310306_Compliance Evaluation Inspection_20231107

O Division of Water Resources
Facility Number, 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: l o Arrival Time: Departure Time: j cl County: Region:
Farm Name: a ,, , ,; , 1 �, �� .� �c -r •-�- Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: %VaW"') Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Design _ ` Current
Swine =Capacfty- Pop.
Wean to Finish
Wean to Feeder tO I DO
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
FF
"other
Latitude:
10 25��1 0 "LZ G
Phone:
Integrator:
Certification Number:
Certification Number:
Design Current,
Wet Poultry,
Capacity POP.
Layer
Non -Layer
Design Current
Dry Pnnitry
Canacitv Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Longitude:
Design Current
Cattle` ` r CapacityPop. -''-
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
2<o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
E�XA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
<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
NA
❑ NE
2. Is there evidence of a past discharge from -any part of the operation?
❑ Yes
❑ NA
P10-
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 511212020 Continued

Facility Number: -11 jDate of Inspection: I.1 1
2
Waste Collection & Treatment
No
NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
D7NA
❑
a. If yes, is waste level into the structural freeboard?
[—]Yes
❑ No
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: t'
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
/No[:]
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
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 P,<o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑X ❑ 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 � "` AGO ❑ NA ❑ NE
maintenance or improvement? ZZZ
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes <o ❑ 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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes dNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes �o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [Z/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?
❑ Yes ENVo ❑ NA ❑ NE
[:]Yes [2"go ❑ 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
�(No
❑ 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
o
❑ NA
❑ NE
❑ Waste Applicati ❑ 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
dN
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes❑
�Zj
NA
❑ NE
Page 2 of 3 511212020 Continued

Facility Number: - Date of Inspection: (A 7
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes .�0'❑NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes To ❑ 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 EZNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑Yes ❑ No a<A ❑ 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 To ❑ NA ❑ NE
❑ Yes ED4o ❑ NA ❑ NE
❑ Yes 10 ❑ NA ❑ NE
❑ Yes [—]No ❑ NA 9E
❑ Yes
❑ Yes
❑ Yes
[]C N ❑ NA ❑ NE
V❑ NA ❑ NE
No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other' comments.
Use drawines of facilitv to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 41%5 S- I 'D
Date: V0 7
S/l2/2 20