HomeMy WebLinkAbout670082_Compliance Evaluation Inspection_20231116: s "Divis"' of Water Resources
Fadliiy uMbe�r '� fr't- QDiviston of Soil and Water onservation
:Ot11er Agency
Type of Visit: (2) 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: a 7 Arrival Time: Departure Time: �� County:
Farm Name:Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: �� �' �i c.C,� Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swvine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Cher
Region:
Phone: Ci I i4 LC+ r S'7_ 1
Certification Number:
Certification Number:
Latitude: 3 Li . (;� 6'Longitude:
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
_111 6-31
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No EfNA NE
❑ Yes ❑ No ❑ ElNE
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 No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 641�
❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 511212020 Continued
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