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HomeMy WebLinkAbout820220_INSPECTIONS_20171231NUH I H GAHULINA Department of Environmental Qual Type of Visit: e'Compliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance Reason for Visit: e-ko-utine O Complaint O Follow-up p Referral O Emergency p Other O Denied Access Date of Visit: Arrival Time: ;/ Departure Time: County:,.- Region: .101 Farm Name: J�,..ti �� 5L �arr- Owner Email: Owner Name: �� ;A's l Sure n 1 1 _ Phone: Mailing Address: Physical Address: Facility Contact: AIzx-t`ry Title:,�,n � Phone: Onsite Representative: 5' Integrator: 'i2i�,4'rj _ a Certified Operator: Certification Number: Back-up Operator: Location of Farm: Latitude: Certification Number: Longitude: Design Current ©esrgn Current ldAlll I Design Current Swme Capacity Pop Wet;Poiltry Gapactty Pop Cattle Capacity Pop. Wean to Finish Layer Dairy Cow Wean to Feeder A. INon-Ia -er Dairy Calf Feeder to FinishE• it Dairy Heifer Farrow to Wean Design Current D Cow Farrow to Feeder ©E. P,oult Ca �ac"i Po . Non Farrow to Finish Layers Beef Stocker Gilts;,. Non -Layers . Beef Feeder Boars Pullets I Beef Brood Cow I'urke s M• Otbe urkey PoultsF Other :. Other „.z:,,��.: 3_y,. �.::..;.,��;.,. Ems,. : � �.,.: :•�° �uEE�.y:, . Discharges and Stream_ Impacts I. 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 0_N0 ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes [] No ❑ NA ❑ NE ❑ Yes ❑ No ❑ Yes MC No ❑ Yes [4 No ❑ NA ❑ NE ❑NA ❑NE ❑NA ❑NE Page I of 3 21412015 Continued F'acili Number: _ Date of inspection: Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E No a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Structure I Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) ❑ NA ❑ NE ❑ NA ❑ NE Structure 5 Structure 6 ❑ Yes Ea -No 0 NA ❑ NE 6. Are there structures on -site which are not properly addressed and/or managed through a [:]Yes gg-No ❑ 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 El -No ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [ o ❑ 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 Eg-No ❑ NA ❑ NE maintenance or improvement? Waste Apolication 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes P31-No ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? 1 f yes, check the appropriate box below. [:]Yes [ 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 ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area 12. Crop Type(s): 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes Eg-No ❑ NA ❑ NE MA 15. Does the receiving crop and/or land application site need improvement? ❑ Yes L:L-F No [] NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [allo ❑ NA ❑ NE acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? [] Yes [3-No ❑ NA ❑ NE ❑ Yes [3-No ❑ NA ❑ NE Renuired Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes allo ❑ 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 5TNo ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [�JNo ❑ Yes [ig-No ❑NA ❑NE ❑ Weather Code ❑ Sludge Survey ❑ NA ❑ NE DNA ❑NE Page 2 of 3 21412015 Continued Vacility Number: - fl Date of Ins ection: a7/ 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [2-No ' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [No 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 Callo 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes D.No 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? ❑NA ❑NE ❑ NA ❑ NE ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes C&No ❑ NA ❑ NE ❑ Yes W_No ❑ NA ❑ NE ❑ Yes 51-No ❑ NA ❑ NE ❑ Yes , o ❑ NA ❑ NE ❑ Yes �No [:]Yes [Y—No ❑ Yes Ea No ❑ NA ❑ NE ❑ NA ❑ NE ❑ NA ❑ NE Cortnura~ots (refer to quiesttoni;# Ezpfain4oyYES answers and/or any addihoaallrecommendations or any other comments:, Use drawings of facility4d;N tter ei lain, situations ase additional P ( Pages'as-necessary) . _ Reviewer/inspector Name: Phone: :�� —U-1" Reviewer/inspector Signature: Page 3 of 3 Date: 21412015 ` ivi"lion of Water Resources Facility Nutttber � - ® OO Division of Soil and Water Conservation ENK@) Other Agencyffl Type of Visit: ompli ce Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: Arrival Time: Departure Time- County: egion: Farm Name: �.ra S Owner Email: Owner Name: _ �K/ j /-j �� Phone: Mailing Address: Physical Address: Facility Contact:��� �/l i Title: Phone: Onsite Representative: �Integrator: �1`r Certified Operator: ��� Certification Number: 2?-69 Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: a� : Design Current �; #-Design Current f" Design Current Swine Ca aci Po Wet Poult Ca a i Po Ct�'. "'Ca aci _ rY P�> tY P ! ��_ � P tY Po P• Wean to Finish La er Dairy Cow Wean to Feeder 3 QJa Non -La er I I Dai Calf Feeder to Finish a _ . .: Dairy Heifer Farrow to Wean %'Design Current Dry Cow Farrow to Feeder D > P� Alt > % �= Cd acit Po . Non -Dairy Farrow to Finish Layers Beef Stocker Gilts Non -Layers I Beef Feeder Boars Pullets Beef Brood Cow Turkeys Other Other Turkey Points I 10ther 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)? ❑ Yes allo ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE 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 _Z No ❑ NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes Cg-No ❑ NA ❑ NE of the State other than from a discharge? Page I of 3 21412015 Continued Facili Number: jDate of Inspection: / 1 , Waste Collection & Treatment %i`4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes PLNo ❑ 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 allo ❑ 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 E2No ❑ 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 �No ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes S_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 Z 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 2Dlo ❑ 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): 0l ,_rmg/! 13. Soil Type(s): � 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes LEJ_�lo ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes ®.No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes Z[No ❑ NA ❑ NE acres determination? IT Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment'? ❑ Yes allo ❑ NA ❑ NE [:]Yes allo ❑ NA ❑ NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes JD 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: 2 1. Does record keeping need improvement? If yes, check the appropriate box below. D Yes Z No ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes yD No 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'? ❑ Yes P!J-No ❑ NA ❑ NE ❑ Weather Code ❑ Sludge Survey ❑ NA ❑ NE ❑ NA ❑ NE Page 2 of 3 21412015 Continued E ti FaciIiii Number: jDate of Ins ection: 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes P4-No if 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0 No 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 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes � No 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? ❑ NA ❑ NE ❑ NA ❑ NE ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes �No ❑ NA ❑ NE ❑ Yes ®No ❑ NA []NE ❑ Yes [a No ❑ NA ❑ NE ❑ Yes allo ❑ NA ❑ NE ❑ Yes allo ❑ Yes ® No ❑ Yes C?"o ❑NA ❑NE ❑NA ❑NE ❑NA ❑NE fr r any other comments. $ 101RAW5MV gs of facility to better a plate a t ahon (use additional pages as necessary), mendarions o y Reviewer/Inspector Name: Reviewer/Inspector Signatut Page 3 of 3 Phone: �-.3D Date: 21412015 Irl r i Type of Visit: QCompliance Inspection Q Operation Review Q Structure Evaluation p Technical Assistance Reason for Visit: outine O Complaint O Follow-up O Referral Q Emergency O Other O Denied Access Date of Visit: — -/b Arrival Time: � Departure Time: County:.Region: Farm Name: ', Z 5 L �`—"— Owner Name: rf !yi Mailing Address: Owner Email: Phone: Physical Address: Facility Contact: A24z'x Z t ty—e -y Title: Phone: Onsite Representative: �_ Integrator: Certified Operator: Certification Number: Back-up Operator: Location of Farm: Latitude: Certification Number: Longitude: Design Current Design Current Design Current Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pop. Wean to Finish I ILayer Dairy Cow Wean to Feeder 2WO I INon-Layer D ' Calf Feeder to Finish Dairy Heifer Farrow to Wean Dry Cow Farrow to Feeder D . P.onl Ca .aci P,o Non -Dairy Farrow to Finish Gilts Boars Layers Non -Layers Pullets Turkeys Beef Stocker Beef Feeder Beef Brood Cow Other Turkey Poults Other 1 101 10ther Discharges and Stream Im acts l . 