090037_Routine Inspection_20240417

Date of Visit: ' /'� pp}" �/yArrival(T� Time:
�e:� Iu/u� r�{� Departure Time: /D'do County: b1den Region: 1 1 V
Farm Name: u n':IIL I L4 �� OD V V g? i I Owner Email:
Owner Name: NO mms `NC Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
OnsiteRepresentative: oI I-eit UVeN
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes .®'No ❑ NA ❑ NE
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 ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
.DNo
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
Page I of 3 511212020 Continued

Facility Number: Cj - Date of Inspection: 7—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
_allo
❑ 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):
I q. Fo
i
Observed Freeboard (in): 35
5. Are there any immediate threats to the integrity of any of the structures observed?
—ED--Yes
j�jVo
❑ 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�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
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
'[S 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
,E!fNo
❑ 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 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 AcceptableCropWindow ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): CB M Rye
13. Soil Type(s): Linn, UnfieH
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes E 'No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? gYes TKk ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes eNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes EINo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes -RNo
❑ NA
❑ NE
Required Records & Documents
19. Did facility fail
the to have the Certificate of Coverage & Permit readily available?
❑ Yes f�No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes dNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements El other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes L.I No ❑ 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 _[� No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes eE�No ❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facili Number: 9 - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes „Q'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) below. P
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
Non -compliant sludge levels in any lagoon f
List structure(s) and date of first survey indicating non-compliance: 0. (a I I -
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ErNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes E�No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes E�rNo ❑ 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?
S;6TI.
�i mPLC sD P 3$- VrIG" �� r
q dZll 1 kAo
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes E!rNo ❑ NA ❑ NE
❑ Yes o No ❑ NA ❑ NE
❑ Yes E�No
❑ NA
❑ NE
[—]Yes E�No
❑ NA
❑ NE
❑ Yes .,EI No
❑ NA
❑ NE
❑ Yes ,E�fNo
❑ NA
❑ NE
f b
Phone: 'r/I 1 I V b -r
Date: '/ 1 12
511212020