310791_Inspection_20181008 (2)

Division of Water Resources
Facility Number ©- ® O Division of Soil and Water Conservation
O Other Agency
Type of Visit: O Compliance Inspection 0 Operation Review ® Structure Evaluation 0 Technical Assistance
Reason for Visit: O Routine O Complaint ® Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: d f/►.$ "'' Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
OnsiteRepresentative: —�Tnrx-4 Ct1ra"
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
to Finish
to Feeder
-to Finish
v to Wean
to
Other
Other
Phone:
Title:
Latitude:
Integrator:
Region:
Phone: C I (A 2 S ZS'3 g-r
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
IN
Non--
La er
Design Current
Dry Poultry CRDacity POD.
La ers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ? No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other.
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ 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
❑ No
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

FacW 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
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?: '
Designed Freeboard (in): %5
Observed Freeboard (in): :30
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
NpNo
❑ 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
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?
[;; fYes
T❑
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
Yes
[5; 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
NJ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
❑ NA
J�LNE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
`W
❑ 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
❑ NANE
F
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
❑ NA
�0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
*,Fg] 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 ❑LeaseAgreements
❑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 fail to install and maintain rainbreakers on irrigation equipment?
Page 2 of 3
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA [PINE
❑ Weather Code
❑ Sludge Survey
❑ NA ]0 NE
❑ NA NE
21412015 Continued

Facility Number: jDate of Inspection: b
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes ❑ No ❑ NA NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes ❑ No ❑ 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?
❑ Yes ❑ No ❑ NA PDNE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes ❑ No ❑ NA U NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ❑ No ❑ NA NE
9
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 []g No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
T
30. Did the facility fall to notify the Regional Office of emergency situations as required by the
❑ Yes 4No ❑ 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
V NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes `pNo
❑ 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 drewin of facility to better explain situations (use additional pages as necessary).
q 17
C"'h� Y �p�u.� vim. ��, -� Io
fill
Reviewer/Inspector Name:
Reviewer/Inspector Signature: \ /— _
Page 3 of
Phone: (61c(4-7 1 `7
Date: I
21412015