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 ®.No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE [] Yes Q No . ❑ NA ❑ NE ❑ Yes [&No ❑ NA ❑ NE Page 1 of 3 21412014 Continued Facili Number: - p Date of inspection: —/ Waste Collection & Treatment t 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): ,1 191 Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes §4 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 &No ❑ NA ❑ NE waste management or closure plan? If any of questions 4fi 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 J�o No ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 0 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 [Z 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): Bry�y c /`fr ed 13. Soil Type(s): ,kjL)Ar7 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes allo ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? [—]Yes run 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? IT Does the facility Iack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? ❑ Yes 14 No ❑ NA ❑ NE ❑ Yes ® No ❑ NA ❑ NE Reauired 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 [allo ❑ 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 a 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 [R No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 21 No ❑ NA ❑ NE Page 2 of 3 21412014 Continued Y Facility Number: - 17 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 [2 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 P No ❑ NA ❑ 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? ❑ Yes U� 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 C' 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 [a No ❑ NA ❑ NE ❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: 32. Were any additional problems noted which cause non-compliance of the permit or CA WMP? ❑ Yes 29-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 asnecessary).' Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 Phone: �9�la y� 3 3 Date: 21412014 Type of Visit: C Kompliance Inspection O Operation Review p Structure Evaluation O Technical Assistance Reason for Visit: tine Q Complaint Q Follow-up Q Referral O Emergency O Other O Denied Access Date of Visit: / Arrival Time: 7 U Departure Time: County: Region: FJZ O JV Farm Name• f liYj � r1 � � C Owner Email: Owner Name: h r-h ` L Phone: Mailing Address: Physical Address: Facility Contact: jf f�_ J�j��r-y Title: r• Phone: If Onsite Representative: Integrator: %%l /v"_)f Certified Operator: �f.�� Certification Number: . 5p':53-g' Back-up Operator: Location of Farm: Latitude: Certification Number: Longitude: Design Current Swine Capacity Pop. Design Current . WEffiet Ponitry Capacity Pop. Cattle Dairy Cow Design Capacity Current Pop. Wean to Finish Layer Wean to Feeder / Non -La er ! Dai Calf Feeder to Finish Farrow to Wean D . IP,o_ul Ca aci P,a Dairy Heifer Dry Cow Farrow to Feeder Non-Dai Farrow to Finish Layers Beef Stocker Gilts Non -Layers Beef Feeder Boars Pullets Beef Brood Co — Other Other IML10ther Turkeys Turkey Poults 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 ❑ No ❑ 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 ❑ No ❑ NA ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [kNo ❑ 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? Page I of 3 21412014 Continued " Facility Number: jDate of Inspection: Waste Collection & Treatment 14. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 13-No ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE Structure I 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 ❑ 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 No ❑ 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 DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes Eg No ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes allo ❑ 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 n No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ER 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): W zVM UJ.' 13. Soil Type(s): _ j/9 A 14. Do the receiving crops differ from those designated in the CA WMP? ❑ Yes L&No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes Q No O 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 RNo ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes Z No ❑ NA ❑ NE Reguired Records & Documents 19_ Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes C&No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ELNo ❑ 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 allo ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [g No 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [allo ❑NA ❑NE E] Weather Code ❑ Sludge Survey ❑NA ❑NE ❑NA ONE Page 2 of 3 21412011 Continued 1:acili Number: - I Date of Inspection: 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes KNo ❑ NA ❑ NE ' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 5? 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 n No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0 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 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 Imo+ No ❑ NA ❑ NE ❑ Yes [0 No ❑ NA ❑ NE ❑ Yes Eg No ❑ NA ❑ NE ❑ Yes Dq No ❑ NA ❑ NE ❑ Yes No [:]Yes No ❑ Yes CE No ❑ NA ❑ NE ❑NA ❑NE ❑NA ❑NE Comments (refer to question�ff)Eirplain any=YES answers and/or any additional recommendations or any other cornments Use,drawings'of facility to better expEam'situations (use additional pages as necessary). Reviewer/Inspector Name: Reviewer/inspector Signature: Page 3 of 3 Phone: 5j z.53`'3300 Date: J-6 — 2/4/2011 $IMS UVY tah,1113 _ Diyiiion of Water Q r(J Facility Number ®- ® © Divisionrof Soil a i Water Conservation Q Other Agency Type of Visit: IS Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: 19 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: Arrival Time: Departure Time: ' 30 County: sari S Farm Name: CA M Swine �d/,Il �Af'Q f 1 Owner Email: Owner Name: M s iv �)P _ L Ix Phone: Mailing Address: Physical Address: 3% C mox Facility Contact: C i C CIO_ Title: Fbiry}-r l9h'nfl Phone: Onsite Representative: Certified Operator: hlr �j G �I � r, y -- Back-up Operator: Location of Farm: Region: Fw Integrator: + E B Certification Number: [ Certification Number: Latitude: Longitude: kg �Dest n Curren bFPgt Capactty o. Finish -Destgn;Current actty ' Pop. Wet PoultryCap1;. i,l*'t; A La er Design Current-. @attle Capacity Pop. Dai Cow Feeder Non -La er " Dai Calf Dai Heifer Finishy o Wean E ¢ Destgn�Current D Cow o Feeder D ..Poultr_Ca aci Po Non -Dairy o Finish La ers Beef Stocker -Layers Beef Feeder Boars Pullets Beef Brood Cow d Turkeys Other*` TurkeyPoults Other Other 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 DWQ) 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) 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 ❑ NA ❑ NE ❑ Yes ❑ No [:]NA ❑ NE [:]Yes [—]No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE [:]Yes M No ❑ NA ❑ NE [:]Yes 50 No ❑ NA ❑ NE (JV9 21412011 Continued Facili I Number: -Q -ao jDate of inspection: !� Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ER 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: 0 A Spillway?: T Designed Freeboard (in):_Iq I (jvj) Observed Freeboard (in): H J 30 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes N 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 tS� No ❑ 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 DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes CR No ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes U 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 r$j No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [S No ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes [SINo ❑ 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 Wind Drift ❑ Application Outside of Approved Area nEv 12.CropType(s): Cea�1 A&' k,.r1Q YMi2 rni nV4MIOA , r' v 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes to No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes CR No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 0a No ❑ NA ❑ NE acres determination? IT Does the facility lack adequate acreage for land application? ❑ Yes C' No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes CkNo ❑ NA ❑ NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [] Yes [51 No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes CR 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 ER No ❑ NA ❑ NE ❑ 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 Survey 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 15a No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [—]No C' NA ❑ NE Page 2 of 3 21412011 Continued �Facilitq Number: a, - -0'tj f) Date of Inspection: a 24, Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes tR No ❑ NA ❑ NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 5a 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 Iagoon 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? 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: ❑ Yes 15a No ❑ NA ❑ NE ❑ Yes ❑ No [ NA ❑ NE ❑ Yes No ❑ NA ❑ NE ❑Yes R]No ❑NA ❑NE ❑Yes UNo ❑NA ❑NE ❑ Yes N No ❑ NA ❑ NE 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 1>_� 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 prefer. to:qu tion #): Explain any YES,answers and/or an gadditional recommendations or any. others omID �ts. " en Use. drawtn s -of-facility to better explain situations use additional pages a es as necessary. L fie. name, % o f G4VI"i .;4 G�u111yl 1ns��`�rp� , CMa� �o ca �a 3�-131, fro s�� lla�pQ.1 (S MAIl I oC�Q 6 )I TAdAaboy, n�-o1i el�vice-c ftl no_71 Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 0 Phone: -, qL 3—, �1 UiTl 'J Date: Q 3 21412011 Facility No. �- Farm acne Permit COC EMAWMW 1,ue AN VA5 Cq H S W L�Ip Date P-40119 OIC_ NPDES (Rain breaker PLAT Annual Cert Daily Pipe) Lagoon Name, S forspillway 1 2 3 4 5 6 7 Design Freeboard I Last Recorded in Observed freeboard Slud a Survey Date Sludge Depth ft }, ) Liquid Trt. Zone ft Ratio Sludge to Treatment Volume if> 0.45 Date out of compliance/ POA? Soil Test Date $ 1 Crop Yield �� Transfer Sheets pH Fields Wettable Acres— RAIN GAUGE Lime Needed _k)D WUP Dead box or incinerator Lime Applied Weekly Freeboard Mortality Records Cu-I `/ Zn---IZ;7- 1 in Inspections Check Lists Needs 5 (S-1<25) 120 min Insp. —� Storm Water Needs P Weather Codes pH E01111.0 RE .. .. . Z� FelliX�' Verify PHONE NUMB R and affiliations Date last WUP FRO &Q Q310b FRO or Farm Records Date last WUP at farm Lagoon # App. Hardware Top Dike Stop Pump Start Pump Conversion- Cud 3000= 108 lb/ac; Zn-I 3000= 213 Ib/ac G r Ql) O i v QF s' 91 r i ype of vnit; qp t-ompnance inspection Lj uperatton mevtew tJ Structure r vaivanon C.J tecnmcat Assistance Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency Q Other O Denied Access Date of Visit: j zo Arrival Time: O'] '� Departure Time: County: s ,S anti Region: �j r Farm Name: C1� Owner Email: Owner Name: 114 Phone: Mailing Address: Physical Address: Facility Contact: Max A±�L, Title: Phone: Onsite Renresentative: 1 1 I Integrator - Certified Operator: Certification Number: D 0 to SO Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: ,[ r Des Current � Design# ;Curreut� �"` Design Current Swine Capa ty Po Wet Poultry Capa� r p ci Pop Cattle Capacity Pop. �, _ Wean to Finish ILayer Dairy Cow Wean to Feeder j j Non -La er Dairy Calf Feeder to Finish Dairy Heifer Farrow to Wean Dry Cow Farrow to Feeder D , P,oult . Ca acit ,P,o .: Non -Dairy Farrow to Finish Layers Beef Stocker Non -Layers Beef Feeder aGilts oars Pullets Beef Brood Cow Turkeys Other T urkey Poults Other LjOther 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 DWQ) c. What is the estimated volume that reached waters of the State (gallons)? [] Yes N No ❑ NA ❑ NE ❑ Yes ❑ No [ NA ❑ NE ❑ Yes ❑ No [� NA ❑ NE d. Does the discharge bypass the waste management system? (If yes, notify DWQ) 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 ❑ No ❑ Yes [jq No ❑ Yes 99 No EnA ❑ NE ❑NA ❑NE ❑ NA ❑ NE Page I of 3 21412011 Continued Facili Number: y- 2217 Date of inspection: 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 I 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 FQ 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 ® No ❑ 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 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 ❑ 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 PD No ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [gj No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN [] PAN > 10% or lO 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 j 12. Crop Type(s): a" ( �f 4 t3:/7r - S C�' 1 �i 1/ �M • aa., t�' 0 wsezw 13. Soil Type(s): 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 ❑ 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 [P No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes P No ❑ NA ❑ NE Reauired Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes rMNo ❑ 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 ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections ❑ Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [a No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 1� No ❑ NA ❑ NE Page 2 of 21412011 Continued Facili Number: -7, Z.O Date of Inspection: I 2-0 /Z 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �K No ❑ NA ❑ NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes t&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 P No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes V] No ❑ NA ❑ NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes X 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 'V*L No ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE ❑ Yes ® No ❑ NA ❑ NE [:]Yes No ❑ Yes No ❑ Yes ® No ❑NA ❑NE ❑ NA ❑ NE ❑ 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). Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 Phone: f 3;-3AV Date: I '� 1 Z. 21412011 f ype of visit: W Compliance Inspection V Operation Review C) Structure Evaluation U Technical Assistance I Reason for Visit: 0 Routine O Complaint O Follow-up Q Referral O Emergency Q Other O Denied Access Date of Visit: 4 Arrival Time: f o�u„Departure Time: ! t /+, County: Region: Farm Name: C, "1 Vt—' 5W I Owner Email - Owner Name: 1 f` Phone: Mailing Address: Physical Address: Facility Contact: [A a* Al i Title: Onsite Representative: Certified Operator: Back-up Operator: Phone: Integrator: /�%tr.YQD�cf't Certification Number: 9 Certification Number: Location of Farm: Latitude: Longitude: Design Current Design urrent ; : - Design Current Swine Capacity Pop. Wet Poultry CapaciCty Pop ' Cattle Capacity Pop. to Finish La er Dai Cow to Feeder V / Non -La er Dai Calf r to Finish' Dairy Heifer Farrow to Wean Design Current Dry Cow Farrow to Feeder - . -� D , ,P.oult, ! C►_a aei P,o , Non -Dairy Farrow to Finish Layers Beef Stocker Gilts Non -Layers Beef Feeder Boars Pullets Beef Brood Cow WIN Ill Turkeys V Other TurkeL Poults Other Other Discharues and Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes P No ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? ❑ Yes ❑ No [P NA [] NE b. Did the discharge reach waters of the State? (if yes, notify DWQ) ❑ 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 DWQ) ❑ Yes ❑ No NA ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes (P No TCjj ❑ 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? Page 1 of 3 21412011 Continued Facili Number: - Date of inspection: j G Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [B�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): 3 ! 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes f�3 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 � No ❑ 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 DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes No [DNA ❑ NE 8. Do any of the structures lack adequate markers as required by the pen -nit? ❑ 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 FA�No [DNA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes r$No ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes fig No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN 0 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): �02slt� e S 13. Soil Type(s): A)o-r4lk- 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [)5 No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes W 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 LN No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes Arlo No ❑ NA ❑ 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 [W 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 ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" 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 ❑ NE Page 2 of 3 21412011 Continued Facility Number: -L2 Date of Inspection: 4 ZZ 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 ❑ 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 [P No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes ® No ❑ NA ❑ NE Otherlssues 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 [V No ❑ NA ❑ NE permit? (i.e., discharge, freeboard problems, over -application) 3 L Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. [:]Yes P 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 EP No ❑ NA ❑ NE Reviewer/Inspector Name: Reviewer/inspector Signature: Page 3 of 3 fro--�(33-33go r 1 zyA 21412011 Division of Water Quality iFacility Number - 22U Q Division of Soil and Water Conservation 0 Other Agency Type of Visit 0 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 ❑ Denied Access Date of Visit: Arrival Time: D:� yt„ Departure Time: p.' County: Farm Name:92 !" 1 SW l� iH Owner Email: Owner Name: 1 Phone: Mailing Address: Physical Address: Region:Eoln Facility Contact: _ l/1/y✓t�� Title: Phone No: Onsite Representative: �i Integrator: /✓Lt}LcJ GL-� Certified Operator: Operator Certification Number: 05� Back-up Operator: Back-up Certification Number: Location of Farm: Latitude: = o Longitude: E-1 o Design Current Swine Capacity Population Design Wet Poultry Capacity Current Population Cattle Design C►urrent Capacity Population ❑ Wean to Finish 1A ❑ La er ❑Dai Cow Wean to Feeder ❑ Non -La er ❑Dai Calf Feeder to Finish ❑ Farrow to Wean Dry Poultry ❑ ❑ Non -Layers ❑ Pullets u ❑ Dairy Heifer ❑ Dry Cow ❑ Non -Dairy El Beef Stocker ❑Beef Feeder ❑ Beef Brood Cow ❑ Farrow to Feeder El Farrow Farrow to Finish IIE] ❑ Gilts Boars Other ❑ Turkeys ❑ Turkey Poults Number of Structures: �=00ther ❑ Other Discharges & 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 DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (if yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ? No ❑ NA ❑ NE ❑ Yes ❑ No TNA ❑ NE ❑ Yes ❑ No L�)NA ❑ NE ❑ Yes ❑ No XaNA ❑ NE ❑ Yes No ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE Page 7 of 3 12128104 Continued Facility Number: Z Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 11P No ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No N NA ❑ NE Strijeture 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 b No ❑ NA ❑ NE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes i�g No ❑ NA ❑ NE through a 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 DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes tallo ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes n 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/improvement? 11. Is there evidence of incorrect 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 CQQr��op Window Evid e of Wind Drift El Application Outside of Area /1❑ 12. Crop type(s) l�J" C-vy -s YA, , 13. Soil type(s) NgY-4 I _ c Ai Al 14. Do the receiving crops differ from those designated in the CA WMP? ❑ Yes (O No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes No ❑ NA ❑ NE 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 Comments (refer to question #): Explain any YES answers and/or anyrcomendatonsorany other com dional pagny):Use drwings of facility to bplainsituations(tirments. IUD CWEI0- - p4grPq14- Cfe Reviewer/Inspector Name �'� T '_ Phone: /P-c67• i3o0 Reviewer/Inspector Signature: Q Date: I /D Page 2 ol.s ititoiv4 UUMIrruru Facifity Number: — Z Date of Inspection C j0 Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Ovo ❑ 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 El Checklists El Design ❑Maps ❑Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No { ❑ NA ❑ NE El Waste Application El Weekly Freeboard El Waste Analysis El Soil Analysis El Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes b No [I NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No 0 NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ;E] No ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes JgNo ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes i§ No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No [RNA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes F No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes �9 No ❑ NA ❑ NE and report the mortality rates that were higher than normal? 30. 