820674_Routine Inspection_20231120

Type of Visit: eltompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 42rkoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: U,LYI/i17% County:=� Region:
Farm Name: 19 6 Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: d/
Certified Operator: Lj'I'j Gx
Back-up Operator:
Title:
Pho :
Integrator: J2�
Certification Number: G -7 �aS
Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ZNo ❑ 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
ONo
❑ NA
❑ NE
❑ Yes
,❑'No
❑ NA
❑ NE
Page 1 of 3 511212020 Continued

Facility Number: jDate of Inspection: 50 F
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes T::�No ❑ 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):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [2-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? ❑ Yes E:fNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes ,E�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 [D"&o ❑ 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):
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?
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 -ETNo
❑ Yes ,�No
❑ Yes E� No
❑ Yes O'No
❑ Yes E�No
❑ Yes �o
❑ Yes .E]�No
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ED-T�o
❑ 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 E]"No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ETNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3
511212020 Continued

Facility Number: %
Date of inspection: {' '
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E;I-No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes C;J'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 allo ❑ NA ❑ NE
❑ Yes e"No ❑ NA ❑ NE
❑ Yes T] No ❑ NA ❑ NE
❑ Yes EfrNo ❑ NA ❑ NE
[—]Yes 0No ❑ NA ❑ NE
❑ Yes E�No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes J❑[No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 2°No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
i
�KMZVRMM�07 M
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes ,gNo ❑ NA ❑ NE
/� Imo/
Phone: -/d
q/ �JJ�
Date: / I Id-1) M
511212020

FACILITY#:ga-(FARM NAME: 7"Z LAGOON LEVEL
PERMIT (++s)
DUE EVERY 5 YEARS
EXPERIATION DATE
- CURRENT NUMBER OF ANIMAL
- OIC CARD YES OR NO
NUMBER OF ANIMALS
WASTE UTIL17ATION PLAN (WUP) (#20)
SOIL TYPES
CROP TYPES
- ODOR CONTROL CHECKLIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (*21)
-GOOD FOR 60 DAYS BEFORE OR AFTER
(/'
DATE '10'A D/` ")- NITROGEN LEVEL
DATE a/F��` a"3 NITROGEN LEVEL
DATE `Z Gl.�'� NITROGEN LEVEL o2J3
�li�la3 2-6s
g,ba 1 a-3 !. a-3 SOIL REPORT G(uz�)
7j // 11
- EVERY 3 YEARS: DATE(
- P-1 (NO MORETHEN 400)
- PH (Not if 4 or less)-
- Cu2N (NO MORE THEN 3000) CU ZN�
(IF PEANUTS NO MORE THEN 300)
IRR2 (mI)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RA
Not over PAN CROP TYPES
FLOW RA
_ NITROGEN (N)
NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)

CALBRIATION Is24)
EACH REEL SHOULD BE CALIBRrED EVERY OTHER YEAR
DATE OF CALIBRATION l f / i, 1
FLOW RATES
RAIN FALL (*21)
-INITIAL AFTER 1 ° RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED POA NEEDED.
,% SLUDGE y ma25)
-DUE EVERY YEAR: DATE e/�/
O: 3,,5" P: % %RATIO OF SLUDGE 170
O: P: % RATIO OF SLUDGE -
O: P: % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE
OTHER FORMS (#22 AND 421)
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 1st- Ends September 30t
Small Grain Over seed: Opens October 1-t- Ends March 31k
Corn: Opens February 15s - Ends June 30+
Cotton: Opens March 15N - Ends August 1A
Rye: Opens September 1�-Ends March 31A
Oats: Opens September 1�t- Ends April 15u
Wheat: Opens September 1st - Ends April 30th
Soybeans: Opens April 1st- Ends September 15t
Fescue: Opens August 1st- Ends July 31�t
Sorghum Hay: Opens March 15ffi - Ends August 31 st