820356_Routine Inspection_20231012

Date of Visit: Arrival Time: — Departure Time: f County'
Farm Name: A Owner Email:
Owner Name: 50[G UtT Phone:
Mailing Address:
Physical Address:
Facility Contact: 56et7 - ea-e z- Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
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?
Region: X51ri
Phone:
Integrator:
Certification Number: J931.1
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 EjNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes 12-No ❑ NA ❑ NE
❑ Yes ErNo ❑ NA ❑ NE
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 eNo
❑ 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: l
Spillway?:
Designed Freeboard (in): 1 %
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes,E'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 -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?
-2ryes ,❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes 4D 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 -0 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes ❑"No
❑ 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 AcceptableCrop WinjJdow/� ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Or�u'T.u�' /3t N a Ciil (ram s� ice.
r�ilrvr. CSG�
13. Soil Type(s): i,�)a 6
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes .-LINo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes EFNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes -Q]-No
❑ NA
❑ NE
acres determination?
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 4ENo
❑ Yes oNo
0�00
❑ NA ❑ NE
❑ Yes )2 No ❑ NA ❑ NE
[:]Yes j2No ❑ NA ❑ NE
❑ 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? ❑ Yes ,[/] No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑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:
Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 1D No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No
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:
❑ NA ❑ NE
❑NA ❑NE
[—]Yes ETNo ❑ NA ❑ NE
[]Yes ,❑'No ❑ NA ❑ NE
❑ Yes E]'No ❑ NA ❑ NE
❑ Yes _EE `No ❑ NA ❑ NE
❑ Yes 2rNo ❑ NA ❑ NE
❑ Yes `ff No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes f:rNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 0 No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes fG No ❑ NA ❑ NE
Reviewer/Inspector Signature:
Page 3 of 3
Date: 161.�2_ /2 3
511212020

FACILITY #:�� `� FARM NAME: ��,//'+ LAGOON
PERMIT pna)
- DUE EVERY 5 YEARS
- - B(PERIATION DATE NUMBER OF ]i.NIMALS
CURRENT NUMBER OF ANIMAL
- OIC CARD YES OR NO
WASTE UTILIZATION PLAN (WUP) (#20)
SOIL TYPES
CROP TYPES
ODOR CONTROL CHECK LIST YES OR NO
Irrigation Plan Maps YES OR NO
WASTE REPORT
-GOOD FOR 60 DAYS BEFORE OR AFTER
FO1611V
DATE NITROGEN LEVEL r
�0/ /
DATE I Ca-3
NITROGEN LEVEL G %
DATE
NITROGEN LEVEL
Soil RE ORT(u2i)
- EVERY 3 YEARS:
DATE %1
- P-1(NO MORE THEN 400)
- PH (Nate if4 or lees)
- Cu2N (NO MORE THEN 3000) CU ZN
OF PEANUTS NO MORE THEN 300)
IRR2 (u2i)
Not over PAN CROP TYPES
FLOW RATES
NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)

CALBRIATION X4)
EACH REEL SHOULD BE CALIBRATED EVERY OTHER YEAR
DATE OF CALIBRATION /,2_//,7e /�,
FLOW RATES �(��_���
RAIN FALL xi)
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED PDA NEEDED.
// /?6L1LUDGE (m1 azs)
-DUE EVERY YEAR: DATE
O: _ Q '? P: S U % RATIO OF SLUDGE - G
O: P: % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE
OTHER FORMS (#22AND a2l)
RAIN BREAKER FORM CROP YEILDS N 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 tat - Ends September30t
Small Grain Over seed: Opens October 1n-Ends March 31st
Corn: Opens February 15w - Ends June 30t
Cotton: Opens March 15w- Ends August 1�
Rye: Opens September 1-t-Ends March 31st
Oats: Opens September 1�t- Ends April 15*
Wheat: Opens September 1st - Ends April 30t
Soybeans: Opens April 1Ends September 15t
Fescue: Opens August 1st- Ends July 31 A
Sorghum Hay: Opens March 15t - Ends August 31 st