820508_ROUTINE_20231011

V Division of Soil and Water Conservation
0 Other Agency L �
Type of Visit: Compliance Inspection 0 Operation Review Q Structure Evaluation p Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency Q Other O Denied Access
Date of Visit: ®Arrival Time: Departure Time: 3 p County, Region: F-0
Farm Name: Owner Email:
Owner Name: �rrf�s-r��A/Yytsftli Phone:
Mailing Address:
Physical Address:
Facility Contact: Z;r OvCJ ! 0'�"b Title: 7-Z- -- � Phone:
Onsite Representative: V42_1- 2�1'-14""` Integrator: / r�
e Ir
/
Certified Operator: WV)tr-L Certification Number: 9-"flXtJ
/4—
Back-up Operator:
Certification Number:
Location of Farm: Latitude. Longitude:
Swine
Wean to I
Wean to 1
Feeder to
Farrow to
Farrow to
Farrow to
Gilts
Boars
Other
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
IN
Non--
La er
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure ❑ Application Field Other:
a. Was the conveyance man-made?
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 D WR)
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?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes EJ-No- NA Ej NE
Yes ❑ No
Ej Yes [-]No
[:]Yes No
[-]Yes 0 o
[:]Yes �
Ej NA Ej NE
[:]NA E]NE
NA NE
NA NE
�NA [-]NE
Page 1 of 3 511212020 Continued

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4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
❑ Yes [�7Qo
[-]Yes [—]No
El NA ❑NE
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):• le
Observed Freeboard (in):
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 Structure 6
❑ Yes Poo ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes ETNo ❑ 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 LJ "'o ❑ 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 P No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes e No ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [—]Yes eo ❑ 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?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired 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 No ❑ NA ❑ NE
E],i'es o ❑ NA ❑ NE
❑ Yes
ED-No
❑ NA
❑ NE
❑ Yes
E],No
❑ NA
❑ NE
❑ Yes
❑"fro
❑ NA
❑ NE
❑ Yes [a-Kri
❑ Yes [3-?To
Mother:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Q`I`Io
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [—]Yes ❑-Ko
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes o
Page 2 of 3
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
[] 1� ❑ NA ❑ NE
511212020 Continued

24. Did the tacility tail to calibrate waste application equipment as required by the permit? Lj Yes ['No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes LffNo ❑ 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)
[:]Yes
0-No
❑ NA
❑ NE
❑ Yes
❑9 o
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes Ll 5o ❑ NA ❑ NE
❑ Yes �o ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
0-IC
❑ NA
❑ NE
O No
❑ NA
❑ NE
ESKo
❑ NA
❑ NE
Vo
❑ 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 necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: