040005_Routine Inspection_20231128

Evaluation
LReason for Visit: -,CT-Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: AArrivaI Time: 9,619 Departure Time: ounty: Aft Region: F46
f
Farm Name: /' / Owner Email:
Owner Name: / 14 14ei Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: _
Back-up Operator:
Location of Farm:
t(
Title:
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?
Phone:
Integrator:
41
Certification Number: I & & 70
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 E"14o ❑ NA ❑ NE
❑ Yes
[:]No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes -.Eno ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
Page l of 3 511212020 Continued

Facility Number: © - 0 Date of Inspection: // t �3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes J�f'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): 3(�
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 „L7rNo
❑ 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 �o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes E71'fTo
❑ 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 ,2 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 �To
❑ 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? ❑ Yes fn No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ID -No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ,[Df�o ❑ 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 -Ef-&o
❑ Yes ..E]"No
❑ Yes _E�—No
❑ Yes jEfj'No
❑Other:
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. -FrYes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard Ef'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 'E2No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EE�'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 Q'No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [2-iNo
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 Pf`No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes J2/No
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:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[—]Yes C2/No ❑ NA ❑ NE
❑ Yes 2No ❑ NA ❑ NE
❑ Yes ,❑'No ❑ NA ❑ NE
❑ Yes 4E�No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes 'E2'No ❑ NA ❑ NE
[—]Yes L'No ❑ NA ❑ NE
z n,
6;-tl?_
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
511212020

0
FACILITY#:C �—a/J FARM NAME: LAGOON LEVEL
PERMIT t#+e)
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 F R 60 DAYS BEFORE OR AFTER J //
DATE l-174-3 NITROGEN LEVEL 7
DATE NITROGEN LEVEL
DATE. NITROGEN LEVEL
EVERY 3 YEARS:
P-1 (NO MORE THEN 400)
PH (Not if4orles )
Cu/ZN (NO MORE THEN 8000)
(IF PEANUTS NO MORE THEN 300)
f�SOIL REPORT (#2i)
DATE <1)R6--3
IRR2 (#2f)
Not over PAN CROP TYPES
FLOW RATES - NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES
NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
'2J,1 6)
4695

CALBRIATION ht241
EACH REEL SHOULD BE CA� RATED EVERY OTHER YEAR
DATE OF CALIBRATION /�S�la'l
FLOW RATES
RAIN FALLIxz11
-INITIAL AFTER 1" RAIN EVENT
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED PDA NEEDED.
-DUE E�V�g Y, YEAR: DATE `
O: "5T P: q -1r % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE
0: P: % RATIO OF SLUDGE
OTHER FORMS (#22 AND #21)
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
AREASTREES 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 1st- Ends March 31st
Corn: Opens February 15t - Ends June 30*
Cotton: Opens March 15t - Ends August 1st
Rye: Opens September 1st- Ends March 31 st
Oats: Opens September 1st- Ends April 15t -
Wheat: Opens September 1st - Ends April 30+
Soybeans: Opens April 1st- Ends September 15u -
Fescue: Opens August 1st- Ends July 31st
Sorghum Hay: Opens March 15t - Ends August 31 st