820613_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quality
Technical Assistance
0 Denied Access
Date of Visit: [ ?--IH £t Arrival Time:[ 9":.'07.> I Departure Timed~// .'OZ) I County:...,z~r--Region: fJS U
Farm Name: R;rJ. Nvt:'fo/ /J, 0· 3 -J-z;;f:lc-k }1 vo/ Owner Email:
Owner Name: ;rc t::... :0 J)v cA Phone:
/
Mailing Address:
Physical Address:
Facility Contact: --·~.:...;<2~..::· ;.;.!4-.::f:'\...~_b=-;v~rJ..::;_:_ ____ Title: &? LU , r-•.-Phone:
/
Onsite Representative: = Integrator: 1/n ;-tf..l:fr/ /.
Certified Operator: ~c..... a -Certification Number: JY.Ob2
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation? ~
D Yes E:J No D NA 0 NE
Discharge originated at: 0 Structure D Application Field D Other:
a. Was the conveyance man-made? DYes 0No DNA ONE
b. Did the discharge reach waters of the State? (If yes, notify DWR) DYes 0No DNA ONE
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) DYes 0No DNA ONE
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?
Page 1 of3
-.,,
DYes
DYes
[3-No DNA ONE
Bf\Jo DNA ONE
114/2015 Continued
!Facility Number: loateoflnspection: 2-LZ-/Y' I
'. Waste CoUection & Treatment
4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a . If yes, is waste leve l into the structural freeboard?
Structure I Structure2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): I 9-·
Observed Freeboard (in): 3o .3~
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
30
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes E:(N: DNA D NE
DYes 0No DNA ONE
Structure 5 Structure 6
0 Yes [3-"No DNA D NE
DYes g<o DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threa~ notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste AppUcation
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes [2Jilo DNA D NE
D Yes EfNo DNA ONE
DYes [31\fo DNA D NE
0 Yes B1'{o DNA D NE
1.1. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. 0 Yes ~ DNA D NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn , etc.)
D PAN D PAN > 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12 . Crop Type(s):
13. Soil Typ<(s)' ~tELmc ~I.J.,Iru'O
14. Do the receiving cro;s~er from those designated in theCA WMP?
15. Does the receiving crop and/or land application s ite need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste appli cation equipment?
Required Records & Documents
19 . Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the fac ility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box.
0WUP Ochecklists D Design 0 Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
D Yes [3'No DNA ONE
DYes Q-No DNA ONE
DYes GJ-No DNA ONE
DYes ~ DNA ONE
0 Yes Q-N6 DNA ONE
0 Yes (3-No DNA ONE
DYes (3--N o DNA ONE
DOtber:
0 Yes [}No DNA ONE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analys is D Waste Transfers D Weather Code
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 S ludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes [J-No DNA D NE
23. I f sel ected, did the facility fail to in stall and ma intain rainbreakers on irrigation e quipment? D Yes [3-No D NA D NE
Page 2 of3 21412015 Continued
..
I •
(!<'acility Number: <l':J--l,>l_j I nate of IDS(!ection: 7-L.~-I..s /1
~ 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes DNA ONE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes ~ DNA ONE
the appropriate box(es) below.
Q Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date offust survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? DYes [31'fo DNA ONE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes G}1(o DNA ONE
Other Issues
28 . Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes [:fNo DNA ONE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quali ty concern? 0 Yes ~0 DNA ONE
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 DYes [Jf( DNA ONE
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes rr' DNA ONE
0 Application Field 0 Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes ~ DNA ONE
33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 0 Yes ~0 DNA ONE
34. Does the facility require a follow-up visit by the same agency? 0 Yes [31'1o DNA ONE
fo/m 1//,-(/ d;;;u-Fr •~·--· fthv,· /f'V<"'J p;_rc 7 D .h./...,<~/ /'p,,../
l"\>cv>~VJYL-7tJ ·---· i..$ doy, rl .. c/Yt:,}:f/
Reviewer/Inspector Name :
Reviewer/Inspector Signature :
Page3of3
Date: ?·-/ s~ {J Is--
21412015
Date of Visit: I t>-z-) 71 Arrival Time: I E ~ ..3 0 I Departure Time: I 9 /tiD I County: ~ Region:~ 0
Farm Name: J5 y nJ N u(J~r y /,_;1.. I 3-rn-frlck Nvl}7)lner Email:
r I J '
Owner Name: Q0 "t::.. .12 J5ycd Phone:
Mailing Address:
Physical Address:
Phone: Facility Contact: VVh ""-ry ,J..
Onsite Representative: ___ __.?'~~===-------------
Title: ---~~~;:;...;.n.;..~~r ____ _
Integrator: 5n!Jlii;J
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation? DYes ~No
Discharge originated at: 0 Structure 0 Application Field 0 Other:
a . Was the conveyance man-made? 0 Yes 0No
b. Did the discharge reach waters of the State? (If yes, notify DWR) 0 Yes 0No
c. What is the estimated vo lume that reached waters of the State (gallons)?
d . Does the discharge bypass the waste management system? (If yes, not ifY DWR) 0 Yes 0No
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?
Page I of3
DYes lliNo
DYes ti?J__No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
11412015 Continued
(!acility Number: IDate of Inspection: b -7-I Z
• Waste CoUection & Treatment
t-\ 4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): (=t lc::t_ L? Lc;-
Observed Freeboard (in): #.-~ .. ~ ,,;z. 7
• 4?--
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?
D Yes ~No DNA D NE
D Yes 0 No DNA 0 NE
StructureS Structure6
0 Yes Qf-No D NA 0 NE
0 Yes g.No 0 NA 0 NE
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?
8. Do any of the structures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes !:)iNo
0 Yes ~No
0 Yes [8LNo
0 Yes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
II. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. 0 Yes liJ_No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. CropType(s): pr:r-m"~a._ I &vc<:xr"?-J I ~rrJ f:.. Ye
~ 7
13. Soil Type(s): t{/p.rz_('~ I G ·/) /)!5) () rO
14. Do the receiving crops diff~m those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate ofCoverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, c heck
the appropriate box.
OwUP 0Checklists 0 De s ign 0 Maps 0 Lease Agreements
0 Yes e'}No
0 Yes {:8lNo
DYes ~No
DYes l8f No
DYes ~No
DYes ~No
0 Yes ~0
00ther:
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21 . Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysi s 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and I" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~ No 0 NA D NE
23 . If selected, did the fa c ility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~No 0 NA 0 NE
Page1of3 1/4/2015 Continued
·, (Facility Number: '12-=-b f3 (Date oflnspection: b-7-: 17 I
~ •
24. Did the facility fail to calibrate waste application equipment as required by the pennit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes , check
the appropriate box(es) below.
0 Yes 5fNo 0 NA 0 NE
DYes ~o DNA ONE
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 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.
0 Application Field 0 Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
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?
Reviewer/Inspector Name :
Reviewer/Inspector Signature:
Page3 of3
DYes gNo DNA ONE
0 Ye s [29_No 0 NA 0 NE
0 Yes [3.l-Jo D NA 0 NE
D Yes ~No D NA 0 NE
0 Yes LR_No 0 NA D NE
DYes ~No DNA ONE
DYes ~No
0 Ye s ()a No
DYes ~No
DNA ONE
DNA ONE
DNA ONE
Phone: 9)p-_5o3--ors/
Date : I.e-7-./ol?
21411015
ompliance Inspection Operation Review
Reason for Visit: ~tine 0 Complaint 0 Follow-up 0 Referral 0 Erne ency 0 Denied Access
Date of Visit: D?:ff-ZlJ Arrival Time:l 8: ~ ~0 I Departurr Time:l 9':; :pu I County: f.~~n-Region: F~
rd?-,?f<..E--1-rr~.
Farm Name: .1? y rd rJ LA r ..s r--7 .!_., ;z.. I 3::f-'1 1J V."J7 Owner Email:
Owner Name: ro '1::-D :s Y'~ Phone:
Mailing Address:
Physical Address:
Facility Contact: 2P}, "'--p y d Title: ,IUV rt/" v'" --~~~~--~~,~~~---------Phone:
Onsite Representative: Integrator: ....Lin.;..:....,.~ ____________ _
Certified Operator: ,2~ Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation? DYes ~o DNA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other:
a . Was the conveyance man-made? DYes 0No DNA ONE
b . Did the discharge reach waters of the State? (Ifyes, notifY DWR ) 0 Yes 0No DNA ONE
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) DYes 0No DNA ONE
2 . Is there evidence of a past di scharge 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?
Page I of3
DYes ~No
0 Yes l)i.No
DNA ONE
DNA ONE
21411015 Continued
• !Facility Number: !Date oflnspection: ?-11-.ez.pAb
Waste Collection & Treatment
'• 4 . Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): lj: ra,-t'T
Observed Freeboard (in): 3~ 3.;.2-j)Z-
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Jcr
0
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
\
DYes ~o DNA ONE
0 Yes 0 No 0 NA 0 NE
Structure 5 Structure 6
DYes ~No DNA ONE
0 Yes f;Zl No 0 NA D NE
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 ~ 0 NA 0 NE
8. Do any of the structures lack adequate markers as required by the permit? 0 Yes ~ No 0 NA 0 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
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes gNo DNA ONE
0 Yes (i}..No 0 NA 0 NE
II . Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes [t}..No D NA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. CropType(s): hrM fA,}& lr;rv~":j-ed /(...-,--r-~ ry~
13 . SoH Type(s)o /Pl,r"""-/&t; /J$)~
14. Do the receiving crops diffe;(}m those de~ignated in the CA WMP? D Yes (N_No 0 NA 0 NE
15. Does the receiving crop and/or land application site need improvement?
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
Page 2 of3
0 Yes ttJ No
0 Yes 00-No
DNA ONE
DNA ONE
0 Yes GiNo 0 NA 0 NE
0 Yes _p;J No 0 NA 0 NE
DYes
DYes
00ther:
0 Yes
!29-No
~No
Ud_No
DNA ONE
DNA ONE
214/2015 Continued
. I FacilitY Number: d-&!3 !Date of Inspection: z~ 19= llb
24. Did the facility fail to calibrate waste application equipment as required by the permit?
' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
D Yes ~No DNA 0 NE
DYes _[8.No DNA 0 NE
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
0 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.
0 Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/in spection with an on-site representative ?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Pt~ge 3 of3
DYes ISJ.No D NA ONE
DYes ~No D NA O NE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA O NE
0 Yes DNA ONE
DYes DNA ONE
0 Yes DNA O NE
Phone: -5/D-1(33~
Date: 2 -I 7-.. ,,.i?-f)/"/., ·
21411015
I tz -...r-151 Arrival Time: I 9: : p Q Departure Time: I/ pi t!l" I County: c$'yutV'"'--Region: ~0
1D
Date of Visit:
Farm Name::..........J,13;;.J.r "-1yf-.Ja~J~o....-----t.'iJ~u::~..:r-.:.....=::".5:...:;:~:.;..~:· 7+-------Owner Email:
0wner Name: t/', ("-~~ t1. j a.... 5 p II cd V I
Phone:
Mailing Address:
Physic~Addr~s: -----------------------------------------------------------------------------------
Facility Contact: Phone:
Onsite Representative: Integrator: -......c..lnc.....:..~'JJ'"'"'-----------
Certified Operator: Certification Number: /9-o~>?
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discbarg~ and Stream Imoacts
1. Is any discharge observed from any part of the operation? 0 Yes !3-No DNA ONE
Discharge originated at: 0 Structure D Application Field 0 Other:
a . Was the conveyance man-made? DYes 0No DNA ONE
b . Did the discharge reach waters of the State? (If yes, notify DWR) DYes 0No DNA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d . Does th e discharge bypass the waste management system? (If yes, notify DWR) DYes 0No DNA ONE
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?
Page 1 ofJ
DYes
DYes
~No DNA ONE
~No DNA ONE
214/1014 Continued
!Facility Number: O,?L--7P 13 I Date oflnspection: Co-,£-} 5:
. Waste Collection & Treatment
·~.Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure2 Structure3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): I cr L'f-Lc:r
Observed Freeboard (in): ;<r ~~5"' • dls-
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
L'r
s.P-:
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
DYes b(l No DNA ONE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
DYes ~No 0 NA D NE
DYes ~No DNA ONE
DYes ~No DNA ONE
II. Is there evidence of incorrect land application? lfyes, check the appropriate box below. DYes ~No DNA D NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc .)
