820109_Routine Inspection_20240516 (2)

racmry rvo.-� 0� Time in
Time Out Date
Farm Name ( FavA4.
Owner IntegraroY
Site RszE
Operator:
Sack -up _
COC
FREEBOARD: Design
Circle: General
Obseed
Crop Yield
Rain Gauge
^
Soil Test Wettable Acres
Weekly Freeboard ✓ Daily Rainfall
Spray/Freeboard Drop
Weather Codes 120 min Inspections
Waste Anatvsis:
No..
No. _
or NPDES
Sludge Survey �631 AY y�
Calibration/GPM 22:41,2
Waste Transfers 7CP 13. ,2 74,
Rain Breaker
PLAT
1-in Inspections
Date Nitrogen (N)
<a ;X3 /.7 �-

Type of Visit: Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: jaMoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency O Other O Denied Access
0
Date of Visit: 3t Arrival Time: ' lUQ Departure Time: County: '=5� Region: 11�ed
Farm Name: Owner Email:
Owner Name: )�iy�, r� Phone:
Mailing Address:
Physical Address:
Facility Contact: f%( ,/(- ��a22 Title:
OnsiteRepresentative: fi
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: Js%7 _ ,� ,—eC
Certification Number: 97,3661
Certification Number:
Longitude:
.��
till l
&&( I 1 { t
i � { �� � §
{{€ii'C
1 1 ,�I i j�'�q77ii~
l'3tx�� !�}
�• 41 i�1
�9 14
Sj i
d,�3,� �
IS,€il.
�i"t
to 1'j �e�ti
II
T��t.���,i, h.+, -
�4'.��.
Wean to Finish
Layer
F'
Dairy Cow
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
INS.
Dry Cow
Farrow to Feeder
I
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Giltsl
Non -Layers
Beef Feeder
j
Boars
jPullets
Beef Brood Cow
Turkeys
rani �iihYti'
`'+I iE
Turkey PouIts
Other
ti.
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?
❑ Yes eNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes []No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
12No
❑ NA
❑ NE
❑ Yes
EffNo
❑ 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 —Mo
❑ 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): L T
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes eNo
❑ 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 ,f No
❑ 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 e No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes 2�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
❑ 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 �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):
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
EJ-No
❑ NA
❑ NE
❑ Yes
ETNo
❑ NA
❑ NE
❑ Yes
ErNo
❑ NA
❑ NE
❑ Yes
&No
❑ NA
❑ NE
❑ Yes
L"No
❑ NA
❑ NE
i
❑ Yes
eNo
❑ NA
❑ NE
❑ Yes
[]-No
❑ NA
❑ NE
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ®"Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield .®'T20 Minute Inspections []Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes dNo
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

Facili Number: U Date of inspection: /(c d y
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [�fNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ErNo ❑ 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? ❑ Yes [J-No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes r--INo ❑ NA ❑ NE
Other Issues f
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [2'INO ❑ 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? ❑ Yes _E:],No ❑ NA ❑ NE
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 [:]Yes O'No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[:]Yes
V No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
VNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone:
Date:
Page 3 of 3
511212020