710003_Inspection_20180205

Facility Number 4 - O Division of Soil and Water Conservation
11---�� O Other Agency
O Follow-up O Referral O'Emergency O Other
Date of Visit:
�/ I j/PPf
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Arrival Time:
Departure Time:© County:
Farm Name:
Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Phone:
Region:
Onsite Representative: r/PS �dn� Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Design Current Design Current
Swinc Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish I I La ver
W to Feeder Non -La er
eeder to Finish
Farrow to Wean Design Current
Farrow to Feeder Dry Poult Capacity Pop.
Farrow to Finish Lavers
Gills Non -Layers
Boars Pullets EtE
'turkeys
Other Turke Poults
Other Other
Discharges and Stream Impacts
I. 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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dai Heifer
D Cow
Non -Doi
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes E24o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[-]No
❑ NA
❑ NE
[:]Yes ❑ No ❑ NA ❑ NE
❑ Yes No A ❑ NE
❑ Yes o ❑ NA ❑ NE
Page 1 of
21412015 Continued

Facility Number: IDate of Inspection, 2.
Waite 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? es ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ['Lble- ❑ 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 0,110 ❑ 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 O'No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance altematives that need ❑ Yes ❑ No ❑ NA E NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, cheek the appropriate box below. [—]Yes ❑ No ❑ NA [D'9E
❑ Excessive Pending ❑ 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 [�FNE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA CTI E
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA QdNE
acres determination? 17. Does the facility lack adequate acreage for land application? ❑ Yes ❑ No ❑ NA EKE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ❑ No ❑ NA ❑'FIE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA E
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA
the appropriate box.
❑WUP ❑Checklisrs ❑Design ❑Maps ❑ Lease Agreements ❑Other: /
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ^�rvC
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑Rainfall ❑Stocking ❑Crop Yield ❑ 120 Minute Inspections ❑Monthly and l" Rainfall Inspections ❑Sludge Survey
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 minbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ,❑ E
Page 2 of 21412015 Continued

Fscilit Nu ber: Dateof Inspection:
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
lE
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
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
EJ- AA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
En No ❑ NA
En'
❑ 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
do ❑ 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
PI 'v
❑ Application Field ❑ Lagoon/Stomge Pond ❑ Other:
32. Were any additional problems noted which cause noncompliance of the permit or CA WMP?
❑ Yes
/
❑-IPO ❑ NA
�No
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ff ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
eNo ❑ NA
❑ NE
Comments (refer to question t): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawines of faciliry to better exolain situations (use additional oases as mecessarvt.
7e2
P)!�Si�n, t'"� .S L-[a i•/ro��FiP ���//?°"",f
Q �I 0 La
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
7/o77G 7��y
Dale:
7 S (F
v
I
2/412015