710006_Inspection_20170901

td'Division.of Water Resources "
1FAcifit-rNumber ' L1�J - © Division of Soil and Water Conservation a'
�O Other Agency M a
Type of Visit: ompliance Inspection 0 Operati -Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint ollow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Arrival Time: jq�=
Departure Time: County:
Farm Name:
Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: pa V Alf, f 4
Certified Operator:
Back-up Operator:
Title:
Location of Farm: Latitude:
Phone:
Phone:
Integrator:
Region:
Certification Number: (7�- 7%'
Certification Number:
Longitude:
Design- Current--, Design Current,--
RwinP Canarity , Pan Wet Poult Ca acity Po Cattle
4-
Wean to Finish
Wean to Feeder
Feeder to Finish 7-29
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
m Othen
- : rY .s ,P L• �,•, b
La er
Non -La er
Design Current
-
Dry Poultry Canacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design - Current
b Capacity ' Pop,
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
J
Discharges and Stream Impacts
�esoNo
1. Is any discharge observed from any part of the operation?
El
❑ 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)? N
SOD
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 / N/❑
NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes ,Z No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

lFacility Number: Z4 - 6 jDate of Inspection'
WasTe Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑Yes E3o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _ 7 3 7 3
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?
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
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 rJN�o
_NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ YesElNA ❑ 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 0 90 1__I NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ONo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect lan ication? 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
0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑Yes
�
❑ 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
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
rN
❑ NA
❑ NE
Renuired 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
[�1
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
❑ NA
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
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?
❑ Yes ❑ No ❑ NA I[
❑ Yes ❑ No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

lFacility NTrmber: - Date of inspection:
24. Lid 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 ;]_ „
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 ❑< ❑ NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No 1A ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes �o ❑ 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?
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:
❑ Yes No ❑ NA ❑ NE
❑ Yes i No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA OT1E
32. Were any additional problems noted which cause non-compliance 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
i No _ NA
❑ NE
No NA
❑ NE
o[ o NA
NE
Comments°(refer to question ft Explain any YES answers and/or,any additional recommendatibns,or any otli�r comments.
Use drawin s of facility to`better explain situations use additional -Pages as necessary).
O�✓ ^' \ �9 I l* o � �, c14 y , S%�� � I' �C� a `� �/' cP ('i (� r� � � .� n ��%S �J ���..-� (/Lou c�! clfl[,.ns/,Gz�.,,�
0 -5Q N,,.p��l �' •-�-«.�/� ti �..�/�,L 1��..,�t � ���,^�. ,5�✓'7`�-� /L�-a l !�, -- u�,S1`�Y�e-.._
G- f (OL� 't'� c✓ �1� J�h s Lc%i� L-�S�G ��9r— S/1J►-✓��G �oCa/� �� a /` '3ri� n� AyC[w
r a � ,F.. � �� �. S�a � � � S �. d , � s � k-
Wj,1 i��S D1%2 cam^-+�� l\<'a—'(Cr0 -C t�lnsi�
Cis 6�4
G �t C o %-�
l l l J) D ✓I nJ/, � t'k l IL.A'i2 r �� r�-!i d 1.5 � 0.
S JL,,Cc, +`�ZL/ f�•L Ids PP 1(
5 t4- (2--`' L! e- o r)%�a4Lo0^ i-4 uJ41n G/lS° G S r-
\ L r5I Ci k�S �n-� flF StiS�Gc�t�S ^�-n.-5
l✓�+L q� ,rJ_1taT�s
fu�r�E`IgL.� �S 1g9�P"`► �`5� n zt
/ln
olnl d �s+l/L CK n "P 5,L44 N 7�9 On 9A l��J 7�`5e'-� o ~ V7 �( ✓�edC 7 h� aQ L'rtsSP�
1, n,e x4- 0--q , LI r 7 � !,� �. e f'.r�sr�• ,� 1-� 4--�; � 9 � ? f'� 7 � �S`f
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone: 9 (0 776 %.? o Ll
Date: 9Z111_7
21412015