430013_routine_20231108

type of visit: T Uompliance inspection V Operation Review U Structure Evaluation U Technical Assistance I
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: it a 3 Arrival Time: ; Departure Time: �County:
Farm Name: CA r M U S f Ld i N & ffl (N RCO O V Owner Email:
Owner Name: 11R W O m b I-e- Co [ P Phone:
Mailing Address:
Physical Address:
Facility Contact: Tiles S OV 0m h) 9- Title: owl `per Phone:
OnsiteRepresentative: Sari -9 Integrator: cm% hOW
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Region: 'I Ro
Design Current
Design
Current
Design Current
Swine Capacity Pop :
Wet Poultry
:Capacity
, Pop
CattleCapacity % 'op -
Wean to Finish
Layer
Dairy Cow
Wean to Feeder J
Feeder to Finish'.-
INon-Layer
I
_
Dairy Calf
Dairy Heifer''
Farrow to Wean
�" Design
-Carpent.
Dry Cow
Farrow to Feeder a
Dry Poultry
: Capacity
Po
Non -Dairy
Farrow to Finish -
Layers
Beef Stocker
21,
Gilts _
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
�
Other
Turkey Poults
�
Other
j '
Discharizes and Stream Imaacts
1. Is any discharge observed from any part of the operation? ❑ Yes V No ❑ NA ❑ NE
Discharge originated at: ❑ Structure. ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes NI 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)
❑ Yes
No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
0 Yes
\ No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 511212020 Continued

Facility Number: H9- Date of Inspection: I)
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Eq No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes N, No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 2
NO -
Designed
Spillway?: N o
Freeboard (in):
r
Observed Freeboard (in):
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 I \I 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 No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes &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 No ❑ 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): C (;? Ne
13. Soil Type(s): �i Q� IelQa. N/
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes \ No ❑ 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 No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tran fers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑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: I 1 1 Z17)
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 'fZ� No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 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?
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:
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?
❑ Yes
No
R❑
❑ NA
❑ NE
Yes
ram( No
❑ NA
❑ NE
❑ Yes
L�,No
❑ NA
❑ NE
❑ Yes �No
❑ Yes 'E;�No
❑ Yes n_No
❑ Yes tNo
❑ Yes ` qNo
❑ Yes �No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer -;to question #):.�xpla a any YES answers and/or any recommendations or°auy.other'comments
Use drawings of facility4 betteroexplain situations (use additional,pages'as-necessary).
s
1�
CaI1brajjoN
Cpop gie44
Reviewer/Inspector Name: Mh� ` oU�U"I Phone: I 1 q(p-
Reviewer/Inspector Signature: +uQ9 20��t�r Date: I li 171-,
Page 3 of 3 511212020