820402_Routine Inspection_20231010

Date of Visit: 1Q Arrival Time: 3d Departure Time: County: Region: Aeo
Farm Name: ).gyp, v Owner Email:
Owner Name: Zy-!, Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: �t
Certified Operator: P
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ;�fNo ❑ 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 ❑ 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)
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
EjNo
❑ NA
❑ NE
❑ Yes
2�No
❑ NA
❑ NE
Page I of 3 511212020 Continued

Facili Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: / 2 vim
Spillway?:
Designed Freeboard (in): All
Observed Freeboard (in): J(5 �
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Structure 5
'O'No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 6
,❑''Yes ❑ No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes ;2,11[o
❑ 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 J:�JNo
❑ 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 �7rNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes ZNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes ❑ 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 ElApplication
Outside of Approved Area
12. Crop Type(s): &c7ti cs(plZ UlIZ440 c�/i `
13. Soil Type(s):
14. Do the receiving crops differ fro those designated in the CAWMP?
❑ Yes E] No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ,EI—No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes [3'No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes J ' o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes /EDNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes E2Iv%
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes [ J 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 _E]-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 ONo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes . fNo ❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: G 0 Date of Inspection: C
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes fNo
NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ 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 to provide documentation of an actively certified operator in charge? ❑ Yes -E3-No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
�o
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
. J No
❑ NA
❑ NE
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?
❑ Yes
eNo
❑ NA
❑ NE
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
[:]Yes
r�`No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
No
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[:]Yes
E
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
dNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ZNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
j2No
❑ NA
❑ NE
�° er cue z /a /3 Wa3
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: (��[) // �� --g !g,$
Date: ld//O
511212020

FACILITY#:-/ FARM NAME: ( _>�(. LAGOON LEVEL
PERMIT pis)
- DUE EVERY 5 YEARS
- EXPERIATION DATE NUMBER OF ANIMALS
CURRENT NUMBER OF ANIMAL
- OIC CARD YES OR NO
WASTE UTILIZATION PLAN (WUP) (#20)
SOIL TYPES
CROP TYPES
ODOR CONTROL CHEC I YES OR NO
Irrigation Plan Maps R NO
WASTE REPORT
-GOOD FOR/ 60 DAYS BEFORE OR AFTER 61 G �
G A)DATE
of �&43
NITROGEN LEVEL A 3 S 123
)• %q
DATE �/^/,j
NITROGENLEVEL � a`� / aL?
,
, 64
DATE �D �/ e�-3
NITROGEN LEVEL �� 3 �- /JS/
U
/S--7
l• a�
-
SOIL REPORT (#2.4)
l
- EVERY 3 YEARS:
DATE Iall a-G
- P-1 (NO MORE THEN 400)
- PH(Note if4or less)
- Cu2N (NO MORE THEN 3000) CU ZN
OF PEANUTS NO MORE THEN 300)
IRR2 O# i)
Not over PAN CROP TYPES
FLOW
Not over PAN CROP TYPES
NITROGEN (N)
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)

CALBRIATION 424l
EACH REEL SHOULD BE CALIBf} TE EVERY OTHER YEAR
DATE OF CALIBRATION
FLOW RATES DtJ-recY�
RAIN FALL lm�l
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED PDA NEEDED.
SLUDGE1a21a25l
-DUE EVERY YEAR: DATE
G F /
O: 3 7 P: <S i d-
% RATIO OF SLUDGE
0: 3.ff P: L/.O
% RATIO OFSLUDGE
!`�—
? qV U
RATIO OF SLU DGE
%
G Y�
O: P:
RATIO OF SLUDGE
OTHER FORMS (#22AND a21)
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 1 �- Ends September 30th
Small Grain Over seed: Opens October 1-t- Ends March 31st
Corn: Opens February 15t - Ends June 30ts
Cotton: Opens March 15t - Ends August 1�
Rye: Opens September 1 n- Ends March 31 st
Oats: Opens September 1-t- Ends April 15t
Wheat: Opens September 1st- Ends April 30th
Soybeans: Opens April 1st -Ends September 15t
Fescue: Opens August 1st- Ends July 31st
Sorghum Hay: Opens March 15N - Ends August 31 st