090125_Routine Inspection_20240425

Type of Visit: . Compliance Inspection 0 Operation Review O Structure Evaluation p Technical Assistance
Reason for Visit: ,,.O�_Rkoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: ; U(jfipi Departure Time: v,`w/ County:A�
Farm Name: ' /Z� Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ` 6zyn x5eylz�Tit►e:
Onsite Representative
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Region:
ti
Fri
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish
(07'
Dairy Heifer
Farrow to Wean
Dry Cow
f{ Farrow to Feeder
I lNon-Dairy
;j Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
j: Boars
Pullets
Beef Brood Cow
I�
,;"i`
Turkeys
Turkey Points
in E
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
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 D WR)
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 J�o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[—]Yes
[allo
❑ NA
❑ NE
[—]Yes
[]-No
❑ NA
❑ NE
Page I of 3 511212020 Continued

Facility Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,2'No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: [
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ,E ` o ❑ NA ❑ NE
❑ Yes FrNo ❑ NA ❑ NE
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 eNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ Yes �o ❑ NA ❑ NE
9. Does any part of the waste management system other than the waste structures require [—]Yes PTNO ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E51No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Feko ❑ 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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[71'No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
4E!rNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
2]"No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E!fNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
,,FXNo
❑ 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 of the CAWMP readily available? If yes, check
[—]Yes
.'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.
.E"i'es
❑ No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard -PT<aste 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
,❑ No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ETVo ❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facili Number: [Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes _E/rf o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes _L�FiNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey m1ure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon b �r %
List structure(s) and date of first survey indicating non-compliance: i
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 „®"No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes IP7Mo ❑ 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?
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?
❑ Yes J2 No ❑ NA ❑ NE
❑ Yes d ' o ❑ NA ❑ NE
❑ Yes ❑'No
❑ NA
❑ NE
❑ Yes EDIRo
❑ NA
❑ NE
[—]Yes ,E�l/o
❑ NA
[INE
❑ Yes )"O
❑NA
❑NE
a7,.e � dal
021)
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone:
Date:
511212020
Page 3 of 3

"CURy No. �`2 �� Time In Time Out
Farm Name !'� a �.t cam✓
Integrarw
Owner Site Rer
Operator
No.
Back-up No.
COC Circle: General or NPDES
FREEBOARD: Design
Observed
Crop Yield
Rain Gauge
Soil Test
Weekly Freeboard _
Spray/Freeboard, Drop _
Weather Codes
Waste Analysis:
Date
Wettable Acres x
Daily Rainfall
120 min inspections
Nitrogen (N)
Dace
Sludge Survey / % t5 ��� 3 ./ C�
Calibration/GPM —Z-% 2J2;L
Waste Transfers
Rain Breaker /'7I
PLAT I�
1-in Inspections
Date Nitrogen (N)