310760_Inspection_20181015 (2)

(3i^57 ✓ -I- d/ "
Division of Water Resources
Facility Nirmber F-31 - :jo 0 Division of Soil and Water Conservation
t' 0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint ® Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: E1u County:
� � r i-�
Farm Name: r V % ft6 -1 " U Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
OnsiteRepresentative: � �i�jr p Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to
Farrowto Wean
Farrow to Feeder
Farrow to Finish
Other
Other
Latitude:
Phone:
Certification Number:
Certification Number:
Design Current
Design Current
Capacity Pop.
Wet Poultry Capacity Pop.
Layer
Non-- La er
IN
Design Current
Dry Poultry Capaeity 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?
Longitude:
Region:
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 VNA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No 1W 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 ❑ No 1ANA ❑ 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 T/11 No ❑ NA ❑ NE
of the State other than from a discharge? r
Page I of 3 21412015 Continued

Facility Number: Date of —Inspection, 113 J
Waste Collectlo t & Treatment
4. Is storage cap city (structural plus storm storage plus heavy rainfall) less than adequate? ® Yes
a. If yes, is waste level into the structural freeboard? 7❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4
Identifier.
Spillway?:
Designed Freeboard (in): , j
Observed Freeboard (in): K-
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
❑ No ❑ NA ❑ NE
A No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes qNo ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
Ep
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4fi 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?
S Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as requited 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
�1 No
❑ 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?
T
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
[a NE
❑ Excessive Pondmg ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
T
❑ 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
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
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fad to install and maintain rainbreakers on irrigation equipment?
Page 2 of
❑ Yes ❑ No
[—]Yes [—]No
❑ NA NE
❑ Weath Code
❑ Sludge Survey
❑ NA NE
❑ NA 4
NE
21412015 Continued

Facilf Number: Date of Inspection: it
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA TTNE
25. Is the facilityout of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA E
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 reviewrinspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
fer to question #): Explain any YES answers add/or any
of facility to better explain situations (use additional pas
('n " ` ` ' 2S , Z
M
Reviewer/Inspector Name:
Reviewer/Inspector Signatw
Page 3 of 3
❑ Yes [—]No ❑ NA TPNE
❑ Yes ❑ No ❑ NA NE
❑ Yes ❑ No ❑ NA NE
❑ Yes 1p No ❑ NA NE
❑ Yes
17No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
C�PNE
[:]Yes o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
ons or any other comments.
Phone: 910 7 SA `t l
Date: I (D I )
2/412015