520073_Annual Report_20240311

RECEIVED
112024 ATTACHMENT A
ANIMAL FACILITY ANNUALWEPORIMFORM
Report for(previous)Calendar Year:20 g Today's Date: ,
Certificate of Coverage or Permit Number Sa - -7 3 j County,. 0
Facility Name(as shown on Certificate of Coverage or Permit) I( e-
Operator in Charge for this Facility eiV► n m- S Operator Certification#
Facility's Integrator,if applicable: ` )
Part I: Facility Information(As of December 31st of reportinp, Near unless otherwise specified):
Land application of animal waste as allowed by the above permit occurred during the past calendar year
® YES_F-1 NO. If NO, skip Part I and proceed to Part II and Part M. Also, if animal waste was
generated but not land applied,attach an explanation on how the animal waste was managed/disposed.
CAWMP SUMMARY 1
Total number of application Fields or Pulls in the Certified Animal Waste c 1 Fields or
Management Plan(CAWMP): Pul zones
Total Useable Acres approved in the CAWMP Acres
Total pounds of Plant Available Nitrogen(PAN)allowed to be land applied
Lbs.PAN
annually by the CAWMP and thepermit:
LAGOON SUMMARY
Number of Permitted Lagoons #Lagoons
Number of Permitted Lagoons with a sludge removal or management plan
#Lagoons
per Permit Condition III-22
ANNUAL OPERATIONS SUMMARY
(for all crops with windows that ended during the previous calendar year
Total number of Fields or Pulls on which land application occurred during Fields or
the year: Pull zones
r. `` ffJJ,,
Total Acres on which animal waste was applied �' �/ Acres
Total pounds of Plant Available Permitted Animal Waste i Lbs.PAN
Nitrogen(PAN)applied during the year for all application sites: Other Nutrient Sources(incl Dry Litter) ® Lbs.PAN
SOIL SAMPLE SUMMARY
Total number of Fields or Pulls for which the most recent soils evaluation Fields or
indicated a Soil P(P-index)greater than 400 Pulls/zones
Total usable acres of Fields or Pulls for which the most recent soils 7^
(J Acres
evaluation indicated a Soil P(P-index)greater than 400 _
1 AFOAR 4-12-2019

ATTACHMENT A
BENEFICIAL USE SUMMARY
Estimated amount of total manure,litter and process wastewater sold or tGslllon�s
given to other persons and taken off site during the year
PRODUCTION SUMMARY
Annual average number of animals by type at this facility during the vrevious ear
Operation Type Number of Animal
Swine Cattle Dry Poultry Other Tvpes
Wean to Finish Dairy Calf Non-Laying Chickens Horses—Horses
Wean to Feeder Dairy Heifer Laying Chickens Horses—Other
arrow to Fims Milk Cow Pullets Sheep—Sheep
Feeder to Finish Dry Cow Turkeys Sheep-Other
Farrow to Wean Beef Stocker Calf Turkey Pullet
Farrow to Feeder Beef Feeder
Boar/Stud Beef Broad Cow Wet Poull rN
Gilts Other Non-Laying Pullet
Other Layers
Part II: Facility Status (Respond for activity within the Calendar Near of reportinu year unless
otherwise specified):
Directions: Check box next to the appropriate answer, for each statement were the answer is"No",provide a
written description of any action take taken or pending to address the requirements and return the facility to
compliance
1. All "major changes,""revisions,"and"amendments"to the CAWMP were made QYes ao
according to requirements of Condition I.4.
2. There were no freeboard exceedances in any lagoons or storage ponds. Yes®No
3. There was no PAN application to any fields or crops at this facility greater than the des ffNo
levels specified in this facility's CAWMP.
4. Sludge Surveys as required in Condition 111.22 have been completed. [ayes ONO
5. For any temporary lagoon lowering event, drawn down restrictions and record Lies ONO
keeping requirements in Condition II.29 have been met.
6. Soils analysis were performed within the last three years on each field receiving animal ffesF-]No
waste.
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ATTACHMENT A
7. All required monitoring and reporting were performed in accordance with the facility's ffyes❑No
permit during the past calendar year.
8. Crops as specified in the CAWMP were maintained during the past calendar year on all 0Yes❑No
sites receiving animal waste and the crops grown were harvested and removed in
accordance with the facility's permit.
Part III: Affirmation Statement
"I affirm by my signature that this document and all attachments were prepared under my direction or
supervision. The information submitted is,to the best of my knowledge and belief,true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the
possibility of civil and criminal penalties."
Permittee ti ame and Title(type or print)
1 \
Signature of Permittee Dat
Signature of Operator in Charge Date
(if different from Permittee)
3 AFOAR 4-12-2019

Appendix 1.Lagoon Sludge Survey Form Revised August 2008
A.Farm Permit or DWQ Identification Number__ 73
B.Lagoon Identification I ' c
C.Person(s)Taking Measurements J
D.Date of Measurements
E.Methods/Devices Used for Measurement of
a.Distance from the lagoon liquid surface to the top of the sludge layer:
b.Distance from the lagoon liquid surface to the bottom(soil)of the lagoon:
c.Thickness of the sludge layer if making a direct measurement with"core sampler":
F.Lagoon Surface Area(using dimensions at inside top of bank): (acres)
(Draw a sketch of the lagoon on a separate sheet,list dimensions,and calculate surface area. The lagoon may
have been built different than designed,so measurements should be made.)
G. Estimate number of sampling points:
a.Less than 1.33 acres:Use 8 ints
b.If more than 1.33 acres acres x 6= ,with maximum of 24.
(Using sketch and dimensions,develop a uniform grid that has the same number of intersections as the
estimated number of sampling points needed.Number the intersection points on the lagoon grid so that
data recorded at each can be easily matched.)
H. Conduct sludge survey and record data on"Sludge Survey Data Sheet"(Appendix 2).Also,at the location of
the pump intake,take measurement of distance from liquid surface to top of sludge layer and record it
on the Data Sheet(last row);this must be at least 2.5 ft.when irrigating.
I. At the time of the sludge survey,also measure the distance from the Maximum Liquid Level to the Present
Liquid Level(measure at the lagoon gauge pole): It
J. Determine the distance from the top of bank to the Maximum Liquid Level
(use lagoon management plan or other lagoon records)
K. Determine the distance from the Maximum Liquid Level to the Minimum Liquid Level 1p
(use lagoon management plan or other lagoon records)
L. Calculate the distance from the present liquid surface level to the Minimum Liquid Level 44
(Item K minus Item I,assuming the present liquid level is below the Maximum Liquid Level):
M. Record from the Sludge Survey Data Sheet the distance from the present liquid surface level to the lagoon
bottom(average for all the measurement points): f-
N. Record from the Sludge Survey Data Sheet the distance r om present liquid surface level to the top of the
th
sludge layer(average for all the measurement points):
O. Record from the Sludge Survey Data Sheet the average thickness of the sludge layer: . L
P. Calculate the thickness of the existing Liquid Treatment Zone(Item N minus Item L): 5
Q. If Item O is greater than Item P,proceed to the Worksheet for Sludge Volume and Treatment Volume.
If Item O is equal to or less than Item P,you do not have to determine volumes.
Completed by: Date:
Print Name Signature

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