360006_Inspection_20230509 (2)

Division of Water Resources
Facility Number 3(a - ® O Division of Soil and Water Conservation
O Other Agency
Tpe of Vuitl Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of visit. Arrival Time: / Otl Departure Time: )) (rp County: +1)n
Farm Name: .Q/n AOr Dr]101 Owner Email:
Owner Name:
Mailing Address:
Phone:
Physical Address: 0--
Facility Contact: Title: Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish I I Laver
Wean to Feeder I jNon-L.ayer
Design Current
Dry Poulin Capacity Pop.
ft
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?
Region: r4 Q.0
Design Current
Cattle Capacity Pop.
Dairy Cow
ZZS
O
Dairy Calf
Dairy Heifer
Dry Cow
j
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes q No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
4 No
❑ NA
❑ NE
Page 3 of 511212020 Continued

FaciR Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[A 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: ate, V, n
Spillway?:y/{�._
Designed Freeboard (in): I'L 1 2
Observed Freeboard (in): 0 _ M
5. Are there any immediate threats to the integrity of my of the structures observed?
❑ Yes
[P 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
P No
❑ 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
[P No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
4 No
❑ 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
m No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[� No
❑ NA
❑ NE
❑ Excessive Pending ❑ 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):
13. Soil Type(s):
14. Do the receiving craps differ from those designated in the CAWMP?
❑ Yes
5 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
© No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
® No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[X No
❑ NA
❑ 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
❑ Yes
❑ No
❑ NA
❑ NE
the appropriate box.
❑WOP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
E• 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 minbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
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5/]Z,2020 Continued

Facili Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes U No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [`j] No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structures) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphoms loss assessments (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[N No
❑ NA
❑ 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?
❑ Yes
®No
❑ NA
❑ 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
❑ Yes
W No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
`h' No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause noncompliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail w discuss review/inspection with an on -site representative?
❑ Yes
O No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[5] No
❑ NA
❑ NE
Comments (refer to question 0): Explain any YES answers and/or any additional recommendations or any other comments. _
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name: -7 1q kZt [ Phone:
Reviewer/Inspector Signature: Date:
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