540093_Inspection_20190424

_Division of Water Resources.
Facility Number � - ® 0 Division of Soil and Water Conservation
fry 0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: I* Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: i e,
Farm Name: �� pS y',•y-- Owner Email:
Owner Name: Phone:
Mailing Address: eri 1' �{c...� I I V C� ay, S
Physical Address: I
Facility Contact: � 1 �CW( Title: Phone:
Region: WI'k�o
�
S r �J
Onsite Representative: �jy-Q 1' �' 1 )lM Il Integrator: J I -� — i r1aci 11,E
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
arrow to Feeder O (_q
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Certification Number:
Certification Number:
Longitude:
Design
Current
Wet Poultry
Capacity
Pop.
Layer
Non -Layer
Design
Current
Dry Poultry
Capacity
Pon.
Layers
Non -Layer
Pullets
Turkeys
Turkey Poults
Other
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?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
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
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes VNo
❑ Yes
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

[Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes o ❑ 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?:
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 �oEj ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental hreat, 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 o ❑ 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 Io ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E� o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ 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
EP�N❑
NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
L G 1VO
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
2fNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
to
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Pj"No
❑ 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
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis
❑ Rainfall ❑Stocking 616/op Yield ❑ 120 Minute Inspections
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain
box below. EDY'es ❑ No ❑ NA '❑ NE
❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
on irrigation equipment?
❑ Yes <o ❑ N NE
❑ Yes ❑ No 0 NA ❑ NE
Page 2 of 3 1 21412015 Continued

Facili Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [� o ❑ NA ❑ NE
25'. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes I No ❑ 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 cel rtified operator in charge? ❑ Yes D4 ❑ NN ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No [ A ❑ 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 o� 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 Ithe appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑I Other:
32. Were any additional problems noted which cause
33. Did the Reviewer/Inspector fail to discuss rev
34. Does the facility require a follow-up visit by the same
Hance of the permit or CAWMP?
with an on -site representative?
❑ Yes La"No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA lE
❑ Yes No ❑ NA ❑ NE
❑ Yes Z/No ❑ NA ❑ NE
❑ Yes 1�6 ❑ NA
❑ Yes NA
❑ Yes No ❑ NA
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to beater explain situations (use additional pages as necessary).
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Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
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Phone: 90-oa3��
Date: ` /-2q _. M
21412015