400150_Inspection_20230808

Dwision of W',ater'Resovz`ees
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Nu'i4ttha � � /Sd , O"7piV�ion afsoist'ndWatez Conseri7a6ip
s
O Ofper Agency
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type of visit: ® Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
2eason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit:Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Gi _���� , . Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: r
Back-up Operator:
Location of Farm:
Wean to Finish (p
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
B oars
• �(i�t1wY . '
Latitude:
Phone:
Integrator: 15 1-7--
Certification Number:
Certification Number:
Design 0wrent
Wetroultry Capacity Pop.
Layer
Non -La er
. .Doogn Cwent '
T)rv'Phnlfra" "ngeity Van.
Layers
Non -Layers
Pullets
Turkeys
Turke Poults
Other
Discharees 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:
Catile
:wt�lnwt<
C4
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 5No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ❑ o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 511212020 Continued

Facility Number: # 6 - _�_Date of Inspection: — a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes dNo ❑ 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): / f
Observed Freeboard (in):�
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 1 o ElNA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes fNo ❑ 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 E2(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 U�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):� /65 =
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
ElYes
o
❑ 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
o
❑ 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
o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design [:]Maps ❑ Lease Agreements ❑ Oth
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes YfNo
o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes
❑ NA ❑ NE
Weather Code
Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 511212020 Continued

IFaclUty Number: #6 - j> Date of Inspection: 23
—
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes El"No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check �3 Yes ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
E?rFailure 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 21N0 ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [—]Yes W(No ❑ 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 �No
❑ Yes �No
❑ Yes [(No
❑ Yes ;No
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes TNo ❑ NA ❑ NE
1 etaq Ott faint any f`ESans er $ndCor any add 'analxecommenda ql ,t 'aik01111 u
oI"dis" , of "fsdii * to h06ex m1ohn siMadons addidonal nay as necessary?.
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4 f � W_Z�'a� _r
Reviewer/Inspector Name: Fr Zen e- � '1 7v �o f Phone: 7 j,9 —9�j (o
Reviewer/Inspector Signature: Date:
Page 3 of 3 /12/2020