820159_Routine Inspection_20240830

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Type of Visit: ompliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: Qr outing O Complaint O Follow-up Q Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: iGi9 Departure Time: fOd County.
ounty �ta Region: /KJ
Farm Name: /� Owner Email:
Owner Name:— Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative:
o /
Certified Operator:
o,
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Phone: �`�
`� —Z
Certification Number: /(,,(,2 0j 5
Certification Number:
Longitude:
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Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish
�p,?Wr
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
I' E
'
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
�vn
Turkeys
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f°.lid' Turke Punits
FF)
( Other
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Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
2TNo
❑ 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
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
El Yes
�No
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 '[2To
❑ 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: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ENo
❑ 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 ONo
❑ 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?
❑ YesoNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes JNo
❑ 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 ONo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes P.'fNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes &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):7/n
r
13. Soil Type(s):(rjL, l�laz/�rai
14. Do the receiving crops difrom those ate in the CAWMP?
❑Yes „[allo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes Q`No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes j'No
❑ NA
❑ NE
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 ONo
❑ Yes ONo
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes jallo ❑ NA ❑ NE
❑ Yes /❑INo ❑ NA ❑ NE
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes f:J'No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
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 `f::FNo
❑ Yes �o
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3
511212020 Continued

Facility Number: Date of Inspection: a'
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes En'No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ,,ffNo ❑ 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 4a"No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ,fNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 4�:fNo ❑ 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 ,[/]'No ❑ NA ❑ NE
❑ Yes „0 No ❑ NA ❑ NE
❑ Yes JZNo ❑ NA ❑ NE
❑ Yes
eNo
❑ NA
❑ NE
❑ Yes
E�No
❑ NA
❑ NE
❑ Yes
J�No
❑ NA
❑ NE
Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature: ��� 7 � c��� Date: LZ& /DSO
Page 3 of 3 511212020

0 �5� raCillry NOTime In Time Out
. ---
Farm Name �pism� lntegrara
Owner Site Rey, ,
Operator No. _
Back-up No. _.
COC Circle: General , or NPDES
Date
Des' n
Current I Design Current 1
Feed
Farrow — Feed
Finish
#Farrow
Farrow — Finis`
Finish
Gins / Boars
—.Wean
ie
FREEBOARD: Design
Observed
Crop Yield
Rain Gauge
Soil Test y Dh Wettable Acres _
Weekly Freeboard Daily Rainfall
Spray/Freeboard Drop _
Weather Codes
120 min Inspections
Sludge Survey S /
Calibration/GPM �� 7/ a
Waste Transfers
Rain Breaker
PLAT
1-in Inspections
Waste Analysis:
Date Nitrogen (N) Date Nitrogen (N)
/G o
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