WQ0029289_Routine_20230412

C:TDivision-of Water Resources
n `0`Division of Soil and Wateit
i—J
„Q'Othex Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance I
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: CountRegion:`
Farm Name: � 117 Syr Z Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:lj�d'p ! '%/Irk! Title: gjp�h'r_ /­ Phone:
Onsite Representative: Integrator: VO ( Z/
Certified Operator: !� Certification Number: w9v
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current Design Current Design Carxent
Swine Capacity r°°I'op Wet Poultry : Capacity, Pop . Celtic Cap`acYty 1?ap
Wean to Finish
Layer
Wean to Feeder!
Non -Layer
Feeder to Finish
Design Cur-e'nt
,Dr 'Poultry. ,,Capacity .Po P. '
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Layers
Gilts
Non -Layers
Boars
Pullets
Turkeys
Otlex . Turkey Poults
TT Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ 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?
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -.Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 2- o 0 NA ❑ NE
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes [:]No
❑ Yes Ej- o
[:]Yes [Tio
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
0 NA ❑ NE
Page 1 of 3 511212020 Continued

Facility Number: ) ` I jDate of Inspection: .
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Z No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ 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?
❑ Yes
No
❑ NA
❑ 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
❑ Yes
To
❑ NA
❑ 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?
❑ Yes
I�o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
F;;Ko
❑ NA
❑ 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
2 <U
❑ NA
❑ NE
maintenance or improvement?
Waste Application
N
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
2
❑ NA
❑ NE
maintenance or im rovement?
P
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window �❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 'L->&r o",
13. Soil Type(s): �41_116 14 `
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ENo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 2r o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes �o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes [fNo
[:]Yes [ I�o
❑ NA ❑ NE
❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E2114
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
r,7114o
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑LeaseAgreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
�No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[] No
❑ NA
❑ NE
Page 2 of 3 511212020 Continued

Facility Number: 1',;L— - ,-� )) I Date of Inspection: j;�L-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EK ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [ <o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ 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)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ 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?
P
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes
®No
❑ NA
❑ NE
❑ Yes
Q No
❑ NA
❑ NE
❑ Yes
ET5o
❑ NA
❑ NE
❑ Yes ®No ❑ NA ❑ NE
❑ Yes ffNo ❑ NA ❑ NE
❑ Yes Ea<o ❑ NA ❑ NE
❑ Yes L 'No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes KNo ❑ NA ❑ NE
Phone:
Date:`—�
511212020