310235_Compliance Evaluation Inspection_20231219

CJ D1vIs101n of Water Resources
F4611ity
Nimber�
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� � � � C� bivis�nn of SoB and��?Vater Conservation
0 Other Agency
_
Type of Visit: @Y Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date,of Visit: Arrival Time: v 0 Departure Time: l 0 County: Region:
Farm Name: �;; ��r�.�. Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone: r, b 0 1 53
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Cl S-) Longitude: 9 i . CID y
>._
Design Cgrfept �� Des�guCurrenf
-� Destg�r Ctr�rent :, `
n
Swine ':'
Capacity Wyk 'a Itty Capac� y op
Cattle Cao*tity fop ,
_ 0
ME
_� '
s4ir�c
4_
m
,v[�S
Turkeys
�
`�� �� Turkey Poults
'
Other
- m
Wean to Finish
�z_�
Layer
Wean to Feeder
Non -Layer
Feeder to Finish
�f�-��
� %� ` `��, �`
Farrow to Wean'
Des ign Carent
- � :,Dry Fault a 'achy )'o
Farrow to Feeder
Farrow to Finish
Layers
Gilts
y�
Non -Layers
Boars
=
Pullets
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
DischarEes and Stream Impacts
l . Is any discharge observed from any part of the operation?
❑Yes
o
❑ NA
❑ NE
Discharge originated at: ❑Structure ❑Application Field ❑Other:
a. Was the conveyance man-made?
❑Yes
❑ No
�A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑Yes
❑ No
❑ �3'A
❑ 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
A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑Yes
[�To
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑Yes
�No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1, of 3
S/12/2020 Continued

Facility Number: Date of Inspection: l Z 1 S `Z._
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes /No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 64A ❑ NE
Structure 1 Structure 2 Structure 3
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): &-A)
Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes 37N90 ❑ NA ❑ NE
❑ Yes WNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or enviromn a threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes �ZEINA
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ 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 io ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes EZ No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes dNo ❑ 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 E3<o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes VNo
<❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ 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?
❑ Yes
[]�No
❑ NA
❑ NE
❑ Yes
[
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [/](No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes YNo ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 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
[o
❑ 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: 3 I - Z3 f 1 1 Date of Inspection: I-?_ 1 l g I ZJ
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes o ❑ 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 YNO ❑ N ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No VNA ❑ NE
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 ZNo ❑ NA ❑ NE
❑ Yes J No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
NE
❑ Yes
2No
❑ NA
❑ NE
❑ Yes
VAO
❑ NA
❑ NE
❑Yes
o
❑ NA
❑ NE
Reviewer/Inspector Signature: Date:
Page 3 of 3 511212020