAgency
rype of Visit: E)Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 01�outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 29irrival Time: Departure Time: I /-3W I County:
Owner Email:
Farm Name: I" c2w— L22
Owner Name: [04 /C Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: tpzo/?�-� Phone:
Onsite Representative: Integrator:
Region:
Certified Operator: 1-5,� Certification Number: Oz ze� 4�17
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Design Current Design Current
-0 -Wctftultry.1111�- Capacity 'Pop.'
Swine Capacity��.,`P p.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
,Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other"
FT
Layer
Non -Layer
Design Current
Pnn.
Dry Pnuitr-�,
Layers
Non -Layers
Pullets
.Turkeys
Turkey Poults
ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field Ej 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?
Longitude:
�,Desigu Current,,
C'
,C
attle, apad
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Yes [3�'<o 0 NA 0 NE
0 Yes E] No
[-]Yes [:]No
Ej Yes
0 No
EJ Yes
E3-11o"
0 Yes
F-1-W6
�71-
0 NA ONE
[—] NA 0 NE
0 NA Ej NE
Ej NA 0 NE
0 NA 0 NE
Page I of 3 511212020 Continued

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

lFacility Number: F17 - 5Ta�spection: z
24. Did the facility fail to calibrate waste application equipment as required by the permit? E] Yes Ea<o [:] NA 0 NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check E] Yes E] No 0 NA E] NE
the appropriate box(es) below.
F-1 Failure to complete annual sludge survey F� Failure to develop a POA for sludge levels
r-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?
0 Yes
E�<o E] NA ONE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
El Yes
ETNo 0 NA 0 NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
0 Yes
[E[<o 0 NA 0 NE
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?
0 Yes
Z/No 0 NA Ej NE
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
0 Yes
E]"No 0 NA 0 NE
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.
0 Yes
2/No [:] NA Ej NE
F-1 Application Field O.Lagoon/Storage Pond F� Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
0 Yes
Ea'<o 0 NA 0 NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
0 Yes
E2-lqo 0 NA Ej NE
34. Does the facility require a follow-up visit by the same agency?
0 Yes
[;]"*No 0 NA 0 NE
Reviewer/Inspector Name:
Phone:
Reviewer/Inspector Signature:
Page 3 of 3
Date: 3'—,F 3 /
511212020