250049_Inspection_20190626

® Division of Water Resources
Facility Number - 0 Division of Soil and Water Conservation
0 Other Agency
(Type of Visit: ® Compliance Inspection U Operation Review O Structure Evaluation 0 Technical Assistance I
Reason for Visit: Q RoutineQ0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
�i l0-1 l Date of Visit: Arrival Time: Departure Time: " o County: � na'u-`.
Farm Name: [ `j'5oh SM f vas l�C, Owner Email:
Owner Name: So N StV� � � Phone:
Mailing Address: SaA 17111 Sv� --,�v� N6A a
Physical Address:
Facility Contact: � Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Region:�k D
I
Integrator:
Certification Number:
Certification Number:
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Dry Poultry Canacitv Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Longitude:
Design Current
Cattle Capacity Pop..
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 62eNC ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA 0 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 U;Ko ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facili Number: jDate of inspection: r
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 E,yNo ❑ NA ❑ NE
Structure 1 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?
(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?
❑ Yes No ❑ NA ❑ NE
❑ Yes [U)10 ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or env�o mental 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 Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[:]Yes VNo
❑ 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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yesgo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes d�'
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes �No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes ❑ o
❑ 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 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E2(No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No 6/NA ❑ NE
Page 2 of 3 21412015 Continued

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