800017_Inspection_20240919

ivisioa of Water Resources i
Facility Number-'-, - 0 Division of Soil and Water Conservation
Q Other Agency
Type of Visit: Compliance Inspection ® Operation Review ®Structure Evaluation ®Technical Assistance
Reason for Visit: b Routine ®Complaint ®Follow-up ®Referral ®Emergency ®Other ®Denied Access
Date of Visit: ;-` ` Arrival Time: `t ` Departure Time: = County g Region
Farm Name: ! to Owner Email:
Owner Name: g ` e Phone: ( '
Mailing Address:
Physical Address: t '.
Facility Contact: Title: Phone:
Onsite Representative: Integrator:
Certified Operator: �? t rf i 5ta Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current Design Current Desigp Current
Swine Capacity Pap. Wet Poultry Capacity Pop. Cattle Gapaci Iap
Wean to Finish_ Layer Dairy Cow }
Wean to Feeder Non-Layer Dairy Calf
Feeder to Finish Dairy Heifer
Farrow to Wean Design Current Dry Cow
Farrow to Feeder Dry Poultry Capacity, Pop. Non-Dairy
Farrow to Finish Layers _ Beef Stocker
Gilts Non-Layers Beef Feeder
Boars Pullets Beef Brood Cow
Turkeys
Other Turkey Pouets
Other
Discharges and Stream Impacts
1.Is any discharge observed from any part of the operation? ® Yes � No ® NA ® NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes allo ❑ NA ❑ NE
b. Did the discharge reach waters of the State?(If yes,notify DWR) ❑ Yes Lo 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) ❑ Yes No ❑NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? Yes No ❑ NA ❑ NE
3.Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑NA ❑ NE
of the State other than from a discharge?
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Facility Number: Date of Inspection: Iql �
Waste Collection&Treatment
4. Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? ❑ Yes [ No ❑ 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): 4
5. Are there a immediate threats to the integrity of any of the structures observed? Yes ® No ❑ NA ® NE
(i.e.,larg ees,severe erosion,seepage,etc.) t t 1 1
6.Are there structures on-site which are not properly addressed and/or managed through a Yes ® No ® NA ❑ NE
waste management or closure plan? i
t
If any of questions 4-6 were answered yes,and the situation poses an immediate public health or environmental threat,notify DWR
Do any of the structures need maintenance or improvement? JN 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 there any required buffers,setbacks,or compliance alternatives that need ❑ Yes ] No ® 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 ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14.Do the receiving craps differ from those designated in the AWMP? ® Yes ❑ No ❑ NA NE
15. Does the receiving crop and/or land application site need improvement? ® Yes M No ❑ NA ❑ NE
16.Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ® No NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Required Records&Documents
cm
Did the facility fail to have the Certificate of Coverage&Permit readily available Yes ❑ No ❑ NA ❑ NE
w:
Does the facility fail to have all components of th6 CA P readily available? _, k agyes ❑ NA ❑ NE
th :a'
`❑W � ❑Cbe�klists [ esignl�❑�a�s Q ase Agreements QOther:
21.Does record keeping need improvement? es,c ec "the appropriate box below._ 'EA Yes ❑ No ❑ NA ❑NE
Waste A Beat Weekly Freeboard ❑Waste Analysis Soil Analysis ❑=W=ast�Tra^�f � , Weather Code
Rainfall c n� Crop Yield Q-128aM u�te-Tnspections [Monthly and 1"Rainfall Inspections �SI%4&d Surve
22.Did the facility fail to install and maintain a rain gauge? Yes M, No ❑ NA ❑ NE
23. If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? Yes [:] No NA ❑ NE
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l)Facility Number: PiLf) f Inspection:
24.Did the facility fail to calibrate waste application/equipment as required by the permit?
Yes No E] NA E] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes,check E] Yes E] No NA E] NE
the appropriate box(es)below.
E]Failure to complete annual sludge survey Ej Failure to develop a POA for sludge levels
F-1 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? E] Yes No F-1 NA F-1 NE
27. Did the facility fail to secure a phosphorus loss assessments(PLAT)certification? E] Yes E] No NA E] NE
,her Issues
her
Issues
f� NA F-1 NE
,18 Did the facility fail to properly dispose of dead animals with 24 hours and/or document Yes E] No F
\'f�land 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? Ej Yes No E] NA E]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 E] 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. F-1 Yes E] No NNA E] NE
E] Application Field ❑ Lagoon/Storage Pond E] Other:
Were any additional problems noted which cause non-compliance of the permit or CAWMP? y V es E] No E] NA F-1 NE 11
33.Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? F-1 Yes M No F-1 NA F-1 NE
34. Does the facility require a follow-up visit by the same agency? r'j Yes jFa No E] NA E] NE
Coruineilu(refer to, 47S#64' any YES"answers,and/or away,additional recarnm n atior sir and other eonidaents.
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Reviewer/Inspector Name: Phone:
6V _14201�3L
Reviewer/Inspector Signature: Date: 'r 21
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