330024_Compliance Evaluation Inspection_20190521

1, - 5 -f r
k"Ivislon of Water Resources
Facility Number - O Division of Soil and Water Conservation
Other Agency
Type of Visit:Comp ' ce Inspection Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: JaRoutine ( Complaint 0 Fallow -up O Referral Q Emergency O Other 0 Denied Access
Date of Visit: 5--3- - Arrival Time: Q jj Departure Time: County:
Farm Name:j i Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title: Phone:
Onsite Representative: Integrator•
Certified Operator:
Back-up Operator:
Location of Farm:
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish
W n to Feeder
eederto Finish ZD
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
La er
Non -La er
Non -L
Pullets
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 ('ow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
12/No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yeso
❑ NA
E]NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
E] 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
❑ NA
❑ NE
Z. 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 I of 3 1/4/1015 Continued

Facili Number: - Date of Inspection: S Waste Collection Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes'N F] NA E] 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):
Observed Freeboard (in): j
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes��rNo ❑ 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 environmenta threat, natify DWR
7. Do any of the structures need maintenance or improvement? ❑Yes [:]NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ YesNo ❑ 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 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 2f No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes XNo ❑ 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): Ls
13. Soil Type(s):,
14. Do the receiving crops differ from those designated in the CAWMP?
❑ YesN
❑ NA
F] 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
❑ YesNo
❑ NA
[] NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E] NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�rNqo
❑ NA
❑ NE
Renuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yeso
❑ 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 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and I" Rainfall Inspections ❑ Sludge 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 2/4/2015 Continued

[Facility Number: - 222 of Inspection: 5- —,,7-/ -7
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes O ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes rE] 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 N NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Na ❑ 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? 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 Reviewerilnspector fail to discuss reviewrinspection 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 ft 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).
S1�d�t' Serve-
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Reviewer+ Inspector Name:
3— (i CIC"V-
Reviewer/Inspector Signature. ,�j� S��/K
Page 3 of 3
Phone: (07 791 yZ-W
Date: Y. Zl — (
2/4/2015