830008_routine_20240718

Ii ype or v ism y t-ompuance inspection V Vperation Keview O Structure Evaluation U 'Technical Assistance I
Reason for Visit: gRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 2 Arrival Time: Departure p County: De Time: � -
Farm Name: �jj (, �j Owner Email:
Owner Name: �' r Cj I C Phone:
Mailing Address:
Physical Address:
Facility Contact: ) , ,�1�,Uj l�1\ Title:' Cj,� Phone•
Onsite Representative: �ii� Integrator: q&"1-r
Certified Operator: f Vc�� Certification Number:
Back-up Operator:
Location of Farm:
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Latitude:
Certification Number:
Longitude:
t'y
Design Current
v
Wet Poultry ,
Cap' acity {Pop
Cattle
Layer
Dairy Cow
_'=
Non -Layer
Dairy Calf
Dairy Heifer
4.
Design Current, ,
Dry Cow
Dry Poultry ¢°„aACapacity°
'Pop.
Non -Dairy
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Region: P
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
N No
[--INA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
K] 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
N] No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[�] No
❑ NA
0 NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 511212020 Continued

Facility Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes q No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes Q,No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: I
Spillway?: NO
Designed Freeboard (in): I
Observed Freeboard (in): 1 5
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ 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
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
NNo
❑ NA.
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[qNo
❑ 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
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes N No ❑ 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): % 05H
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.
❑ Yes
rR"'No
0 NA
❑ NE
❑ Yes
[R No
❑ NA
❑ NE
❑ Yes
\ No
❑ NA
❑ NE
❑ Yes NK, No ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
❑ Yes Q No ❑ NA ❑ NE
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ELNo
❑ 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 tg No
❑ NA 0 NE
❑ Weather Code
❑ Sludge Survey
❑ NA ONE
❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes \ No
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?
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 CAWNIP?
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
[—]Yes �No ❑ NA ❑ NE
❑ Yes E�No ❑ NA ❑ NE
❑ Yes IX No ❑ NA ❑ NE
❑ Yes N No ❑ NA ❑ NE
❑ Yes N No ❑ NA . ❑ NE
❑ Yes
N No
❑ NA
❑ NE
❑ Yes
[N No
❑ NA
❑ NE
❑ Yes
N No
❑ NA
❑ NE
❑ Yes
N] No
❑ NA
❑ NE
Ivu141l1A,4ll L�l,��41.�.14V yuc�lly lu rr�. 1..apj' 14 4"y _a 1.0-415vr,c43 auuivl ally auum"1141`€1m; A11111unuquUm Vl a 1y ut11G[ (:V111"1t;HtN
Usezdrawings.oF acility,to better°ekolainsituations (use additional DAQes as necessary).
-f�ivm loo�� goa(
Rul,ewed *�
�a Nfi►1
Calibtc�'DN
Slvd9e III ocvl29)
3111)29' 11401
Reviewer/Inspector Name: Ka- lhnt- , f\0+_
Reviewer/Inspector Signature: KQ bri -fe r ot
Page 3 of 3
Phone: q I Cl . bC1(.v ' —1I o
Date:
IS/12/2020