770018_Routine Inspection_20240311

AArrival Time: Departure Time: I A;111, lyptp County:
Owner E"maiil:"J1
Mailing Address:
Physical Address:
Facility Contact: / Z/,yl Title:
Onsite Representative: t(
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure El Application Field Other:
a. Was the conveyance man-made?
Region: c'PCT— o
Phone:
Integrator:7
Certification Number: v?CJ �7 q!?
Certification Number:
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?
Longitude:
[:]Yes ❑ No NA NE
❑ Yes
No
NA
Ej NE
❑ Yes
No
M NA
❑ NE
Ej Yes
❑ No
NA
❑ NE
Yes
❑ No
NA
❑ NE
Yes
No
NA
NE
Page I of 3 511212020 Continued

Facility Number: 7- Date of Inspection: /C
�-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes 'L::-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:
Spillway?:
Designed Freeboard (in): (�
Observed Freeboard (in);
TT
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes CD 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 QNo
❑ 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 .Q No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes 0 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 4E] 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 :2rNo ❑ NA ❑ NE
❑ Excessive Pending ❑ 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): �f�
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
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 ®-No ❑ NA ❑ NE
❑ Yes Jallo ❑ NA ❑ NE
❑ Yes E No ❑ NA ❑ NE
❑ Yes ©No ❑ NA ❑ NE
❑ Yes .� o ❑ NA ❑ NE
❑ Yes -®-No ❑ NA ❑ NE
❑ Yes e Rio ❑ NA ❑ NE
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 'E�"No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes +E�No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes .� o
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: Date of inspection: 3
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E!j"No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes JE�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
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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
[—]Yes
�No
❑ NA
❑ NE
❑ Yes
�;_IrNo
❑ NA
❑ NE
❑ Yes
„&No
❑ NA
❑ NE
[—]Yes rNo ❑ NA ❑ NE
❑ Yes ®'No ❑ NA ❑ NE
❑ Yes [�j No ❑ NA ❑ NE
❑ Yes J'jNo
❑ Yes EffNo
❑ Yes .® No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone:
Date:
511212020

FACILITY#: .� r FARM NAME: LAGOON
PERMIT (vs)
DUE EVERY 5 YEARS
- EXPERIATION DATE NUMBER OF ANIMALS
CURRENT NUMBER OF ANIMAL
OIC CARD YES OR NO
WASTE UTILIZATION PLAN (WUP) (#20)
SOIL TYPES
CROP TYPES
- ODOR CONTROL CHECKLIST YES OR NO
- Irrigation Plan Maps YES OR NO
WASTE REPORT (# i)
-GOOD FO 60 DAYS BEFORE OR AFTER
DATE tSt% / d3 NITROGEN LEVEL
DATE /`< 1 1 aL3 NITROGEN LEVEL o� • a
DATE NITROGEN LEVEL
EVERY 3 YEARS:
P-1 (NO MORE THEN 400)
PH (Note if4 or less)
Cu/ZN (NO MORE THEN 3000)
(IF PEANUTS NO MORE THEN 300)
DATE
Not over PAN CROP TYPES
FLOW RATES
SOIL REPORT (#21)
IRR2 (#zi)
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 (#za)
- EACH REEL SHOULD BE CALIPPATED EVERY OTHER YEAR
- DATE OF CALIBRATION ) J � 3.
FLOW RATES U
RAIN FALL (#)
-INITIAL AFTER 1" RAIN EVENT -
-LOOK FOR ANY LEVEL THAT IS LESS THEN THE DESIGNED FREEBORED POA NEEDED.
-DU VERYYEAR:
O:P:
O: P: _
O: P:
O: P:
11136193SLUDGE (mt a2e)
%RATIO OF SLUDGE x�
% RATIO OF SLUDGE
% RATIO OF SLUDGE
% RATIO OF SLUDGE
OTHER FORMS (s22AND #21)
RAIN BREAKER FORM CROP YEILDS MORTALITY_
*If fields are grazed there will be no crop yields
VISUAL CHECK
FOUNDATION OR PIT LEAKS PIPE LEAKSLAGOON 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¢- Ends September 30t
Small Grain Over seed: Opens October 1st- Ends March 31st
Corn: Opens February 15* - Ends June 30t
Cotton: Opens March 15t - Ends August 1st
Rye: Opens September 1�-Ends March 31st
Oats: Opens September 1-t- Ends April 15t
Wheat: Opens September 1st -Ends April 30w
Soybeans: Opens April 1�-Ends September 15t
Fescue: Opens August 1st- Ends July 31 st
Sorghum Hay: Opens March 15t - Ends August 31 st