830014_routine_20230612

FACILITY#: FARM NAME: I `I M Farm LAGOON LEVEL
PERMIT (nos)
- DUE EVERY 5 YEARS t fb
- EXPERIATION DATE NUMBER OF ANIMALS ALLOWED o
- CURRENT # OF ANIMAL
- OIC CARD YES OR NO: OIC Name
WASTE UTILIZATION PLAN (WUP) (#20)
� 'n
SOILTYPES VI lie
CROP TYPES C GH I GOO
- ODOR CONTROL CHECK LIST YES OR NO
- Irrigation Plan Map YES R NO
- Rain Breaker or Stays with Pump
WASTE REPORT (#21)
-GOOD FOR 60 DAYS BEFORE OR AFTER
DATE 1 ,N '!Z NITROGEN LEVEL 2 • CO
DATE l ' T_� NITROGEN LEVEL �' �►
DATE NITROGEN LEVEL
- EVERY 3 YEARS:
- P-1 (NO MORE THEN 400)
- PH (Note K4 or less)
- Cu/ZN (NO MORE THEN 3000)
(IF PEANUTS NO MORE THEN 300)
DATE
SOIL REPORT (#21)
IRR2 (#21)
Date of Irrigation 30 2�5 Recommended PAN 60 Crop oyell e?-e_d
FLOW RATES 1009 NITROGEN (N) a . (pI Field or Pull # 9, r
Pan AppliedQ4 • 29 Remaining Pan Left �, -11 1 h-1 I K-e- Cudd 1 Q44 1d1NS0N 01 C
Date of Irrigation �50I 12:3 Recommended PAN 5 0 Crop
FLOW RATES JQoy QVPA NITROGEN (N)VP(N)VPY Field or Pull #
Pan Applied Z'j, !qj Remaining Pan Left �C �� M C � F-v 0 l C
Date of Irrigation 12'3 Recommended PAN 5 I) Crop
FLOW RATES j0Oy NITROGEN (N)a' (y 1 Field or Pull # 1,1175
Pan Applied Ly• 'Z( Remaining Pan Left I • MCI rIV ®i C

Date of Irrigation ( I3 Recommended PAN GO Crop
FLOW RATES 100 Lf NITROGEN (N)l - (P 7 Field or Pull #
Pan Applied 2'3. 0® Remaining Pan Left j. 13 O [C
CALBRIATION (#24)
- EACH REEL SHOULD BE CALIBRATED EVERY OTHER YEAR
- DATE OF CALIBRATION-t-�i"2�
- FLOW RATES 1 �°
RAIN FALL (#21)
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED POA NEEDED.
SLUDGE (#21 &25)
-DUE EVERY
YEAR: DATE
O:
P:
% RATIO OF SLUDGE
O:
P:
% RATIO OF SLUDGE
O:
P:
% RATIO OF SLUDGE
O:
P:
% RATIO OF SLUDGE
OTHER FORMS (#22 AND #21)
CROP YEILDS MORTALITY if -K
*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 I
r
i
CROPS NO PONDING REELS_ FEED BINS LAGOON GARBAGE I '" �p
Bermuda grass: Opens March 1st- Ends September 30thaC�,v
Small Grain Over seed: Opens October 1st- Ends March 31st 11 21,
Corn: Opens February 15th - Ends June 30th -7 J
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 31 st
t-17 5
-11►3, L4 1, -Ll
wo

Division of Water Resources
acility Ntraxrber -22 �} C7�Dev�siai of Sail and Water Coraservafxoa�
0,Otlae' Agency"
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Beason for Visit: *0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: [ Arrival Time: Departure Time: County: �( I I q nq
Farm Name: �I 1 1 U_ fdI M Owner Email:
Owner Name:, Than g Phone:
Mailing Address:
Physical Address:
Region:_
Facility Contact: Izo m� Title: n' Phone:
Onsite Representative: U m —P-) Q n `/ Integrator: C rn ah f L
4
Certified Onerator: I �-1 `CV�/`i'1� Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
i)esign Current ' Design Current
Capacity ' I'op." Wet]Pouitry,Capacity " Pop: Cattle
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
her
Layer
Non -Layer
Design Current
,Dry',Poultry Capacity Top'
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:
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 9n No ❑ NA ❑ NE
❑ Yes NA No
❑ Yes Z No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 511212020 Continued

Facility Number: M - 14 FD—ate 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
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 19
Observed Freeboard (in): *3_
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
ONE
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 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): h l b d tn&� i Soo
13. Soil Type(s): (Ilead 1 ea d , IK: .2 1p-'6ry d)e
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes CA 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
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.
❑WUP El Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑ Yes 9 No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes Dy No
❑ 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 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: M - J Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes P No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes ❑ No
the appropriate box(es) below. 7
❑ 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 'A No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes © No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
�/ C
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes U No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ NA ❑ NE
Comments (refer to questionft `Explain any YES answers and/or any additional recommendations or any other come i6bts.
Use drawings of facility to better explain situations (use additional pages as necessary).
1.)worK on bare SPor on lagoon
iolote o q-et So j' l
ini�01 aff:er
(�:) bC1 _6K freM
sample' and Sludge survey
k11 fr-eeboard ieve( on �he-et- an
i" rain P_venrs
ne-edc woDl-v
4we, svcg�sted dam �a�i e�c�-.ens��or� Off �and�
mood qin- 2-7-1- 2'422 1D h21p.
yam -boo i_ 01 c
Reviewer/Inspector Name:
Phone:
717
Reviewer/Inspector Signature: Date:
Page 3 of 3 511212020