330030_Compliance Evaluation Inspection_20190521

Facility Number
rivision of Water Resources
Division of Soil and Water Conservation
0 Other Agency
?3 -
Type of Visit: 0 Compl' nee Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 011outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: 97 IS Jd � 561. 6 I'e4,,_edi; Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: r#
Sack -up Operator:
Location of Farm:
Swine
Wean to Finish
n to Feeder
eeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
Other
Title: Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Pullets
Other
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation?
Poults
Design Current
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 [3 NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes XF]
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 o
❑ NA
❑ NE
2. Is there evidence ora 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 2/4/2015 Continued

Faci t y Number: - Date of Inspection: -Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I
Structure 2 Structure 3
Identifier: IVa4,J
❑ NA
Spillway?:
15. Does the receiving crop and/or land application site need improvement?
Designed Freeboard (in):
Fl,
Observed Freeboard (in): �1
t r
Structure 4 Structure 5
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?
VNoN ❑ NA ❑NE
❑ NA ❑ NE
Structure 6
�Ye jJ fN o ❑ NA ❑ NE
❑ Yes EfNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environm;�-
reat, notify DWR
7. Do any of the structures need maintenance or improvement? [] Yes [j NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? D Yes No DNA ❑ 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 No ❑ NA ❑ NE
maintenance or improvement?
Waste At) lication
I0. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 No} ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] YesNo ❑ 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): L r" h d4, = SGc,-e
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
'�
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes❑
Fl,
NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ 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
rNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
g
❑ 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? I f yes, check the appropriate box below. ❑ Yes o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [] Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall InspectionsSludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑Yes o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE
Page 2 of 3 21412015 Contlnrred

Facili Number: 3 - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 25No ❑ 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? ❑ YesN ❑ NA [:]NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ❑ No ❑ 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 ❑ 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 ❑ No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? Ifyes, check the appropriate box below.
❑ Yes ❑ No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes ❑ No ❑ 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 drawings of facility to better explain situations (use additional pages as necessary).
S� 1410
c�SpSurJ�
7
-7Z,
Reviewer: Inspector Name: Phone: C 2 -
Reviewer
Reviewer Inspector Signature: Date: 5-- 2-1 rl %
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