110558_Inspection_20231128

Division of Water Resources
F=,dfityN,m '.� 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: /{ Arrival Time: Departure Time: t Cf County: l why"egiom--42r-1../
Farm Name: 1(s'l �. c.-G{s.` 1p_{Oywt ner Email: .L''pyi. (' Jr, �j6t2. 6G�
N - Gh%1'/I,tP..Gs-� f9 T` /i'�`, 'yIWyFPhone- zr"
Owner Name:
Mailing Address: Fc3a Pl.t RY I d,
Physical Address: +�Sa�/ZL �Cti %k``( �` __-
Facility Contact: �f(,{ptyt y�'y� (�j�'p�{l,q_ Title: AC%Xi T_
Onsite Representative: fs%'�. Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Layers
Non-La ers
Pullets
Turkeys
Turkey Points
Other
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 D WR)
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? -
Page 1 of 3
Dairy Cow
7
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes {ANo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
E5y4o
❑ NA
❑ NE
❑ Yes
%,No
❑ NA
❑ NE
511212020 Continued

Ii-Jq OV
Facilit Number: DateofIna ect,,a 11 ZJSY
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
�ANo ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
4No ❑ NA
❑ NE
Structure 1 uct e 2 Structure 3 Structure 4
Identifier: to
Structure 5
Structure 6
Spillwa},9:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E�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
E5�No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
FNo ❑ NA
❑ HE
(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
EXim ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
5LNo ❑ NA
❑ NE
❑ Excessive Prancing ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cm Zm etc.)
❑ PAN ❑ PAN> 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside ofAccellptt1able Crop Window o�f�yWind Drift ❑ Application Outside ofApp^roved
A�re�aa
/❑�,�Ev-idenc�e
12. Crop Type(s): �Jn (i��� 17.. P9 — A,l/WT _f A� a69r—)
�
_{_,�
X- b7 /�/T 1
:/Gi/V\
13. Soil Type(s): L @d
14. Do the receiving crops differ from those designatrA
the CAWMP?
❑ Yes
2No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
allo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the inrigation design or wettable
❑ Yes
[A.No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�LNo
❑ NA
❑ NE
IS. Is there a lack of properly operating waste application equipment?
❑Yes
EANo
❑NA
❑NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
ENo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
%No
❑ NA
❑ HE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
�o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rzinbreakers on irrigation equipment?
❑ Yea
o
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

AJ r 5- - s
Faci6 Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
15�
❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
El Yes
,No
It/I No
❑ NA
❑ NE
the appropriate box(es) below.
T
❑ Failure to complete annual sludge survey ❑Failure to develop a PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating noncompliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
�o
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
t�gNo
❑ NA
❑ NE
Other Issues
28, Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[j-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
*.
❑ 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
,--/''
yV1va
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
T
31, Do subsurface tile drains exist at the facility? If yes, checkthe appropriate box below.
❑ Yes
R -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
Eirlso
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
C2�Nu
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
gNo
❑ NA
❑ NE
Comments (refer to question ft): Explain any YES answers and/or any additional recommendations or any other comments.
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Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of3
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Phone:
Date:
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