D PAN D PAN> 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Type(s): 75....-v:m ted 4...._1 eu r-r.!>~ I Cc,....-eJ /<. Y?::"
I
13. So;) Typ*): .w'l. ,.,.....___( {h{hiw CD
14. Do the receiving crops lifer from those des1gnated m the CA WMP?
15. Docs the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
Pagelof3
DYes
DYes
DYes
DYes
DYes
DYes
DYes
Oother:
0 Yes
J2S. No
~No
~No
~No
~No
~No
!g) No
[ElNo
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
214/2011 Continued
lli'acility Number: I nate of Inspection: t.. =£~ J,,--
. 24. Did the facility fail to calibrate waste application equipment as required by the permit?
•
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes ~No DNA ONE
D Yes ~ No D NA D NE
D Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to 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.
QYes ~No DNA ONE
QYes J2?l No DNA ONE
DYes ~No DNA ONE
DYes 18J.No DNA ONE
DYes 5a No DNA ONE
QYes {2g.No DNA ONE
0 Application Field D Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes rgJ No DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE
34. Does the facility require a follow-up visit by the same agency? QYes 6ZJ. No DNA ONE
Reviewer/Inspector Name: .:;;-;-~ G-ry~
Reviewer/Inspector Signature: -----~o;:::;;.."'::£::::=~-=?7""~"'"~-""'~~--------------------------­
Page3of3
Phone: 9/o--"(3 5-3.:JvV
Date: 0 --£ -;?{J/0
11412011
~~~~~~~~~~~~~~~~ ompUance Inspection O~.Jion Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: {3'l(outine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Owner Name: r j
Mailing Address:
Departure Time: I /!) :.m I County;J'~
Owner Email:
Phone:
Region:
PbysicaiAddress: -----------------------------------------------------------------------------------
Facility Contact: _.f;t....~..:::;._.L..C..~..i c.~K~___::D~v~rc..:;..J;.._ ___ Title: t:Jc,vn .._/"""' -J
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any di scharge observed from any part of the operation?
Discharge originated at: D Structure 0 Application Field D Other:
a. Was the conveyance man-made?
b . Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Pbone:
Integrator: /.l?~ClJc..v"­
Certification Number: /?Dt,?
Certification Number:
Longitude:
0 Yes j8No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE
2. Is there evidence of a past discharge from an y part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of th e State other than from a discharge?
Page 1 of3
DYes
DYes
~No DNA ONE
~No DNA ONE
214/2011 Continued
'[Facility Number: ct).-(,J3 I nate of Inspection: 7-.t:?--/~ I
Waste Collection & Treatment
• 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Snucture 1 Structure 2 Snucture 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): /9 19 'f<=f 'cr
Observed Freeboard (in): 37 3/-3L 3/o
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?
DYes ~o DNA ONE
D Yes D No D NA D NE
Structure 5 Structure 6
DYes jgNo 0 NA 0 NE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
DYes (gNo DNA D NE
D Yes [R No D NA c::J NE
DYes EJ.No DNA D NE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ')a No 0 NA 0 NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu , Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12.CropType(s): ~«-/ /:}Ciqc'{.,.-r/
13. soil Type(s): ILl?'-~/ &,/)_(JDco
14. Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Docs the facility lack adequate acreage for land application?
Page2of3
DYes
DYes
DYes
DYes
DYes
DYes
DYes
00ther:
DYes
~No
J29. N o
~N o
~No
J:B-No
fEJ.No
~N o
~0
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21412011 Continued
•
I Facility Number: !nate oflnspection: Z? -/y
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes ~No
0 Yes ~No
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to 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)
3 I. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond D Other:
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes ~No DNA ONE
DYes !29-No DNA ONE
DYes ~No DNA ONE
DYes &No DNA ONE
------------------------
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 0 Yes !;8lNo DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes [B..No DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes {l[No DNA ONE
Comments (refer:to:question #):rE:Iplaimany·YES answers and/or any additional recommendations or any other comments.:..;~'"'~.:'\':~">:':':··
Use drawings of facility to better expiain situations (use additional pages as necessary). . · · • ·
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3of3
Phone: Vo~...yJ"'.f-5~
Date: ?-.PZ~IL(
21412011
Date of Visit: Departure Time: I I.:) ~ 15 ~ I County: 52,~
Owner Email:
Region: lqf .JOJ13 I Arrival Time:lq;,oA-f'f
Farm Name: B~ NvrS8'Y
Owner Name-:~\/~trg--~.....:..;;..ya~~lyi,_'Y_~_r& _____ _
Phone:
Mailing Address:
Physical Address: YS:t lafte .ArJeit'a Pd. ) T111 l'9'
Facility Contact: Mn'ck flwr.L Title: HtJ,oe I ---'-....:.:"t)"'T"'-------Phone:
Onsite Representative: _Rr\ttL..IIQ...J.L..u.C...:f--...~'?f~.:..aJ__x....;;;.....;... _________ _
u.._n
Integrator: .....:..I...:,_ 1....:42.=-----------
Certified Operator: Job 0 fbir/ ({' l, 11d
I
Back-up Operator:
Location of Farm:
Discharges and Stream Impacts
l. Is any discharge observed from any part of the operation?
Latitude:
Discharge originated at: D Structure D Application Field
a . Was the conveyance man-made?
D Other:
b . Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Certification Number: ...JJ...Jq....lQ~h~7 ____ _
Certification Number:
Longitude:
0 Yes 0No DNA 18fNE
DYes 0No DNA ONE
DYes 0No DNA ONE
d . Does the di scharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ~NE
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
ofthc State other than fr om a di scharge?
Page I of3
DYes 0No
DYes 0No
DNA ~NE
DNA i54"NE
214110 1 I Continued
IFacilitf'Number: Cb ib I Date oflnspection: c::'(IJo U3
Waste Collection & Treatment
4 . Is storage capacity (structural plus storm storage plus heavy rainfall) Jess than adequate?
a . If yes, is waste level into the structural freeboard ?
Structure I Structure 2 Structure 3 Structure4
Identifier: ~07;:-3Jn~l ~[3 357'j_
Spillway?:
Designed Freeboard (in): r9 l<} l2 l2
Observed Freeboard (in): s]~ ~Q 3.) L/3
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?
DYes ~No
DYes 0No
DNA ONE
DNA ONE
Structure 5 Structure 6
DYes ~No DNA ONE
DYes ~No DNA ONE
H any of questions 4-6 were answered yes, and the situation poses an immediate public health or environ~fl threat, notify DWQ
7 . Do any of the structures need maintenance or improvement? DYes l$'No DNA ~ NE
8 . Do any of the structures lack adequate markers as required by the permit? 0 Yes ~No DNA D 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
maintenance or improvement?
Waste Application
10 . Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
D Yes 0 No D NA fia NE
DYes 0No DNA ~NE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. DYes jE'No 0 NA D NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN > 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): Coo,ia \ 'Btrmvda./ilfowazt;_; SmHgmJh CN1He:d
7
13 . Soil Type(s): YvD.j_f{k!b GotdrbtrO
14. Do the r eceiving crops <liffer from those designated in the CA WMP?
15 . Does the receiving crop and/or land appli cation site need improvement?
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17 . Does the facility lack adequate acreage fo r land application?
18 . Is there a lack of properly operating waste applica tion equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate ofCoverage & Permit readily available?
20 . Does the facility fail to have all components ofthe CAWMP readily available? If yes , check
the appropriate box .
DYes ~No
DYes 0No
DYes 0No
LJ1<1)
DYes ~No
DYes 0No
DYes DNo
DYes 0No
DNA ONE
DNA ~NE
DNA l)dNE
DNA ~NE
DNA ~NE
DNA JSaNE
DNA gNE
DWVP Ochecklists 0 Design D Maps 0 Lease Agreements 00ther: _________ _
21. Does record keeping need improvement? If yes, check the appropriate box below. ~Yes D No 0 NA 0 NE
~Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Ra infall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~No 0 NA 0 NE
23 .1f selected, did the fa cility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes D No k3 NA D NE
Page 1 of3 2141101 I Continued
lf'acility'"Number: $¢ I nate of Inspection: qlJO /l3
24. Did the facility fail to calibrate waste application equipment as required by the pennit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes D No ~AA [}}NE
0 Yes ~No .,)4 0 NE
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance :
26. Did the facility fail to 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 fac ility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
DYes
DYes
DYes
DYes
DYes
DYes 31 . Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other: -----------------------
32. Were any additional problems noted which cause non-compliance of the pennit orCA WMP? DYes
33. Did the Reviewer/Inspector fail to discuss re view/inspection with an on-site representative? DYes
34. Does the facility require a follow-up visit by the same agency? DYes
~No DNA
0No ~NA
&No DNA
[}a' No DNA
DaNo DNA
IS(l No DNA
[8No DNA
!ENo DNA
~No DNA
Comments (refe(to question#): Explai,n any YES answers and/or any additional recommendad:oll~c9r';ll;J!Y.OJ~,er ~~!Ji:e_!lh'
Use drawingsoffacility to better explain situations (u5e additional pa es as necessary). -;--~,~~t;·~:;r~~;~V!·. ·. ':: -~~'t.f.~~
PEv at oowfal"'
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Noo io re ~.ss~cL (~<.e~ M~)
Reviewer/Inspector Name : "0o0a Schneife
R eviewer/Ins pector Signature:
Page 3 of3
8:Compliance Inspection Operation Review 0 Structure Evaluation
Reason for Visit: S Routine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency
Departure Ti~e:U~~Q PH I County:Jb..,~JD] ,
Owner Email:
Region: t;="l2 0 Date of Visit: 15"'Jt~J \3 I Arrival Time:h~ooPH
Farm Name: ByaL lJvr.1:frl ------------------
Owner Name: \tir"JbitL '6yrt& Phone:
Mailing Address:
Physical Address: 'iS":r lol<=e M-rJja fJJ..
7
Twft-ev
I
FacilitY Contact: Pattr1Ck e~trl Title: ~~ Phone: I ~~..;K:;..::r:.l-loL..------
Onsite Representative: P@rclt By~ Integrator: _lt-.......... .9;;:...._ ________ _
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? 0 Yes ~No
Discharge originated at: D Structure 0 Application Field D Other:
a. Was the conveyance man-made ? D Yes DNo
b. Did the discharge reach waters of the State? (Ifyes, notify DWQ) DYes DNo
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 DWQ) DYes 0No
2. Is there evidence of a pa st 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?
Page 1 of3
DYes ~No
DYes jgNo
D NA ONE
D NA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21411011 Continued
loate of Inspection: .S:II~h3
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: 351~ 3513 3Sl~ ~{]1~
Spillway?:
Designed Freeboard (in): ,q l9 lq I~
Observed Freeboard (in): ~ ~ .3~ 3~
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?
DYes ~No
DYes 0 No
DNA ONE
DNA ONE
Structure 5 Structure6
DYes ~No DNA D NE
DYes f'itNo 0 NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public healtb or environmental threat, notify DWQ
7. Do an y of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
f)g"Yes 0 No D NA D NE
D Ye s ~No 0 NA D NE
DYes [B"No 0 NA D NE
DYes l}iNo 0 NA D NE
I I. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~ No D NA D NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn , etc .)
D PAN 0 PAN > 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s))' 'W~ =~
13. Soil Type(s): ~ Cl l ~-= ~Jo/tt;,SPV/f 0t4~
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per th e irrigation de sign or wettable
acres detennination?
17. Does the facility lack adequate acreage for land application ?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19 . Did the facility fail to have the Certificate of Coverage & Permit readily available?
20 . Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box. ·
OWUP 0checklists D Design 0 Maps 0 Lease Agreement s
21 . Does record kee ping need improvement ? If yes , check the appropriate box below.
D Yes ()a No DNA
DYes ~No D NA
DYes fid"No D NA
DYes ~0 D NA
DYes ~No DNA
DYes (lgNo DNA
D Yes ~No D NA
0 0ther:
0 Yes lXt No DNA
ONE
ONE
ONE
ONE
ONE
O NE
ONE
ONE
D Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analy sis D Waste Transfers 0 Weather Code
D Rainfall 0 Stocking D Crop Yield D 120 Minute Inspe ctions D Monthly and 1" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? D Yes Q!No 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes 0No ~NA ONE
Page 2 of3 21412011 Continued
· I Facility Number: I Date of Inspection: slt3 In
24. Did the facility fail to c alibrate waste applica tion equipment as required by the permit?
25 .1s the facility out of compliance with permit conditions related to sludge? lfyes, check
the appropriate box(es) below . ·
D Yes [SI-No D NA-0 NE
DYes rs(No DNA D NE
D Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail. to 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.
