820297_Routine Inspection_20240205

OI visit: S
on for Visit:
O Follow-up 0 Referral
Evaluation
Other U Denied Access
Date of Visit: Arrival Time: Departure Time: 0 !R/h County:
Farm Name: Dora ��, , Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: �171 Title:
Onsite Representative: 11
Certified Operator: CLIC,� G
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Region: 637eD
Integrator:
Certification Number:
Certification Number:
Longitude:
i'l'iF
loll,
1111iii�i
;i
��,. 91MRB
13
F
Wean to Finish
Layer'
DairyCow
Wean to Feeder
Non -Layer
DairyCalf
Feeder to Finish
lyd S
�c31i
a
Dairy Heifer
FazrowtoWean
����iIla
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Beef Stocker
Gilts
i
a ers
Beef Feeder
Boars
Beef Brood Cow
ijv si;�a
Tu[ke s
I L �'
ilIk-its
ai i 41i
Turkey Poults
�!jiII�I1Stl
i nisi u i a i
ii s ii
i :Other
<xi
, :, i i x
i i �� E
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes E f Ro ❑ NA ❑ NE
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ 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
,.�o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
P�-No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 511212020 Continued

Facility Number: 7 Date of Inspection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes E51t
❑ 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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes Ef['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 L2-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 .0'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes Q4
❑ 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 [2,No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes , No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ NA
❑ NE
'L21Ko
❑ 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): / GiiG�4/L� j0L
a�
SNft� i ✓4a e-A L6
/"i
©r o
13. Soil Type(s): r�n A
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes 1::FNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes 2!fNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes [3-No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes g�,No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes E]"No
❑ 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
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes 2-No ❑ NA ❑ NE
[—]Yes e No ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ,2'Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 12-No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E'No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3
511212020 Continued

Facility Number: - Date of Inspection: �-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ..E!rNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes allo ❑ 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 ,E!rNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes „ErNo
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ,4®' o
❑ NA
❑ 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?
❑ Yes &No
❑ NA
❑ NE
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
❑ Yes 9TNo
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes f �No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes •E3"N' o
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes .�No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes eNo
❑ NA
❑ NE
i
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: //() / �97��3 s--
Date:
511212020

FACILITY#: FARM NAME: LAGOON LEVEL
PERMIT cns)
- DUE EVERY 5 YEARS
EXPERIATION DATE NUMBER OF ANIMALS
CURRENT NUMBER OF ANIMAL
- OIC CARD YES OR NO
- WASTE UTILIZATION PLAN (WUP) (#20)
SOILTYPES
CROP TYPES
- ODOR CONTROL CHECKLIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (# i)
-GOOD FOR 60DAYS BEFORE OR AFTER
DATE a �U+� NITROGEN LEVEL 7� v
DATE ' U !/[ 1 3 1 !%3 NITROGEN LEVEL
DATE �-3 NITROGEN LEVEL --
SOIL REPORT (#71)
- EVERY 3 YEARS: DATE
- P-1 (NO MORE THEN 400)
- PH (Noteif4.,I..) �
- CU/ZN (NO MORE THEN 3000) CU //ZN
(IF PEANUTS NO MORE THEN 300)
IRR2 (# i)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)
Not over PAN CROP TYPES
FLOW RATES NITROGEN (N)

CALBRIATION Ixzal
EACH REEL SHOULD BE CALIB T�EP, EVERY OTHER YEAR
DATE OF CALIBRATION Y A 5
FLOW RATES ")
—
RAIN FALL lurt>
-INITIAL AFTER 1" RAIN EVENT ,
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED PDA NEEDED.
SLUDGE(masxe)
-DU�V�RYYEAR: DATE � i
O: P: % RATIO OF SLUDGE
O: P: % RATIO OF SLUDGE
0: P: % RATIO OF SLUDGE
0: P: % RATIO OF SLUDGE
OTHER FORMS (#zz AND#21)
r ;1
RAIN BREAKER FORM - CROP YEILDS MORTALITY
'If fields are grazed there will be no crop yields
VISUAL CHECK
FOUNDATION OR PIT LEAKS PIPE LEAKS_ LAGOON SEEPAGE LAGOON BARE
AREASTREES OR GRASS NEED TO BE REMOVED EROSION DITCHES
WINTER CROP(OVERSEEDED) HARVESTED FIELDS_ GOOD HEALTHY CORPS_ CORRECT
CROPS NO PONDING REELS FEED. BINS_ LAGOON GARBAGE
Bermuda grass: Opens March 1-t- Ends September 30t
Small Grain Over seed: Opens October 1 st- Ends March 31st
Corn: Opens February 15* - Ends June 30t
Cotton: Opens March 15th- Ends August 1st
Rye: Opens Septemberlst-Ends March 31A
Oats: Opens September 1-t-Ends April 15*
Wheat: Opens September 1-t- Ends April 30u -
Soybeans: Opens April 1st- Ends September 15w
Fescue: Opens August 1st -Ends July 31st
Sorghum Hay: Opens March 15* - Ends August 31 st