990012_Inspection_20190726

=ypc o= . sn: T"inpuance Inspection v operation xeview V Ntructure ];valuation V I cenmcat Assistance
Reason for Visit: O Routine O Complaint Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: m County: 0&AKjh
Farm Name: Owner Email:
Owner Name.. Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Region: tI
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l I
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€ im I
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -La er
Da Calf
Feeder to Finish
i
Dairy Heifer
Farrow to Wean
' `ii
Dry Cow
i
Farrow to Feeder
� r.
�iiNon-Dairy
}'
Farrow to Finish
Layer s
Beef Stocker
Gilts
Non -Layers
Beef Feeder
i
�(4
Boars
Pullets
Beef Brood Cow
,
Turke s
I'
ii+';`=
„aJ
Turke Poults
Other
Other
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Air
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?
❑ Yes P No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
F7 No
❑ NA
❑ NE
❑ Yes
[8 No
❑ NA
❑ NE
Page I of 3 21412015 Continued

Facility Number: `'3L�L -
Date of Inspection: 1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2
Structure 3
Structure 4
Structure 5
Identifier:
o� Cfl ( _
}�
A-_�
4_1�
Spillway?:
14 No ❑ NA ❑ NE
[—]No ❑ NA ❑ NE
Structure 6
Designed Freeboard (in):
Observed Freeboard in
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [4 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 q 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
[(No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
g, 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
hA
❑ 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
[Z No
❑ NA
❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or10 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
[ZNo
❑ 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
[ No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[P No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[A No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
P No
❑ 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
V] 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
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
]Z
[:]No
M NA
❑ NE
Page 2 of 3
21412015 Continued

Facility Number: el Date of inspection: K
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �§No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No MNA ❑ 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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?
r 1�i V._s �
bay V'�
❑ Yes M No ❑ NA ❑ NE
Look
❑ Yes M No ❑ NA ❑ NE
❑ Yes
[q No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
❑ Yes
❑ Yes
PUr Laci No
❑ NA
❑ NE
L No
❑ NA
❑ NE
[g No
❑ NA
❑ NE
tied . l,obs<- i vv L"_ 49
i
Reviewer/Inspector Name:
Reviewer/Inspector
Phone:
Date:
Page 3 of 3
21412015