820539_routine_20230705

Division of Water Resources
Facility Number ®- ® O Division of Soil and Water Conservation
O Other Agency
Type of Visit: Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: ,�_ 7 Departure Time: E� County:
Farm Name :u.Y ;r� �; �J- Owner Email:
Owner Name:Y3?� a'� Phone:
Mailing Address:
Physical Address:
-77 r---
Facility Contact: a47 r`3 Title:
Onsite Representative:
Certified Operator: J�f�Gtd {'jam'
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
:Other
FE
Latitude:
_c�Oo-`-Region:
Phone:
Integrator: - �'r
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
49_700 Non -Layer
Design Current
Dry Ponitry Capacity POD.
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 [a-N ❑ NA ❑ NE
❑ Yes [:]No
[—]Yes [:]No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ❑ N ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes Ef'No ❑ NA ❑ NE
Page I of 3 511212020 Continued

Facility Number: Z 7 - Date of Inspection: �=
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes , No
a. If yes, is waste level into the structural freeboard? ❑ Yes [—]No
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?: _
Designed Freeboard (in):
Observed Freeboard (in): 3_
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
❑ NA ❑ NE
❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
0 Yes
ENo
❑ 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
[]'N
❑ 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 0-N'o-- ❑ 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): Zn fg/ fijO65e_ Igg U
13. Soil Type(s): f /e9f7-} L K
�
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?
❑ YesF5-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?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
2-N-5--
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
To
❑ 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. ❑ Yes Q'No ❑ 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 ©"No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Q 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 D150
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Duo
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 [�No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No
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?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes [ No ❑ NA ❑ NE
❑ Yes El"No ❑ NA ❑ NE
❑ Yes allo ❑ NA ❑ NE
❑ Yes / No ❑ NA ❑ NE
❑ Yes L`J 5o
❑ Yes 2 1V e
❑ Yes ❑moo
❑ NA ❑ NE
❑ NA ❑ NE
❑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`additionalpages as necessary).„
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
age 3 of 3
Phon
Date:
511212020