040036_INSPECTIONS_20171231

Type of Visit: • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:f Ir 7 � Arrival Time: 2 i/ Departure Time:©�. County: „�,f Region:
Farm Name: )1� 94_ ! alt��, Owner Email:
Owner Name: FOCI L -Eln wi LLC Phone:
Mailing Address:
Physical Address: J
Facility Contact: raj ��'�'✓�eTitle: Phone:
Onsite Representative: l Z S �� Sz-✓ Integrator:
Certified Operator: �%t-L�S� Certification Number: 7.7-1490
—149
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Dischar2es 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)
❑ Yes M No ❑ NA E] NE
C] Yes ❑ No
❑ Yes ❑ No
NA ❑ NE
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 K] NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ® No E] NA El NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes T[) No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 1/42015 Continued
Design �l C►urrent
Design
Current
Design Current
Swine'
Capacity Pop." Wet Poalt .
ry
Ca aci
p ty
Po p. ,, ''
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow -7co 5 -lo
Wean to Feeder
= Non -Layer
Dairy Calf
Feeder to Finish
""
Dairy Heifer
Farrow to Wean
Design
Carrent
Dry Cow
Farrow to Feeder
D , ` Poul
Ca `aci
Po" .
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
TurksPoults�
Other
Other
Dischar2es 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)
❑ Yes M No ❑ NA E] NE
C] Yes ❑ No
❑ Yes ❑ No
NA ❑ NE
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 K] NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ® No E] NA El NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes T[) No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 1/42015 Continued

6acili -dumber.- Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 1�d No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No W 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® No [jNA [—]NE
(i.e., large trees, severe erosion, seepage, etc.) T`
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes }yam No [:]NA ❑ NE
waste management or closure plan? jT�`�'
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 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
[P 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?
T
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 [—I PAN > 10% or 10 lbs_ ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window E] Evidence of Wind Drift❑ Applicati n O side of Approved Area.
12. Crop Type(s): t C_K S5 E�s
r,
13. Soil Type(s): A�h
14. Do the receiving crops diher from those designated in the CAWMP?
❑ Yes
P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
f�q No
❑ NA
0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[)q No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
T No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ YesNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
2l. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [WN
El Waste Application ❑ Weekly Freeboard El Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
El Rainfall ❑ Stocking [:1 Crop Yield [:1120 Minute Inspections [:]Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [::]Yes [ No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes N
o ❑ NA [—]NE
❑ Weather Code
❑ Sludge Survey
[]NA ❑NE
No
❑ NA ❑ NE
Page 2 of 3 2/412015 Continued

[Facility -Number: - Date of Inspection: 12
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[g No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
0 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 provide documentation of an actively certified operator in charge?
❑ Yes
No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
`M No
❑ NA ❑ NE
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 Reviewerlinspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes [' No ❑ NA ❑ NE
❑ Yes �j No ❑ NA ❑ NE
❑ Yes 6� No ❑ NA ❑ NE
❑ Yes ja No ❑ NA ❑ NE
❑ Yes 1� No
❑ Yes TT`` No
❑ Yes %No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/inspector Signature:CA � i �� "'-'" Date: rl 7
Page 3 of 3 2/4/2015

type of Visit: ® Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: * Routine 0 Complaint Q Follow-up Q Referral Q Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County:A
Farm Name: Ka a, Owner Email:
Owner Name: Wer {""nS LL G Phone:
Mailing Address:
Physical Address:
Facility Contact: 2cclS Q—r Title:
It
Onsite Representative: t
Certified Operator: 3D5 Pc�r
Phone:
Integrator: P Z& Q
Certification Number: 1 � [ W 6 3
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
❑ No
Design
Current
Design Current
Swine Capacity. Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pap.
Wean to Finish
"KIDairy Cow UO
Wean to Feeder
Non-LMer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Desiga
Current
Dry Cow
Farrow to Feeder
D . P,oal
Ca aci
P,o P.
Non -Da'
Farrow to Finish
Lavers
Beef Stocker
Gilts
Non -Lavers
Beef Feeder
Boars
jPullets
r Beef Brood Cow
Turkeys
aQther
Turkey Poults
Other
Other
Discharees 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 ❑ No NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No NA E]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?
Page I of 3
[:]Yes
❑ No
[:]Yes
No
❑ Yes
tP No
�NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
21412014 Continued

