820275_Routine Inspection_20240806

Visit: ('Compliance Inspection U Operation Review 0 Structure Evaluation 0 Technical Assistance
for Visit: .E�rRoutinc 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: s Arrival Time: ,` Departure Time: ! Q County: Region: Fl e)
Farm Name: 06r?,tGp J—Z/,
Owner Name•,
Mailing Address:
Physical Address:
Facility Contact: �yt Title:
Onsite Representative:
Certified Operator: � 9-F /�e�
Back-up Operator:
Location of Farm:
Latitude:
Owner Email:
Phone:
Phone: /
Integrator: �x:GGiO
Certification Number:
Certification Number:
Longitude:
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish 2726
5T40—y
1 11
Dairy Heifer
Farrow to Wean
i
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Ilj
Layers
Beef Stocker
G His
i_,!� !,
Non -Layers
Beef Feeder
Boars
r;
Pullets
lBeef Brood Cow
Turkeys
Turke Poults
��' �RZ, z
Other
rera, ;u i,i
siiG1l
� � �i h
Dischar¢es and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes k1lNo
❑ 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 ❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes EnNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes 44�No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 511212020 Continued

Facility Number: - ,) Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes -E]�No ❑ 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):
Observed Freeboard (in):
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 2� 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 E]�No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes �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 2No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes 12'No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[—]Yes eNo
❑ 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?
❑ Yes eNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes [a"No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes ,fNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
a"No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Z f No
❑ NA
❑ NE
Repaired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
O'No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
�No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists El Design ❑Maps ❑LeaseAgreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [—]Yes ONo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ZfNo ❑ NA ❑ NE
Page 2 of 3
511212020 Continued

Facility Number: 9 - 7j
Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes FrNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes C3"N�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?
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?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes [XNo ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes L3"No ❑ NA ❑ NE
❑ Yes F,'T`No ❑ NA ❑ NE
❑ Yes fNo ❑ NA ❑ NE
❑ Yes , rNo
❑ Yes TNo
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: Flo— fJS' c�
Date: '<;74'% i
511212020

racniry No.__ ?_ 5
Farm Name _ Time In
/� � �h Time Out
Owner tntegrato+
—
Site ite Rep
Sack -up
cOC
FREEBOARD: Design
Observed
Crop Yield
Circle: General
Rain Gauge
Soil Test 56-2 Wettable Acres
Weekly Freeboard ✓ Daily Rainfall ✓
Spray/Freeboaru Drop _
Weather Codes ✓
Waste Analysis
120min Inspections
Date Nitrogen (N)
No.
No.
or NPDES
Dace
Sludge Survey Cep 5�5'
Calibratton/GPM
Waste Transfers
Rain Breaker
PLAT
1-in Inspections
Date Nitrogen (N)
"^3 / S a2