040010_Routine Inspection_20231128

Date of Visit: _! �3 Arrival Time: Departure Time: County:
Farm Name: �� %��(� o�C�.Gin Owner Email:
Owner Name: ��� Phone:
Mailing Address:
Physical Address:
Facility Contact: p(Gj,LLp Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
/j
Region:-' A, d O
Phone:
Integrator: d; /
Certification Number: `66ts_
Certification Number:
Latitude: Longitude:
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?
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?
❑ Yes e❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes E3'No ❑ NA ❑ NE
❑ Yes _[� No ❑ NA ❑ NE
Page I of 3 511212020 Continued

Facility Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes 2rNo
❑ 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 -E5 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 immediatepublic health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
[—]Yes E'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes _Q"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 Apnlication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes 1:�iNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
Q'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 Wind/ow ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop TYpe(s)
13. Soil Type(s): _ ��] i� /%Zct 6� S
14. Do the receiving crops differ from those designated in the CAWMP? IV
❑ Yes — rNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes -Ef"No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes J:;JIQb
❑ 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 �o
❑ NA
❑ NE
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 (4D No
❑ Yes [_�JAo
❑ Other:
❑NA ❑NE
❑NA ❑NE
21. Does record keeping need improvement? If yes, check the appropriate box below. [—]Yes 2j No ❑ 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 �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: - Date of inspection: a'
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [D No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Ef �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? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes -2No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes L2�No ❑ NA ❑ NE
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? ❑ Yes [E�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 ETNo ❑ 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 E]"No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑fifo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes �io ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes L2'lVo ❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signat
Page 3 of 3
°7611 Z5 7I® "7 /"
Phone: ljly Sic;—_ j'7f15_
Date:
511212020

FACILITY#: FARM NAME: ( Y7'Lr/� �LQ�( .#� LAGOON LEVEL
PERMIT
- DUE EVERY 5 YEARS
- EXPERIATION DATE NUMBER OF ANIMALS
CURRENT NUMBER OF ANIMAL
- OIC CARD YES OR NO
WASTE UTILIZATION PLAN (WUP) (#20)
SOILTYPES
CROP TYPES
- ODOR CONTROL CHECKLIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (#21)
-GOOD
/FOR
% 60/DAYS BEFORE OR AFTER
// 1l e�-� NITROGEN LEVEL o2-6 SG c2- 1 �
DATE /
DATE ���/�.J NITROGEN LEVEL �� l 29 G fS
DATE NITROGEN LEVELrL4 /, (0 G ` ?j-
SOIL RE/PORT
- EVERY 3 YEARS: DATE
- P-I (NO MORETHEN 400)
- PH (N�tei/4or1..)
- Cu2N (NO MORE THEN N00) CU ZN
OF PEANUTS NO MORE THEN 300)
Not over PAN CROP TYPES
FLOW RATES
Not over PAN CROP TYPES
FLOW RATES
IRR2 (#Ti)
NITROGEN (N)
NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
�F7r�

CALBRIATION (mq
- EACH REEL SHOULD BE CALIBRATED EVERY OTHER YEAR
DATE OF CALIBRATION
FLOW RATES
RAIN FALL(#2t)
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED POA NEEDED.
UDGE (u21 a25)
-DUE EVERY YEAR: DATE 63- a'/ Q`L/
G i l 0: U `S P: o?. ° ATIO OF SLUDGE
aC °2 O: 7 t P:a, /� % RATIO OF SLUDGE 3 $
L U rt l 0: rr / P: 3, ( % RATIO OF SLUDGE 3
0: U P: 2, 91Y % RATIO OF SLUDGE 35
OTHER FORMS (422 AND 921)
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
WINTERCROP(OVERSEEDED) HARVESTED FIELDS_ GOOD HEALTHY CORPS_ CORRECT
CROPS NO PONDING REELS FEED BINS LAGOON GARBAGE
Bermuda grass: Opens March 1st- Ends September 30*
Small Grain Over seed: Opens October s-t- Ends March 31 �
Corn: Opens February 15* - Ends .dune 30t
Cotton: Opens March 15N - Ends August 1°t
Rye: Opens September I° -Ends March 31-t
Oats: Opens September I°t- Ends April 15th
Wheat Opens September 1st- Ends April 30t
Soybeans: Opens April 1st -Ends September 15w -
Fescue: Opens August i A- Ends July 31
Sorghum Hay: Opens March 15w - Ends August 31 st