090038_Routine Inspwction_20240827

of
for Visit f(YRoutine O Complaint O Follow-up O Referral O Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ,L r Departure Time: , (JU County:
Farm Name:13, ��,Ayioyq i Owner Email:
Owner Name: /"i!L✓ Oh1/��i� Phone:
Mailing Address:
Physical Address:
Facility Contact: Owtzy Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Region: / 1-eCI
%9S .2�/
ji
Wean to Finish
I Layer
Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
6- (oU
it
��
Dairy Heifer
Farrow to Wean
t
Dry Cow
Farrow to Feeder
�i
j
Non
Farrow to Finish
I
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
i
Boars
,�„ Pullets
v�
Beef Brood Cow
ti
Turkeys
fSi
"°
It Turkey PouIts
� Other
l l ii i i flit
i lti� N.I? 4
.>4_V
t Hi! Iii{ (�
11 �111ii����Et1
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
ZrNo
❑ 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 (12No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
f f '�o
❑ 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 ONo
❑ 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): ate_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes jD'"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 jD No
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes J2'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 E No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes 12'1�o
❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ED No ❑ NA ❑ NE
❑ Excessive Pending ❑ 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): (�Uc�7�ii/,/) glil/s% iol GA' r)5 — )
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.
❑WIIP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑ Yes �No
❑ Yes )2—No
❑ Yes )2j'No
❑ Yes PrNo
❑ Yes el�kNo
❑ NA
❑ NE
❑NA
❑NE
❑NA
❑NE
❑ NA
❑ NE
❑NA
❑NE
❑ Yes—E]'&o ❑ NA ❑ NE
❑ Yes 6No ❑ NA ❑ NE
❑ 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 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes Ej`No ❑ NA ❑ NE
❑ Yes -[]-IUo ❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: - Date of Inspection: 7
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes_ZNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes,,EI'No ❑ NA ❑ NE
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 �No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [�No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes )allo ❑ 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 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 JC2-No ❑ NA
❑ Yes f�No ❑ NA
7
❑ Yes I� No ❑ NA
j`
❑ Yes J�rNo ❑ NA
❑ Yes DNo ❑ NA
[—]Yes ❑'No ❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
m
Mill
Reviewer/Inspector Name: Q rlIkIllf/S50 P✓
Phone: 5l//0 935; 5;�/ D s -
Reviewer/Inspector Signature: n
Date: �/a7/17+/
Page 3 of 3
511212020

racmry No. 3 D Time In Time Out
Farm Name IntegratW _
Owner Site Rec
Operator NO
Back-up No.
COC Circle: General or NPDES
Dare
Wean -Feed
Des' n
Current Design Current
Farrow - Feed
Wean- Finish
Farrow - Firiis
Feed :Finish
Gilts / Boars
Farrow -.Wean
I I Other --
FREEBOARD: Design
Observed
Crop Yield
Rain Gauge
Soil Test
Weekly Freeboard
Spray/Freeboard Drop _
Weather Codes
Waste Analysis:
Sludge Survey
Calibration/GPM ;�U �!
Waste Transfers
Rain Breaker
Wettable Acres PLAT
- Daily Rainfall 1-in Inspections
120 min Inspections
Date Nitrogen (N)
-?31ay
_Yl3olay I,Srs
Date Nitrogen (N)
3 360 /r &o ?
'71a)(a� /.g4,