640072_Compliance Evaluation Inspection_20230901

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Date of Visit: - 2 17 Arrival Time: Departure Time: County: ljR s J4 Region: %� K
Farm Name: ' 1 9A
Owner Name: G
Mailing Address:
Physical Address: L3 13 c/4
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Owner Email:
Phone:
1 ►9 - 34,1 1s
Title: Phone:
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Swine
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Wean to Finish
Wean to Feeder
Feeder to Finish
q -2,vD
Farrow to Wean
i/A
Farrow to Feeder
600
Farrow to Finish
Gilts
Boars
Other
rou
Pullets
Poults
Design Current
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharees and Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
o
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
WNo
❑ 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
UNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Fj No
❑ NA
[] NE
of the State other than from a discharge?
Page 1 of 3 511212020 Continued

Facility Number: Z t/ - 'Z 2, Date of Ins ection: 9- / •
L 3
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
E No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: --"A P, R'0'j ia�' Jy rD A -1-1Q9 A7
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ffNo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
/No
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
Ej
❑ 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 environment
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
FTNo
❑ 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
�o
❑ 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
dNo
❑ 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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes u7 o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes Eo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes Wo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes o
Z
❑ 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 Co ❑ 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 ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E6 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 o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Humber: j1,q - 7 Date of Ins eetion: -.
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ZrNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0 l�o
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:
❑NA ONE
❑NA ONE
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ja No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑"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 ❑ NA ❑ NE
[:]Yes �No ❑ NA ❑ NE
❑ Yes EfNo ❑ NA ❑ NE
❑ Yes El"No ❑ NA ❑ NE
❑ Yes No
[:]Yes ENo
❑ Yes ETNo
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Comments (refer to question #1): Explain any YIDS answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional ees as necessa ).
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,urtisAyree a@ F.9GV
1 >J s P work cell: 919-810-2691
a_r` " Grt". E C40 Y4 6157f1147 ,jo
Reviewer/Inspector Name: Z�z r Phone: 71 r ~ Z
Reviewer/Inspector Signature: Date: Q- I 2
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