310386_2018 Structure evaluation_20181009

Division of Water Resources
Facility Number F - Division of Soil and Water Conservation
0 Other Agenc
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint�,—�-F��olllyloow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time:
r Departure Time: IT^ County: Region:
Farm Name: tOI(1!/QIry L(4U41- C1
�r(3T✓O�L — Owner Email:
Owner Name: (W 'f 1 a Ire f3'r fj 0'C'—'— Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish La er Dairy Cow
Wean to Feeder I INon-Layer I 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 Lavers Beef Stocker
Gilts Non-Lavers Beef Feeder
Boars Pullets Beef Brood Cow
Turkeys
Other Turkey Pouets
Other Other
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes 2<0 ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes EJ'NS ❑ 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) ❑ Yes V00
NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 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: 3 ( - 3 j � jDate of Inspection: O -
Waste Collection&Treatment
4.Is storage capacity(structural plus storm storage plus heavy rainfall)less than adequate? 5Ye 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): / li/ </
5.Are there any immediate threats to theintegrity 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 �❑ 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 eat,notify DWR
7.Do any of the structures need maintenance or improvement? ❑ Yes N NA ❑ NE
8.Do any of the structures lack adequate markers as required by the permit? ❑ Yes No A ❑ 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 El Yes o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10.Are there any required buffers,setbacks,or compliance alternatives that need ❑ Yes ❑ No ❑ NA ILJ<
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): Q r 6t Cy 9
13. Soil Type(s):
14.Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA NE
Lo
15.Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA LLI N
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
18.Is there a lack of properly operating waste application equipment? ❑ Yes ❑ No ❑ NA V�;
Renuired Records&Documents
19.Did the facility fail to have the Certificate of Coverage&Permit readily available? ❑ Yes ❑ No ❑ NA
20.Does the facility fail to have all components of the CAWMP readily available?If yes,check ❑ Yes ❑ No ❑ NA eNE
the appropriate box.
❑WUP El Checklists ❑Design ❑Maps ❑Lease Agreements ❑Other:
21.Does record keeping need improvement?If yes,check the appropriate box below. ❑ Yes ❑ No ❑ NA EfNE
❑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 Surve ,
22.Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA
23.If selected,did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE
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F3xili Number: - Date of Inspection: - -
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA
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 PDA 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 provide documentation of an actively certified operator in charge? ❑ Yes ❑ No ❑ NA
27.Did the facility fail to secure a phosphorus loss assessments(PLAT)certification? ❑ Yes ❑ No ❑ NA
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 ❑ 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 ❑ 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 ❑ No ❑ 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? ❑ Yes ❑ No ❑ NA ❑ NE
Comments(refer to question#): Explain any YES answers and/or any additional recommendations or any other comments.'
Use drawings of facility to better explain situations(use additional pages as necessary).
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Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature: /344 S� Tbwe-11 C.9 1/ al 2M - Z3l-/22-O Date:
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