820008_Routine_20230817

Division of Water Resources
H✓ R V
Facility Number3 s a O,Divislon of Soil and Water Conservation 1
O Other=Agency„„'-
Type of Visit: 9 Compliance Inspection 0 Operation. Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit: t Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 41• Arrival Time: Departure Time: F9_50__� County:m
Farm Name hQd� wn uh &,j o f Owner Email:
Owner Name: Sh adq OI c1 (b I IC Phone:
Mailing Address:
Physical Address:
Facility Contact: Cy�1S �� � Title: It l `�P. Phone:
Onsite Re
Certified
Back-up Operator:
Location of Farm:
Latitude:
Region:
Integrator: 04
Certification Number:ZIftr- I bl l q
Certification Number:
Longitude:
Y Design: Current' s Design `Current ' ° Design ° Currents s
Capacity 'op , Wit Poultry Capacity, Pop. Cattle ., _E Capacity `Pop
to Finish L ayer
to Feeder ` (ppU Non -Layer
to Finish
v to Wean _ Design Current s
v to Feeder -Dry Poultry . Ca `acity 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?
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
i
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?
❑ Yes 1� No . ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes U No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 511212020 Continued

Facility Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes IN
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: -1 2 ✓ l
�j
(Q
Spillway?: N I\f _Nf N
Designed Freeboard (in): I q I- -I 1_
IC?
Observed Freeboard (in): 1 I II (D
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 N, 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): CLUS$, , C E / RIV
13.SoilType(s): N®liuAlK MOMM, bldntON
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 No ❑ NA ❑ NE
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 ❑ Checklists [:]Design ❑ Maps ❑ Lease Agreements
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Other:
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes V No ❑ NA ❑ NE
❑ ❑ ❑ ❑ Waste Application ❑ Weekly Freeboard Waste Analysis Soil Analysis Waste Tra fers ❑ 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 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: - Date 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
X1 Yes
❑ No
❑ NA
❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge
levels
p�o22
F4 I I -
15-11.
❑ Non -compliant sludge levels in any lagoon �n
List structure(s) and date of first survey indicating non-compliance: -tu gods
w2-) ai � l
r CJ ` gl��)
�J A
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
'M 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
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?
If
0 Yes]
No
❑ NA
❑ NE
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 CAWIVIP?
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?
0 Yes �] No ❑ NA ❑ NE
❑ Yes X1 No ❑ NA ❑ NE
❑ Yes J? No ❑ NA ❑ NE
❑ Yes �] No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
I�.y.u.■,cuw k■ c■c,� sv, rtj.. a:aPiaiu ally, Ina auawUl b auuiv► duy auultauuat, [e4ummenuaugns or an Diner commenrs
Use drawings -of facility to bett&-explaidsituations (use additional pages as necessary)
Note' lagoon belflKS 6%I(la H Agwn--w '1o0i<. rnvU-) Mf+ep) " vp
ft WOM .
NN-6-- Form G1-e0h�d sJvdge fROM lagoon 2
91"-e of 10VR IggDOM NR hcAd hfgh Blvdp more i-hdn 2
q,e4 f2C
tDd al W f Df MOM
3,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: q L S
Date: 9)- IT - lb
511212020