820683_Routine Inspection_20230725

for Visit:
0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: - d County: S� P2j Region: �F?ed
Farm Name: 'z'4� "�� Owner Email:
Owner Name: n[�vum4 C222 iy Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: Integrator: A
Certified Operator: _ 'G4/Cc��^'' Certification Number: IF l --yam
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
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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?
❑ Yq _j_ iV Ttt [_]NA ❑ NE
[—]Yes [—]No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes .E5"No ❑ NA ❑ NE
❑ Yes .ffNo ❑ NA ❑ NE
Page I of 3 511212020 Continued

�93
Facility Number: g 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 ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): (IT
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 E]"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 ,❑'fsIo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes allo
❑ 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 QIo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes [71`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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
[—]Yes ,❑-No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes J'No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes ­[J'No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes _EfNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes „e'JNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes,,jE]`No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes _E]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 allo
❑ 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 E]�No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes _[allo
❑ NA
❑ NE
Page 2 of 3
511212020 Continued

Cow
Facility Number:
Date of Inspection: Z �5
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes F No ❑ NA
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes .E No ❑ NA
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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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?
/IMPOSE!i
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
❑ NE
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
E]°No
❑ NA
❑ NE
❑ Yes
�o
❑ NA
❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes .ED"No ❑ NA ❑ NE
❑ Yes —ENo ❑ NA ❑ NE
[—]Yes Ef�No
❑ Yes ,2 No
❑ Yes QiNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: C�?,) 53S , 9 ??
Date: 7 /as--1d_3
Page 3 of 3 511212020

FACILITY#v FARM NAME: _ /�/w„j� LAGOON LEVEL
PERMIT R
- DUE EVERY 5 YEARS
- EXPERIATION DATE NUMBER OF ANIMALS
- CURRENT NUMBER OF ANIMAL
- OIC CARD YES OR NO
WASTE UTILIZATION PLAN (WUP) (420)
SOIL TYPES
CROP TYPES
- ODOR CONTROL CHECKLIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (m4)
-GOOD FOR 600 DAYS BEFORE OR AFTER
DATE /
�5-b-3 NITROGEN LEVEL. 3
DATE LL!
/G/!OG ;L-3 NITROGEN LEVEL ?�
DATE 3-bg NITROGENLEVEL l•`!(
roi 34/a' (• 3�
cl
SO/ILIRE/PORT (trzi)
- EVERY 3 YEARS: DATE'
- P-1 (NO MORE THEN 400)
- PH (Note if 4sr less)
- CuIZN (NO MORE THEN 8000) CU ZN
(IF PEANUTS NO MORE THEN 300)
I RR2 (#21)
Not over PAN CROP TYPES
FLOW RATES J1 NITROGEN (N)
Not over PAN C P Y S
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)

CALBRIATION (sza)
EACH REEL SHOULD BE CALIBRATED EVERY OTHER YEAR
DATE OF CALIBRATION rf t .9 Ce IJ-�
FLOW RATES
RAIN FALL (x i)
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED POA NEEDED.
DUVV5RY YEAR
O: o P:
0:
P: _
0:
P: _
0:
P:
ul�la-�
• RATIO OF SLUDGE y`7
• RATIO OF SLUDGE
• RATIO OF SLUDGE
• RATIO OF SLUDGE
SLUDGE (m1 a2s)
OTHER FORMS (#22 AND #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�t- Ends September 30u
Small Grain. Over seed: Opens October 1st- Ends March 31st
Corn: Opens February 15ffi - Ends June 30t
Cotton: Opens March 15t -Ends August 1st
Rye: Opens September IA -Ends March 31st
Oats: Opens September 1-t-Ends April 15t -
Wheat: Opens September 1st- Ends April 30th
Soybeans: Opens April 1st- Ends September 15t
Fescue: Opens August 1st -Ends July 31st
Sorghum Hay: Opens March 15t - Ends August 31 st