310111_Compliance Inspection_20180712

� Division of Water Resources
FaMity Number - �--/ t r O Division of Soil and Water Conservation
0 Other Agency
for Visit: 0-Routine Q Complaint Q Follow-up O Referral O Emergency O Other 0 Denied Access
Date of Visit: / 2 1 Lrival Time: f. O Departure Tlme: County: Dtirbyl Region:( (/
Farm Name: Ct i:6` 'roFe-yotj Owner Email:
Owner Name: H-e— b of 46P/1`5 Imo y /l 0 r— Phone:
Mailing Address:
Physical Address:
FacilltyContact: CbN'� I, 3ay wt`Gt( Title:
Onsite Representative: l
Phone:
Integrator: �aro��c7 Ft�'VavrQ�7i✓/11S
Certified.Ope� rator� 'j I P� PIS e c/}� O V Certification Number: Tq 8ff 17
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
to
to
to
Other
Other
Certification Number:
Latitude: Longitude:
Design Current
Wet Poultry Capacity Pop.
]Layer
Non -La er
Design Current
' Dry Poultry Canacitv Pon.
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)?
C Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ©_WC_❑ NA ❑ NE
❑ Yes ❑ No ❑'PA ❑ NE
❑ Yes ❑ No E NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) Lj Yes LJ No L�] NA LJ NE
2. Is there evidence of a past discharge from any part of the operation? [—]Yes [TNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes FTNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 21412015 Continued

Facility Ndmber: :91 jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
,®N-6�0 NA
❑ NE
a If yes, is waste level into the structural freeboard?
❑ Yes
❑ No �❑ 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
L GNXo ❑ 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
EG,1go ❑ 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 reat, 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 [ Io ❑ 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 Eq-Ko�[:] NA ❑ NE
maintenance or improvement?
Waste AunEcation
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
L1'110 ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[:P<�❑ 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 ofWind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Sod Type(s): Fp rr 5/ 0
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Q'go­❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑'15ro— ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
D 1e ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
0-ITo' ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
qgo ❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[q-9-OE] NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design El 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 ❑ Stockmg ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspectio ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[—]Yes
Now
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
1Qo
❑ NA ❑ NE
Page 2 of 21412015 Continued

IFaciUty Nufaber: 3 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ZN ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes MY o ❑ 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?
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:
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
❑ NA
❑ NE
❑ Yeso
ro
❑ NA
❑ NE
❑Yes
❑K
❑NA
❑NE
❑ Yes 2<0 ❑ NA ❑ NE
❑ Yes Io ❑ NA ❑ NE
❑ Yes E No ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
[rNo
❑ NA
❑ NE
EJ�No
❑ NA
❑ NE
Io
❑ 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).
31—/6 slw�Y �� Ii-2-T-l-7
L 3, s s vz��
Cal( - 9to-SD6-68sf
Reviewer/Inspector Name:
Reviewer/Inspector Signatw
Page 3 of
Pbone:Rto-"1C 3`,333
Date: I —Qu
2/4/201