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 31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes No Cl NA ❑ NE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 1�1 No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes bi No ❑ NA ❑ NE Page 3 of 3 12128104 Type of Visit d'mpliance Inspection 0 Operation Review .Structure Evaluation 0 Technical Assistance Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency eOtber ❑ Denied Access Date of Visit: Arrival Tiroe: ' Q Departure Time: County: Farm Name: i� Owner Email: Owner Name: 0 r) 'w rJ�/ill n kt__ /' Li phone: Mailing Address: Physical Address: jv Facility Contact: n � L �/� _ Title: Phone Onsite Representative: integrator: Certified Operator: Operator Certifca on Number: Back-up Operator: Location of Farm: Back-up Certification Number: Region: Latitude: = o = f = u Longitude: = ° Q ' Q Design nFM Design Current Design Current Swine Capacity Populatian Wet Poultry Capacity Population Cattle Capacity Population ❑ Wean to Finish ❑ La er ❑ DairyCow Wean to Feeder ❑ Non -Layer ❑ DairyCalf ❑ Feeder to Finish ❑ DairyHeifer ❑ Farrow to Wean Dry Poultry ❑ Farrow to Feeder ❑ Layers ❑ Farrow to Finish ❑ Gilts ❑ Non -Layers ❑ Pullets ❑ Boars ❑ Turke s ❑ D Cow El Non -Dairy ❑ Beef Stocker ❑ Beef Feeder ❑ Beef Brood Co Other ❑Turke Pouhs ❑ Other ❑ Other umber of Structures: I Discharges & 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 DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? [I Yes �VNo El NA ❑NE El Yes El No ❑NA El NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes ❑ No ❑ Yes (@ No ❑ NA ❑ NE ❑ Yes [Z No ❑ NA ❑ NE 12128104 Continued • Date of Inspection© Facility Number: — Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ®.No ❑ NA ❑ NE a. 1f yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: _ k2wogtt- CIR5;4 Balt Designed Freeboard (in): JV Observed Freeboard (in): Lnay 6 s.a/ 5. Are there any immediate threats to the integrity of an of the structures observed? y El Yes No ❑ NA ❑ NE (ic/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes VJ'No ❑ NA ❑ NE through a 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 DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes [N No ❑ NA ❑ NE 8. Do any of the stuctures 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 ONE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA 1�,NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA E9 NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area 12. Crop type(s) 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA eA M NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA ) NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ❑ No ❑ NA 3Q_ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes ❑ No ❑ NA P NE 18, Is there a lack of properly operating waste application equipment? ❑ Yes ❑ No ❑ NA WLNE 'ComQients refer to uestion Ex lain Iny answers and/or7any;'rec6mmendans or any other comments Use drawings.'of facility to better egplam situations (use additional;pages as necessary) p lttaLq U f JAG=�'Y! GIJa✓1 zvL f %/'�+`� $�+r ]�%� CVr r .S Reviewerllnspector NamePhone: eel 330D Reviewerllnspector Signature: Date: Facility Number: — Date of Inspection— ■ Required Records & Documents 19. Did the facility fail to have 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 V[NE the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA 0 NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code 22_ Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA El NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ® NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA ERNE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No ❑ NA ONE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ❑ No ❑ NA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No ❑ NA ® NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA 13 NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes ❑ No ❑ NA CR NE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ❑ No ❑ NA TINE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes ❑ No ❑ NA JZ NE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ No ❑ NA gl NE 33. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No ❑ NA W NE iv�A- errs `(—Cl ,Slx/ Z�1 U46bf '�r F7L9 �Yi rl w ��r Dr cv I Pr Ina li )6 e 1 tom/ r 12128104 r Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit a Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access Date of Visit: t o t (!717 Arrival T1me:Fa,_&1?7^ Departure Titne: : °vim+-` County: S S0^ Region: Farm Name: Ct J-7t�c) l n.Q►^t Owner Email: OwnerName-. Phone: Mailing Address: Physical Address: Facility Contact: �''t t�n¢� Title: Onsite Representative: r9�16_' S, C _, Certified Operator: Back-up Operator: Phone No: Integrator: U,.../J►a�, �i�37.Qt,�c, . Ltc Operator Certification Number: Back-up Certification Number: Location of Farm: Latitude: ❑ o ❑ I = u Longitude: E__1° ❑ ' ❑ u Design Current Design Current Design Current Swine Capacity Population "Wet Ponitry Capacity Population Cattle C+apacity Population ❑ Wean to Finish 10 Layer ❑Dai Cow Wean to Feeder p Non -Layer ❑Dai Calf Feeder to Finish ❑ Dairy Heifer ❑ Farrow to Wean Dry Poultry ❑ Dry Cow ❑ Farrow to Feeder ❑ Non -Dairy ❑ Farrow to Finish ❑ Layers El Beef Stocker ❑ Gilts ❑Non -La ers ❑ Beef Feeder ❑ Boars ❑ Pullets ❑ Beef Brood Co ❑ Turkeys Other ❑ Other ❑ Turkey Poults Other Number of Structures: VEI Discharees & 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? i ❑ Yes ❑ No [PNA ❑ NE b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No EP NA ❑ NE c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No [9 NA ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 'P No ❑ NA ❑ NE 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes SNo ❑ NA ❑ NE other than from a discharge? 12128104 Continued Facility Number: — Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 1P No ❑ NA ❑ NE a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No WA ❑ NE Stricture I Structu 2 Structure 3 Structure 4 Structure Structure 6 Identifier: 5 Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes K)No ❑ NA ❑ NE through a 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 DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes (@ No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes �gNo ❑ 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 [ 1 Yes 0 No ❑ NA ❑ NE maintenance or improvement? Waste Ap,_p lication 10. Are there any required buffers, setbacks, or compliance alternatives that need 0 Yes �No El NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �J No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [:]Heavy Metals (Cu, Zn, etc.) - ❑ PAN ❑ PAN > l0% or l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside off Acceptable Crop Window El Evidence o 'nd Drift ❑ Application Outts��id��e,, of Area �� 12. Crop type(s) �WJAS S !�;4 , 13. Soil type(s) 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 ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination` [] Yes i� No ❑ NA ❑ NE 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 Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. Use drawings of facility to better explain situations. (use additional pages as necessary): L Reviewer/Inspector Name Phone: Reviewer/Inspector Signature: Date: O 12/2S/04 ' C,onanueu Facility Number: Date of Inspection l I 1 ID j_Q7_J Reouired Records & Documents i 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes '3No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Z No ❑ NA ❑ NE the appropirate box. ❑ WUP ❑Checklists El Design El Maps El Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes fiDNo ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No 1P NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes lj� No ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes V,No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ®No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No ONA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ONo ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes No ❑ NA ❑ NE and report the mortality rates that were higher than normal? 30. 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 31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes [S,No ❑ NA ❑ NE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 14 No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes W No ❑ NA ❑ NE Additional Comments aadUor Drawings - Page 3 of 3 12128104 Division of Water Quality �IkCifit�ymber ` Q Division of Soil and Water Conservation 0 Other Agency i ype of visit 0 Compliance Inspection U Operation Review 0 Structure Evaluation (.)Technical Assistance. Reason for Visit Routine O Complaint 0 Follow up 0 Referral O Emergency 0 Other ❑ Denied Access Date of Visit: 10 23 06 Arrival'Time: Departure Time: �� County:Region: a --- Farm Name: �+�C, II�'`l 5W 1 r)C_ �+�' _ Owner Email: Owner Name: CW t �p� 1/e 6—a.