820208_Routine Inspection_20240730 (2)

for Visit:
Review
O Follow-up Q Referral 0 Emergency 0 Other 0 Denied Access
i
Date of Visit: U Arrival Time: 2Ci Departure Time: County: �7
Farm Name: F m 94ja Owner Email:
Owner Name: .7�_ek2� 41_Q/ Phone:
Mailing Address:
Physical Address:
2
Facility Contact: Title:
Onsite Representative: `
Certified Operator: / 7vyL hk_ z—
Back-up Operator:
Location of Farm:
Phone:
Region: lc; C&
Integrator: ! 1L
c
Certification Number:
Certification Number:
Latitude: Longitude:
Discharges and Stream Impacts /
1. Is any discharge observed from any part of the operation? ❑Yes 2 No ❑ 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)
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 ❑ No ❑ NA ❑ NE
❑ Yes,,ffNo ❑ NA ❑ NE
❑ Yesi] No ❑ NA ❑ NE
Page I of 3 511212020 Continued

Facility Number: VcT - . Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ZNo
❑ 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 '2L 3
Spillway?:
_� c c C
Designed Freeboard (in): �/ 1 /
Observed Freeboard (in): 3.2- -2� 30
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
allo
❑ 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?
2 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
,[�No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are
&No
there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ NA ❑ NE
maintenance or improvement?
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): (yu� Y�Civr�c ii/ C1S, [�Ly Cc77 CB ✓ �o�f(lZc r�
13. Soil Type(s): oU O;i
r
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.
❑ Yes
Yes
[—]Yes
allo
❑ No
❑'No
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
[:]Yes .2 No ❑ NA ❑ NE
[:]Yes ,fNo ❑ NA ❑ NE
❑ Yes / ff No ❑ NA ❑ NE
❑ Yes [D/No ❑ NA ❑ NE
❑WUP []Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes -ffNo
❑ 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 E] No
❑ Yes /❑' No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Pose 2 of 3 511212020 Continued

Facility Number: O Date of Inspection: p
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ETNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ,[Er —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: �% 'f l}({/r 2(1�(Jy� Aj-13 i//
aaaS'
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ es/ No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes f�'No ❑ NA ❑ NE
Other Issues j`
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ETNo ❑ 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
a No
❑ 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
ZNo
❑ 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
[/7No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
� No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑iNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
ZNo
❑ NA ❑ NE
/44 c24_& J
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
9)
Phone:
Date: % l 36/a((
511212020

raauty No. 2I —2o g Time In Time Out
Farm Name �,r2
Owner Integratc.,
Site Raj.
Operator No.
Back-up
No.
HOC Circle: General or NPDES
FREEBOAtcu: uesign
Observed
Crop Yield
Rain Gauge
Soil Test 9 ;- Wettable Acres
Weekly Freeboard Daily Rainfall
SpraylFreeboar Drop
Weather Codes 120 min Inspections
Waste Analysis;
Date Nitrogen (N)
Data
/C�%//
Sludge Survey __xf&a _j4 7���
"
CalibrationlGPM Aa2AL ;76.;
Waste Transfers
Rain Breaker
PLAT
i
1-in Inspections
Date Nitrogen (N)