DYes [8"No DNA ONE
DYes DNo Di-NA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes jgNo DNA ONE
DYes ~No DNA ONE
D Application Field D Lagoon/Storage Pond 0 Other: -----------------------
32 . Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes 1)jtJ No DNA ONE
33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes ~No DNA ONE
Comments (refer to question#): Explain any YES answers andlor·any·additional recommendations or any;other C:ommelitS,"-~'~t.S:jti~:
Us~ drawings offaciJjty to b~tter explwn situations (use additional pa es. as necessary). , ; ~;::: ~;,.~~i_;· ~y:;I:Jtil:'rtL':
1 Pt~&lcf"k~r bee, srr~~~M.dll On ~~ btn A. ~~ Wt\rk~ 011 lo-'OC'Il I [S'!:Ysl~}
1 ~. H:IJfvre.r-hdt" nm.ltJ l+ Y"8"e I r'mfl ~to,/ Qc. ril -fbI~ a Dl ~~ , ~
J:J. L~ a is ... T t>. '#f. sludJ~ io lrf''tL -t-lfth,.,.-t-wAI.bte.. ' I+ ,.,{f fl'('er;l c. '1/'rtJ.:f-m
a -tetv yetYs.
we\( Q'j~ heJ.. r~cfYfis \
Reviewer/Inspector Name:
Reviewer/Inspector Signature :
Page3 of3
Phone: q(l):<f33-3~
Date: Ha.v l3i ~013
hao'ii
. Date . sll3)l3
.. .
: NPDES (Rain breaker PLAT ..('nnual Cert ·Daily Pipe )
·.; L--:1 .• -: ·.· 'JD11-. . ·: J L-'1 ·. ' .. :: .. : :~·:· :
1 'r a.'J-:1. :
/_
,..., '3DII . '. ·: ,.: .... rn ·, j 'tt. In -· . ,·
lagoon Name, S for' spillway . ·-
Design F reepbarcU. Last Recorded (in) --
~-
lbll:t I)...· 'J&I/1 : : · ···•·· ··
Ratio Sludge to Treatmen_tlVolume if> 0.45 ,~ . 4~ , )p • *
Date out of compliance/POA?·;. ~. ~s--s1"rkfftJ~
Calibration Date ·:'· _; :: • 1 :~~~h. · ·2 WA-3 ' 4
Ring Size (in) : · · . i-j;fr" " ~ ~
Design Flow (gpm) . ; :trd£:0: ..Jf4;"'
Actual Flow ; : · · : ; . ~ l(J(J): .:! ~:
Design D i am ~ (ft) ..• : :M-:000·. ,: :hr
Actual Diam.' :. : · :-~-~~~ ·
: S'!.f~L \(Sdtjj ;~ .; ;''
Soil Test Oat~ Qbr'lti ' i i ·! :' , ·
HF. ld ' ~.-'. p 1e s 1 ; :•·: :: .• i: :
5
..
6 7
Transfer Sheets
RAIN (3AUGE
8
lime Needed : 1 : • ' ! ::-:! · · ·
lime Applied l "1'Jir-:UiRt( 1
Cu-I ~n-1..../·:·i'.!i_ .
Dead box or incinerator __ _
Mortality Records
Check lists
N d S (s I '25). -~··; ;.: . ee s -c;: · ·-k ''·:; !;:.;j;:
Needs P ~ l , :W: i1 I !1-l' ii;r ;j !: .: I • . . '~ ' • . . ...
Storm Water
Pull/Field I ! Soil ~ : ~ : Crop Acres PAN Window Max Rate MaxAmt I '
I(I)!Qp tA-lO : Wd : ::! ~ ; :: 1 e:a PDtf. sr;r'fC "'"-II ~O_~_!JJ:Jtv_ . ~~Sttl ~",(Jtf-1-flt O,f:> .()
IOltt ~ '.hd ! l L' ·~F _,. r.q IAI ..L ..
' . : ..
If !.')). QA-at hi :tOn · : ;_ ~ ! . ; ; :: [ . ; i . .• ~ . ; (&fn Q~~ />O ('), r-
~G BJ~t~ !~ 1 a~q. ~"/c;() Os-. ! ~
' ''
4c-€ :~~ ' '"' J'L'f'' Pl.\Jioo (),(b ~ :
' ·. ' j l i : ~
I . ~ ! := !
i ' !' i
I :I i j:·; ~· f ~ ~ ! i :·'I :!:'1
i :! i ~ ~ i -· I ;:·
I . ··: ., ! ;;
-' ' .. ' . ,. ' .. . I l!t-ql J Al-:t
! : · ·~: I' I •:: .: · O -SJP ty-1 ~fJ0 J '(J
Verify PHONE NUMBE :and affiliations IP -J'1«<J fe-
Date last wup FRo' ~ufos : · FRO or Farm Records fet'~ t.t. 1
Date last wu~ a~ ~armj ~M~ Lagoo~ # V'-:2~ 10 \1"8/tJ.H..
App. Hardware i .· · .. ·, , Top D1ke
I ,.·'1 " St p ! 1 i · , · ; . . op ump
' J ~ ~ I ! i .· . ! ! • i ' . Start Pump . I i i : ., ; : i : ...
Conversion-Cu -i 3ooo:=! oa· ib,ac; Zn-1 3000:: 213 lb/ac
. ·•· . .!:!·!!''···,· •.
CompUance Inspection Operation Review Structure Evaluation
Reason for Visit: fi!fRoutine 0 Complaint ,Q Follow-up 0 Referral 0 Emergency
Date of Visit: I {t f l'// b I Arrival Time: I~ ; S:O J4IJ Departure Time: I jf): )())1 V'fl County: ~~flh
Farm Name: Byf'l. IJVIS(J-y Owner Email:
Owner Name' ll;tgWu'a. l'l r,J.,. Phone'
Region: FRO
Mailing Address:
Physical Address: 45Y Lalte Adet,'a flt~ \vrlt'ofr
./ I
Facility contact: Pafdctt P>7rtl-Title: H01qgf/ Phone: 533-3~3~
Onsite Representative: _.lhl~.:..~l:....fw·'c.:..t_ .... e~.:.T_,....!:ccL...¥.:=------------
certified Operator: \Job 0 lbtr.' ck By rti
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I . Is any di scharge observed from any part of the operati on?
Di scharge originated at: 0 Structure 0 Application Field
a. Was the conveyance man-made?
0 Other:
b. Did the discharge reach waters of the State? (If yes, notiry DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Integrator: ___,~H...L...-....l8"'-----------
Certification Number: 1'10w7
Certification Number:
Longitude:
0 Yes ~No DNA ONE
DYes 0 No DNA ONE
0 Yes 0 No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notiry DW Q) DYes 0No DNA ONE
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?
Pagel of3
DYes BNo
0 Yes ~No
DNA ONE
DNA ONE
2/411011 Continued
• [Fii'C[l'ly Number: ~ {)... -<013 !nate of Inspection: "/flf/b
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): 19 ~~ I~ l'l
Observed Freeboard (in): J~ 32 i;J_] 3s-
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?
0 Yes g No 0 NA 0 NE
DYes 0No DNA ONE
Structure 5 Structure 6
DYes ~No DNA ONE
DYes ~o 0NA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit''
(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 requi re
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes !Sa No 0 NA 0 NE
0 Yes !B'-No 0 NA 0 NE
11. Is there evidence of incorrect land application? Ifyes, check the appropriate box below . 0 Yes ~No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu , Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Appli cation Outside of A pproved Area
I2.CropType(s): Co0-fa/ Bf'r111c.rk StndUyo/a 0Vft!fft1_
Wqgtrm \s ; Golds-W() Is 13. Soil Type(s):
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Pagelof3
DYes
D Yes
DYes
~No
~No
~No
DNA ONE
DNA ONE
DNA ONE
DYes 'EJNo DNA ONE
DYes ~No DNA ONE
0 Yes ~No DNA ONE
0 Yes [it No DNA ONE
Oother:
0 Yes lSJ No
0 Yes ~No 0 NA 0 NE
0 Yes 0 No ~ NA 0 NE
21411011 Continued
•I Facil!ty Number: I Date oflnspection: 6/14/(rl.,
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes ~No
0 Yes ~No
DNA ONE
DNA D NE
D Fa ilure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
Li st 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 th e facility fail to secure a phosphorus loss assessments (PLAT) certification'!
Other Issues
28. Did th e 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 a ir quality concern?
If yes, contac t a re g ional Air Quality representative immediately.
30. Did the facility fail to notifY the Regional Office of emergency siruations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do s ub s urface tile drains exist at the facility? lfyes, check the appropriate box below.
0 Yes ~ No 0 NA 0 NE
0 Yes 0 No llJ NA 0 NE
0 Yes ~No 0 NA 0 NE
DYes ~No DNA ONE
0 Yes l}g No 0 NA 0 NE
D Yes a No 0 NA D NE
D Application Field 0 Lagoon/Storage Pond 0 Other: ----------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
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?
DYes QJ'No DNA ONE
DYes jgNo DNA ONE
0 Yes ~No D NA 0 NE
Reviewer/In s pector Name: Phon e: ctlo-433-33CYJ{ rift(€}
J
Reviewer/Inspector Signature :
Page 3 of3
Date: Jme N. ~OJ d..
I
21412011
, . ·F~~cility No.~;)-0lJ Farm Name ......:;13-fy ...... rJ .............. AJ:,._v~._~-=(J-~y--Date {o\ l~)lJ--
Permit L COC ../ OIC_ /
I
NPDES (Rainbreaker PLAT Annual Cert Daily Pipe )
FBD ~ rops 3 Lt
l3_J, ~ • tlfl
(YiL..J.. ,I I
11:>111 " fA
~ Lf 'IS'. I~
-"'
Lagoon Name S for spillway 1 .~d 2-~ n3 3~(/ 4.:>mt'
Design Freeboard I Last Recorded (in
Observed freeboard ;JLJ 37 cl.'"l ~-
Sludge Survey Date ~lgJu ,
Sludge Depth (ftJ .~ .. 't S,f J,_} ;},8'
Liquid Trt. Zone (ft :Yd 4,!0 s11 4,t.,
Ratio Sludge to Treatment Volume if> 0.45 , Y_'1
Date out of compliance/ POA?
