350055_Compliance Evaluation Inspection_20190529

v yr
A()5 Division or Water Resources
Facility Number O Division of Soil and Water Conservation
O Other Agency _
of Visit: 7
Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
In for Visit. 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit:
Arrival Time: %
Departure Time: County:
❑ NA
Farm Name; aqMV6
Q� nAs 1
Owner Email:
.. __.
a. Was the conveyance man-made?
❑ Yes
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsile Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
-5'3 @- r- was
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
0cxs4a I l'c_
Design Current Design Current
Capacity Pop, Wet Poultry Capacity Pop.
La er
Non -La er
Discharees and Stream Imnacts
Dry roultr
Layers
Non -Layers
Pullets
Turkeys
Turkey Pou
Other
Design Current
Longitude:
Region:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
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?
❑ 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)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
u No
❑ NA
❑ NE
2. 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 1 of 3 1/4/1015 Continued

Facili Number: - Date of Inspection:
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 No ❑ 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? ❑ Yes [ZNo ❑ 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 ❑ YesNo [1]NA E]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 �No ❑ NA ❑ NE
maintenance or improvement?
Waste ADDlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes/No [:]NA [:]NE
maintenance or improvement? j—'
1 I. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes[� No F]NA E] 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 P"IN"4o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes ErNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes P No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes 2 No
E]NA
E]NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes PNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes 16 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
El Yes !!!!`"4o
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
2I. Does record keeping need improvement? If yes, check the appropriate box below.
❑ YesNo
E] NA
❑ NE
F-1WasteApplication ❑ Weekly Freeboard E] Waste Analysis ❑ Soil Analysis
E] Waste Tr nsfers
❑ Weather
Code
❑ Rainfall E] 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?
❑ Yes E❑
NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes Yes No
❑ NA
❑ NE
Page 2 of 3
214/2015 Continued

x
Facility Number: Date of Inspection:
24. Did the f il'ty fail to dbancewid
rate w ste application equipment as required by the permit? ❑ Yes No [:)NA ❑ NE
-1—iiii
25. Is the facility out of com r�it�conditions related to sludge? I f yes, check Yes No NA NE
the appropriate box(es) below. �.o (
❑ ❑ ❑
❑ 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? ❑ Yeso ❑ 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
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?
Ifyes, 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)
3 I. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
[:]Yes 2(No ❑ NA ❑ NE
❑ Yes jNo ❑ NA ❑ NE
[:]Yes 2(No ❑ NA ❑ NE
❑ Yes ZNo ❑ NA ❑ NE
[] Yes
❑ Yes
❑ Yes
o ❑ NA ❑ NE
[ o ❑ NA ❑ NE
�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).
s -n10 l? O - 3 iS P= 'V, S
L
3D ir�•Y, es.a..p
(o o h ­Ln q 4eu'd cto '- „ 0-r ZAZL
Reviewer, Inspector Name:
Rev iewerl Inspector Signatur
Page 3 of 3
Phone:
Date:
21412015