820226_Inspection_20190508

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Type of Visit: ompliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: / ©; Oc7 Departure Time: County: Region:
Farm Name: �j a��`� Owner Email:
Owner Name:
2277,-,
f /< Phone:
Mailing Address:
Physical Address:
Facility Contact: IfAr-O J i41,­oJ Title: B&eJ0 �,�'` Phone:
Onsite Representative: j_ Integrator: �y
Certified Operator: Certification Number: / S�
Back-up Operator: Certification Number:
Location of Farm: Latitude:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[:]Yes ❑ No ❑ NA ❑ NE
❑ 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 ❑ 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 0-5o_ ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 21412015 Continued

Facility Number: jDate of inspection: S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes EyNo ❑ NA ❑ 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?:
❑ Yes
D-N'o
❑ NA ❑ NE
Designed Freeboard (in):
❑ Yes
F, -Ko
❑ NA ❑ NE
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes
�o
❑ NA ❑ NE
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?
❑ Yes
Ivo
❑ 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?
'es
❑ No
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Ejlvo
❑ 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
Q'1 o
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[D"Ko
❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 9-<O-'
O ❑ 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):/7!1
13. Soil Type(s): wiir /
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ©'No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? 2"re-s ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 0 o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes [3 --No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
D-N'o
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
F, -Ko
❑ NA ❑ NE
the appropriate box.
❑WUP El Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If 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 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
Ivo
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑l�o__
❑ NA ❑ NE
Page 2 of 3
2/4/2015 Continued

Facility Number: jDate of inspection: -�
❑ Yes
[a -Ko-'
❑ NA
/ 24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
E] No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
fo
❑ NA ❑ NE
the appropriate box(es) below.
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge
levels
❑ Non-compliant sludge levels in any lagoon
❑ Yes
No
❑ NA
List structure(s) and date of first survey indicating non-compliance:
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
©'1Go
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
E N
❑ NA ❑ NE
Other Issues
No
❑ NA
❑ NE
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
E] 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
[a -Ko-'
❑ 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
Io
❑ 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 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
�o
❑ NA
❑ NE
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Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
Phone: 252— 3 D3-6 LL/
Date: ,J` 9-,5;q'0/
21412015