310630_Compliance Evaluation Inspection_20230718

C��,)ivWResources
Facility Number',1 - (,�) V DTDivision of Soil and -Water Conservation =,
Other Agency
Type of Visit: © Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: (i� Departure Time: County:
Farm Name: 'j W C� skz / C-,,( ✓w Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ,W ;3 V S 4_ Title:
Onsite Representative: L--e o
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
Region:
c
c110 28s g
Design
Current y
Desig"
Current
_ Design :.Current
Swine
Capacity
Pop.
Wet Poultry
Capacity
Pop
Cattle Capacity Pop
_
=v
Wean to Finish
I
ILayer
Wean to Feeder
Non -Layer
Feeder to Finish
= _
Farrow to Wean
Design
Current
`'
-
Farrow to Feeder
'lam
, `
Dry,Poultry
-Capacity
Pop. _
Farrow to Finish
Gilts
-
Boars
Other
_ _
,�
Fyn
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
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[—]Yes
❑ No
lA
❑ 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
Q1Io
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
�o
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 5/12/2020 Continued

Facility Number: Date of Inspection: i ?
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E�o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [:]No NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: _ I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): `LC
5. Are there any immediate threats to the integrity of any of the structures observed? 0 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 OI10 ❑ NA ❑ NE
waste management or closure plan? L
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 pKo
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes T ❑ 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 L9 ivo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ZNo ❑ 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? 0 Yes �o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 64o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA ❑ NE
acres determination? f
17. Does the facility lack adequate acreage for land application? ❑ Yes [[!J o ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? El Yes No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA E2 1VL
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑-W
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
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weat►4 er 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 ❑ No ❑ NA riz
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA
Page 2 of 3 511212020 Continued

Facility Number: j- GDate of Inspection: -7
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA D KE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA 61NV�
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 ❑ No ❑ N NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [—]No NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No A ❑ NE
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-IG ❑ NA ❑ NE
❑ Yes I �o ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ No ❑ NA
No ❑ NA
210�0 ❑ NA
®No ❑NA
❑ NE
❑ NE
❑ NE
Comments �rerex fp ueshon #} E ptam any, q eks au'&/i` any dittau I re omme dat�tiias ter any €►ther coma a is
WIN
__� s
IlJse drawing o ;fac�ity to better eatplain situations_=(use,a dit ou 4VOges asnecessary) T
S
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 1� ( 0 SZ6 PO
Date: 711 � f 2-3� f 2-3
511212020