Facility Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No D�7NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: _
Spillway?:
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1p No
Designed Freeboard (in):
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Observed Freeboard (in): N
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
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.)
I
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
No ❑ NA
0
❑ NE
waste management or closure plan?
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
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
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)
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
9. Does any part of the waste management system other than the waste structures require ❑ Yes O 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 P 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 Cr p i dow ❑ E enc o Windd Drift ❑ Application Outside otApproved, la,12. Crop Type(s):[[[/ r�JQSf\
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1p No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[N No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes'�n1
No
"
❑ NA
❑ NE
acres determination?
I
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
R_enuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes[�
No
❑ 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®
No
❑ NA
❑ NE
❑ Waste Application El Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Tr
sfers
❑ 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
I No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[Z No
❑ NA
❑ NE
Page 2 of 3
214/2014 Continued

Facili Nu ber: - Date of Inspection: k
24f Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 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? [] Yes
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes
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 file drains exist at the facility? if yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
No ❑ NA ❑ NE
No ❑ NA ❑ NE
o ❑ NA ❑ NE
[:]Yes No ❑ NA ❑ NE
❑ Yes �To [:]NA E] NE
❑ Yes 0 No ❑ NA ❑ NE
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;andfor any additional recommendations or any, other comments..,
Use Brawings of facility .*better explain: situations use additional pales as necessary).'
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
AM
Phone:
Date: I
214!1014

Type of Visit: 40 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 4 Z 13 Arrival Time:1 Departure Time: :2 = � County-AA&tu
Farm Name: rlA`F-� C� �Cl;�( MS`r'Owner Email:
t r� _
Owner Name: W� t �Q t�r'Wl S Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: t� SOSn t.�.rSp-tr Integrator:
Phone:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Region: );`O
Discharges and Stream lmnacts
1. Is any discharge observed from any part of the operation?
[—]Yes
❑No
❑ NA
M NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
Design Current
Durrenapacity
❑ Yes
[]No
❑ NA
® NE
P p.'m'
Wet Po
M
Capacity
Pop.
@attle
Capacity Pop.
Wean to Finish
sF
Layer
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
Dairy Cow
700 0.
Wean to Feeder
® NE
Non -Layer
❑ Yes
[]No
Dairy Calf
® NE
Feeder to Finish
❑ Yes
❑ No
❑ NA
[SJNE
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D Poul
Ga aci
l;o .
Non -Da'
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
113eef Brood Caw
Turkeys
her,
Turkey Poults
Other
Other
Discharges and Stream lmnacts
1. Is any discharge observed from any part of the operation?
[—]Yes
❑No
❑ NA
M 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 DWQ)
[:]Yes
❑ No
❑ NA
q 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 DWQ)
[:]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
[SJNE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facili Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No ❑ NA
NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ No ❑ NA
(Sad 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
❑ No ❑ NA
[P NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ 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?
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 ❑ No ❑ NA ® NE
❑ Yes ❑ No ❑ NA ONE
❑ Yes ❑ No 0 NA [n NE
[—]Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
❑ NA NE
❑ 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 pages as necessary).
AwCogoo36
U�as�e i�a►-� - �`'i
net da,�ri _G_r f 1 , X+ ska rPS la -,d
CA-W50V 33) -same. owner,
cL ff f' CA4, b
-�t rm S S ��i �yi-►dey f ori 5Wlu c +,`a �-, - e s 4 -,�,,W `7. s%
'P°`AV�
Corm?
Reviewer/Inspector Name: _ 3P�1 `� A i" l4�_ _
Reviewer/Inspector Signature: �X u�Jl Vv1(C1�
Page 3 of 3
Phone: ?1D --(33-3%V
Date: el 111413
2/4/2011

!Facility Number: If - Date of Inspection. L 43
❑ Yes
❑ No
❑ NA
r5M NE
Waste Collection & Treatment
❑ Yes
❑ No
❑ NA
42 NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
E8 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
❑ NA
Identifier:
the appropriate box.
Spillway?:
❑WUP ED Checklists ❑ Design ❑ Maps ❑ Lease Agreements
[]Other:
Designed Freeboard (in):
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
Observed Freeboard (in): fA
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather
Code
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.)
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
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?
T
i
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
❑ NA
[�] NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NA
nR NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
T
9. Does any part of the waste management system other than the waste structures require
[] Yes
❑ No
❑ NA
P NE
maintenance or improvement?
Waste AvRlication
10. Are there any required buffers, setbacks, or compliance alternatives that need
[3 Yes
❑ No
❑ NA
23 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 F-1Evidenceof Wind Drift ❑1 Application Outside of Approved Area
12. Crop Type(s): GS- 6l '�S ( WTt4 �a l ti 55 ` ' ls 4_B X C �
13. Soil Type(s): 9uyo�1 f
� 1
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 ❑ No ❑ NA [H] NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA [�g NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
r5M NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
42 NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
❑WUP ED Checklists ❑ Design ❑ Maps ❑ Lease Agreements
[]Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ 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
❑ No
❑ NA
`" NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
W NE
Page 2 of 3
2/412011 Continued