330008_Inspection_20230912

Facility Number ® -
W Division of Water Resources
0 Division of Sol] and Water Conservation
Q Other Agency
Type of Visit: 95 Compliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: 0 Routine 0 Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: rrival Time: Departure Timer County:�j Region:
Farm Name: Owner Email:
Owner Name: V%r-01-1seder- fo"Z`ms Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Phone:
01-59 "1 3- 031
man Certification Number:
_%jr tic- k YrsS- Certification Number:
Location of Farm;
B(D- 04s(p
Cwina
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
'7 7 - 3 50 $
Design Current
rr.. .,:s- n..
r^---d - --1.
Latitude:
Design Current
Wet Poultry Capacity Pop.
La er I I :::]
L_LNon-Layer
lets
Other
Poults
Design Current
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?
Longitude:
R
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non-Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ZNo ❑ NA ❑ NE
❑ Yes 16No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes 00iVo ❑ 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)
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 0
❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3 511212020 Continued

Facility Number: -_j Date of Inspection;
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes _allo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes JE!rNo
❑ NA
❑ NE
Structure I Structure 22 / 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 [D No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
jam"
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes J'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 E:rNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[] Yes Ef"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 eNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes Er No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[] Yes E� 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 ❑ 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 - ff No
❑ NA
[] NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes -ffNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
[] Yes ff No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes ff No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes EfrNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes [2-No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes allo
❑ NA
0 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 ❑'No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes .E[ No ❑ 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 21412015 Continuer)

Facility Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permi ?
❑ Yes
No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
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 provide documentation of an actively certified operator in charge?
❑ Yes
[7 No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
14 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)
3 I. 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 Revieweriinspector fail to discuss review., inspection with an on -site representative?
Reviewer/Inspector Name:
Reviewer/Inspector Signatu
Page 3 of 3
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes [p No ❑ NA ❑ NE
❑ Yes [] No ❑ NA [] NE
❑ Yes [A No
❑ Yes [1] No
❑ NA ❑ NE
❑NA ❑NE
Phone: q!q' - q) ` `7�e
Date:
21412015