310564_Inspection_20180912

ivision of Water Resources %
Facility Number -FCZFJ O Division of Soil and Water Conservation V/
0 Other Agency
Type of Visit: O1iance Inspection Iteration Review O Structure Evaluation O Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: I Gi //Z/JA Arrival Time: ® Departure Time: ® County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: Z96 1I , J�YX�l
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
to
to
Other
Other
Owner Email:
Phone:
Title:
Latitude:
Phone:
Integrator:
Certification Number: 17207
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
GI INon-Laycr
Design Current
Dry Poultry Caoacitv Poo.
Layers
Non -Layers
Pullets
Turkeys
Turkey Pouets
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. I 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 Z No ONA ONE
Yes ❑ No NA 0 NE
❑ Yes ❑ No NA ❑ NE
[—]Yes [—]No
Yes No
Yes I No
Ej NA NE
❑ NA 0 NE
NA Ej NE
Page 1 of 2/4/20IS Condmred

lFacility Number: - Date of Inspection: ' /Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
r VI No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
0 No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier.
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): .33
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
0 No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
TT
6. Are there structures on -site which are not properly addressed and/or managed through a
[—]Yes
PfNo
❑ 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
ffNo
❑ 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
(j No
❑ NA
❑ NE
maintenance or improvement?
7T��
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
❑ 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
P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
rF/t 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
[0 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
UNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
j�ji No
❑ NA
❑ NE
the appropriate box.
T
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements
❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
PNo
❑ 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
[g, No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
[—]No
❑ NA A NE
Page 2 of 3
21412015 Continued

Facili Number: Date of Inspection: Z
i
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Vo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes OTNo ❑ 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 fast survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively rertified operator in charge? ❑ Yes 6 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No WNA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes rMNo ❑ 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 M No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Offrre of emergency situations as required by the ❑ Yes rv'u'9No ❑ 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.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
32. Were any additional problems noted which cause non-complranre of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
❑ No ❑ NA NE
19 No ❑ NA /—❑ NE
® No ❑ NA, ❑ NE
0 No ❑ NA ❑ NE
Comments (refer to question #)c Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better exulain situations (use additional Daees as necessarv).
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Reviewer/Inspector Name:
Reviewer/Impector Signature:
Page 3 of 3
Phone:
Date: Z
21412015