820321_Routine Inspection_20231010

Type of Visit: Q Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit:.—aRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Q O a Arrival Time: ;3d /1m Departure Time: Iyji7t County: 5"hRegion: Foe
Farm Name: Owner Email:
Owner Name: Phone:
a
Mailing Address:
Physical Address:
Facility Contact:Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Discharees 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?
Phone:: p
Integrator:
Certification Number: OV q06
Certification Number:
b. Did the discharge reach waters of the State? (If yes, notify DWR)
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?
Longitude:
❑ Yes ,rNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑NA ❑NE
❑ Yes ❑ No ❑ NA [_]NE
❑ Yes E7No ❑ NA ❑ NE
❑ Yes FrNo ❑ NA ❑ NE
Page 1 of 3 511212020 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes , _-Mo
❑ 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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): y
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 6No
❑ 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 eNo
❑ 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 .43 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes ,❑i'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 Ea -No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes _Q"No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes �' o
❑ 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): ��i 4ZV� z��.e-�f.�-.
6
J &0
13. Soil Type(s):�
14. Do the receiving crops differ ft& those designated in the CAWMP?
❑ Yes [3"No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes allo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ NE
acres determination?
'[3-No
17. Does the facility lack adequate acreage for land application?
❑ Yes E]'No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes .ego
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes �jNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes r No
❑ NA
❑ NE
the appropriate box.
T
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ErNo ❑ 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 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 511212020 Continued

Facility Number: - _3 `
Date of Ins ection: . /Q a'
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ENo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes O'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 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 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?
socl'�' _1�9 /' -_
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes fNo ❑ NA ❑ NE
❑ Yes J2'No ❑ NA ❑ NE
❑ Yes 2rNo ❑ NA ❑ NE
❑ Yes Ej'No ❑ NA ❑ NE
❑ Yes JCJ�'No ❑ NA ❑ NE
❑ Yes -E�No ❑ NA ❑ NE
❑ Yes
E3'*No
❑ NA
❑ NE
❑ Yes
E2'No
❑ NA
❑ NE
❑ Yes
La'No
❑ NA
❑ NE
Phone: '1y 9.2s —9225
Date: 0/L0
511212020

FACILIFf #: _��/ FARM NAME: LAGOON
PERMIT ma)
DUE EVERY 5 YEARS
EXPERIATION DATE_
CURRENT NUMBER OF
OIC CARD YES OR NO
NUMBER OF ANIMALS G 3y0
WASTE UTILIZATION PLAN (WUP) (#20)
SOIL TYPES
CROP TYPES
- ODOR CONTROL CHECKLIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (#21)
-GOOD FO/R 60 J)AYS BEFORE OR AFTER
DATE �`,�/� / - 3 NITROGEN LEVEL !
DATE z/� ` `/�3 NITROGEN LEVEL
DATE L ` S L r3 NITROGEN LEVEL G
//e-117- 3 DES
SOIL REPORT (#21)
- EVERY 3YEARS: DATE
- P-I (NO MORE
f4.r IW 600)
- PH (Note if4 or lesv)
- Cu2N (NO MORE THEN 3000) CU ZN
(IF PEANUTS NO MORE THEN 300)
Not over PAN CROP TYPES
FLOW
Not over PAN CROP TYPES
IRR2 (#21)
NITROGEN (N)
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES q��
FLOW
NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)

CALBRIATION (s24)
EACH REEL SHOULD BE CALI"AJ'ED RY OTHER YEAR
DATE OF CALIBRATION !!//)
FLOW RATES
RAIN FALL (#21)
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED POA NEEDED.
DUES EV,fRY YEAR: DATE
o2/a(aX SLUDGE (#21 &25)
0:-1 P: 3 %RATIO OF SLUDGE
0: P: % RATIO OF SLUDGE
0: P: % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE
�40
OTHER FORMS (tt22 AND #21)
RAIN BREAKER FORM CROP YEILDS—,X—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 I�t- Ends September 30t
Small Grain Over seed: Opens October 1 st- Ends March 31A
Corn: Opens February 15N-Ends dune 30*
Cotton: Opens March 15w - Ends August 1�
Rye: Opens September Id-EndsMarch 31st
Oats: Opens September 1�f- Ends April 15t
Wheat: Opens September 1st - Ends April 30t
Soybeans: Opens April 1 st- Ends September 15n
Fescue: Opens August 1 at- Ends July 31st
Sorghum Hay: Opens March 15th - Ends August 31 st