310445_Compliance Evaluation Inspection_20231012

Facility Number = qT
for Visit: eYlFoutine 0
tlDivision of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Operation
0 Referral
Evaluation
Other 0 Denied Access
Date of Visit: yArrival Time: �� I Departure Time: County:
Farm Name: QM h I t I/l llf�� d 141 Owner Email:
Owner Name:
/y�
r G . I t I1 tti' Phone:
40
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: T6,1,4ke, AVf—,
Certified Operator: l�{�t
Back-up Operator:
Location of Farm:
Swine
to I
can to I
Feederto
Farrow to
Farrow to
Other
Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer I
� Non-Layer
Poults
Design Current
Region: ��
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
� /
o ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No ❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No ❑ NA
❑ NE
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)
❑ Yes
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
WA ❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3
511212020 Continuer(

Facility Number: Date of Inspection: d
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3
Identifier: L Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes No ❑ NA ❑ NE
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 I31Ve ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes E3-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 No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes &<o_ ❑ 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
M No
❑ NA
❑ NE
❑ Yes
(!�No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
�o
❑ NA
❑ NE
❑ Yes D_� <o❑ NA ❑ NE
❑ Yes �o ❑ NA ❑ NE
❑ Yes E?No ❑ NA ❑ NE
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes a<
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[—]Yes E:j7do
❑ Yes [�j4o
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA [3 NE
❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facilit Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes %l(lo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes C2�No ❑ 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 E;_Ne- ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
Eg—M<
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
�
C3 o
❑ 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
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
E�rNo ❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�o NA
❑ NE
33. Did the Reviewer Inspector fail to discuss review/inspection with an on -site representative?
❑Yes
Io Q NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No ❑ 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).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: `(tb �olyQYj7'1
Date: 16 .?.'
511212020