820019_Routine Inspection_20240806

Date of Visit: Arrival Time: O;uoP607 Departure Time: County:'S' Region: f
Farm Name: t ' Gc! >6-/ Owner Email:
Owner Name: _� l/fi IM �? 7 ivrtEf / v�da/CLl2&1// Phone:
Mailing Address: V V
Physical Address:
Facility Contact: —d4;i' Title:
Onsite Representative:
Certified Operator: 11 v 2 n
Back-up Operator:
Location of Farm:
Phone:
Integrator: (�A�
Certification Number:
Certification Number:
Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes EJ'lNo ❑ NA ❑ NE
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?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes e'No ❑ NA ❑ NE
❑ Yes AErNo ❑ NA ❑ NE
Page 1 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 12-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 -tNo
❑ 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 E]'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 ,Ef No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes :EI'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 In -No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes ,E]'No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes An'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) (�C3Z/h , �J�4>� � N - e YsL/
y
�AGca/7 6(X� 1 "✓f-�i L
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes ErNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes -Ef�No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes &No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes •�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes .e No
❑ NA
❑ NE
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 ❑LeaseAgreements
❑ Yes ;.e rVo ❑ NA ❑ NE
❑ Yes ❑i No ❑ NA ❑ NE
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes „Q-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 [2-No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ,E]'No ❑ NA ❑ NE
615
Page 2 of 3 511212020 Continued

Facility Number: - Date of Inspection: _-75
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EyNo
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
❑ NA ❑ NE
❑ NA ❑ NE
❑ Non -compliant sludge levels in any lagoon %
List structure(s) and date of first survey indicating non-compliance: �'f / /3/� 3
26. Did the facility fail to provide documentation of an actively certified operator in charge? [:]Yes .fE!rNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes, -'No ❑ 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?
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?
Reviewer/Inspector Name: Uwr -e
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes �i No ❑ NA ❑ NE
❑ Yes Q"&o ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes
[;]-No
❑ NA
❑ NE
❑ Yes
E jNo
❑ NA
❑ NE
❑ Yes
[2-No
❑ NA
❑ NE
Phone: (?Io
Date: F`(o(gf
511212020

racmty No. O — ( Time In
Time Out
Farm Name Fcwv,.7/
lniegrato^
Owner
Site Rat
Operator
No. _
Back-up No. _
HOC Circle: General or NPDES
FREEBOAHu: Design
Observed
Crop Yield
Rain Gauge //
Soil Test 2l i } Wettable Acres
Weekly Freeboard Daily Rainfall
Spray/Freeboar Drup
Weather Codes 120 min Inspections
Waste Analysis:
Date Nitrogen (N)
(a y /,0-7
Dare
Sludge Survey ��3C �j < Vio
Calibration/GPM
Waste Transfers
Rain Breaker
PLAT
1-in Inspections
Date Nitrogen (N)
it gl O/