820200_routine_20241016

Division of Water Resources
Facility Number /u Q Division of Soil and Water Conservation
0 Other"Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
RISA
Reason for Visit: W, Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: () j21�j Arrival Time: rej Departure Time: County:Cj Region:
Farm Name: 2'1bmccu l Iq` I - I ry Owner Email:
Owner Name: Ga m-e Phone:
Mailing Address:
Physical Address:
Facility Contact: I mccu i i-P)n Title:
Onsite Representative: Sg 1 1 1 e
Certified Operator: C,�,Q Me
Back-up Operator:
Location of Farm:
"Swine
Latitude:
Phone: Integrator: P nN qe,
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. .° Wet Poultry 'Capacity Pop.
Layer
Non -Layer
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Design Current
Dry Poultry Canacitv Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Stricture ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes
\1 No
❑ NA
❑ NE
❑ Yes] No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes LV 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
'q No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
s, No
❑ NA
❑ NE
Page I of 3 511212020 Continued

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Facility Number: I jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes N No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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 N No ❑ NA ❑ NE
❑ Yes V No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes "'N No ❑ NA ❑ NE
❑ Yes b No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes E� No
❑ Yes N No
❑ Yes ' No
❑NA ONE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.,
Use drawings of facility to better explain situations (use additional valzes as necessarv�).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone:
Date:
Page 3 of 3
511212020