820722_Routine Inspection_20241001

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for Visit:-AEF-Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: / a Arrival Time: / Departure Time:
Farm Name: � ij r ccoi� Owner Email:
Owner Name: 2LZ5'e� Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
R
7
r171� Title:
Region: / AEU
Phone:
Integrator: �
Certification Number: �� 9 0d
Certification Number:
Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El 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 J2-"qo NA ❑ NE
Yes ❑ No
❑ Yes Ej No
EjNA [—]NE
❑ NA ❑ NE
❑ Yes ❑ No NA Ej NE
❑ Yes zj"No NA NE
Yes ,6No ❑ NA NE
Page I of 3 511212020 Continued

Facilit Number: Date of inspection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
J2 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
Q/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
ZNo
❑ 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 environme tat threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 'E� 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 Efj`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 E]"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): (.%) /fit riyu oy(� S l4�, d5
13. Soil Type(s):
14. Do the receiving crops differ Wom those designated in the CAWMP? ❑ Yes .4E�No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? []Yes -E!�No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes E�rNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes eNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes &No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail have Certificate
to the of Coverage & Permit readily available?
❑ Yes E�No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes .fNo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑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 I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes / No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Z No ❑ NA ❑ NE
Page 2 of 3 511212020 Continued

Facility Number: jDate of Inspection:�-
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes J�' o NA NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes [2,,Ko NA Ej 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 --Ef�No NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? El Yes eNo 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:
El Yes 4D_Vo
El Yes j�'No
❑ NA NE
NA NE
Yes {2'PIo NA NE
El Yes �i Io NA NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Yes ,B" o
[] NA
NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
Yes �No
NA
NE
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Ej Yes Fa*o 0 NA NE
Phone:
Date:
Page 3 of 3 511212020

■
"cwty NO. _�
' Time In Time Out _
Farm Name
Integrazw
Owner
Site Rae, ,
Operator
No. —
Back-up
No. —
COC
Circle: General or NPDES
Dam
Design
Current Desi n Current
Wean -Feed
I Farrow -Feed
Wean- Finish
Farrow - Finish
Feed _ Finish
Gins 1 Boars
Farrow -.Wean
I I Other-,
FREEBOARD: Design
Observed
Crop Yield
Rain Gauge
Soil Test ttable Acres
Weekly Freeboard ✓ Daily Rainfall _V/_
SpraylFreeboary Drop
Weather Codes 120 min Inspections _
Waste Analysis:
D20p Nitrogen(N)
(a �
Sludge Survey 5­>
Calibration/GPM 1�l ll�A/�a `%V
Waste Transfers /5-99
Rain Breaker
PLAT
1-in Inspections
Date Nitrogen (N)
e01,.Pd-"4 is-/y/a
664-11,14le /9-/a rid;
IAY,