490008_Compliance_20231017

Division of Water Resources
Facility Number - ® Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 1PCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: In/ Arrival Time: p;Ob Departure Time: County: T�t Region:
Farm Name: Fox arm Owner Email:
Owner Name: c (n�� L�� Phone:
Mailing Address:
Physical Address: Z 2 16UA Y-gg 0
Facility Contact: Title: Phone:
Onsite Representative: lCO oQ fyy/l n Integrator:
Certified Operator: Phi 1�`l fy�C-C�.te) Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish Layer Dairy Cow goo 335
Wean to Feeder I INon-Layer I Dairy Calf
Feeder to Finish Dairy Heifer
Farrow to Wean Design Current Dry Cow
Farrow to Feeder Dry Poultry Capacity Pop. Non-Dairy
Farrow to Finish Layers I Beef Stocker
Gilts Non-Layers I Beef Feeder
Boars Pullets jBeef Brood Cow
Turkeys
Other Turkey Poults
Other P—v 0 44 Co W S
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 ❑ 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 �ZNo ❑ NA ❑ NE
of the State other than from a discharge?
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Facility Number: 41q - 06 jDate of Inspection: 0
Waste Collection&Treatment
4.Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑ Yes t No ❑ NA ❑ N E
a.If yes,is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ N E
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: V') S e
Spillway?:
Designed Freeboard(in): ZS 2
Observed Freeboard(in): Ce 0
5.Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 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 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 [:] No ❑ NA ❑ NE
8.Do any of the 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 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 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): CO Y h S I I a 1,& 9 Wm
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes U No ❑ NA ❑ NE
15.Does the receiving crop and/or land application site need improvement? ❑ Yes f(No ❑ NA ❑ NE
7 `
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes %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 No ❑ NA ❑ NE
Required Records&Documents
19. Did the facility fail to have the Certificate of Coverage&Permit readily available? ❑ Yes Q No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available?If7er,'Meak ❑ Yes RNo ❑ NA ❑NE
rK- WUP Checklists Design ,Maps ase grec ❑Other:
21. Does record keeping need improvement?if ye Yes No E
Waste Application Weekly Freeboard Waste Analysis Soil Analysis e'+°aste T Weather Code
Rainfall Q�C Stocking rop Yield s �Monthly and 1"Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0No ❑ NA ❑ NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ANA ❑ NE
Page 2 of 3 5/1212020 Continued

Facilit Number: qj - O$ Date of Inspection: j 0 _1
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes P No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes,check ❑ Yes ❑ No R] 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 L,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 ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal? ukwa'
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes [ No ❑ 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 No ❑ NA ❑ NE
permit?(i.e.,discharge, freeboard problems,over-application)
31. Do subsurface tile drains exist at the facility? If yes,check the appropriate box below. ❑ Yes ❑ No ❑ NA 1] NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: ►►��
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? R71� Yes ❑No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes )ZfNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes '<No ❑ NA ❑ NE
Comments(refer to question#): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations(use additional pages as necessary).
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Reviewer/Inspector Name: ( GI �GC O� Q OAUMW Phone: U-3�U
Reviewer/Inspector Signature: Date:
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