820478_routine_20240419

O'bivision of Water Resources
Facility Nuuib6 - 5/7-77eL O Division of Soil and WaterConservation L
O Other Agency
type of Visit: Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
leason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: iov Departure Time: County: l �j—Region:
Farm Name: ; S' J� t eJG Owner Email:
Owner Name: �,�.���6/�S t�;/�u� ► J� Phone:
Mailing Address:
Physical Address: j
Facility Contact: ���- s� �� L�9 ky Title:
Integrator:
Certification Number:
Onsite Representative:
Certified Operator:�c��
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number:
Design .
Current
Design
Current
Swine Capacity
Pop.
Wet Poultry Capacity
Pop. e
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean 4�
Farrow to Feeder
Farrow to Finish
Gilts
Boars
FT
Other`
Layer
Non -Layer
Design Current
Dry Poultry, Capacity Pion. `
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
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 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:
Design Current
Cattle Capacity Pop."
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
0 Yes Lal�o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
E31No
❑ NA
❑ NE
❑ Yes
E24o
❑ NA
❑ NE
Page I of 3 511212020 Continued

Facility Number: - 4 jDate of Inspection: —/
K
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
es
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
0-<o
❑ NA
❑ NE
Structure 1 Structure/ 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in): _ G�27
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
E] <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?
2-IVes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�o
❑ 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
�o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E] o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
0 Yes
[2'&o
❑ 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): GPr9 "'.7 �!J hr� �S d Y s �vrr C./� � /�i^�� �,
� �r�'/y
.�/ �� ✓ mo w
13. Soil Type(s): 6k
14. Do the receiving crop differ from those designated in the CAWMP?
❑ Yes
❑'hTo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E]-No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[2'1�o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Q o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[3-1Go
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E3 <o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[2,Tqo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑LeaseAgreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
�o
❑ 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
[J-No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Oslo
❑ NA
❑ NE
Page 2 of
511212020 Continued

Facility Number: 72 - L Date of Inspection: /�
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Ea <o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �o ❑ 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:
❑ Yes
[]"No
❑ NA
❑ NE
❑ Yes
[ o
❑ NA
❑ NE
❑ Yes
�o
❑ NA
❑ NE
[:]Yes En -No ❑ NA ❑ NE
❑ Yes Quo ❑ NA ❑ NE
❑ Yes Eal�o ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [ 41 o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 2 No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [:]Yes [ o ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any, additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional pages as necessary).
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Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: j© -- 3 © /,ri
Date:
511212020