090213_routine_20230724

a
ivision of Water Resources "
Facility Number f 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: ()-Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
,,��
Reason for Visit: �xoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: D Departure Time: !Q County:
Farm Name: G��� �— ;�� 7�Gr/,yi� Owner Email:
Owner Name: u ; S y (9d z I) lubc Phone:
Mailing Address:
Physical Address:
Facility Contact: 9/-_5-;2j_ '-g / OofyS Title: 2 zo Phone:
Onsite Representative:
Certified Operator: -j Dd- z:7
Back-up Operator:
Location of Farm:
Design 'Current
-Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
arrow to Wean p-o
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Integrator:
Region:
Certification Number: �(�p
Certification Number:
Latitude:
« Design Current
Wet poultry Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry Capacity Pop.
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?
Longitude:
Design ` 'Current
Cattle . Capacity,,, 'Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [i]No ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes [:]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: - J Date of Inspection:
-�-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ONo
❑ 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?
El 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 [i] 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 E]"No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [-]Yes [] N ❑ 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): L-J✓` n/ /G(�/i z��/ /� J%/��// ��`` d ZL-
//
13. Soil Type(s): ` 'V,.7--
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
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
E�rNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[] No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[,-4"Ko
❑ NA
❑ NE
Reouired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes []'No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes [3No
❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
NA NE
2s record keeping need improvement? If yes, check the appropriate box below.
es o
❑ ❑
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 �o
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ❑.4do
❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: -_4Z 13 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �Io ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes io ❑ NA ❑ NE
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 Ejl�o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [—]Yes <o ❑ 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 <o ❑ NA ❑ NE
❑ Yes [a'�o ❑ NA ❑ NE
❑ Yes [2-Ko ❑ NA ❑ NE
[:]Yes
E] 1V O
❑ NA
❑ NE
❑ Yes
a10
❑ NA
❑ NE
❑ Yes
O'fio
❑ NA
❑ NE
❑ Yes
0 o
❑ 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 necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
'age 3 of 3
Phone:
Date: — G
S/12/2020