310554_Compliance Evaluation Inspection_20230309

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dMivision of Watef Resources .
Facility Number - Q Division of Soil and Water Conservation
0 Other Agency
Type of Visit: ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: g Routine 0 Complaint O Follow-up 0 Referral O Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: ® Departure Time: County:
Farm Name: ���ii`�y✓� Owner Email:
Owner lame: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
,Design Current.
-,Swine-, Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish Imp o
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other.
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current`
Wet 'Poultry -Capacity Pop.
Layer
Non -Layer
Design, . Current
Dry Poultry Capacity Pony.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Cattle
Region:
Design Current
Capacity Pop.
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 Q NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑"NA
❑ 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
Q NA
❑ 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
No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 S� �� 511212020 Continued

Facility Number: I % - % Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [—]Yes �No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑Yes ❑ No ii`A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure
' 6
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 57()
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 ® 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 O/No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes E,_ ❑ 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 ❑/No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ElYes ❑/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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
ffNo
❑ NA
❑ NE
❑ Yes
E3"No
❑ NA
❑ NE
❑ Yes
[�No
❑ NA
❑ NE
❑ Yes E2"No ❑ NA ❑ NE
[:]Yes E'No ❑ NA ❑ NE
❑ Yes D No ❑ NA ❑ NE
[—]Yes [:] No ❑ NA ❑ NE
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [/'No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [%f o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes YNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ONE
❑NA ❑NE
Page 2 of 3 511212020 Continued

Facility Number: % jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
FTNon-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance: S
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 phosphorus 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
dN o
❑ 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
1240
❑ 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
2rNo
❑ 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 ❑ No ❑ NA ENE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 2 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes EV�NiNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ NA ❑ NE
Reviewer/Inspector Signature: Date: l
Page 3 of 3 511212020