670087_Compliance Evaluation Inspection_20240627

Division of Water Resources
Facility Number [-6 7—� - £j % 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: �om/pHance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (9 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 6 ��.77 %f IAr�riival,�T,,,ii�me: �D Departure Time: G - County: Region:
Farm Name: 9r ,w m''U *—,5dh Owner Email:
Owner Name: &C FW rm Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
A I&s P' m
Title:
Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current
Design Current
Swine Capacity Pop.
Wet Poultry Capacity Pop.
Wean to Finish
La er
Wean to Feeder
Non —Layer
eederto Finish
Farrow to Wean
Design Current
to
Other
Discharees and Stream Imuacts
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?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes PDNo ❑ NA ❑ NE
❑ Yes ❑ No
[:]Yes [—]No
DNA ❑NE
❑ NA ❑ NE
❑ Yes
[:]No
❑ NA
❑ NE
[:]Yes
ONo
❑ NA
❑ NE
❑ Yes
OqNo
❑ NA
❑ NE
Page I of 3 511212020 Continued

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Facili Number: G9 Date of Inspection: 7
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �, No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [P No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a PDA 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:
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
M No
❑ NA
❑ NE
❑ Yes
❑ No
VQNA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes Q2 No ❑ NA ❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
[� NE
❑ Yes
[jG No
❑ NA
❑ NE
❑ Yes
Qq No
❑ NA
❑ NE
❑ Yes
[M No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Vork(� 0✓1 010sw". Ply
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
M
Phone: ��0 —?16—?Z/S
Date: Z Ztiy
511212020