820634_Routine Inspection_20240821

Date of Visit: Arrival Time: J,,C Departure Time: :cl/ County
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Farm Name: ✓�i//?y�y�q /opp r� Owner Email:
Owner Name:v/iviiry/ A� Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Region:
Integrator: AQM
n,
Certification Number: gD 77%3
Certification Number:
Longitude:
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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 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 PI-Ro ❑ NA ❑ NE
[:]Yes [:]No ❑ NA ❑ NE
[:]Yes [—]No ❑ NA ❑ NE
[—]Yes
[:]No
❑ NA
❑ NE
❑ Yes
f!�No
❑ NA
❑ NE
❑ Yes
Q No
❑ NA
❑ NE
Page I of 3 511212020 Continued

Facilit Number: 12 3q Date of Inspection: ,;F
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,E5No ❑ 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 P'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 ONo ❑ 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 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?
10
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes ONo ❑ 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?
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.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes gNo
❑ Yes XJD No
❑ Yes E�fNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes OfNo ❑ NA ❑ NE
❑ Yes P! No ❑ NA ❑ NE
❑ Yes P71 No
❑ Yes ,rNo
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 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 o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ETNo
Page 2 of 3
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
511212020 Continued

Facility Number: q,2 - Date of Ins ection: of
24. Did the facility fail to calibrate waste application equipment as required by the permit?
Yes ..O-�Io
NA
NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
Ej Yes ,�?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 -fl No
NA
NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Yes �No
NA
Ej NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
El Yes .2)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?
Yes -EE['�o
NA
NE
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
Yes �o
NA
NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Yes ETNo
NA
NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El Yes [i]'No
NA
O NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
Yes E5`&o
NA
NE
34. Does the facility require a follow-up visit by the same agency?
Yes , E3 No
NA
0 NE
a
Reviewer/Inspector Name: %Q/? Ae6&5oo
Phone:
Reviewer/Inspector Signature:
i
Date: C!d
Page 3 of 3
511212020

rac ury No. _ �3Y Time In
Farm Name
Time Out Daia
Ci//' ,�
Owner Integrato'
Operator
Back-up _
HOC
FREEBOARD: Design
Observed
Crop Yield
Circle: General
Rain Gauge �/
Soil Test tea/ Wettable Acres
Weekly Freeboard Daily Rainfall
Spray/Freeboard Drop
Weather Codes
120 min Inspections
Waste Analysis:
Date Nitrogen(N)
�13/aV /01
Site Rep
No.
No._
or NPDES
Sludge Survey
Calibration/GPM pe�
Waste Transfers
Rain Breaker
PLAT
1-in Inspections
Date Nitrogen (N)
/6 3 d )-3 r !1,9