780092_routine_20240821

0-Division, of Water Resources
Facility Number 0 Division of Soil and Water Conservation '<
4 0
0 Other Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 04outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I Arrival Time: Departure Time: /'1 County: Region:
Farm Name:y rr�_j y(��[ /-;' � 1��p�� Owner Email:
Owner Name: t'3 %w Phone:
Mailing Address:
Physical Address:
� o
Facility Contact: r�-� \` �� Title: a -_r; Phone:
r
Onsite Representative: �'��¢ Integrator: ,�/y/
W�Ajj
Certified Operator: �� /, /,t- ��i�� Certification Number: 92-,-6- 7 ! 7
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Other
FF
Certification Number:
Latitude:
.Design Current. Design Current
Capacity Pop.. Wet Poultry Capacity Pop.
Layer
Non -Layer
DrvPoultrV
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
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?
Longitude:
Design r Currenti
Cattle Capacity,., Pop. ,
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood C
ow
❑ Yes r o ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
E2'<o
❑ NA
❑ NE
❑ Yes
�o
❑ NA
❑ NE
Page I of 3 511212020 Continued

Facility Number: : Pf - I Date of Inspection:
Waste Collection & Treatment
No
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[D]
❑ 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): Z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[�J/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
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?
E Yes
❑ 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
❑-T4o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes []-Kfo ❑ 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 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 J ❑ Application Outside of Approved Area
12. Crop Type(s): JW__ 061er�
13. Soil Type(s): (�cr „p L y
14. Do the receiving crops differ from those designated in the CA WMP?
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.
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
[2 No
❑ NA
❑ NE
❑ Yes
[]] No
❑ NA
❑ NE
[:]Yes 0--No
❑ Yes 0_1�0
❑ Yes [/"No
[:]Yes ®No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [5 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? ❑ Yes Ej N ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Ej-'No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection: - ?-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [jio ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 2-les ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
on -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 �o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [ o ❑ NA ❑ NE
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?
❑ Yes []'go ❑ NA ❑ NE
❑ Yes ENo ❑ NA ❑ NE
❑ Yes E24o ❑ NA 0 NE
❑ Yes
2<o
❑ NA
❑ NE
❑ Yes
[r] No
❑ NA
❑ NE
❑ Yes
❑'No
❑ NA
❑ NE
[:]Yes
[] N
❑ NA
❑ NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional aaees as necessarv).
� �•��/�11� � v� � L'�j �o� �7a��� /�jfJdz GU u drC ��ro'� � ✓ �
J pail -725
Reviewer/Inspector Name:
Phone: / %2 ­5aj-n L f
Reviewer/Inspector Signature:
Page 3 of 3
Date:(-
5112/2020