.:')_t · v_fi dbrQ H91~
Calibration Date / 1 qJJJ to 2 3 4
Ring Size (in) J.t*' /
Design Flow (gpm) ;:)o'i'· -50/J 1 (;;>/}){57_}
Actual Flow aor
Design Diam. (ft) ~On i::nt
Actual Diam. 'db')
Soil Test Date ~h'lht
pH Fields ~ '[',~5'f>
Lime Needed L)-f, b
Lime Applied '
Cu-I ~ Zn-1 1./
Needs S (S-1<25) <---
Needs P .. (',
Waste Date --lltJlh
-60 Day
+ 60 Day
N (lb/1 000 Gal) JS.tU~:?.;J
pH I
~1~111'1
~IS."l .ll
") l( J,h
I I
CropYield ~
Wettable Acres ·
WUP
Weekly FreeboardV""
1 in Inspections· ..../
120 min lnsp c./'
:::::::::"' Weather Codes
l:lJr.t;lfl IDIJF/r 1 I <1./ffifl
~~ l3l 'I 'J,11J 1-i' ~liJtS
l..,Y f. C.. lt>:OCJ
5
lb/rr;/ t'
I,Lf.~J) I:.,"
IS-7,) ,,:0-1~ 7,1-"J.I.f 7-tf-1,5 (,"J-·1./ 1/-g ,_Q
;> l.dYIJ•
.Lh f1
5 6 7
6 7 8
Transfer Sheets
~UGE ~
~or incinerator -~
Mortality Records
Check Lists
Storm Water
Pull/Field Soil Crop Acres PAN Window Max Rate MaxAmt
IA-t.D vva_ tB~-001 M6--Se.9i o.b '· £) ~'te b'ol-e__·tth 100 Cci, f1ty
::) !tva C~'lli
'iA-e~~v lt;"f.lt ~ ~).... 0>
50 lSG OS
Ll B -8Hv 6oV!Jb1YD lS&i!J£
I
4c.-4e IVVO-o~~-v
Verify PHONE NUMBERS and affiliations
Date last WUP FRO q/11~ FRO or Farm Records
Date last WUP at farm ~f -Lagoon#
App. Hardware Top Dike
L... J~ 11 ..L _ ~t Stop Pump
"··?)-wit t'Orc.t'MI\ ~~Hll\(f'" Start Pump \~~ot~·
Conversion-Cu -I 3000= 1081b/ac; Zn-1 3000= 213 lb/ac
Operation Re\'iew 0 Structure Evaluation
0 Follow-up 0 Referral 0 Emergency
Date of Visit: Arrival Time :I11~10At1 l Departure Time: II iCXJPH I County:.5:Jmp{))
Fa•m Name: Corti Ahuuy LJ.3-Pattie k ~ AIIISftJ Owne. Email: I y I
Owner Name: \fo-e \), "6} ~ Phone:
Mailing Address:
Physical Address: 455 Lllrf Ariola Ja. Tw key
7 I
Phone:
Region: [gc
Facility Contact: Pa-\ck'<. BJaL Title: ....:.t\oo....~~~~o:..a.;~~ff'~..A------
Onsite Representath·e: llitricJt.. By,J < Integrator: __,_H..:..-__..8:::....._ _________ _
Certified Operator: "\[Of Syal Certification Number: ..:..1 q....:..:..b'..;..ICj.#--------
Back-up Operator: \Jo~n P, Y3ycd.._ Certification Number: ..~..JCl...:..:B~h::...7.L.......-----
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any di scharge observed from any pan of the operation?
Discharg e originated at: 0 Structure 0 Application Field
a. Was th e conveyance man-made?
0 Other:
b. Did the discharge reach waters of the State'! (If y es, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass th e waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there a ny observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Pag e I of3
Longitude:
D Yes fia No DNA ONE
D Yes D No DNA ONE
D Yes D No DNA O NE
DYes f8 No DNA O NE
D Yes ~No D NA ONE
D Yes D No DNA ONE
214/2011 Continued
.IFacili~: Number: ltd---bl3 I Date of Inspection: 9}7/1 I
' Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the stru ctural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): i9 lg ~~ l2
Observed Freeboard (in): Q5 ~L 4-d.. :3'J.
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?
0 Yes r;i{No
0 Yes 0No
DNA ONE
DNA ONE
Structure 5 Structure 6
DYes ~No DNA ONE
DYes ~No 0NA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public bealth or eR\•ironmental threat, notify DWQ
7. Do any oftbe struct ures need maintenance or impro vement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than th e waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or com pliance alternatives that need
mainte nance or improvement?
f:g Yes
0 Yes
0 Yes
DYes
0No DNA ONE
~No DNA ONE
f)rNo DNA ONE
~No DNA ONE
II. Is there evidence of incorrect land application? If yes , check the appropriate box below. ~Yes 0 No 0 NA 0 NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Z n, etc.)
D PAN 0 PAN > 10% or 10 lbs . D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
S outside of Acceptable Crop Window 0 Evidence of Wind Dri ft 0 Application Outside of Approved Area
12 .CmpType(s): ~~~M~~ f~,~· ~~mfO Ovrod
u. so11 Type(s): .huua"lls ;_6.dd.sb.Dm [s
. ./
14. Do the receiving crops differ from th ose de signated in theCA WMP?
15. Does the receiving crop a nd /or land application site need improvement?
16. Did the facility tail to secure and/or operate per the irrigation design or wettable
acres determinati on?
17 _ noes the facility lack adequate acreage for land appli cation?
18 . Is there a la ck of properly operating waste appli cation equipmt:nt?
Required Records & Documents
19. Did the facility tail to have the Certificate of Coverage & Pcnnit readily available?
20. Does the facility fail to have all co mponent s of theCA WMP readily available? If yes, check
the appropriate box.
DYes ~No DNA
gYes 0No DNA
0 Yes 0No DNA
DYes l2'f No DNA
DYes lSQNo DNA
DYes f2] No DNA
DYes 0No DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
OwuP 0Checklis ts 0Des ign 0 Maps 0 Lease Agreements 00ther: _________ _
21 . Does record keeping need improvement? If yes, c heck the appropriate box below. ~ Yes 0 No 0 NA 0 NE
S' Waste Application 0 Weekly Freeboard t;:;a Waste Analysis 0 Soil Analys is 0 Waste Transfers D Weather Code
D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute In specti ons 0 Monthly and I" Rainfall In spections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~;){No 0 NA 0 NE
23. If se lec ted, did the facility fail to in stall and maintain rainbreak ers on irri gation equipment? 0 Yes 0 No Q:"NA 0 N E
Page 2 of3 21412011 Continued
{Facilit:;. Number: 15~ -013 I Date of Inspection:q ("ll//
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes r)tNo DNA D NE
DYes l:i}No DNA D NE
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 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? DYes f8No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes DNo RjNA ONE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes "'t8 No DNA ONE
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.
DYes t;i~No DNA ONE
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)
DYes ~No DNA ONE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes S,No DNA ONE
0 Application Field 0 Lagoon/Storage Pond 0 Other: ----------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP ? DYes DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes DNA ONE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
• i=~ciiitv No. ~·d~IJ Fann Name D, rd N'rJflfi r Date ____ _
Permit ~ COC .-/ r OIC_ I
l
NPDES (Rainbreaker PLAT Annual Cert )
\ a .2-:? .3 4
Pop. Design Current FB ....... lobJIJl) 11/lJIJJ 111>
31 ~/11 111 l llfl.
Type Drops 1/h/1. f) ~l[J b ~n ,J/J " "" I" "" y ~. I J ~ ~-~~ll ') J ~; IJJ}if ·
ltd i)-t 'rf'l 6 !il ru (,J. ~. IJJ ~~';\) 11
I oWl ;,r' ;mr ,/n~~ :.t,S-IA.. -~s· 3 357'li
Lagoon 1 2 3 4 5 ff 7
Spillway
Design freeboard
Observed freeboard (in) .. ~-1 .... ~ /Ja 1.1'\ .3'1-"'"'CCt..
Sludge Survey Date ~~ ~~ I -
Sludge Depth (ft) -,., L 5t) 1 d.5 io}.'6
Liquid Trt. Zone (ft) c;-, I ij .~ c;-{'1 4 ·~
Ratio Sludge to Treatment Volume O,Lf"l, ,a<f
Calibration Date 1-f/IIIV 2 3 4 5 6 7 8
Design Flow (:Ju;'
Actual Flow ;)£))
Design Width 'l/)J
Actual Width ~
Soil Test Date I, 11 ~ Ftit1o t1( Wettable Acres AUGE ~ ~or incinerator V"
Mortality Records
PuiUField Soil Crop Acres PAN Window Max Rate MaxAmt
lA I~ ~~~Goy> ~3.5 ftJ~/ Hi--y,~fli--H-.r o.tt? ,, t)
\t3 J,a C)f13/too .....
~ .:>.~ I
lO d;' I d,4 \V
~ I~ ~ ,,q I';JIJliltoo
* loo it13/!E6ra'>€. s;o ', b~:\/S"O D.'<\
llA..W ~f) 1,0
lle-E l ~l 'JJ}D
~tH1 jt v
LIC.-£ W()... "-.. l ~lf+q,o 'dDa !too "
I ~ QI/~-IOtb ..i:> . 3J .~~/ rcttYC~~ 4h HIY-;.. Verify PHONE NUMBERS and affiliations ~OW ~ If_ Fefr-Hthll J"t)
Date last WUP FRO 9/1 )ay-Date last WUP at farm · lrl. I tQr App . Ha!dware
FRO or Farm Records
Lagoon#
Top Dike
Stop Pump
Start Pump
Conversion-Cu-I 3000= 108 lb/ac; Zn-1 3000= 213 lb/ac
:bet-~JS~-)J~~~ len/~-~~
Out-· ~ ...-k,f ~ /
. . . . .
rraJ e -d{J'<~ ~ -v I ~h tJ~ af_ JJ.\ ~ V{ ~
orx ..
I 1\L\b (j~J<ti
\i:\11~~ ()~~;
Ol-%{lj
~}~JLO (JJ-Y-?t
f'JFJJ\,(} 0 10c-fO ~~~ ~"9 kJJ 5
b}qljl1
bJ(ete
bpe\eJ
<»1\L~lb
Olj~Jjl
ll)blS
~Lo~~~o
Type of Visit ~Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason tor Visit ~ Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Dat e ofVisit : 91~1\JQ I ArrivaiTime:lq ',~O'WI DepartureTime: Ill~ 15"&71 Coun ty:~fSGb
Fa rm Nam e: l4cd.. /Vvcr;er; J;'.:}; 3 ·-fbtrJ!l(B~rJ Alvt>y Owner Email: ---------
Region: ER.t?
Owner Nam e: _j:........_Q:e..u.· -------Byrd_ Phone: ...:..5 .... ~ .... J3.._·-_,.3=dJ=-.)-_____ _
Mailing Address: -----------------------------------____ _
Physical Address:----:-:-------.::----------------------------------
·-,...... ''~,..~.,. t, '' n .J Facility Contact: .JOhl\ ruwtc\(. PYftb: Title:---------Phone No : 53}. JJ1.3:l.
.-''\ltr~ll T
Ons ite Rep resentative: ..JioJIL..WO:....;h-.:n:..J.............;7~n_.~....::::::;.___________ Int egrator: .....:....M .... -___.,B..L-------------
C ertified Operator: J'oe..-___.B.....,.y .. ,.J.. ......... ______ Operator C ertification Number: __._)q....:.,.,.8:....:./__.lf,___ __ _
Back-up Operator: :fohn ____,\3"""'i'y .... aL""-=------Back-up Certification Number: lCf0b7
Location of Fa rm: r--~o D'D " Latitude: L.....J Longitude: D OD'D"
Discharges & S tream Impacts
l. Is any discharge observed fro m any part ofthe o perati o n?
Disch arge orig inated at: 0 Stru ctu re D Appli cati on Fie ld 0 Oth er
a. W as the conveyan ce man-made?
b. Did the di scharge reach waters of th e State? (I f yes, not ify DW Q)
c . Wh at is the es tima ted vo lume that reached waters of th e State (ga ll ons)?
d . Does disc harge bypass the wa ste manage ment system? (I f yes, noti fy DWQ)
2. Is there e vid ence o f a past disc harge fro m any part of the ope ra ti on?
3 . We re th ere a ny adverse impact s or potential adverse impacts to th e Wa ters of the State
other tha n from a d is charge?
Page I oj3
D Yes iaNo DNA ONE
D Ye s 0 No DNA ONE
D Ye s 0 No D NA ONE
D Yes 0 No DNA O NE
D Yes .QJ No DNA O NE
D Yes 8"No DNA O NE
12128104 Co n tinued
1 I Facility Number:cp~ -C,f3l Date oflnspection jqj-;nltp I
~ CoUection & Treatment
4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: ~J. 73 7':1. 75'
Spillway?:
Designed Freeboard (in): \9 19 I~ )'f
Observed Freeboard (in): ~(t; ~s-3g 2?(4
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ 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?
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
DYes ~No DNA ONE
DYes 'liaNo DNA ONE
If any of questions 4-6 were answered yes. and the situation poses an immediate public health or environmental tbreat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
DYes ~No DNA ONE
DYes J)aNo DNA 0 NE
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
DYes ~No DNA ONE
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
I\. Is there evidence of incorrect application? lfyes, check the appropriate box below. DYes 1)4-No DNA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12 . crop type(s) Coada\ Betooda Po.ifve ·Small brata OS
}
13 . Soil type(s) WaJ,, \s ; Goldrb«'D \s
14 . Do the receiving crops differ from those designated in the CAWMP? DYes IS" No DNA
15. Does the receiving crop and/or land application site need improvement? DYes 0No DNA
ONE
ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? DYes i1 No 0 N~ 0 NE
17. Does the facility lack adequate acreage for land application? DYes lia'No DNA ONE
18. [s there a lack of properly operating waste application equipment? DYes 'Ga-No DNA ONE
~ -:-..~ :-.~.; . . .. ·. ~~; ..... ;; < :~; .. ~--'._._. .... _=-----·._-:._;r~~~:~---~-.--> '-#~, •• -~· ··~-t7:~ · .... ~ · :-. ~ ..:;~~~1:Sif.:: .. -
:C~mR,ten~s (r~~e~~to~ ~-ues_ti~~lm _ Expl~in ~n-~,~~-~~~swers,:~~.d/or any recommendapons or any •o~be~~·~i~~~~~c-
. U~ drawmgs o(ffacibty ,to'better explam satu~_t;oos. (use add.!~aooal -pages as necessary): .:~ ,:f ;~--. ~ • >-~:..'; i~ -. •-
-~~h-. .1" •• =~.;..)._ ·-·--·:,.;~:--~.--., ....... _. ~. ~1-;!. . .'-; ·~-~'f·-::;·. ~-~, ~ :: ... •--
• -
-...