�� _ Phone: Mailing Address: Physical Address: Facility Contact: Title: Title: Phone No: Onsite Representative: bj Integrator: : � Li'm Certified Operator: t G1 �� ('e/' Operator Certification Number: ! eOD6 Back-up Operator: Back-up Certification Number: Location of Farm: Latitude: ❑o ❑' ❑d Longitude: =o =i = N Jill Design -_ s CuYr'rent Design Curre�nyt Design Current Swine Yf' Capacity vyn' 'Population �'�'et Poultry 6 &�➢lss� W CapacityPopulation C*attle Capacity Population ❑ Wean to Finish " airy Cow airy Calf ❑ Dairy Heifer Wean to Feeder UP-15,51 3000 Feeder to Finish` ❑ Farrow to Wean Dry Poultry = El Dry Cow ❑ Farrow to Feeder — ❑ Non -Dairy ❑ Farrow to Finish ❑ Layers ❑ Non -Layers ❑ Pullets ❑ Turkeys ❑ Beef Stocker ❑ Beef Feeder ❑Beef Brood Co ❑ Gilts ❑ Boars Other ❑ Turkey Points ❑ Other El Other I Number of Structures: Discharges & 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 DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Page 1 of 3 ❑ Yes P No ❑ NA ❑ NE ❑ Yes ❑ No F NA ❑ NE ❑ Yes ❑ No P9NA ❑ NE NA ❑ NE ❑ Yes ❑ No ❑ Yes 1P No ❑ NA ❑ NE ❑ Yes N No ❑ NA ❑ NE 12128104 Continued Facility Number:j�- " Date of Inspection Z3 Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No P NA ❑ NE Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): p Observed Freeboard (in): D� j 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes f] No ❑ NA ❑ NE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes { No ❑ NA ElNE through a 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 DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes R, No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes V9No ❑ 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 [ 1 Yes Da No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ANo ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes �jNo ❑ 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 ❑l Application Outside of Area 12. Crop type(s) CM50 fY�Q " 55 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes FE No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes 17. Does the facility lack adequate acreage for land application? ❑ Yes 18. Is there a lack of properly operating waste application equipment? ❑ Yes 1P No ❑ NA ❑ NE L-Pi ❑ NA [I NE P No ❑ NA ❑ NE ONo El NA ❑NE Reviewer/Inspector Name mm k Phone: Rio �-33c� Reviewer/Inspector Signature: Date: 1 0 23 D$ Page 2 of 3 12128104 Continued Facility Number: Pg Date of Inspection ! OS Re uired Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes F No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes r] No ❑ NA ❑ NE the appropirate box. ❑ WUP ❑Checklists ❑Design El Maps El Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E9 No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes `P No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE 24_ Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes PNo ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes F3 No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ® No ❑ NA ❑ NE Outer Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes P No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes ,® No ❑ NA ❑ NE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes EgNo ❑ NA ❑ NE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes RNo ❑ NA ❑ NE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes P No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes �&No ❑ NA ❑ NE Add�rionai�Commeiutsiagd/or D wings i4 +� AL Page 3 of 3 12128104 r> Division of Water Quality Facility Number `� ��� O Division of Soil and Water Conservation O Other Agency Type of Visit 0 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 ❑ Denied Access Date of Visit: �a Oq Arrival Time: O i sQ Departure Time: 1 ; County: Region: Farm Name: c ! r l sW t�� Rwm Owner Email: Owner Name: t� ka- v- Phone: Mailing Address: Physical Address: Facility Contact:'3 Title: Phone No: tl Onsite Representative: Integrator: Certified Operator: _., ___ - Operator Certification Number: Back-up Operator, Location of Farm: Back-up Certification Number: Latitude: ❑ 0 0 ' 0 « Longitude: 0 ° = ' = Design Current -Design Current Swine Capacity Population Wet Poultry Capacity Population Cattle ❑ Wean to Finish Wean to Feeder j (( oco Feeder to Finish ❑ Farrow to Wean g ❑ Farrow to Feeder ❑ Farrow to Finish ❑ Gilts ❑ Boars Other ❑ Other ❑ Layer ❑ on -Layer Dry. Poultry ❑ Layers ❑ Non -Layers ❑ Pullets ❑ Turkeys ❑ Turkey Po Its ❑ Other Discharges & 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? Design Current Capacity Population ❑ Dairy Cow ❑ Dairy Calf ❑ Dairy Heifer ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stocker ❑ Beef Feeder ❑ Beef Brood Cowl Number of Structures: all b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system'? (if yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [�No ❑ NA ❑ NE ❑ Yes ❑ No P NA ❑ NE ❑ Yes ❑ Na A I T ❑ NE ❑ Yes ❑ No [!PNA ❑ NE ❑ Yes 1PNo ❑ NA ❑ NE ❑ Yes Pq No ❑ NA ❑ NE 12128104 Continued Facility Number: Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes In No ❑ NA ❑ NE a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No E;NA ❑ NE Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: 6 Spillway?: Designed Freeboard (in): c Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E No El NA El NE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes KNo ❑ NA ❑ NE through a 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 DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes FoNo ❑ NA ❑ NE 8. Do any of the stuctures tack adequate markers as required by the permit? ❑ Yes fQ 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 Vi No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes P No ❑ NA ❑ NE maintenance/improvement? 11, Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes RNo ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window El Evidence of Wind Drift El Application Outside of Area 12. Crop type(sCt LZ`�_( 2vry1gq lT' � C�i6 Z l a49 ) t Sw,a C"'a 1' O we-sead— 13_ Soil type(s) 4fA((rI r k_ PoA I Oob _. 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 ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes 19 No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes �9 No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes [3 No ❑ NA ❑ NE Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments. IUse drawings of facility to better explain situations. (use additional pages as necessary): Reviewer/InspectorName MaOle Phonek /O 3.1r�� ReviewerAnspector Signature: Date: / O'7 12128104 Continued Facility Number: — Date of Inspection 07 Required Records & Documents 19. Did the facility fail to have 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 appropirate box. ❑ WUP El Checklists El Design El maps El other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 19 No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [b No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes h No ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 95No ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes nNo ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes n No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes nNo ❑ NA ❑ NE Other Issues 2$_ Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes H� No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes EP No ❑ NA ❑ NE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes V No ❑ NA ❑ NE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes J'No ❑ NA ❑ NE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes T No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes *No ❑ NA ❑ NE Comments and/or Drawings: J2/28/04 Z H 2z O Type of Visit ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit @ Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access Date of Visit: ��Arrival Time: ,�dQ Departure Time: County: Farm ,Name: C £ Ak _ SWi j �e' _ Owner Email: Owner Name: C— u uJtT1e t_ _ _ f v e ✓ �. Phone: Region: Mailing Address: Za S ___ 24— 94VIlie± C �� u� nl NC— Z 8325 Physical Address: ,,.