430013_Inspection_20181221

L
Division of Water Resources
Facility Number - ® 0 Division of Soil and:Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Ili R` I Arrival Time: Departure Time: Q '� County: Region: rYzy
Farm Name: �r1.'-,rV'n(s r-rZ., M j �S l 2 Owner Email:
Owner Name: �fl' j,JQ�+. �1(-' C1:11e Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
OM6Z5 POM4 Title:
Lf
I
Latitude:
Phone:
Integrator: Sf" r 4_e
Certification Number: g�? z�9
Certification Number:
Longitude:
Design
Current
Design
Current
Design
Current
Swine Capacity
Pop.
Wet Poultry Capacity
Pop. Cattle
Capacity
Pop.
Wean to Finish
I
I Layer
Wean to Feeder
I
INon-Layer
Feeder to Finish
Design Current
Dry Poultry Capacity Pop.
Farrow to Wean
Farrow to Feeder
Farrow to Finish
2 qgD
I Layers
Gilts
Non -Layers
Boars
Pullets
Turkeys
Other Turkey Poults
Other Other
DischarEes and Stream Impacts
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
1. Is any discharge observed from any part of the operation?
❑ Yes
R 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
❑ 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 I of 3 21412015 Continued

aciliq,Number: U3 - ��j Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes _F No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ED NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: C 2 �AC> h
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): t' 14
5. Are there any immediate threats to the integrity of any of the structures observed?
[]Yes
N No
❑ 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 environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[�j No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
f] 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
P No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[!p No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes � No ❑ NA
❑ 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 s ❑ Evidence of Wind Drift [:j Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in
CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
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
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes P No ❑ NA
❑ Yes ® No [j NA
[:]Yes
F] No
❑ NA
❑ Yes
Fa] No
❑ NA
❑ Yes
E� No
❑ NA
[:]Yes No ❑ NA
❑ Yes ® No ❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ 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 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ` 9 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes N No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facilit Number: Q - j Date of Inspection: Z 2
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
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 No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No
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?
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
permit? (i.e., discharge, freeboard problems, over -application)
31. 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?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes I - No ❑ NA ❑ NE
❑ Yes [�g No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes `t No ❑ NA ❑ NE
[:]Yes ® No
❑ Yes T No
❑ Yes No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Signature: �� �GL..(�1 Date:
Page 3 of 3 21412015