Reviewer/Inspector Name Kf'"OAN SC@€f6~ : I Phone: 433-33>3
Re,·iewerllnspector Signature: ~ _ ~A-. J.JJH Date: ~;).I .~0//)
Page2of3 U 121211104 Continued
• I Fa~ility Number: <;S~ :::<R l3 I Date of Inspection RI-;;)..J It b
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fai I to have all components of the CA WM P readily available? If yes, check
the appropriate box. D WUP 0 Checklists D Design D Maps 0 Other
DYes ~No DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes CiNo DNA D NE
D Waste Application D WeekJy Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers D Annual Certification
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal_?
30. 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
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
DYes ~0 DNA ONE
DYes 0No (iNA ONE
DYes &f"No DNA ONE
DYes ~No DNA ONE
DYes R!No DNA ONE
DYes 0No !RNA ONE
DYes R!No DNA ONE
DYes ~No DNA ONE
DYes fgNo DNA ONE
DYes jgNo DNA ONE
DYes ~No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE
.. ,
3l./, Ora)h T; fer -NOI-e. ~W'1
Gad -{a~~~ reltd! ~-101/acre \!Me. srreocL Se,-t 40(01 P/o,rfo sf!Pd Yllt¥e ih s f'">:J. .
~,5/vJJe SiJfv( I'VOr Jt>re lrt ~010' ?>LfJOl!1J detned c.-+ aoo'6. L?P a IS
at 't s01 o. sZt~ -to I f t"''c1 volu.re .• \'It .'II nf'l'IL c.l-e~» o4 wi.P. 1M a )lf1# d(
h lihnj !50 o/ ().
Page 3 of3 12/28104
~ .Fac~lity No. 't;')__-ft1 l3
Permit /coc
Farm Name r!>yrd Alv~J
/ OIC_
Date _____ _
NPDES (Rain breaker PLAT Annual Cert )
FB
Drops 4-lS'I~i Pop. Design Current
Type
trn~ro I I I I
Lagoon
Spillway
Design freeboard
Observed freeboard in)
Sludge Survey Date
Sludge Depth (ft)
Liquid Trt. Zone (ft
Ratio Sludge to Treatment Volume
1 2 3
1 .fo
t), ')_ ln. 'i
Calibration Date 1 qiJ £0 2 3 4 5
Design Flow ~OJ'
Actual Flow ~D's
Design Width 300
4 5 6 7
~hi to
_,
,...:;;r
~
J.'-1 6r0 ~-q 0)
~~~ 4. 1 ~-' :-) ,f..lj{
6 7 8
Actual Width ~&,} •
~ SoiiTest Date ~.J~?s-lfO Wettable Acres .__...... ~G._AUGE
\pH Fields ~[i ~·/ IJpJ'bw, WUP \.::="'""' ~or incinerator
Lime Needed '\..-Lit L. J\f.tl~~~ Weekly Freeboard ../". Mortality Records __ _
Lime Applie~ q~o3=1Ailfi_AAY , /.d'\1 in Inspections v 1,., Si~lt!J 7 _(jm. '."A'*"'.A 1~ ltXJafl~ ~
Cu-I V Zn-1 ./ lf:!FI~ '-{ ~120 min Insp. ___ vv rJ ·' r,Jtl':tiJ..f'(f(V ""0.,
Needs P -~D Weather Codes fL}e,-if'~
Crop Yield 9 Transfer Sheets 7 '·-(
Waste Analysis Date ~Ill fn ~!d.}.. Lila. b\n lcll\ 1 ln\;)7 ~nl07
-60 Day
+ 60 Day
Pull/Field Soil Crop Acres PAN
\fvo__ li?r! Poit ~d.
U!J.-~ h) J~;).._
L\Jr(:~ do_cr-
Sr-.. 100
Verify PHONE NUMBERS and affiliations
Date last WUP FRO Date last WUP at farm
FRO or Farm Records
Lagoon#
Top Dike
Stop Pump
Start Pump
Conversion-Cu-I 30QQ ::: 108 lb/ac; Zn -1 3000= 213 lb/a c
Window Max Rate Max Amt
{').)
App. Hardware
IKs UVf I3laIlo9
' ID Division of Water Quality —11
Facility Number®—� 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review (Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency &Other ❑ Denied Access
Date of Visit:lt ,Arrival Time: �s Departure Time: County: SaTiffol Region:FP-Q
Farm Name: NV/j' l Owner Email:
Owner Name: / ,I A _I., 6 't/�7PhLone:
Mailing Address: 66o Laky - A 1'o -�
a k4ej )VC- 3
Physical Address:
T u
Facility Contact: -V n h n f adUck Title: H",O/- Phone No: 533--333a,
Onsite Representative: Integrator. WAY -910"
'fl
II�� ❑❑ J / 129/2
Certified Operator: �iie- JJ d7y/C1t- Operator Certification Number: A V&
Back-up Operator: anhh, T Back-up Certification Number: AWA I &7
Location of Farm:
0
Latitude: F-1 71
- Design Current Design Current
SwineCapacity Population Wet Poultry Capacity Population
❑ Wean to Finish I I Layer _
I® Wean to Feeder I I MOO I— 1 10 Non -La et
Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & 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?
Longitude: [A o "
Design Current
Cattle ICapacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ BeefStocket
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes CgNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
RfNo
❑ NA
El NE
❑�,
Yes
0 No
❑ NA
CINE
12128104
Continued �,

< I Facility Number: ~ j?tJ Date of Inspection It:> f~ tfD9 I
Waste CoUection & Treatment
4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: r'.2i1J • :3ST3 :>57'{ ;;){)lS'
Spillway?:
De signed Freeboard (in): 19 I~ I~ I?
Observed Freeboard (in): 3l ~} ~.J /Jp
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/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?
DYes l)ji'No 0 NA 0 NE
DYes 0No DNA ONE
Structure 5 Structure 6
DYes ~No DNA ONE
DYes IS(No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
DYes ~No DNA ONE
D Yes 'tia'No 0 NA 0 NE
DYes ~No DNA ONE
10. Are there any required buffers, setbacks, or compliance alternatives that need O Yes D No 0 NA fi"NE
maintenance/improvement?
11. Is there evidence of incorrect application ? Jfyes, check the appropriate box below. 0 Yes 0 No 0 NA ~E
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 100/o or 10 lb s 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s) -------------------------------------
13. Soil type(s)
14. Do the receiving crops differ from th ose des ignated in the CA WMP?
15. Does the receiving crop and/or land applicati o n site need improv ement?
DYes 0No DNA ~N E
DYes 0No DNA ~
16 . Did the facility fail to sec ure and/or operate per th e irrigation design or wettable acre determination?O Yes 0 No DNA ~NE
17. Does the facility lack adequate acreage for land appli cation ?
18. Is there a lack of properly operating waste appli cation equipment?
Reviewer/Inspector Name
Reviewer/Inspector Sign
Page 1 of 3
DYes 0No DNA ~NE
D Yes 0No DNA laNE
11118/04 Co ntinued
/
/~
• IFacilityNurober:<&d-. -"fJ I Date of Inspection I bl~l lor I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the fac ility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design D Maps 0 Other
DYes 0No DNA fif'NE
DYes 0 No 0 NA t)}NE
21. Does record keeping need improvement? If yes , check the a ppropriate box below. 0 Yes 0 No DNA ~NE
0 Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute In spections D Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes 0No DNA ~E
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes 0No ~NA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes 0No D NA ~NE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes 0No DNA ~NE
26. Did the fa cility fail to have an acti vely certified operator in c harge ? DYes DNo DNA g"NE
27 . Did the facility fail to secure a phosphorus loss assess ment (PLAT) certification? DYes 0No ~NA ONE
Other Issues
28 . Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes !2No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes ~0 DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? D Yes ~No DNA ONE
If yes , contact a regional Air Quality representative immediately
31. Did th e facility fail to notify the regional office of emergency situations as required by DYes ~No DNA ONE
General Permit? (ie/ discharge, freeboard probl e ms, over appli cation)
32. Did Reviewer/Inspector fail to discuss review /inspection with an on-~>ite representative? Q-ies 0No DNA O NE
33. Does facility require a follow-up vi sit by same agency? DYes 18No DNA O NE
-...
Page3 of 3 12128/04
Type of Visit Q}:;compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit §JRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Region: E~ Date of Visit: Arrival Time: I Cf.31J AtJ I Departure Time: I JO:S' A'11 County: SJ.,f Sb)
Farm Name: ~nl w vrsft' I) dj 3 -PM tt ~ yrL ~"'l(r) Owner Email: ----------
Owner Name : \JO-e.... By cd_ Phone:
Mailing Address:· t,fJo Lillte AcfeJ i a r/.J.._... --------------___ _
Physical Address: _]j...~..~~:~L..ri(..;!.~~Y---------------.:..~Nu.C-----------dg3 ~
Facility Contact: ""JJhn (lbbid;J ByrL Title: H&~ Pf' Pbone No: -------
Onsite Representative: ------------------Integrator: Nw=ro/ fD.,i ~ f-t¥J!JJ
Operator Certification Number: ......:...lq_.:;;N_I_.'f'-----Certified Operator: ___,~-D'-L_,=--------lii~"Jl<l'ii"--------
Back-up Operator: J'ol)n ( Rdncit) ~ Back-up Certification Number: _\_~_lJ_".;;......,J'-----
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation ?
Discharge originated at: D Stru cture D Application Field 0 Other
a. Was the conveyance man-made?
b. Did the discharge reach waters ofthe State? (If yes, notify DWQ)
c. What is the estimated vo lume that reached waters of the State (gallons)?
d . Does discharge bypass the waste management system? (Ifyes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
0 Yes 61No 0 NA O NE
D Yes 0No DNA O NE
D Yes 0No DNA ONE
DYes 0No DNA ONE
D Yes !9N o DNA ONE
D Yes (8No DNA ONE
12128104 Continued
rFaciUty Number:CZ')... -~l3 I Date oflnspection If] It{() lr I
Waste Collection & Treatment
4 . Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a . If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes fiSINo DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:----------------------------------------
Spillway?:
Designed Freeboard (in):-~) q-L---_.....,...,_1....~9 _____ -t:J~qJ!c-------+/9-'-------------
Observed Freeboard (in): -----'Y'-0 _____ 4....;....;o.0 ______ 3~ ____ ___;;;_3.x8' __ ------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc .)
0 Yes r)?No 0 NA 0 NE
6 . Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE
through a waste management or closure plan?
If any of questions U were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any ofthe structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the penn it?
(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
maintenance or improvement ?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
D Yes !)a No 0 NA D NE
0 Yes (llNo 0 NA 0 NE
DYes 3No DNA ONE
DYes i)gNo DNA ONE
II . Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~No DNA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc .)