__..S 7S •Qiyla %_&Lal CG.NN _ _ 2 03_C Facility Contact: C, 1.0% V i Sk e Title: Phone No: g/'q Sbs/ 33S/tia Onsite Representative: Integrator: _.0 I' , m+um :jia jd a r Q Fete .,,5 Certified Operator: Back-up Operator: Location of Farm: Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Other ❑ Other Operator Certification Number: Back-up Certification Number: Latitude: ❑ o ❑ I ❑ Longitude: ❑ ° ❑ d ❑ Design Current Design Current Capacity Population Wet Poultry Capacity Population ❑ Laver I❑ Non -Laver Dry Poultry ❑ Layers ❑ Non -Layers ❑ Pullets ❑ Turkeys ❑ Turkey Poults ❑ Other Discharges & 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 DWQ) Design Current Cattle Capacity Population ❑ Dairy Cow ❑ Dairy Calf ❑ Dairy Neifej ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stocker ❑ Beef Feeder ❑ Beef Brood Co c. What is the estimated volume that reached waters of the State (gallons)? Number of Structures: ❑ d. Does discharge bypass the waste management system? (]fyes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [X No ❑ NA ❑ NE ❑ Yes Wo ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE 12128104 Continued Facility Number: $Z — ZZD Date of Inspection ,/ 2/ o& 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): .7 g— A 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes] No ❑ NA ❑ NE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE through a 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 DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE 8. Do any of the stuctures 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 AiRplication 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes JXNo ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect 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 l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ElApplication Outside of Area 12. Crop type(s) Re tI-- c4 d/r_ . /%JG S>4k ��i.���% �t cv n/ 015 13. Soil type(s) /Vpk 14. Do the receiving crops differ from,those designated in the CAWMP? ❑ Yes Vo ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes FNo ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination': ❑ Yes XNo ❑ NA ❑ NE 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 E�Jqo ❑ NA ❑ NE 14. lkaoNS q+?_ / r°lsff �cr'w, 4-�vi.,� rQ �� uPdn~�d w��r14vSr (b�►-3 �Vr uic,j t.el ' o V/Vt,—J o W n► e.r5L_+ �1 rr Reviewer/Inspector Name _ IBC ' '' c:43 R Gi% .. �. Phone q/D Reviewer/Inspector Signature: Date: Z 12128104 Continued Facility Number: �'Z —ZZU Date of Inspection Z Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [P 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 appropirate box. ❑ WUP El Checklists El Design ❑Maps [I Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes OfNo ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ANo ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes XNo ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes UTNo ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes �No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ja No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes 0 No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 2T No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes R] No ❑ NA ❑ NE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No [:1 NA ❑ NE If yes, contact a regional Air Quality representative immediately JW 31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes ,R] No ❑ NA ❑ NE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes A No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes JE No. ❑ NA ❑ NE Wddi4 na%Coll nts' and/or. Drawings "i � � s 12128104 I IType of Visit • Compliance Inspection O Operation Review O Lagoon Evaluation Reason for Visit • Routine O Complaint O Follow up O Emergency Notification O Other © Denied Access F_ Facility Number Date of Visit: Time: �4 v O Not erational G Below Threshold E310�ermitted Q tertified © Conditionally Certified D Registered Date Last Operated or Above Threshold: Farm Name: ....... ...... ......_�...._..,�E►3.n..__...............WW_ .� __.m...... Owner Name:.... Phone No: ....................._..... ............. ................ .. ....... Mailing Address: ............... Facility Contact: -- - --- ,......._.... -- —_. Title:Phone No: Onsite Representative:. ._....... Integrator: Certified Operator: ............ .......................... Operator Certification Number• Location of Farm: &• Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 ti Longitude ' ° 64 Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. If discharge is observed, was the conveyance man-made'? ❑ Yes ❑ No b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No c. If discharge is observed, what is the estimated flow in gaUrnin? d- Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No 2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No Waste Collection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: 1 .12 .) ............... . ................ ......_ ...... ... .......... ... &... ......... Freeboard (inches): 13 7'T 12112103 Continued Facility Number: 82 — .2 p Date of Inspection S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ❑ No closure plan? (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need mainteruancefimprovement? ❑ Yes ❑ No S. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No 9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ❑ No elevation markings? Waste Application 10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No 11. Is there evidence of over application? if yes, check the appropriate box below. ❑ Yes ❑ No ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc 12. Crop type « e9virle, see 60-12 13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No 14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No b) Does the facility need a wettable acre determination? ❑ Yes ❑ No c) 'Phis facility is pended for a wettable acre determination? ❑ Yes ❑ No 15. Does the receiving crop need improvement? ❑ Yes ❑ No 16. Is these a lack of adequate waste application equipment? ❑ Yes ❑ No Odor Issues 17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No liquid level of lagoon or storage pond with no agitation? 18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No 19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No roads, building structure, and/or public property) 20- At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ❑ No Air Quality representative immediately. {rC�l3s3;D`)' +..'!"'o"+a�y#8�5WS5`8II�/Q3 a� Ql3lntyOt�tel'�D. o" � 5.�.:-a ^�_.ri'; � .�c [3sc"�drawm s of bMTityxto:b-ftfa- ima�am� use Pad-" as 3'�'� veld C ❑ �. _. , AL 1Tske-I lnr, WPsI- /yl/- l✓2f Re f��n /n/'h5 /a Pv~,P f�% c14 Ass Ovee5pee./ c " � r Reviewer/inspector Name ''' ReviewerAnspector Signature: Date: /d - I3 - o y 1�/lz/U3 Connnum I -" Division of Sorl and Water Conservation - Operaiion".Review - 13,1)1 shin of Sod and.Water Conservation - Compliance Inspection vision of Water Quality - Coiripliance inspection D -. 