820663_routine_20240409

division of Water Resources
Facility Number - T ��"70 Division of Soil and Water Conservation �� 1 !%
O Other Agency
fppe of Visit: ,_�om�pliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
2eason for Visit: 10 Routine 0 Complaint 0 FulloNt-up O Referral O Emergency 00ther 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: j�• j �"-
Farm Name:-- �� l.1'.^ r'y� Owner Email:
Owner Name: 1�e1� £1�i: �'9 �i , /� Phone:
Mailing Address:
Physical Address
Region:
Facility Contact: Z2ICI I�� YI� Title. �^'�e'II Phone: /—
OnsiteRepresentative: Integrator: U
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: longitude:
Swine
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Laycr
Non -Layer
Wean to Finish
Wean to Feeder
Feeder to Finish
0
r , v
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
boars
Other
lets
Poults
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ StRiCtare ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of State? (Ifyes. notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the Neaste 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?
Design Current
Cattle Capacity Pop.
CONN
Heifer
Feeder
Brood
❑ Yes - t o ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑NA ❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
Quo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Page I a j 3
511212020 Con/rnaed

Facility Number: Date of Inspection: 9r
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spilhvay?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
�o
❑ 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
�o
❑ 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
E3 "'o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
O Ko
❑ 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
�s
[0o
❑ 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
❑rNo
❑ NA
❑ NE
❑ Excessive Painting ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge
into
Dare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
Area
12. Crop Type(s): CC/ 1
13. Soil Type(s)a:
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[a No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[D No
❑ NA
❑ NE
I S. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ 7Cto
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[:No
❑ NA
❑ NE
20. Does the facility fail to have all components ofthe CAWMP readily available? If yes, check
❑ Yes
E3<o
❑ 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
❑ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
�o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
INo
❑ NA
❑ NE
I'age 2 of 3
511212020 Continued

Facilitv Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E, No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑-Yes ❑ No ❑ NA ❑ NE
the appropriate box(es) beloNN.
❑ Failure to complete annual sludge surrey ❑ 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 actiN ely certified operator in charge? ❑ Yesf1E No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ Vo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No ❑ NA ❑ NE
and report mortality rates that were higher than not trial'?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ❑No ❑ NA ❑ NE
If ycs, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emeigency 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 ❑ Lacoon/Storage Pond ❑ Other:
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ o ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33, Did the Reviewer/Inspector fail to discuss rCView/inspection with an on -site representative? ❑ Yes Q No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [2-N"o ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone:
Date. Y�—� ,�L o�' (
Pnge 3 of 3 S11212020