D PAN D PAN > 10% or 10 Jbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12. Cr~p type(s) <Ada' iftJ!Io~da ( PJ; ~G 0) wri\.J& lomva I
13 . S01l type(s) Goldrlxro j braJUJt,
14 . Do the receiving crops differ from those de signated in theCA WMP ? DYes
15. Does the receiving crop and/or land application site need improvement? DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination?D Yes
17 . Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 2 of 3
DYes
DYes
18No DNA ONE
~No DNA ONE
18'No DNA ONE
MfNo DNA ONE
Da'"No DNA ONE
Continued
., Facility Number: q~ -kB I
Required Records & Documents
Date of Inspection bJ II Of
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box . 0 WUP 0 Checklists 0 Design 0 Maps D Other
DYes ~No DNA ONE
DYes id"No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes tid No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~N o DNA ONE
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes DNo ~NA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes IS" No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes !ilNo DNA ONE
27 . Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 0No ~A ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes fil No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document D Yes IRI No DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes '6lNo DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes IS' No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes tia'No DNA ONE
33 . Does facility require a follow-up visit by same agency? DYes ia"No DNA ONE
Additiona'lcom~~~~~~:iili'dlor/!>~~gs:.;_·· \ · '~.:~ .,~, · · '···. 't'~Tt~¥~i~t,.~,·-·:;: .. ·,;'"~ ·,.· •';::~:~:~~1f,f.'i~t ·. · "',:~;~\~~~
~· Calibral&l ~It'll~. w;lf nettL-fo 'hed41e_ -/1,/J ye~,
;;rr . L~ijt»~ 4 ( :ltatns) h~ CL ;;). '!; {!.+1 \~e(h!. CO<./J.. noi-~ -h-e P04
Of) J.~ \1\spec\-etL. Peth1t\-r-e"-e~\ is by 1nJ.. ~ s e,-+-~oo 'I J tvi.Jrl,
..? affllcll'l\o., dt>a..! I k '»y ir.J oT H 1YC ~ 01 OO'f. tv Ill -to I H·o P~n lolly-
ahovT-ofh'o"5.
W~l' ti-t{Tt ~"' oJ_ f'ecOrdJ,
Page3 of 3 12118104
...
1--
1--....
• FacilityNo.~f3 Timeln ____ TimeOut ___ _ Date _____ _
Farm Name ---------------Integrator __________ _
Owner Site Rep------------
Operator No.--------
Back-up ~ No.--------
COC (/ Circle: ~ or NPDES
DesiQn Current Design
Wean-Feed IO'-foo Farrow-Feed
Wean -Finish Farrow-Finish
Feed -Finish Gilts I Boars
Farrow-Wean Others
Current
1* J-'-1()
*J.-'/o
J-33
Lf-J 'i ~
FREEBOARD: Design m;]U #-)? tO-~) t:r~-~ 0$="1.9 I ~V' Observed Jl.tpM 08'
lhi./~ 10Lfllt1 d.flfJI .J ,,/, Carfbration/GPM _no __ :..../ _"'_~ __ q,l~ Sludge Survey JO:iQ...Q) tt; 1F ..3" ?
lH1I-in l?o"'·O S =;> 9 ~Jn;) -~\ .
Crop Yield ,~ Lf~ q,~~s-3 ~3ri) -1t ,, Waste Transfers ____ _
Rain Gauge Jhit;t91Pe.. S" s~
Soil Test 3oolOQ Wettable Acres ___ _
Rain Breaker __ _
PLAT _____ _
Weekly Freeboard _/ Daily Rainfall __ _ 1-in Inspections ____ _
Spray/Freeboard Drop ----------------------
Weather Codes __
Pull/Field Soil
120 min Inspections __ _
Crop
1'. LU-I ~·
j
Date Nitrogen (N)
tohffrn :151 J.O. ''ta ''3
i/h/()) ;>.i ~.~>~~ J~e
o.•''/& -,.o ,,
Pan Window
Oct--Ht¥-
y
It
V
Division of Water Quality v
Facility Number 6 O Division of Soil and Water Conservation
O Other Agency
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Q 7 Arrival Time: lV' Departure Time: bq:3 4ti, County: S10"PS0A) Region: FAQ
FarmName:
r f
Owner Name: �� rd
Mailing Address:
Physical Addres .
Facility Contac 84rd Title:
Onsite Representative: 1,11
Certified Operator: U
Back-up Operator:
Location of Farm:
Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: [ o = Longitude: =0=,
Design ' `' Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish ❑ La er
�Wean toFeeder I MOO I ILINon-Layer
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design Current -
Cattle Capacity Populaiiiiii
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: ED
Discharges & 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?
Vb. Did the discharge reach waters of the State? (If yes, notify DWQ)
/- c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑Yes qNo ❑NA EINE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
NA
EINE
❑ Yes
❑ No
❑ Yes
[ANo
❑ NA
❑ NE
❑ Yes
rRNo
❑ NA
❑ NE
12128104 Continued

:::,. . • -i'·
I Facility Number: e~" 13 I Date of Inspection ~
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structura l freeboard?
DYes ~o DNA ONE
DYes 0No ~A ONE
StructureS Structure 6 Structure I Structure 2 Structure 3 Structure 4
Identifier: _IL--______ ;l. ____ __.3"'------__ Y...__ ___ ------------
Spillway?:
Designed Freeboard (in): --~.,......,-,rr---~::1J::;;;;.::2t:""""----~~~"""":":------~...,....,..----------------
-t.UP ~~~as _ _..~_.:.a_'t __ ___.J,~?.C.L--1/---------Observed Freeboard (in): ___ v_.::I_....L..--~ ~ "'. I :22._
5. Are there any immediate threats to the inte!:,>Tity of any ofthe structures observed?
(ie/large trees, severe erosion, seepage, etc.)
DYes ~o DNA ONE
6 . Are there structures on-site which are not properly addressed and/or managed DYes SNo DNA ONE
through a 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 DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
DYes Jf~No DNA ONE
DYes DONo DNA ONE
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
DYes Z)No DNA ONE
I 0. Are there any required buffers, setbacks, or compliance alternatives that need 0 Yes 'f::l.! No O NA O NE
maintenance/improvement? i
11. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes IX] No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12. Crop type(s) Cotts/.,J f!.trmuda cYqS,S {f~~)1 5Ma.ll ~\.. 0Jtf~, W,~ A.n"l4l
13 . Soiltype(s) Gold..$b¥o-6cA, ~m-tJa.B
14 . Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
DYes
DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre deterrnination?O Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
DYes
DYes
~No
~No
~No
,K}No
~No
Comments (refer to question#): Explain any YES answers and/or any recommendations or any other comments.
Use dra~ings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name
Reviewer/Inspector Signature:
DNA
DNA
DNA
DNA
DNA
ONE
ONE
ONE
ONE
ONE
11128104 Continued
..
• , .. •• r fill...
I Facility Number: ~9,. -" L3]
Required Records & Documents
Date of Inspection I qfttt}o11
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps D Other
DYes ~No DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code
22 . Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes [ll.No DNA ONE
24 . Did the facility fail to calibrate waste application equipment as required by the permit? DYes !BNo DNA ONE
25. Did the facility fa il to conduct a sludge survey as required by the permit? DYes ~No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes lSNo DNA ONE
27 . Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 18No DNA ONE
Other Issues
28 . Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes 11JNo DNA ONE
29 . Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes ~0 DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes ~No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32 . Did Reviewer/Inspector fail to discus s review/inspection with an on-site representative? DYes ~No DNA ONE
33 . Does facility require a follow-up visit by same agency? DYes IS No DNA ONE
Additional Comments and/or Drawings: ...
i-
r-...
12118/04
•
Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Dateof Visit : I 11/EVob I ArrivalTimc:l 06!SJ'"Q.MI DepartureTime: l10:15'a.IW\ I County: S<z.mpson Region: FRO
Farm Name:
1
Pa±n"<...k. SycJ. U!..rSlV'{ ) ByrJ ~ ~¥owner Email: -----------
Owner Name: Joe.. D, ByrJ Phone: ...._{!J""'I~0 ...... )_5=33~-!J=::?::-'I"-t------
l\failing Address: (i,o L&t~ Arks,\t RJ . J ltAN"k..e; ,JL 2B.3't3 <1lt>) 3BS-~:l??
lt J
Physica l Address: • '(7-1-~ f, "17'
Fadlity Contact' :ro~ D, '& .--J((OJi'i'i -::.,-rv-c~ Phone No' --------
Onsite Representative: ~e: 1>1 ByrJ Pa-l·n'ck ByrJ-I '(OintZrator: _.,M~IA.Y_.,p;;,;h,..;,'f~--------
Certified Operator: Jpe_ D. Bycd ____ \1_1______ Operator Certification Number: .......;;.Jq...o....="S;..:;I __ c./L...-__ _
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude: D OD'D "
...... ; .. :·:-::,··
o·~sign : <Current Design Current -P ~·-Ji..J"· ·-·-·-----· <::ap'acity ~Population Wet Poultry C~pacity Population
I .... ~--I· r=-,0-Lay-er ---..----r-_, __ -----.,_,1
D Non-Laye1 . ·.
· S\\ioe
-_ID Wean to Finish
1&1 Wean to Feed er 10,&.{00 '1~5'"'0 :
· D Feeder to Finish
D Farrow to Wean
D Farrow to Feeder
· D Farrow to Finish
0Gilts
D Boars -... --·-· . -· I -..
Dry Poultry
Other
D Layers I
D Non-Layers
I
!
D Pullets
I
~
D Turkeys I
I
Cattle
D DairyCow
D Dairy Calf
D Da iry Heife1
0Dry Cow
0 Non -Dairy
D Beef Stocket
D Beef Feeder
. :·· _·.-'iJ",: :~--":j..;."'~ ..•.
. ~esigo .. Cur.re~t .~
·capaCity ·pJi)~tatioii ·:·: ..
I ,.
I;
i
I
t
I
r.
I
i
I
D Beef Brood Cow
I
! --.. ··-. .. .··,•:.
. .: :·: ~-~":"~· .... ;-·}:~· ~::=;_
Number of Structures:
r-:-Fl ·i\~;:?>j " L!t..J '.· . ._.,~
--i-~:. -~:--~:-:;j~ ~ri-~~-i~{=··; · .
D Turkey Poults I D Other I
.... l .JD Other _I ······---·-·--· --· . -
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: D Structure 0 Application Fie ld 0 Other
a . Was the con ve yance man-made?
b. Did the discharge reach waters of t he State? (If yes, no tify DWQ)
c . What is the estimat ed vol ume that reached wa ters of the State (gall ons)?
d . Does di scharge bypass the wa ste management system? (If yes , notify DWQ)
2. Is there evidence of a past discharge from any part of the operation '!
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
· .. ,·.·.
DYes eylNo DNA ONE
DYes 0No rf}NA ONE
DYes 0No lf]NA ONE
I
DYes 0No ~NA ONE
DYes ~N o DNA ONE
DYes f{JN o DNA ONE
11128104 Co ntinued
I
J.
jFacilityNumber: e~-6/;3 Date oflnspection ufs/ob
' I
Waste Collection & Treatment
4. Is storage capacity {structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
0 Yes ltJNo DNA 0 NE
DYes DNo ~NA ONE
Structure 5 Structure 6
Identifier: ___ .!...,_ ______ ;)... _____ .....,.....3;:;.._ _______ '-/.;._ __ ------------
Spillway?:
Designed Freeboard (in): -----:------,..,...--------.::..------------------------
--:::2 '2 t, 3., II _"§!? 4' ~_,~I
Observed Freeboard {in): ___ .=..'J_v ___ ----""'------~-_______ ..;:;.J_..-t ___ -------------
5. Are there any immediate threats to the integrity of any of the structures observed?
{ie/ large trees, severe erosion, seepage, etc.)
DYes ~No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
0 Yes lSJ No D NA D NE
DYes 8No DNA ONE
DYes filJNo DNA ONE
II. Is there evidence of incorrect application? Ifyes, check the appropriate box below. 0 Yes ~No DNA 0 NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area
12. Croptype(s) Gus+cJ WM~ Gi-a?Sc&sk),SfY\tt.U ~h 0~, c~Af)nya{ f?,e ~
13. Soil type(s) Gt,lJs~o Gotj-3 ~ /))c.B
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
DYes
DYes
16. Did the facility fai I to secure and/or operate per the irrigation design or wettable acre determination! D Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
DYes
DYes
p9No DNA ONE
~No DNA ONE
~No DNA ONE
6iJ No DNA ONE
~No DNA ONE
I Facility Number: Sd---6/3 I
Required Records & Documents
Date oflnspection I nJi/ o6 I T4
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design D Maps D Other
DYes $No DNA ONE
DYes ~No DNA ONE
21 . Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes fj'l No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Tran sfers 0 Annual Certification
D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes
25. Did the facility fail to conduct a sludge survey as required by the permit? lXI Yes
26. Did the facility fail to have an actively certified operator in charge? DYes
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes
Other Issues
28. Were any ad9itional problems noted which cause non-compliance of the permit orCA WMP? DYes
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
DYes
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? DYes
33. Doe s facility require a follow-up visit by same agency? DYes
;;.r:;. ~ ~l~--kn~f,\,J!.f sckJJJ +o-r ~c~.
