310855_Compliance Evaluation Inspection_20230912

EY Divasibn ofNVater Resources
°
Facriity Number, 3 y
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0 Division of Soil and -Water Conservat<on
°
s
Q Other Agency
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Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: b Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ��, Z Arrival Time: Departure Time: County:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: c.v�n�� t,�,i/ Title: Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Region:
_ _�
e Design Current _ sign
Current
Design
Current
Swine "y Capacity
' "P,
WetIOU ltry
.`.Capacity
:
Pop a ,
Cattle Capacity
-s
_
_
Layer
Non -Layer
j
s Design
Current
D2 Pou,ltry
=MCa{raci
Po,3
;
Other E . a>
e°
Ej
Wean to Finish
Wean to Feeder'L
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Layers
Non -Layers
Pullets
Turkeys
Turkey Pouets
Other
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
❑,P3��❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
c
a. Was the conveyance man-made?
❑ Yes
❑ No ❑,NAi
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No ❑�,
❑ 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
No ❑ NA
❑ 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: jDate of Inspection: i Z
2J
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
0 Yes
EjVo
F-1 NA
0 NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[j No
,e'] IA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
e o
❑ 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
�Ydo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑
❑ 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
❑ Ida
❑ NA
❑ NE
maintenance or improvement?
/
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ lea
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ ]X
❑ 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
�
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
7
7
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
to
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑115o_
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ Wo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
CP4o
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Ito
❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements
❑Other:
Y
21. Does record keeping need improvement? If yes, check the appropriate box below.
E] s
❑ No
❑ NA ❑ NE
❑ Waste Applicatio ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall tocking ❑ 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
No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
o
❑ NA ❑ NE
Page 2 of 3
511212020 Continued

Facility Number: ',3 jDate of Inspection: C1
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes D<o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [z ❑ 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 E2<o
[—]Yes ❑ No
❑ NA ❑ NE
�A ❑ NE
❑ Yes E ❑ NA ❑ NE
[—]Yes No ❑ NA ❑ NE
❑ Yes 3<0 ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA NE
❑ Yes
[3No
❑ NA
❑ NE
[:]Yes
F24o
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Comments{refer to question #): Explain any YES answers; and/or any additional r'.ecomme dati6ns ur anr$, the'r comments
Use drawipgs of:facility to ,bet'ter. a iplain situatiaiis (use additional pages,,as necessary}
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ALd .-( (3
Date: Z
511212020