310291_Compliance Evaluation Inspection_20230726

i ype ut v tstt: C'J %.uutpuance inspection v operation review V structure r vamation V i ecnntcai assistance
Reason for Visit: 1) Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Arrival Time: C� r��
�(�`��
Departure Time: O County: Region:
Farm Name:
�'
�- ; e,1 Owner Email:
Owner Name:
Phone:
Mailing Address:
Physical Address:
Facility Contact: ��.ry ��,rc,c.,i r Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone: cl 10 3% b 4Z 1-7
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Az
r Design Current
' 3
Design .Current
Design
Current
Swinee
Ca act Po
P tY - P•
We Poul try
Ca act
P ty,
Po p•,
Cattle �
,Ca acity
p,
P,op
Wean to Finish
I
ILayer
v "€
Wean to Feeder
Non -Layer
Feeder to Finish
-'
Farrow to Wean
Design _
Current_:
Farrow to Feeder
_-
bry Poultry
Capacity,
Pop.. .
Farrow to Finish'
Gilts
Boars
Other
�x
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
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
,--,�
Ldl�o ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No ❑
❑ 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 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
No ❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3
5/12/2020 Continued

Facility Number: jDate of Inspection: `1
2
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
If is level into freeboard?
❑ Yes
Yes
❑ o n NA/
No A
❑ NE
NE
a. yes, waste the structural
❑
❑
❑
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): R,O_
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
N . 0 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 hreat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
o ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
L-�""o ❑ 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 0 NA
❑ NE
maintenance or improvement?
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 N
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes I_'I 1V
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
0 Yes ❑ I' `TO
❑ NA
❑ NE
acres determination?
1
17. Does the facility lack adequate acreage for land application?
❑ Yes ��
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
El Yes VNo
❑ NA
❑ NE
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
❑ Yes o
P'es ] No
❑ NA
❑ NA
❑ NE
❑ 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 1 - mac► Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes To ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ErNo ❑ 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 o ❑ N El NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No 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
[�No
❑ NA
❑ NE
❑ Yes
Ea <No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
[4
❑ NA
❑ NE
YNo
❑ NA
❑ NE
Vi No
❑ NA
❑ NE
❑ Yes
❑ Yes
❑ Yes
Uomments (refer to question ):'Explain any YES answers and/or any additional recoritmendations or any�other- comments.
Use drawngsgof.facility to better, explain situations (nse additional page's as necessary)
V
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ��V
Date: L6 1 ''
1
S/12 020