0\r. e,i rd' vJ' ll co.U . rl\.h·-e~ GOAZ>tv4 ; n ~~ M-
f» <;s;b(e ~'o" -W-sf ~?f-~t/..-('~.
12118104
~N o DNA ONE
_JgJ No DNA ONE
f;INo DNA ONE
0No DNA ONE
fSQNo DNA ONE
(giNo DNA ONE
p9-No DNA ONE
i8No DNA ONE
DQ.No DNA ONE
~No DNA ONE
~No DNA ONE
~No DNA ONE
•. Division of Water Quality • '
0 Division of Soil ~nd Water Conservatio n
0 Other f\gimcy .
Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emer gency 0 Other D Denied Access
Date of Visit: l6·B .or I AHival Time: I 9 :oo I Departure Time: Ll ___ ___.l County: ~!Pfi"SeL!!:l-Reg ion: F/?o
Farm Name: . t5:vd tlvc S~'"' I ~ :J1 J • 1-'af,.,;k A. JA1.---Owner Email: ------:~...------::or-7--:-"2:T'"" /T ~~ Cotl i Po'fr.cK $
Owner Name: ---=J.:....::o~e--=0.""'4"""'"------'3~yanl~--------Phone: t:f 10 · 03 · J ?'lti 1/IJ· > JJ · 32/.;l
Mailing Address: -~"-0 L~de.L ...... 4 _ _,...,,f,=(}Q&l_-::::...... ____ .2_T.._.,w~r:.....!lt~l"c.--97"11'!:----'Nt...:;...;C=-------~I? 3 9J
Phys ical Address:----------------------------------------
Facility Contact: Pa./-,.,t;/c t5l,J Title: ----------Phone No: --------
f_af,.., 'c.k /1 T rd Integrator: ~~~~y__,n_.o:LII,.,::::u..o/~7'"'"---..;...F;...:a::.t.r-",.,:L.J.-f __
Certifie d Operator: ___ -zee_,a.._._tLr_,_.'..._r.L./.1.<-___ ....;IJ~yL:.cl.____ Operator Certification Number: -=-/_.2..,t!J.::;....;:;''-7....__ __
Onsite Representative:
Back-up Operator: --------------------Bac k-up Certification Number:
Location o f Farm: D OD 'r-1" L atitude: L-J Longitude: D OD'D"
Des ign Current De:;ign C urre nt Design Current
Swine Capacity Population Wet Poultry C apacity Population Cattle Capacity Population
I I I' 10 Layer I I D Non-Layer g.-wean to Feeder I/o lfoo If @..Do
. D Feeder to Finish
· D Farrow to Wean
D Farrow to Feeder
D Farrow to Fini sh
D Gilts
D Dairy Cow I D Dairy Ca lf
D Dairy Heife1 I D Dry Cow
D Non-Dairy i
0 Beef Stocker I
D Beef Feeder
ID Wean to Finish
Dry Poultry
D Layers
D Non-Layers
D Boars I D BeefBrood Cow I
D Pullets
0 Turkeys ...
Other 0 Turkey Poult s
0 Other ID Other
--·
Disch a rges & S tream Impacts
I . Is a ny discharge observed fro m any part of the o perati o n?
Di scharge orig inated at: 0 Structure D Application Field D Other
a_ Was th e con veyan ce man-made?
b. Did the dis charge rea ch waters of the Sta te'! (If yes, notify DWQ)
c. Wh at is the estim ated volume that reac he d waters of the State (ga ll ons)?
·-
r-i:l-·· I Number of Structures: L.I....J
D Yes ~0 DNA O NE
D Yes 0 No DNA ONE
D Yes 0 No DNA ONE
d. Docs discharge bypass th e waste management system? (If yes. notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
D Yes
D Yes
0 No
[31\J o
DNA ON E
DNA ONE
3. Were th ere a ny adverse impacts or potent ial adverse impacts to the Waters of the State
other than from a discharge?
D Yes [31jo
12128104
DNA O NE
Continued
I Facility Number: 8~ -&:.13 Date oflnspection I '· 9·orl
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a . If yes , is waste level into th e structural freeboard ?
Structure I Structure 2
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ 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?
D Yes [iJ;l<(o D NA D NE
DYes 0No DNA ONE
Structure 5 Structure 6
DYes ~0 DNA ONE
DYes ~ DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threa~ notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the s tuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stac ks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks , or compliance a lternatives that need
maintenance/improvement?
0 Yes fd"No 0 NA 0 NE
DYes 0'No DNA ONE
0 Yes l3"No 0 NA 0 NE
DYes ~o DNA ONE
I I. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes EJ-No 0 NA D NE
D Ex cessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc .)
D PAN 0 PAN> 10% or 10 lbs D Total Phosphorus 0 Failure to In corporate Manure/Sludge into Bare Soil
0 Outside of Accep_table Crop Window D Evidence of Wind Drift 0 Application Outside of Area lfA-,~,£.1-If10 't&fWI..U 't (.,(}~ I A G c.o rot, 100
12 . Crop type(s) /kr,,J.. (6-,.,uJ) ..... ~ ;s r j.p ~rp:n Oti(Qcc,J,
13 . Soil type(s) G:oA: I I
w, .. ~,
14. Do the receiving crops differ from those designated in theCA WMP? DYes
15. Does the rece iving crop and/or land application site need improvem ent? D Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination! D Ye s
17. Doe s the facility lack adequate acreage for land applicati on ?
18 . Is there a la ck of properl y operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature: ,,.-~ ...
DYes
DYes
!:::}No
0'No
0No
0No
la'No
DNA
DNA
DNA
DNA
DNA
ONE
ONE
ld1ffi
ld'f.J'E
ONE
. . .
I Facility Number: 8:2.. -/,f] I
Required Records & Documents
Date of Inspection I & · 6· t>? I
19. Did the facility fai l to have Certificate of Coverage & Permit readily available? DYes
DYes
~DNA
[B'No DNA
ONE
ONE 20. Does the facility fai l to have all components of the CA WMP readily available? If yes, check
the appropirate box. 0 ~ 0 ,Cbed(Iists O Qesign ~ D O&fte("'
21. Does record keeping need improvement? If yes, check the appmpriate.box below . ., .. !'-'· 0 Yes ~o 0 NA 0 NE
'(-1-) ;).1 ?.f 2 .1 J.t, ,r'lp""J;l.w ,., ,?. r .1.s-o Waste Af'plieali9M 0 Wt:eltly f'tecboard 0 Waste Analysis 0 Seil hai~·M-0 Waste Transfers 0 Annrral Certifieation
0-R,Qiaf'al.l D..£teell"i:ng D 6rop Yit:ld 0 I.2D UiRYH! InsJ'eetieHs 0 MeHthl, and I .. Itai11 lnsl*!tions 0 uriJather Cstic
22. Did the facility fail to install and maintain a rain gauge? D Yes ~0 DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~DNA ONE
24. Did the fac ility fail to calibrate waste application equipment 1a~feq uired by the permit? DYes !fffio DNA ONE
25 . Did the facility fail to conduct a sludge survey as required by the permit? DYes 0No DNA ~
26 . Did the faci lity fail to have an actively certified operator in charge? DYes ~0 DNA ONE
27. Did the faci lity fail to secure a pho sphorus loss asses sment (PLAT) certification? DYes ~ DNA ONE
Other Issues
2M . Were any additional problems noted which cause non-compliance of the permit orCA WMP? D Yes ~0 DNA ONE
29. Did the facility fai l to properly dispose of dead animals with in 24 hours and/or document DYes ~0 DNA ONE
and report the mortality rates that were higher than normal?
30. At th e time of the inspection did the facility pose an odor or air quality concern? DYes ~0 DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notifY the regional office of em ergency situations as required by D Yes ~0 DNA ONE
General Pe nnit? (ie/ discharge, freeboard problems, over appli catio n)
~DNA 32. Did Reviewernnspector fail to discuss review/inspection with an on-site representat ive? D Yes ONE
33 . Does facility require a follow-up visit by same agency ? D Yes ~0 DNA ONE
111'. 0 7 rd . &~,, .·.,~ -·s-k j'k~. Tlr~ r e:sc.•c. ;oa.r/-,,t's ~
•S ks t;r~ .b~,;.:J
C.~ '1 V~l'./yJ h C. ~DI.S -h..! blr,-..vtl~ .:c,e/ . c.,r,.e.., f/7 ~~\/~,~,/ J,)' t.S
A. ft> ~I', '""''l' 'v,u/c. /'/.,, wr,'#~., l:.y w.-s4..., Wt:~N't''),
fl~etS~ CM/acl .s..,..., Weu,.e, A~6vT +It~ /D,tll?h ~~ '91t.S t6r I a,J~,
:;.. f'. TJ..~ .s/.,~~ $Y,...,~, ,~ 6~;~ l''&t""t'" f'or flt.'.t .$, .... t',.,
~LAT •.S
12118/04
Type of Visit I) Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 8 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other D Denied Access
'----F_a_c_il_i~_. ·_:...;_· u_m_b_e_r_l_f_Ol __ H __ <i_t_a ____ .....~l Date of ,-i~it: IO ~ot Opentianal 0 Belaw Threshold
I! Permitted [I Certified Cl Conditionally Certified D Regi~ered Date Last Operated or AboYe .Threshold:
Farm !\arne: _......:..r3..r..::H'r, :~:. .. .!!!pl~--LH....!...!"'-:!...<r!..oJ.z...,c""'-!: .. :loi~~/7) -=Ol~,~· • ....~3~f..:;e:t.-h.:..=AA.::c.....:j/.~,-.p/ Coun~·: 5 a. ._, p .t.a A..l p 12..o
· Jq $-/Jon _ ___.la.......,_r-'77'-"'J=-------Phone No: ( 9 I 0 ) S "S 3 -"3 .:J ~.:? Owner !\arne:
i\lailing Address:
Facilit~· Contact: --------------Title: -----------Phone No:
Onsite Representati,·e: /?a.-f.~o/c.k B 't ,.d)
Certified Operaror: ___ ;J"=-=O...:;:C=----=/J.::::..L... __ .==B:::...=;'fp::-:..~'--=::cf::Jo.... ___ _ Operator Certification Number:
Location of Farm:
~ Swine 0 Poultry 0 Cattle 0 Horse Latitude .__ _ _,I• ~...I _---JI• L..j __ ....~l "' Longitude ._____.I• ._I _ _.I· ._I _ _.I "
Design Current Design Current Design Current
Swine Capacitv Population Poultry Capacity Population Cattle Capacity Population
ID Laver I I I 10 Dairy I I I 10 Non-Laver I I ID Non-Dain '
liJ Wean to Feeder
D Feeder to Finish
,
0 Farrow to Wean
IDOther I I I 0 Farrow to Feeder
Total Design Capacity I I
~===~
0 Farrow to Finish
D Gilts
D Boars Total SSLW I I
Number of Lagoons
Holding Poods I Solid Traps
ID Subsurface Drains Present liD Lagoon Area ·ID -~prn Field Area I
ID l'Oo Liquid Waste Management s~·stem 1---
Discharges & Stream Imoacts
L Is any discharge observed from any pan of the operation?
Discharge originated at: 0 Lagoon D Spray Field 0 Other
a. If discharge is obsen'ecL was the conveyance man -made?
b. If discharge is obsen·ed, did it reach Water of the State? (l fyes , no ti fy D WQ)
c. If discharge is observed. what is the estimated flow in galimin?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ)
2. Is there evidence of past discharge from any pan of the operation?
3. Were there any adYerse impacts or potential adYerse impactS to the Waters of the State other than from a d ischarge?
Waste Colledion & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Identifier:
Freeboard (im:hes):
05103101
Strucnrre 1 Structure 2 Structure 3
I .2 3
3K'' 31'''
0 Spillway
Structure 4 Structure 5
~
DYes ~No
D Yes 0 N o
DYes 0No
NIP.
