830007_ROUTINE_20230522

Division of Water Resources
Facility Number - Division of Soil and Water Conservation �� • j ^ .�f q
p Other Agencye , 1
Type of Visit: Ck Compliance. Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: Departure Time: + 7 County
Farm Name+d, Owner Email:
Owner Name: Un —A Phone:
Mailing Address:
Region:
Physical Address: Facility Contact: CU MM �
Title: 72M9a Phone:
Onsite Representative: Wy Integrator: gm A U d
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine °Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
+�'=
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Certification Number:
Certification Number:
Latitude:
Design Current
Wet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes No ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes No ❑ 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)? T
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ❑ No N NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes N No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 6) 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 V. 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 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 [:]No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 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 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 �Q 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 1Area
12. Crop Type(s): CO �1CJfia BG �rn�a� ��1 R�2 , Q �1
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes t 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 n No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
JK] No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
NJ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Nj No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
%J No
❑ 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
N No
❑ NA
0 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
[SJ No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
N] No
❑ NA
❑ NE
Page 2 of 3
511212020 Continued

Facility Number: M - Date of Inspection: 35
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
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? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [ No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
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
tQ 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
No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�] No
❑ NA 0 NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[K] No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
® No
❑ NA ❑ NE
Comments (refer to question #): 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).
7. Keep mfKing on Me UeZ 1 Igg'oon WKn ,
1. Keep q Neon iour spy l SgmPl�s wo_e are t ,, rh
z a rid Sme are ova v , Moy COM'd-eg regamn-n g
SVi
nOf� f�rrn K ugi hq
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
PhoneaK±q�.
. 1 1 I
Date: �� "✓
511212020

FACILITY#:_ FARM NAME.faI� LAGOON LEVEL)
PERMIT pfls�
DUE EVERY 5 YEARS
- EXPERIATION DATE NUMBER OF ANIMALS
CURRENT NUMBER OF ANIMAL
- OIC CARD YES OR NO
WASTE UTILIZATION PLAN (WUP) (#20)
SOI L TYP ES
CROP TYPES
- ODOR CONTROL CHECKLIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (#21)
-GOOD FOR 60 DAYS BEFORE OR AFTER
DATE W5 NITROGEN LEVELI, C
DATEI I i In NITROGEN LEVEL�'��
DATE NITROGEN LEVEL
SOIL REPORT
- EVERY 3 YEARS: DATE
- P-1 (NO MORETHEN 400) y V
- P H (Note if 4 or less)
- Cu/ZN (NO MORE THEN 8000) CU I ZN
(IF PEANUTS NO MORE THEN 300)
IRR2 (#21)
Not over PAN CROP TYPES }
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES Vj
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)

CALBRIATION (#24)
EACH REEL SHOULD BE CA
LIBRATED ERY OTHER YEAR
- DATE OF CALIBRATION — ® I
- FLOW RATES 12_1,�o
Y`,�,,
* . RAIN FALL (#21)
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT I LESS THEN THE DESIGNED FREEBORED PDA NEEDED.
5_I I ,� SLUDGE (#2i &2s1
-DUE EVERY YEAR: DATE I�
0: P: % RATIO OF SLUDGE `_
lue
0: P: % RATIO OF SLUDGE
0: P: % RATIO OF SLUDGE
��--
0: P: % RATIO OF SLUDGE
OTHER FORMS (#22AIJo #21)
RAIN BREAKER FORM CROP YEILDS MORTALITY
*If fields are grazed there will be no crop yields
VISUAL CHECK
FOUNDATION OR PIT LEAKS PIPE LEAKS LAGOON SEEPAGE LAGOON BARE
AREAS TREES OR GRASS NEED TO BE REMOVED EROSION DITCHES
WINTER CROP(OVERSEEDED) HARVESTED FIELDS_ GOOD HEALTHY CORPS CORRECT
CROPS NO PONDING REELS_ FEED BINS LAGOON GARBAGE
Bermuda grass: Opens March 1 st- Ends September 30th
Small Grain- Over seed: Opens October 1 st- Ends March 31st
Corn: Opens February 15th - Ends June 30th
Cotton: Opens March 15th - Ends August 1st
Rye: Opens September 1st -Ends March 31st
Oats: -Opens September 1st- Ends April 15th
Wheat: Opens September 1st- Ends April 30th
Soybeans: Opens April 1st- Ends September 15th
Fescue: Opens August 1st- Ends July 31st
Sorghum Hay: Opens March 15th - Ends August 31st
i