260071_routine_20240510

O'Division of Water Resources
Faell#y Number 9 , 0 Division of Soil and Water Conservation
0 Other' Agency
Type of Visit: (DIC-ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: C1'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: p- t- Arrival Time: I Departure Time: ; �� County;
Farm Name: kki� z'"'"' I �Y %� Owner Email:
Owner Name: 1�,ti�c ; ,� �/ Phone:
Mailing Address:
Physical Address:
Facility Contact: 510_s Title:
Onsite Representative: SAC.
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Region: -PKC)
Phone:
Integrator: :,��f' fi�d
Certification Number: / q_ �v (1 *;;7
Certification Number:
Design Current Design Current
Swine: Capacity Pop, Wet Poultry Capacity ` Pop.
Wean to Finish
can to Feeder r� U
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Layer
Non -Layer
Design Current
Drv'Poultry Capacity Pon. v
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
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 cone ante 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 l'op:
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes E] o ❑ NA ❑ NE
❑Yes
❑No
❑NA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
E� No
❑ NA
❑ NE
❑ Yes
E io
❑ NA
❑ NE
Page I of 3 511212020 Continued

Facility Number: jDate of Inspection: ;d—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [2-<o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes E]-No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): ;f / C�_
Observed Freeboard (in): 7_ (o
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
�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?
[ 'es
21o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[ ] 1` 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
0' o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Ej`�o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [l'<Io ❑ 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): JJ 1 "J%L! �� ?Z'—y '—Ofe l
13. Soil Type(s): ju v // _ / s �/
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
O o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
.OTio
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
�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
F,_j-No'
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[r]'No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
2-No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes [,_�No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [ErNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 2-To
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [3-'<o
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 2 To
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [2-1�o
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?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes
[D-N/o
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
0 Yes E2r<o ❑ NA ❑ NE
[:]Yes Ej_No ❑ NA ❑ NE
[:]Yes �To
[:]Yes to
❑ Yes DO
❑ NA ❑ NE
❑ NA ❑ NE
❑ 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).
Reviewer/Inspector Name: a� ��z Phone:
Reviewer/Inspector Signature: 'i Date:
Page 3 of 3 511212020