820430_Routine Insection_20230829

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Type of Visit: .Q Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit:--efRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: [ / I Arrival) Time Departure Time: County: Region: A166
Farm Name: /C�//tii'y Owner Email:
Owner Name: tLk Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator: l/lzl�_'G
/� r
Certification Number: C " fE-377
Certification Number:
Longitude:
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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?
❑ Yes _t-j No ❑ NA ❑ NE
[:]Yes [-]No
❑ Yes [-]No
❑ NA ❑ NE
❑ NA ❑ NE
[:]Yes ❑ No ❑ NA ❑ NE
❑ Yes 4❑no ❑ NA ❑ NE
❑ Yes -[2)No ❑ NA ❑ NE
Page I of 3 511212020 Continued

Facili Number: - Date of Inspection: (-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ej-'No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
31
Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes . E])No ❑ NA ❑ NE
[:]Yes in'No ❑ NA ❑ NE
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
ED'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
,eNo
❑ 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
-6 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 0No ❑ 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): /..� r�G fie' G��db Cam) (, & ute, sc
U
13. Soil Type(s): �Gr
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? ❑ Yes E� No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 2�No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ®"�4o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0'i o ❑ 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 eNo ❑ 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 EfrNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �o ❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facili Number: Date of Inspection: a `i
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 ❑ Yes ja�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 E�o
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes _[:INo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes -0"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 _E5�No
❑ 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 ,EI'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 ETNo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes J2'No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes „Q-�Ko
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes o
❑ NA ❑ NE
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Reviewer/Inspector Name: &C:P h >° 17#" 1sd
Reviewer/Inspector Signature:
Page 3 of 3
Phone: /l()/ F95_ c/" 785_
Date:
511212020

FACILITY#: GFARM NAME: / LAGOON
- DUE EVERY 5 YEARS
- EXPERIATION DATE
- CURRENT NUMBER OF ANIMAL
- OIC CARD YES OR NO
PERMIT R19)
NUMBER OF ANIMALS
WASTE UTILIZATION PLAN (WUP) (#20)
SOIL TYPES
CROP TYPES
- ODOR CONTROL CHECKLIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (u l)
-GOOD FOR 60 DAYS BEFORE OR AFTER
��'/6 a'a 7 2
DATE
NITROGEN LEVEL ;
DATE <C.r 6 �'�
NITROGEN LEVEL l �O
DATE a Ia'3
NITROGEN LEVEL
q/ii /7,3
soILRP 6z;)
��3
- E R 3 Y ARS:
DATE �2
- P-1 (NO MORE THEN 400)
- PH (Note if4.,I..)
- CUIZN (NO MORE THEN 3000) CU ZN
(IF PEANUTS NO MORE THEN 300)
IRR2 (m­I)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN )
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)

CALBRIATION (aza)
EACH REEL SHOULD BE CALIB AT€D EVERY OTHER YEAR
DATE OF CALIBRATION 1e�7
FLOW RATES J,3 i SJ—
RAIN FALL (21)
-INITIAL AFTER I"RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED PDA NEEDED.
3171
/ / SLUDGE Iurt azsl
O: P: %R -DUE�VE�RYYEAR:DATE U`7G �G.zJ % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE d
O: P: % RATIO OF SLUDGE
OTHER FORMS (azz AND azt)
RAIN BREAKER FORM /'1 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 1A-Ends September30*
Small Grain Over seed: Opens October 1-t- Ends March 31st
Corn: Opens February 15t - Ends .dune 30*
Cotton: Opens March 15t - Ends August 1A
Rye: Opens September 1-t- Ends March 31st
Oats: Opens September ice- Ends April 15t
Wheat: Opens September 1 st - Ends April 30th
Soybeans: Opens April 1 st- Ends September 15t -
Fescue: Opens August 1 st- Ends July 31st
Sorghum Hay: Opens March 15* - Ends August 31 st