0 Other 'Agency' -.Operation, Review 0 Routine 0 Complaint ® Follow-up of VWQ inspection 0 Folluw-upof DSWC review 0 Other Facility Number �,z d D.4c of Inspection Time of Inspection ! 24 hr. (hh:mm) 0 Permitted (3 Certified © Conditionally Certified 13 Registered E3 Not O erational Date Last Operated: I .. ]harm Name: .............!r:.R...C..�.--••.-� ........-.--...-.......-.- C:ounty:..,..-......__.1.`!�d� ,�t�C.............. Owner Name: ........ �...,... 4 �L�. . ..... ....... Phone No: iC.�� .......`........................................ Facility Contact: ,,,,,••,,,"•- •• -••-- title: Phrrne No: l.........................................................................................-.-....................... Alailiiig Address: ....... ., ! `9 ...'�..!/!fF'.... .....1.�..:�f.....Y�'....I— ,r...�....I...........Z..9'a 3.r ............ .......................... Onsite Representative:. /.. �.f .............. .... Integrator:.......-''.......-..-..............-.......-............. Certified Operator:...............t, .-.! 1......... 0 '- - ......................... Operator Certification Number:...--.............-....................... Location of Farm: .............................................I.-......... Latitude �' �� Longitude �• ��°� Design Current Design Current Design Current Swine Capacity Population Poultry Capacity Population Cattle Capacity Population ❑ Wean to Feeder ❑ Layer I ❑ Dairy ❑ Feeder to Finish ❑ Non -Layer ❑ Non -Dairy ❑ Farrow to Wean ❑ Farrow to Feeder JE1 Other Farrow to Finish 3 JrV Total Design Capacity ❑ Gilts ❑ Boars Total SSLW Number of Lagoons 15 1[]Subsurface Drains Present ❑Lagoon Area ❑ Spray Field Area Holding Ponds / Solid Traps 1E1 No Liquid Waste Management System Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation (If yes, notify DWQ)? Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. if discharge is observed, was the conveyance man-made*.' b. II'discharge is observed- did it reach: ❑ Surface Waters ❑ Waters of the State c- If discharge is observed, what is the estimated flow in gal/tnin? d. Does discharge bypass a lagoon system? 2. Is there evidence of past discharge from any part of the operation'! 3. Were there any adverse impacts to the waters of the State other than from a discharge? Waste Collection & Treatment G. Is storage capacity (freeboard plus storm storage) less than adequate? ma y 4 e Sp"uctt�r•� l/ Structure 2 Structure 3 Structure 4 Structure 5 Identifier: � � � y � � Al ��/i Freeboard (inches): ...................-.. .............."........ ❑ Yes K'No ❑ Yes XNo ❑ Yes AN ❑ Yes kTNo ❑ Yes jNo ❑ Yes "DNo Yes No Structure Ci 1/6/99 Continued on back Facility Number:92 Date of Inspection 5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? 8. Does any pact of the waste management system other than waste structures require maintenance/improvement? 9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum liquid level elevation markings? Waste Application 10. Are there any buffers that need maintenancehinprovemenl? 11. Is there evidence of over application? ❑ Ponding ❑ Nitrogen 12. Crop type .... J�r—_&.gf...,t-A!�� 13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? 14. Does the facility lack wettable acreage for land application? (footprint) 15. Does the receiving crop need improvement'? 16. Is there a lack of adequate waste application equipment? Required Records & Documents 17. Fail to have Certificate of Coverage & General Permit readily available? 18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ic/ WUP, checklists, design, maps, etc.) 19. Does record keeping need improvement? (ie1 irrigation, freeboard, waste analysis & soil sample reports) 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 21. Did the facility fail to have a certified operator in responsible charge? 22. Fail to notify regional DWQ of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? 24. Does facility require a follow-up visit by same agency'? [3_ IVn.violations:or deficiencies .were rioted during tiiis.visit:. Y•oti - ,, ll.reeeive no further.:. _ ..... p....t..a. ...this t..:...:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:...:.:. ....:.:.:.:.:.:.:.:.:. ❑ Yes KNo ❑ Yes KNo )KYes ❑ No ❑ Yes Xlo )(Yes ❑ No ❑ Yes C No ❑ Yes )tNo ❑ Yes $rNo 1$ Yes ❑ No ❑ Yes J+No 1pk(es )&(No ❑ Yes []No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Con, menu (refer to question #} Explain any YES answers and/or any recommendaiioiis'or any other comments.:_ ' Use drawings of facility to better explain situations. (use additional.pages as necessary) r ,-- r ,�,�K/ ��N�9 /fir �f` �%j� �,�7tvd IS pb B��Q•�,�.� � Reviewer/Inspector Name Reviewer/InspectorSignature: Date: I� �7 1/6/99 f/zo State of North Carolina Department of Erwiro--)ment, IVA Health and Natural Resources ` • • Fayetteville Regional Office .lames B. Hunt, Jr., Governor ID � H N .Jonathan B. Howes, Secretary Andrew McCall, Regional Manager DIVISION OF ENVIRONMENTAL MANAGEMENT September 14, 1995 West Farm & Livestock ATTN: Mr. E.C. West 575 Aman Dairy Road Dunn, NC 28334 SUBJECT: Compliance Inspection Sampson County Dear Mr. West: On July 26, 1995, an inspection of your animal operation was performed by the Fayetteville Regional Office (FRO). Please find enclosed a copy of our Compliance Inspection Report for your information. It is the opinion of this office that this facility is in compliance with 15A NCAC 211, Part.0217, and that Animal Waste Management is being properly performed. Should you have any questions regarding this matter, feel free to contact me at (910) 486-1541. Sincerely, Ricky Revels Environmental Technician IV Enclosure cc: Facility Compliance Group Wachovia Building, Suite 714, FayefikeAlle, North Ca►olina 28301-5043 Telephone 910-486-1541 FAX 910-486-0707 An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper -- Site Requires Immediate Attention: No Facility No. Si -- 2Z a DIVISION OF ENVIRONMENTAL MANAGEMENT ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD DATE: 3,1 Z , 1995 Time: l 8 : Z 5 Farm Name/Owner._ W c. s f L; ve s4c k / E C . Oe-S - -- Maiming Address: 57 5 Ap wv Dar Rd . Dmwa NC Z 833 County: Se-tg To" Integrator: N /A _ Phone: On Site Representative: F. C LA Je-s + Phone: (9/0 56 7 - z) 4'S o r 8`: -L 6661 Physical Address/Location: i o a 5 I/, p, - M !! s,"o Type of Operation: Swine Poultry Cattle Design Capacity: Z T00 Number of Animals on Six: DEM Certification Number: ACE DEM Certification Number: ACNEW Latitude:35 " it ' 59Longitude:2 35'S'0' Circle Yes or No Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event (approximately 1 Foot + 7 inches) (e or No Actual Freeboard: z Ft. -! -Inches Was any seepage observed from the la oon(s)? Yes or� Was any erosion observed? Yes or® Is adequate land available for spray. or No Is the cover crop adequate? d?or No Crop(s) being utilized: 13fr- dar R IAJ Crr- s Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? or No 100 Feet from Wells? E0 or No Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or4§) Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Lint: Yes oAN) Is animal waste discharged into water of th state by man-made ditch, flushing system, or other similar man-made devices? Yes If Yes, Please Explain. Does the facility maintain adequate waste management records (volumes of manure, land applied, spray irrigated on specific acreage with cover crop)? Yes or No Additional Comments: F'g e m hour Z S A,, . -r Sc.vw.,.d, 50 Ac- . t -l' Ro j C r s of I q&%-c-5 1-,.u. 3 _ 5r, i;e1 s-fu-fc Di c w: d-l_ r', Scvs . Own., -,�- lnitl 4e X4 P , f gflt� Inspoctor Name Signature cc: Facility Assessment Unit Use Attachments if Needed.