820407_routine_20240924

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Reason for Visit: (DICoutine 0 Complaint. 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: [ Arrival Time: t/ Departure Time: ,' County: Fes- Region:
Farm Name: �j� �I Owner Email:
Owner Name: j ,-� ,f�cy/yr� r �,,, G, Phone:
Mailing Address:
Physical Address:
Facility Contact: �7- ?zZ Title: 4.,,
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:3�
Certification Number:
Certification Number:
Longitude:
Design Current
Design Current'-
Design Current
r Swme ° Capacity pop
Wct`Poultry
Capacity .;>'op
Cattle Capacity Pop
�..
Wean to Finish
'
Layer
-,�-w
Dairy -Cow
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish
c
Dairy Heifer
Farrow to Wean
,
1Desieh Current° ,
Dry Cow
Farrow to Feeder
Dry Poultry
Ca acity. ; .Po ".'
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
t tQther� , ,
Turkey Poults
Other
a
e.
a
,
W b R
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?
❑ Yes ❑-N'o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[:]No
❑ NA
❑ NE
❑ Yes
[�No
❑ NA
❑ NE
❑ Yes
[/No
❑ NA
❑ NE
Page 1 of 3
511212020 Continued

Facility Number: jDate of Inspection:
' I
Waste Collection & Treatment
N
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
E—]
❑ 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):<�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[]'Ko
❑ 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
[3 1Vo
❑ 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?
❑ Yes
[ o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Q-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 there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[a" No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E]-<o ❑ 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
l ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):��^n�,,ti
13. Soil Type(s): Inz / /�/"//-2--
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ONo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [f N ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes E:(No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes �io ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate 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
[3No
❑ 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
DNo
❑ 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 E No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes To ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: 02 jDate of Inspection: —
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes ❑-1_o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes G-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?
❑ Yes E No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes O-No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ❑-No ❑ 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 [ o ❑ 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 ❑ No ❑ 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 ©-No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑-INo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes Q"F10 ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes �No ❑ NA ❑ NE
Pit —
meats (refer to questaon )-* Ex0,1a t ay YF answers andlor any additidnal< recommendations or,any otlae corm entsraw .% s.,of-,acili , to better' ex lamituataons use adhanaI" a es as necessa `<"
ty f! g )
j„ t✓+r
_r Lai
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �7 D' j �?✓ f� 1 �'(
Date:
S/12/2020