310485_Structure Evaluation_20181010

'0 Division of Water Resources
Facility, Number - ® 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Opera Review ('Structure Evaluation (_)Technical Assistance
Reason for Visit: 0 Routine 0 Complaint ollow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: D b Arrival Time: p J Departure Time: County:
Farm Name: 6n rS bie /%� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: c eyY y Mode T Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to I
Wean to F
Feederto
Farrow to
Farrow to
Farrow to
Gilts
Rows
Other
Other
Latitude:
Phone:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non
-Layer
Design Current
Longitude:
Region:
Design Current
Cattle Capacity Pop.
Dairy Cow
DairyCalf
DairyHeifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
0 ties
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
g 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
o
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
[:]Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[:]Yes
[:]No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: 3 1 - 4 IDate of Inspection: D /d
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 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.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
XNo ❑ NA ❑ NE
No ❑ NA ❑ NE
Structure 5 Structure
❑ Yes No ❑ NA ❑ NE
El Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental t eat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes oo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ENO ❑ ❑ 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 o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ZfNE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA 0 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): 1�ij Z /�h'lc�c1
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA 0 N
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
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 VNE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
0 NA
Required 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 NE
the a ro riate box
pp 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
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Cod
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Sury
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: Date of inspection: b / 1
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA 0 NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
N
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
❑ 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
❑ 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
❑ 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
❑ 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 as necessary).
LAGvovr Lwj 5 10f Zf&" rri6,- fo S46P ►s. 1,,, f 30 1r
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
u S 4'r' l t✓ It
Phone: Cl ) q %g I L% ZUb
Date: 1 01 1 a 1
21412015