330017_Compliance Evaluation Inspection_20190521

5. 23•IV
W Division of Water Resources
Facility Number - O Division of Soil and Water Conservation
O Other Agency
Type of Visit: Opiiance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Title;
Phone:
Integrator:
Phone:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
eederto Finish
Farrow to Wean
Farrow to Feede.
Farrow to Finish
Gilts
l3oars
Other
Other
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Pullets
Other
Poults
Design Current
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
D Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
I. 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?
0 Yeso
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes9,0
❑ 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)
❑ Yeso
NA
E]NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
` o ❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Q No ❑ NA
❑ NE
of the State other than from a discharge?
Page f of 3 2/4/1015 Continued

Facilit Number: - Date of Ins ection: :5 -
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 o ❑ NA ❑ NE
Structure I 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? ❑ YesZNo
❑ 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❑ 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 environmenta reat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ YesrNo
❑ NA [:]NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes/No
❑ NA E] 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 ❑ 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?
I I. Is there evidence of incorrect land application? 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): f
I3. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ YesN
E] NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ YesVNo
o ❑ 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
"o ❑ 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
o ❑ 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 CYNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis p Soil Analysis ❑ Waste Transfers 0 Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall InspectionsSludge Survey
22. Did the facility fail to install and maintain a rain gauge? [:]Yes No ❑ 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 2/4/2015 Continued

Facili Number: - Date of Ins ection: -5-
24.
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ YesPNo
o '❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge Ievels
❑ 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 N❑ NA F] 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 the drains exist at the facility? If yes, 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 atiy other comments.
Use drawings of facility to better explain situations (use additional palzes as necessary).
CSI ,bra4,o'✓ /-/ j (q
p
P, 63
Rev iewerl Inspector Name:
Rev iewer..'Inspector Signature: L. f P.J2 lJ
Page 3 of 3
Phone: I ?I ( V Zd Q
Date: -12
214/1015