430024_Routine Inspection_20230814

for Visit: fd'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Lam/ Arrival Time: EEZDeparture Time: County:
Farm Name:_ �o/,�q/,rye Owner Email:
Owner Name Phone:
Mailing Address:
Physical Address:
Facility Contact: �, { Title:
Onsite Representative: r
Certified Operator:
tr
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Region: F1_6
Integrator: Z,/l��t
Certification Number: ©Z :i l ��
Certification Number:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yesj�jlo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
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)?
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 —a" No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[—]Yes f7No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 511212020 Continued

Facility Number: Date of Inspection: x /a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes J'IQo
❑ 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 throats to the integrity of any of the structures observed?
❑ Yes E5'No
❑ NA
❑ Ni
(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?
T
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 ff No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes 1:],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 Q'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes [f]'No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes F-1 �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 WindDriiftt ❑ Application Outside
of Approved Area
�
12. Crop Type(s): G��e� ,[12� yee , ! Pj � C f la ri l�
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes F7rNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ,QNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes _[allo
❑ 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 ,[?No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes 4;]-No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes Q-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. 12- Yes [:]No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard 4 - aste 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 J:allo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes , [�1(Io ❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: jDate of Inspection: J,
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes LQ-No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [,__.No ❑ 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 _EJ'No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes E_LNo ❑ NA ❑ NE
J,
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes E'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 ETNo ❑ 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
[:[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
L]-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
[2-No ❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
J:g-No ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
_[2,No ❑ NA
❑ NE
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a
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
tan e
Phone:
?/(/�
Date:
511212020

FACT LYM � FARM NAME: ' IFLAGOON
PERMIT mal
DUE EVERY 5 YEARS
- EXPERIATION DATE _
- CURRENT NUMBER OF
OIC CARD YES OR NO
NUMBER OF ANIMALS
WASTE UTILIZATION PLAN (WUP) (420)
SOIL TYPES
CROP TYPES
- ODOR CONTROL CHECKLIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (#21)
-GOOD FOR 60 DAYS BEFORE OR AFTER //
DATE4// NITROGEN LEVEL / ! 6 2. -22
a
DATE 0 ( 2 NITROGEN LEVELZ('-',V I j ?)--
NITROGEN LEVEL
SOIL REPORT (*21)
- EVERY 3 YEARS: DATE � L
- P-1 (NO MORE THEN 400)
- PH (Notalf4 or leas)
- Cu/ZN (NO MORE THEN 8000) CU ZN
(IF PEANUTS NO MORE THEN 300)
IRR2 (#21)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES -
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 CALIBRATED EVERY OTHER YEAR
DATE OF CALIBRATION J`' &->
FLOW RATES -'&d
. RAIN FALL(#21)
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED PDA NEEDED.
SLUDGE (ari a2s)
-DU VERYYEAR: DATE a(�
O: o _Z P: 3-G % RATIO OF SLUDGE !�
O: P: -2 '7 % RATIO OF SLUDGE S�
O: P: % RATIO OF SLUDGE
0: P: % RATIO OF SLUDGE
OTHER FORMS (a22 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 30'
Small Grain. Over seed: Opens October 1 � - Ends March 31.t
Corn: Opens February 15' - Ends June 30u
Cotton: Opens March 15t - Ends August 1st
Rye: Opens September 1n- Ends March 31�
Oats: Opens September 1�t- Ends April 15w -
Wheat: Opens September 1st- Ends April 30th
Soybeans: Opens April 1st -Ends September 15t
Fescue: Opens August 1st -Ends July 31•t
Sorghum Hay: Opens March I Sth - Ends August 31 st