330065_Compliance Evaluation Inspection_20190628

Facility Number
W Division of Water Resources
O Division of Soil and Water Conservation
O Other Agency
6 2q -0,
Type of Visit: 0 Co once Inspection 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: J Departure Time: ] 2 County: Region:
Farm Name: _!� ��� �'� 2fL Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: b✓1A-n 5eys-o 'l— r
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
f"e`eder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Phone:
Title:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
I E]Non-La er
Non -L
Pullets
Other
Discharees and Stream Impacts
1- Is any discharge observed from any part of the operation?
Poults
Design Current
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ YesN ❑ NA [:]NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) C—]YesNo ❑ 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) ❑ YesrN
❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Conl;nued

Facility Number: 3 - Date of Inspection: (a —
Waste Collection & 'Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ YesNo - Ej NA
a. If yes, is waste level into the structural freeboard? ❑ YesNo ❑ NA
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Q �(
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and'or managed through a
waste management or closure plan?
❑ YesZ No NA
❑ Yes No ❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environrNv-'
.rent, notify 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? ❑ Yes ❑ 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 ❑ Yeso ❑ NA ❑ NE
maintenance or improvement?
Waste Application
I0. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes qlo
❑ 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
I2. Crop Type(s): -:yt7 " Spy
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes ZrN
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes LZNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes N
E] NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes VNo
❑ NA
❑ NE
Re uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[] 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 E] 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 No
❑ NA
[D 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

Facility Number: - Date of—inspection: 6 - 20
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes rNo
N [3NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? Ifyes, check ❑Yes ❑ 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 No ❑ 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?
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 the 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 Revi ewer/[ nspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
E] Yes E] No E] NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
❑Yes
No
❑NA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ 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).
6 (0Oj e 6Q r✓c lve+ c't' e 1,1Sq 1 -1; ( `ee- - 3 (1 1 %
iv&� 4b DE4- D7C Forn—
Revieweriinspector Name:
Reviewer.. -'Inspector Signature:
Page 3 of 3
�D 5e -f J�jjct -Ce-,0 't-,' [ ndX4 C/,as5 / 40:54
Phone: 211
— C
Date: (pr- 2-& —/
214M15