310148_Structure Evaluation_20181008

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Division of Water Resources
Facility Number ©- 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review ® Structure Evaluation 0 Technical Assistance
Reason for Visit:
�01Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Arrival Time: Departure Time: County: Date of Visit: 1� p ( / I _� Region:
Farm Name: P t^! 1ln 'CM T Ai-M Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: A; f' h^"
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
to
to
to Wean
to Feeder
to Finish
Other
Other
Phone:
Title:
Latitude:
Phone: g1oz'?91b5Z
Integrator:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Design Current
Dry Poultry Capacity Poo.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
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 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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes C 1No ❑ NA ❑ NE
[—]Yes
[—]No
'RNA
❑ NE
❑ Yes
[—]No
[PNA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ Yes
No
QJfNA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
t
Page I of 214120I5 Continued

Facili Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
f7i Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
EPNo
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: rU • Ne , 2.
Spillway?:
Designed Freeboard (in): S
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
J� 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
�o
❑ 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
Wo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
f;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
P}YQo
❑ NA
❑ NE
maintenance or improvement?
TT
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
❑ NA
F;;3\NE
`r
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
i? 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
❑ No
❑ NA
EPINE
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
❑ No
❑ NA
C�?NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
® NE
Renuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [:]No ❑ NA
the appropriate box. P
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA- NE
ElWaste Application ElWeekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ West r 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 min gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[—]Yes No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ®NE
21412015 C titiuued
Page 2 of

Facili Number: Date of inspection:
24. 17id the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA PNE
25 Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ No
❑ NA EPNE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance•
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
❑ No
❑ NA 10 NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[—]No
❑ NA IPE
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 CAWNP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes [:]No ❑ NA VNE
❑ Yes 9No ❑ NA ❑ NE
❑ Yes ` -h No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
Et NE
❑ Yes
E?pNo
❑ NA
❑ NE
❑ Yes
jq No
❑ NA
❑ NE
[:]Yes
0 No
❑ NA
❑ NE
Ioomments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawhies of facility to better exnlafn situations fuse additional oaees as necessarvl.
FG g� q
Oo. l = 21
r-lb12= 23
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Reviewer/Impector Name:
Reviewer/Inspector Signature:
Page 3 of 3 —
W C' Phone: (:�' l0 %cI ^6/ci3�1
On Date: to 15
21412015