780081_Routine Inspection_20230912

Date of Visit: /oti Arrival Time: Departure Time: County: L_ Region: r V
Farm Name: JrL�r,Tp Owner Email:
Owner Name: , 46et e_ 144ro leO Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: ti
Certified Operator:_
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number: l7 5.3
Certification Number:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes .allo ❑ NA ❑ NE
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 ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
eNo
❑ NA
❑ NE
❑ Yes
J�J_No
❑ NA
❑ NE
Page 1 of 3 511212020 Continued

Facility Number: "7 - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes�Ej­No
❑ 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?:
p
Designed Freeboard (in):
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed?
4'Yes 040
❑ 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!rNo
❑ 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 . fNo
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes j2rNo
❑ 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 .E:fNo
❑ 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 2] 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 n Evidence of Wind Drift I-1 Annlicntion
Onkide of Annrnvrd Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
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 _�o ❑ NA ❑ NE
[,2"Yes No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes _Q No ❑ NA ❑ NE
❑ Yes ZNo ❑ NA ❑ NE
❑ Yes 4D'No ❑ NA ❑ NE
❑ Yes .E:rNo ❑ NA ❑ NE
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes D No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ®No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facifi Number: Date of Inspection: /l 13
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes J3"No
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 EfrNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes o
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 CAWNIP?
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 ❑-tCo ❑ NA ❑ NE
❑ Yes .E]'No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes
Q N-0
❑ NA
❑ NE
❑ Yes
Q-No
❑ NA
❑ NE
❑ Yes
Q-No
❑ NA
❑ NE
❑ Yes
Q­I�o
❑ NA
❑ NE
4-01 b 941�� �� 4i ;
::t- oh �!�o ifro �4c�-�/�i
17
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of
Phone: 9`"1
Date: C? /,-zA'j-
S/12/2020

FACILITY#: �17 "d !_ FARM NAME: &47 " 1 LAGOON LEVEL
PERMIT (ns)
- DUE EVERY 5 YEARS 7�
- EXPERIATION DATE NUMBER OF ANIMALS 3 / �LDi
CURRENT NUMBER OF ANIMAL
- OIC CARD YES OR NO
WASTE UTILIZATION PLAN (WUP) (#20)
SOIL TYPES
CROP TYPES
- ODOR CONTROL CHECK LIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (#21)
-GOOD FOR 60 DAYS BEFORE OR AFTER %
DATE qAl NITROGEN LEVEL ° i 3
_ DATE V )/,6
NITROGEN LEVEL -;k L/
/�j
DATE `�
NITROGEN LEVEL
/gl //r�.3
SOUL REPORT (i i)
- EVERY 3 YEARS:
DATE
- P-1 (NO MORE THEN 400)
e
- PH (Note if4orlP )
- Cu1ZN (NO MORE THEN 3000) CU ZN
(IFPEANUTS NOMORETHEN300)
fJ itp[�3 -
"-3
(
6463 �/
IRR2 (#21)
/(
Not over PAN CROP TYPES
/I (%� be-1- p,)31193
"`-
FLOW RATES
NITROGEN (N)
-
Not over PAN CROP TYPES
FLOW RATES
NITROGE )
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)

CALBRIATION (xz<)
EACH REEL SHOULD BE CA41TE EVERY OTHER YEAR
DATE OF CALIBRATION
FLOW RATESf'd7
RAIN FALL (#21)
-INITIAL AFTER 1" RAIN EVENT J
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED PDA NEEDED.
13SLUDGE(miazs)
-DUE EVERY YEAR: DATE s J/3 /�
O:�,q(e P: 3, ke % RATIO OF SLUDGE ry�
O: P: % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE
OTHER FORMS (azz AND 421)
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 1s2- Ends September 302
Small Grain Over seed: Opens October 1n-Ends March 31s2
Corn: Opens February 15* - Ends June 30u
Cotton: Opens March 152 - Ends August 1s2
Rye: Opens September 1st -Ends March 31st
Oats: Opens September Isf-Ends April 15*
Wheat Opens September 1st- Ends April 30*
Soybeans: Opens April 1-t-Ends September 152 .
Fescue: Opens August 1st -Ends July 31st
Sorghum Hay: Opens March 15w -Ends August 31 st