310272_Structure Evaluation_20181016

Division of Water Resources
Facility Number � - ® O Division of Soil and Water Conservation
O Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review Structure Evaluation O Technical Assistance
Reason for Visit: O Routine O Complaint ®Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: [MI ��i i S(� Arrival Time: ^ � Departure Time: County: Region:
Farm Name: /�b►►� <+S � 1 YUV'a Fur VV_S Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: 16 rms '��00 P Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to I
Wean to I
Feederto
Farrow to
Farrow to
Farrow to
Gilts
Boars
Other
Other
Phone: LS 21w 6b u
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -Layer
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)? _
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?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [� No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [—]No
❑ Yes [—]No
❑ Yes V0j No
❑ Yes 1� No
NA ❑ NE
® NA ❑ NE
[J NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Faciii Number: 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
-9 NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �o
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E0 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
%W 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
� 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 [�fNo ❑ 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 ❑ No ❑ NA r 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 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
❑ No
❑ NA
NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA
[:.NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA
§j 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
$-In NE
❑ Waste Application El Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
? No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[-]No
❑ NA
I? NE
Page 2 of 3
21412015 Continued

Facili Number: Date of Inspection: ()
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
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
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes
Other Issues
❑ No
❑ NA
>] NE
❑ No
❑ NA
NE
❑ No
❑ NA
PI:NE
❑No
❑NA,]NE
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No ❑ NA (ENE
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 11�fi No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately. T
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 reviewrinspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
to question #): Explain any YES answers and/or any addii
scility to better explain situations (use additional maees as
: 3p
211M
W,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
ME14
[]Yes [—]No
❑ NA ❑ NE
❑NA NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
ons ore v other comments.
Phone: `5`
Date: 6
1/45, 15