670002_Compliance Evaluation Inspection_20230217

/ 1
Division of Water Resources
Facility,NuuAber a O Division of Soil and, Water Co�iservation
' _
0 Other Agency ,
Type of Visit: ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: i Arrival Time: Departure Time: County:
I
Farm Name: 11 i va 4441 Owner Email:
Owner Name:
Mailing Address:
Physical Address:
IDFacility Contact: Q`IV`
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator:
Region:
Phone: n11 33,ct (% , (.
Certification Number:
Certification Number:
'Longitude:
'design , .urent ` - Design "'Giirxent "r Design R :urrent
Swine - .Canactty :`Pop. ` " Weti Po%Itry �.. ° rapacity-Pop.attIe p-apacitg` ° fop;'� .
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Layer
Non -Layer
Design , Current,
Dry Poultry Ca acit' POP.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Dairy Cow
_
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No lA
❑ NE
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)
❑ Yes
❑ No A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No ❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ 0 ❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 511212020 Continued

Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 1 1—
Spillway?: _
Designed Freeboard (in): _
Observed Freeboard (in): 2-1 _
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
No ❑ NA ❑ NE
❑ No [- <A ❑ NE
Structure 6
❑ Yes o ❑ NA ❑ NE
❑ Yes 21'No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or envi nmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? Yes To ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes-. [,_41�'o ❑ 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 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [—]Yes o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No J ❑ 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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes F 1'o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes []lo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑/Vo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑40
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E�Xo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
dNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E�o
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 6 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 � ❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes To' _
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes ❑ Ng ❑ NA ❑ NE
thopriate box(es) below. '
Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels 1
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did thl facility fail to provide documentation of an actively certified operator in charge? [::]Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [:]No jj'NA ❑ 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)
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?
❑ Yes io ❑ NA ❑ NE
❑ Yes /0D NA ❑ NE
❑ Yes ZrNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA NE
❑ Yes
Ems] No
❑ NA
❑" NE
❑Yes
VNo
❑NA
❑NE
❑ Yes
❑ NA
❑ NE
Comments (refer to question #). Explain any YES -answers and/or,any additional recommendations or any other° comments.. ,
Useihrawings-of facility to better explain situations"(use additional pages as necessary).
F i%e CLC 11 -, e 5G U�e 7
3 �4
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
kb—ez_ 0 V
04- �` l V 061w_4r V%
Phone: l 0
Date a 41, 1,i
5/12/2020 "