760010_Compliance Evaluation Inspection_20180220

9-19-- VL_ o (A
Division of Water Resouri
Facili'ty.Number . - 0 Division of Soil and Water Con's rvation L`
0 Other: Agency
Type of Visit: 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: ` Arrival Time: 00 Departure Time: County: 0� h Region: L0
�"
Farm Name: R,"A j r\ ® F7&.Ar-M Owner Email:
Owner Name: 0-13 r l s a PLJn. 10 4 Phone: 263 A® 9
Mailing Address: R � 41 'V 1 61) I -A Pin U r c� h �� t1� • .�o p h I i� Z. 6
Physical Address: 410D d-b,y m jLd 6o ip h i a.-
Facility Contact: aj r L t' rL 5 Title: Phone:
Onsite Representative: Integrator: �p t) r �p
Certified Operator: Certification Number: 1 $ 10
Back-up Operator:
Location of Farm:
(c) hr5 • b\/ 12-f$1111
Certification Number: i
Latitude: y�� fY Longitude: % 53 ` 36
U
(f
l�Zx
EJ e e - t eau'5'311's.
Design Curre:
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Wet Poultry Capacity Pop. Cattle
Layer
Non -La er
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
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)?
Dairy Cow
DairyCalf
Dairy Heifer
Dry Cow
—,,Tqon-Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 5fNo ❑ NA ❑ NE
[:]Yes
[:]No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
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?
❑ Yes [:]No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: - % U Date of Inspection:
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 ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LL3ppn
Spillway?:
Designed Freeboard (in):_
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes XNo ❑ 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 ONo ❑ 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? K Yes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes gNo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) ,, _ J
9. Does any part of the waste management system other than the waste structures require ❑ Yes N No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes X No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 'N�Ko ❑ 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 Acceptab(lle1 Crop Window Evidence of Wind Drift ❑ Application Outside of Approved Area
/"
12. Crop Type(s): �Irc�fj Chp ( �(dlsa6re , Koj
13. Soil Type(s):
❑ NE
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [;S No ❑ 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 NrNo ❑ 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?
❑ Yes CKNo ❑ NA ❑ NE
❑ Yes 'N? No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[23�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:
T
21. Does record keeping need'mprovement?
XYes
❑ No
❑ NA ❑ NE
Waste Applicaf n ['J eekly Freeboard Waste Analysis Soil Analysis ❑�- '� T--- ` -
1" Rainfall Inspections
Weather Code
'Sludge Survey
Rainfall Stocking op Yield ❑ 120 Minute Inspections
Monthly and
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
gNo
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
Ja NA ❑ NE
Page 2 of 3
21412015 Continued

Facility Number: 1 Co - jDate of Inspection: ;U
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes D No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes $ 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 certified operator in charge?
❑ Yes '0 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
tR'No
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[X 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
YNo
❑ 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
O(No
❑ 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
XNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
N No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
N�'No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[�No
❑ NA
❑ NE
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Reviewer/Inspector Name: �����Ssa
St�
Reviewer/Inspector Signature:
Page 3 of 3
Phone: (J36 31
Date: al
214,12015