820271_Routine Inspection_20240226

Date of Visit: LCGL✓�cyJ Arrival Time: Departure Time: /l% 1�Y7"l� County�elz d— Region:
Farm Name: Owner Email:
Owner Name: f , , Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: i/
Title:
Phone:
Integrator:
Certified Operator: �(�.7t fib Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
4
//ya/S�
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 31T0 ❑ NA ❑ NE
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)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ffNo ❑ NA ❑ NE
❑ Yes _[3-No ❑ NA ❑ NE
Page 1 of 3 511212020 Continued

Facility Number: 27 Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes _L2'No
❑ 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: _ (&VaJJ)
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 02 9
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 4E!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 ..r_' Qo
❑ 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 ,,ETNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes „E�J-No
❑ 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 _E3'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes •-e-No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes -E3'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): �ti`ZccGuttGii�� C C� `���
13. Soil Type(s):i(hy�aG
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes .4Er o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes -Q-No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes J:] No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes .e o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ,® o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes [EJ'f o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes [3-No
❑ NA
❑ 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 ,,[D-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 —2-No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes -EJ-No
❑ 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 O-No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check .0 Yes ❑ No ❑ 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 / 33
List structure(s) and date of first survey indicating non-compliance:_/'? C =J
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes �No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes f :�[No ❑ NA i ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes E]' No ❑ 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 . ®moo
❑ 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 E3- b
❑ 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 [allo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes ❑i -No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes E3-No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes -ED No
❑ NA
❑ NE
r ,,r✓z Ges��
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone:(j/
Date:
Page 3 of 3
511212020

�1 S
Facility No. IQM '1�45 Time In Time Out
Farm Name
tniearatcy _
Owner Site Rep.
Operator' ICJ/ �/.r�(5� No.
aack-up No.
COC Circle: General or NPDES
-REEBOARD: Design —_ n► ►
Observed _ d"►
:rop Yield
?sin Gauge
3oilTest 21 . Wettable Acres
Meekly Freeboard Daily Rainfall
Spray/Freeboard Drop
Veather Codes 120 min Inspections
Waste Analysis.
Date Nitrogen (N)
71ia lY3 e,
5-N/,4-3 a /N
Date
Sludge Survey f/3/l �/ , g � j Q)oq-
Calibration/GPM 5 b-4 (7-1--
Waste Transfers
Rain Breaker
PLAT
1-in Inspections_
Date Nitrogen (N)
:JL 1i3 .ay—

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