DYes 0No
DYes ~N o
D Yes ~No
D Yes 00No
Struc ture 6
Continued
, ' Date of Inspection I q-.;>4/·~f I
5 . Are there any immediate threats to the integrity of any of the structures observed? (iel 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?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or emironmental threat, notify DWQ)
7. Do any of the structures need maintenance.funprovement?
8. Does any part of the waste management system other than waste structures require maintenancefunprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenancefunprovement?
11 . Is there evidence of over application? H yes, check the appropriate box below.
D Excessive Ponding D PAN D Hydraulic Overload D Frozen Ground D coWe! and/or Zinc
12. Crop type Fe..scw.c:.. / &,.~J--. / (; Ya.e,d
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)?
14 . a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitarion?
18 . Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt.
roads, building stiUCtUre, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? H yes, contact a regional
Air Quality representative immediately .
414 -t::s~~
r1... B,.'1e£ s ~0'+~~
.r~.~~c... ~+~ ... e~-
he \ .> ~ w ~-+~\ "'-5 +.
pep(/,,.-~ -~
be~ W\&.A..J~.
DYes JllNo
DYes ~No
DYes K)No
DYes [!No
DYes iZ]No
DYes ~·No
DYes ~No
DYes ijtNo
DYes ijaNo
DYes llfNo
DYes IJNo
DYes (f) No
DYes i1JNo
DYes [)No
DYes rlJNo
DYes rSNo
DYes ti'fNo
La..,ouJ l,Q...,~ 0~ I ~ ~ J., f1. ~ -&arc. sro-14 +k-"""" Ml-. R '"-~~ ~A • .fe.~
h<.. ~ ~l\ l~ ..... c:. ~--~ p \c-" so._,
F";c,..~ +\..~ "'-<. ue
Reviewer/IDspec:tor Name
Reviewer/Inspector Signature:
12112103
''-c. """~ \\ be.
sec.e€.
ol."' fc.+e..-~\s Sc ~'(A IC..
• • I Facility Number: 3 2 _, 131 Date of IDspection I CZ ~~~DC( I
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ieJ WUP, checklists, design, maps, etc.)
23 _ Does record keeping need improvement? If yes, check the appropriate box below.
D Waste Application D Freeboard D Waste Analysis 0 Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ieJ discharge, freeboard problems, over application)
27 _ Did Reviewerllnspector fail to discuss reviewfmspection with on· site representative?
28. Does facility require a follow-up visit by same agency?
29 _ Were any additional problems noted which cause noncompliance of the Certified A WMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Pennit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a n1in gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
D Stocking Form D Crop Yield Form D Rainfall D Inspection After 1" Rain
D 120 Minute Inspections 0 Annual Certification Form
12112103
DYes ~No
DYes Jl] No
DYes Iii No
DYes ~No
DYes ljJNo
DYes !g]No
DYes f;i1 No
DYes JWNo
DYes iC)No
DYes jtJNo
DYes DNa
DYes 0No
DYes DNo
DYes DNo
DYes DNo
Site Requires Immediate Attention: __ _
Facility No. -----
' r
DIVISION OF .ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: ~·"' ~ , 1995
Time: \\: •~
FumN~~~~=-------~-~~~-~-·~~~\~~~~='~~~r~~-----~-'_t_·_$ __ ~~w-~-~-~+-----------------.M~gAd~:~.------~S~~~~---L4~~~~~~~r~~-~-s_, ____ ~1_\~~~~~~~~~~N~~~-ii~~3-~~3~-------------
County: 'SAI't\.'fF rY='
'Integra&or: · f\l,r,h'/ ~,_,,.,"t ~ ... ,._$. Phone: ~,.-1.8~ • 2.\\\
On Site Representative: r ... ~.-.e-\' '6. rd. Phone: Cl\.,\o -'S~'3 • ~z.. ~t.
Physical Address/Location: . S~ 'l]40 \c..~t .• '5"' ~.,~ ~r.,~ ~ \<\~ 2-n.~ ~\.~
-= 3 ""-• \~~ froM \"'r~'t ::£6«-,~ ? ... ~ S ·~cJ. ~ .... ~:~
Type of Operation: Swine X Poultry__ Cattle t ' ~"e.. ~~\,
Design Capacity: 'Z.G. 00 Number of Animals on Site: -----~=G.;..:o:.:o~---------------
DEM Certification Number: ACE OEM Certification Number: ACNEW ______ _
Latitude: __ o _ _.. Longitude:_ o _._"
Circle Yes or No
Does the Animal Waste Lagoon ~ufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot+ 7 inches) Yes r No ~Freeboard: l9 Ft. _Inches
Was any seepage observed from the ~(s)7 Yes No as any erosion ob~ed? Yes or@
Is adequate land available for spray? Yes r No Is th ver crop adequate? ~or No
Crop(s) being utilized: c_oa.~ '\
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelli . Y~ r No
100 Feet from Wells? Yes r o
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o No ~
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Lme: Yes~
Is animal waste discharged into water o~state by man-made ditch, flushing system, or other
similar man-made devices? Yes or~ If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)'? Yes or No No ~Pf'J\y~o t:>~,.~
Additional Comments: ___________ __,. _________ ~-----:---
Nc......... ~r'"' ,,.,.~ \....o~ •f f",ca• '""~ .. --..~ ""'""'--"
~1L""''~'c..•1'10,.,) 'J.'{ Nlt-c...~ -'\'C'-c..' .. ~'-'1 "''fcts r
·Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.
.·
.,
.,,
" -,.
f " ~ f
\... ~
' J .. )
t\ 't ' ,:i. >
)· ~
Site Requires Immediate Attention: __ _
. Facility No. )3 -v-~
DMSION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: ~·"' '\ ; 1995
\\~"'If> Time: --"---""'--
Farm NameJOwner: B't r.Jo.. ~"'-,.~ .. c.•
-Mailing Address: R-t \ \ B.-'5", I
·County: ~1!\.Mt',,..,)
Integrator: . (l'l.,.,.,h .. , ~ .......... , 'r ~-"-">
On Site Representative: 'P,-tC' .. c...~ ~
PhygcUAdd~s~~tion: ____ ~~~~'~~~o~~-~~~~~~-~~~~~~-~~~~s-~_~~~~~~~~=~~~
.J.c... • ~ o-.a . '\3\...J-,. j \)-~'~ ,~ ~--~~~
Type of Operation: Swine~ Poultry_ Cattle---------------
Design Capacity: _l._f.._o_t:J ______ Number of Animals on Site: ___ 'l..l."----'-e»~o ________ _
DEM Certification Number: ACE DEM Certification Number: ACNEW ______ _
·Latitude: __ 0 -_ .. Longitude:_ o _._.
Circle Yes or No
:Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot+ 7 inches) Yes or No ~Freeboard: '-\: Ft. ~Inches
Was any seepage observed from the I n(s)'? Yes o~Was any erosion ob~ed? Yes or@
Is adequate land available for spray? Yes or No Is the cover crop adequate'! Q9'0r No
Crop(s) being utilized: ~s-t-'c~t.r"" .... v.'-
Does the facility meet SCS minimum setback criteria'? 200 Feet from Dwellinp; or No
100 Feet from Wells'! \!.::1 o~o
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or~
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or€)
Is animal waste discharged into water o~e state by man-made ditch, flushing system, or other
similar man-made devices? Yes or o If Yes, Please Explain.
Does the facility maintain adequate waste anagement ~(volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)'? ~or No
Additional Comments: ___ -r\..___~=~<_._o----..-----------------------
Y..,_ o....c...t'--\o...~~on
fl\ 'c. 'ha. c. \ w' ~\<c... I"'
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.
Site Requires Immediate Attention: __ _
Facility No . -----
DMSION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDWT OPERATIONS SITE VISITATION RECORD
Time: \ \".\O •
Farm Name/Owner: ___ ~..;...._ .. ....;~:....;;~:..;:c..:::...'f-.:.::....._3w-9~' cr;;.~~l:....---~-~C')~\e_'--r--~-'-"'~~----=~-'.s....__...:.:\J...,c.... ... ~ .... ""=o:::::..:.r~~,_. -----
.Mailing Address:___,.., ____ _,S"==-<t_';:I...--=--_L-[--'...;..._=--'(\-r_~..:..~;;;;..~.:...\A..=--~--"I;_,_~=--"' .... 'k""""~1~_w___;;c:_;._..--:'l.S---.3....__,~ ... 3._1 _____ _
County: 'Ss""f 2 • ...,
Integrator: · M. .... ~,b ... 1 ~, ....... ,., ~ ... ,.-~ Phone: '\,o-'Z.8"-2-\\\
On Site Representative: '?-..~,...<-\c... ~'t.-..A.. Phone: ~lo-'5'~3-'l~"I2-
Physical Address/Location: •"" ~R \"'\"i o v,_ .... :\s,.. ~--...... ~ \'\<Z~ ~ '""d"-' -\ct -r~y
~ ... .__ s,~-C>L.:, }c>._. 1 '"'Pe."' t i'(M ,J>._-t"'S
Type of Operation: Swine~ Poultry__ Cattle----------------
Design Capacity: -z...c.oo Number of Animals on Site: ____ -z..._,_e:>-=&:?c....__ _______ _
DEM Certification Number: ACE DEM Certification Number: ACNEW ______ _
Latitude : __ o ____ " Longitude: __ o _._.
Circle Yes or No
Does the Animal Waste Lagoon sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot+ 7 inches Yes r No Actual Freeboard: 3 Ft. __ Inches
Was any seepage observed from the n(s)? Yes or@ Was any erosion o~ed? Yes o@
Is adequate land available for spray? Yes or No Is the cover crop adequate? f:!!::}Or No
Crop(s) being utilized : <:....o~ ~~ ~
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelli~ Ye or No
100 Feet from Wells? <Y,Wor No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o~ ~
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue trne: Yes o~
Is animal waste discharged into water of)h( state by man-made ditch , flushing system, or other
similar man-made devices? Yes or~ If Yes, Please Explain.
Does the facility maintain adequate waste management r~ (volumes of manure, land applied,
spray irrigated on specific a\reage with cover crop)? Ye or No
Additional Comments: 12~ \ o...e~t~o"' l .... r o
j,c.~\, v ~~
tv\ 'c. 'he.&\ W'c.\(~r
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed .
Site Requires Immediate Attention: __ _
Facility No. e-a. ·t.'t"
DMSION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: ~·<\ '\ , 1995
Time: _\;..;;\:;..;;'....,~---
Fann Name/Owner: "?c:.~c-.. ~ \<.. 'f:>'(.,.o.\. -\.> -"'-tJ ~-~-.~ry
:Mailing Address: 5~:a,.-l-'f:.c-~~~·s\--r ..... ~\!.~1 N ~ r '2-8 3C\ '3
County: -s·~~ ,..,...
Integrator: · C!\, .... f',h'~ ~ ........... ,., ~-.. _..,. Phone: ,,. -,., -'2.\\ \
On Site Representative: '?-~ .... c.. \c... ~'t:"'~ Phone: '".,-~~'3· ~~~~
.Physical Address/Location: $~ \' "\.O 'h. ""'ls.. \""...,+ -:,~ \ct-.;...._ ~ t..) "t ~v..~c....,
~--I \::> .... '"' t\Xt'""" 1 ~~+ f'.a..,,~'f "'c..l'\ot.. "'"~'-
Type of Operation: Swine X Poultry __ Cattle ---------------
-Design Capacity: ~c; Number of Animals on Site: ___ "'Z..._...;::(g,;;....o;;...=o _______ _
OEM Certification Number: ACE OEM Certification Number: ACNEW ______ _
Latitude:_ 0 _. _. Longitude:_ 0 _._.
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately I Foot+ 7 inches) Yes or No ~tual Freeboard: 5 Ft. ~Inches
Was any seepage observed from the l~oon(s)'? Yes o~Was any erosion ob~ed7 ~or No
Is adequate land available for spray? e or No Is the cover crop adequate? \!!}or No -ow. r.\\., ~~ ... -::::
Crop(s) being utilized: ~ \. 'be. ~ "'1'
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwell~ Y or No
100 Feet from Wells? \..!9 o~o
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream'? Yes o~
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes o@
Is animal waste discharged into water of~ state by man-made ditch, flushing system, or other
similar man-made devices'? Yes or~ If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)?@ or No
Additional Comments: __ ___,,..---.__~-.:....l....l~--------------------
l/~ \ -~ o..csr~on
1W\ 'L 'h& C.\ W' L \<~t"
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.