780045_routine_20230906

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: r( Z Arrival
Time ii Departure Time: % County: RO QSOf� Region:
Farm Name: (� '��I I Cj P —� 0 Owner Email:
Owner Name: Tf�0M0S Y'AIS, Phone:
Mailing Address:
Physical Address:
Facility Contact: I k hm a �, �A/ M I � Title: lj 2 UL Phone:
Onsite Representative:
,�n
r,m
Integrator: I U,(,-=1 q PP
Certified Operator:
�{ (J(�
CJ� l.� r% Cj
Certification Number: n 1100
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
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Wean Lo Finish
Layer
Dairy Cow
Wean to Feeder
Non La er
Dairy Calf
Feeder to Finish
r) ( 00
�k!
Dairy Heifer
Farrow to Wean
, a
{r�i
Dry Cow
Farrow to Feeder
1)
Non -Dairy
Farrow to Finish
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Layers
Beef Stocker
Gilts{Ir.
Non -Layers
Beef Feeder
Boars
ii" {'
Pullets
jBeef Brood Cow
Turke s
;! t i if
t Eis
Turkey Poults
1
Other
ni �a �sr t
o
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes �Q No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
% �No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes\[�j
No
❑ 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
\q No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
1I No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yesq�
No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 511212020 Continued

Facility Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes qNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes jSkNo
—
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
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�'Q 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 _[�No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes T �o
❑ 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(�M, No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes tNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes )q No ❑ NA ❑ NE
❑ Excessive Pending ❑ 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 ❑y Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop TYpe(s): cb_�w2G 0 1 oc�) YI fC12_"2M
13. Soil Type(s): r)C)r-+O1r,) (K)nUIZ(ffn
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes n-No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes JEZNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes "EI No ❑ NA ❑ NE
acres determination? C
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 �,E] No ❑ NA ❑ NE
❑ Yes "No ❑ NA ❑ NE
❑ Yes No
❑ Yes '�No
❑ Other:
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? ❑ Ye in',
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑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 No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 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:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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 the 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 CAW-W?
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?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
ElYes No
❑ Yes [� No
❑ Yes No
❑ Yes RNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
N No
❑ NA
❑ NE
❑ Yes
N�] No
❑ NA
❑ NE
❑ Yes No
❑ Yes No
❑ Yes No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone:
Date: C
511212020