820706_routine_20230912

a D a , rv�sion of Water Resources
Facility Number �2 - (I, Division of Soil and Water Conservation.
O
Otherlgency
Type of Visit: P Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 00 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 2 %j Arrival Time: Departure Time: County: p'?(� Region: II"o
Farm Name: Ann n Cj e ll l Owner Email:
Owner Name: A h Q , ffl Ej Phone:
Mailing Address:
Physical Address:
Facility Contact: RUM IArefoot Title: Phone:
Onsite Representative: �Q W Integrator: p re, ri l U Q ae
v
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design .' Curren.
Design
Cui>rent
Design,,Current
;Swine
Capaciiy Pop
Wet Poultry:°,
Cagaeity
Pop
Cattle
Capacity°Pop a
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish
°
Dairy Heifer
Farrow to Wean
Wo C)
..
Design
Cur rent
Dry Cow
Farrow to Feeder
Dry .Poultry
Capacity
Pop.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
OtherE
T
Turkey Poults
Other
IM
Discharges 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
A
No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
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
No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
�No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Q\No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 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 E
.�No❑ 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: I
Spillway?: NO
Designed Freeboard (in):
Observed Freeboard (in): 3
any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
,15—Are-.there
(i.e., large trees, severe erosion, seepage, etc.)
N]
6. Are there, structures on -site which are not properly addressed and/or managed through a
❑ Yes
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
i
, 7.po any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any ofthe structures lack adequate markers as required by the permit?
❑ Yes
�[�] No
❑ 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 No ❑ NA ❑ NE
maintenance or improvement?
Waste ApDlication
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes © No ❑ NA ❑ NE
maintenance or improvement?
N
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Q No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) a
❑ 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): \M Q Pj No A
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes _4No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes qNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes M No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑Yes
FNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
_
No
❑ 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 NW No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste TranVers
❑ 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 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes L 'No
Page 2 of 3
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
511212020 Continued

Facility Number: - Date of Inspection:
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
FZ] Yes
❑ No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑° 4Non-compliant sludge levels in any lagoon
List date first indicating
structure(s) and of survey non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
4 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 F\_1 No ❑ NA ❑ NE
❑ Yes .K] No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes 6 No ❑ NA ❑ NE
❑ Yes [� No
❑ Yes �g No
❑ Yes [E No
❑NA ❑NE
❑ NA , ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or,Any additionalrecommendations or any, ottier.comments:-
Use drawings of facility to better explain' situations (use additionahpages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
511212020