820233_Routine_20230328

Countylc'_ Region:
Date of Visit: Arrival Time: Departure Time:
Farm Name: Owner Email:
Owner Name:1.f,_,�,L/x5 d`_Xr�tj=� _rLic, Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
J) -Cii' rent'
De�sigu-"�;)Qurxeni
sign:, urrent
Pop
W t P it y Capacity
e - 'On
Pop,
-C e,
'Ott
Wean to Finish
Layer
Dairy Cow
to'Wean
to Feeder
—c,
I
INon-Layer
Dairy Calf
?eeder to Finish
Dairy Heifer
Farrow to Wean
D esigif,
nt
Curve t
Dry Cow
Farrow to Feeder
Y, P ',,.Capacity,:,
oultry
Po'
P.,
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
er, . .. .....
Turkey Poults
Other
Discharlzes 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 DNM)
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?
0 Yes Rr — o Ej NA [:] NE
[:]Yes
[:]No
NA
E] NE
[]Yes
[:]No
NA
Ej NE
[:]Yes
0 No
NA
E] NE
Ej Yes
215'o
NA
E] NE
Ej Yes
2<o
Ej NA
E] NE
Page I of 3
511212020 Continued

IFacility Number: K:�/_ - "�2_9 FDate of inspection:
3 1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes 2�<o 0 NA E] NE
a. If yes, is waste level into the structural freeboard? 0 Yes ONo 0 NA Ej 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? Ej Yes [3<o 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 ETIN"'o 0 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 DV*1R
7. Do any of the structures need maintenance or improvement? EJ-Ke El No E] NA [:] NE
8. Do any of the structures lack adequate markers as required by the permit? Ej Yes Ea<o 0 NA 0 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 0 Yes El"No Ej NA [:] NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need Ej Yes E3<o [:] NA Ej NE
maintenance or improvement? -
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes Ej'<o 0 NA 0 NE
F-1 Excessive Ponding F-1 Hydraulic Overload F-1 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
F-1 PAN F� PAN > 10% or 10 lbs. E] Total Phosphorus F-1 Failure to Incorporate Manure/Sludge into Bare Soil
F� Outside of Acceptable Crop Window Ej Evidence of Wind Drift Ej Application Outside of Approved Area
12. Crop Type(s): &2L&_L za"'W-�3 "j
13. Soil Type(s): K��A " &--z
14. Do the receiving crops differ from those designated in the CAWMP?
E] Yes
Er'Noo
NA
Ej NE
15. Does the receiving crop and/or land application site need improvement?
Ej Yes
Ej'N'o
NA
Ej NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
Yes
Qfl<
E] NA
0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
Yes
240,
Ej NA
Ej NE
18. Is there a lack of properly operating waste application equipment?
E] Yes
ETNo
Ej NA
Ej NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
E] Yes
21"No
Ej NA
ONE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Ej Yes
Z"5'o
Ej NA
[:] NE
the appropriate box.
F� WUP OChecklists Ej Design [:] Maps Ej Lease Agreements
EjOther:
2 1. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes
f-no
0 NA
0 NE
Waste Application Ej Weekly Freeboard 0 Waste Analysis 0 Soil Analysis
Waste Transfers
Weather Code
F-1 Rainfall Ej StockingO Crop Yield Ej 120 Minute Inspections E] Monthly and I " Rainfall Inspections
Ej Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
El Yes
2'<o
Ej NA
0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? E] Yes F.�;Ko 0 NA ONE
Page 2 of 3 511212020 Continued

lFacifity Number: 2V-� ;g35 jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
D Yes
[ET<o
Ej NA Ej NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
D Yes
E]�N�o
D NA D NE
the appropriate box(es) below.
F� Failure to complete annual sludge survey F_� 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-go"
M NA D NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
D Yes
2<o
E] NA ONE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
Ej Yes
[;��<o
DNA D 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?
D Yes
B<o
Ej 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
D Yes
Ej_N_o
D NA E] 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.
M Yes
O<o
0 NA 0 NE
F-1 Application Field - E] Lagoon/Storage Pond F� Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
E]Yes
P�o
D NA Ej NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
D Yes
[2-Tqo
D NA [j NE
34. Does the facility require a follow-up visit by the same agency?
E] Yes
F;Ko
F_� NA E] NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: 5 7:22-41
Date:
ff
511212020
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